U.S. patent application number 11/251695 was filed with the patent office on 2006-02-16 for intravascular systems for corporeal cooling.
Invention is credited to Arthur E. Schwartz.
Application Number | 20060036303 11/251695 |
Document ID | / |
Family ID | 23289735 |
Filed Date | 2006-02-16 |
United States Patent
Application |
20060036303 |
Kind Code |
A1 |
Schwartz; Arthur E. |
February 16, 2006 |
Intravascular systems for corporeal cooling
Abstract
A catheter for intravascular corporeal cooling comprises an
elongated tubular member having at least one lumen extending
therethrough for providing cooled blood, an inflatable annular
balloon positioned on the outer surface of the elongated tubular
member, and a pressure reliever positioned in the external wall of
the elongated tubular member and proximal to the annular inflatable
balloon, wherein when the pressure of blood within a lumen reaches
a predetermined value, the pressure reliever opens to permit fluid
to be released from the elongated tubular member. In other
embodiments of the invention the catheter may have two or more
inflatable annular balloons that are separately inflatable and/or
the catheter has an insulative outer annular member.
Inventors: |
Schwartz; Arthur E.;
(Englewood, NJ) |
Correspondence
Address: |
WOLF, BLOCK, SHORR AND SOLIS-COHEN LLP
250 PARK AVENUE
10TH FLOOR
NEW YORK
NY
10177
US
|
Family ID: |
23289735 |
Appl. No.: |
11/251695 |
Filed: |
October 17, 2005 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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09770603 |
Jan 26, 2001 |
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11251695 |
Oct 17, 2005 |
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09330428 |
Jun 8, 1999 |
6436071 |
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09770603 |
Jan 26, 2001 |
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Current U.S.
Class: |
607/106 ;
607/105 |
Current CPC
Class: |
A61M 25/1011 20130101;
A61M 2205/3606 20130101; A61M 25/0662 20130101; A61M 2025/1059
20130101; A61M 2025/1052 20130101 |
Class at
Publication: |
607/106 ;
607/105 |
International
Class: |
A61F 7/00 20060101
A61F007/00 |
Claims
1. A catheter for intravascular corporeal cooling comprising: an
elongated tubular member having proximal and distal sections, an
outer surface, and at least one lumen extending therethrough, and
annular insulation having proximal and distal ends and arranged
concentrically around the outer surface of the elongated tubular
member, wherein at least one lumen in the tubular member can
provide externally cooled blood in the direction of the distal
section of the elongated tubular member and wherein externally
cooled blood flowing through one or more lumens within the
elongated tubular member is insulated from fluid or tissue external
to the annular insulation to maintain the temperature of the cooled
blood.
2. The catheter of claim 1, wherein the annular insulation extends
over substantially the entire outer surface of the elongated
tubular member.
3. The catheter of claim 1, wherein the distal end of the annular
insulation is tapered.
4. The catheter of claim 1, wherein the annular insulation extends
for from about 50 to 80% of the total length of the elongated
tubular member.
5. The catheter of claim 1, wherein the annular insulation
comprises a fluid-filled tubular member.
6. The catheter of claim 5, wherein the fluid is water or saline
solution.
7. The catheter of claim 5, wherein the fluid is a gas.
8. The catheter of claim 1, wherein the annular insulation
comprises a tubular member filled with insulative material.
9. The catheter of claim 8, wherein the insulative material is a
synthetic polymeric fill.
10. The catheter of claim 1 which also comprises a pressure sensor
at or adjacent to the distal end of the catheter.
11. The catheter of claim 1 which is adapted to be useful for brain
cooling.
12. The catheter of claim 1, wherein at least one lumen is in fluid
communication with a source of cooled blood.
13. The catheter of claim 1, wherein at least one lumen is in fluid
communication with a liquid pharmaceutical source.
14. A catheter for corporeal cooling and maintaining the
temperature of fluid flowing through the catheter, comprising: an
elongated tubular member having proximal and distal sections, an
outer surface, and at least one lumen extending therethrough, and
annular insulation having proximal and distal ends and arranged
concentrically around the outer surface of the elongated tubular
member, wherein externally cooled blood flowing through one or more
lumens within the elongated tubular member is insulated from fluid
or tissue external to the annular insulation so that the
temperature of the cooled blood is substantially unchanged as it
flows through the catheter.
15. An insulated catheter for maintaining the temperature of fluid
flowing through the catheter, comprising: an elongated tubular
member having proximal and distal sections, an outer surface, and
at least one lumen extending therethrough, and annular insulation
having proximal and distal ends and arranged concentrically around
the outer surface of the elongated tubular member, wherein fluid
flowing through one or more lumens within the elongated tubular
member is insulated from fluid or tissue external to the annular
insulation so that the temperature of the fluid is substantially
unchanged as it flows through the catheter.
16. The catheter of claim 14 or 15, wherein the annular insulation
extends over substantially the entire outer surface of the
elongated tubular member.
17. The catheter of claim 14 or 15, wherein the annular insulation
comprises a tubular member filled with insulative material.
18. The catheter of claim 17, wherein the insulative material is a
synthetic polymeric fill.
19. The catheter of claim 14 or 15 which also comprises a pressure
sensor at or adjacent to the distal end of the catheter.
20. The catheter of claim 14 or 15, wherein at least one lumen is
in fluid communication with a source of cooled blood.
21. A catheter set for intravascular corporeal cooling comprising:
a first elongated tubular member having proximal and distal ends,
and a second tubular member arranged concentrically around the
proximal end of the first elongated tubular member and having
proximal and distal portions, wherein the distal portion of the
second elongated tubular member has openings.
22. The catheter set of claim 21, wherein the openings in the
distal portion of the second elongated longitudinal tubular member
can be changed.
23. The catheter set of claim 22 which comprises a third tubular
member arranged concentrically around the distal portion of the
second tubular member and wherein the openings are changed by
rotation and/or sliding of the third tubular member over the outer
surface of the second tubular member.
24. A method of treating, minimizing, or avoiding renal failure in
a patient, comprising the steps of positioning the distal portion
of an intravascular corporeal cooling catheter into a renal artery
of the patient, and providing cooled blood through said catheter
into the renal artery.
25. The method of claim 24, wherein the intravascular corporeal
cooling catheter comprises: an elongated tubular member having
proximal and distal sections, an outer surface, an external wall,
and at least two lumens extending therethrough, an inflatable
annular balloon positioned on the outer surface of the elongated
tubular member, and pressure relief means positioned in the
external wall of the elongated tubular member, wherein at least one
lumen in the tubular member can provide cooled blood in the distal
direction.
26. The method of claim 24, wherein the intravascular corporeal
cooling catheter comprises: an elongated tubular member having
proximal and distal sections, an outer surface, and at least two
lumens extending therethrough, and two or more inflatable annular
balloons arranged on the outer surface of the elongated tubular
member, wherein at least one lumen in the tubular member can
provide cooled blood in the distal direction.
27. The method of claim 24, wherein the intravascular corporeal
cooling catheter comprises: an elongated tubular member having
proximal and distal sections, an outer surface, and at least one
lumen extending therethrough, and annular insulation having
proximal and distal ends and arranged concentrically around the
outer surface of the elongated tubular member, wherein at least one
lumen in the tubular member can provide cooled blood in the distal
direction and fluid flowing through one or more lumens within the
elongated external member is insulated from fluid or tissue
external to the annular insulation.
28. The method of claim 24, wherein the catheter is a catheter of
intravascular corporeal cooling comprising: an elongated tubular
member having proximal and distal sections, an outer surface, and
at least one lumen extending therethrough, and annular insulation
having proximal and distal ends and arranged concentrically around
the outer surface of the elongated external tubular member, wherein
externally cooled blood flowing through one or more lumens within
the elongated tubular member is insulated from fluid or tissue
external to the annular insulation so that the temperature of the
cooled blood is substantially unchanged as it flows through the
catheter.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of commonly assigned,
co-pending U.S. patent application Ser. No. 09/770,703, filed Jan.
26, 2001, which in turn is a divisional of U.S. patent application
Ser. No. 09/330,428, filed Jun. 8, 1999, now U.S. Pat. No.
6,436,071, each of which is incorporated herein by reference in
their entirety.
FIELD OF THE INVENTION
[0002] This invention is directed to intravascular systems for
corporeal cooling. More particularly, this invention is directed to
catheter systems that have features that are especially useful for
cooling organs, tissue, or limbs.
BACKGROUND OF THE INVENTION
[0003] It has been found that cooling of the central nervous system
provides many advantages in dealing with neurological problems.
Beneficial results have been obtained from hypothermia of the
intracranial structures in surgical treatment of certain brain
tumors, cerebrovascular lesions such as aneurysms and hemangiomas,
and head injuries. Hypothermia of the intracranial structures
results in a decrease in brain volume and cerebral blood flow, as
well as the arrest of cerebral edema when present. Furthermore,
when the tissue of the central nervous system cools, there is a
decrease in oxygen consumption and, therefore, greater protection
against anoxia during deficient or arrested circulation. In
addition, the resistance of brain tissue to surgical trauma is
markedly increased and surgical bleeding is easy to control. Thus,
local or regional hypothermia of the central nervous system is
effective as a therapeutic technique, per se, as a surgical aid and
also as a post-operative technique.
[0004] Cerebral hypothermia in the past has been brought about by
cooling the entire body (surface cooling and intravascular
perfusion), cooling the vascular supply to the brain, regional
hypothermia by extracorporeal intravascular perfusion, or by the
use of cold capsules or ice applied directly to the cerebral
hemispheres. Systemic hypothermia by intravascular perfusion
requires an additional major surgical procedure and carries with it
a number of complications. A serious complication sometimes
experienced through the use of systemic hypothermia (surface or
intravascular) is ventricular fibrillation and cardiac asystole,
which is attributable to the lower temperature tolerance of heart
neuromuscular elements, as compared with central nervous system
tissue.
[0005] There are a number of intravascular systems that are
presently used for corporeal cooling, especially brain cooling.
However, it has been found that there are certain disadvantages
when such systems are used, and there is a definite need for
improved systems.
OBJECTS OF THE INVENTION
[0006] It is an object of the invention to provide intravascular
systems useful for corporeal cooling, especially cooling the brain
or other organs, such as the kidneys.
[0007] It is also an object of the invention to provide an
intravascuar system for corporeal cooling that has a pressure
dependent valve.
[0008] It is a further object of the invention to provide a method
for treating stroke patients where the patients are treated by
brain cooling shortly after the stroke event to minimize insult
and/or damage.
[0009] It is yet a further object of the invention to provide an
intravascular system having balloons with variable inflation.
[0010] It is an additional object of the invention to provide an
insulated intravascular system.
[0011] It is a still further object of the invention to provide an
intravascular system having variable fenestration.
[0012] It is likewise an object of the invention to provide an
intravascular system for cooling organs, tissue, or limbs.
[0013] It is a yet further object of the invention to provide an
intravascular system for delivering drugs or other fluids to a
desired corporeal location.
[0014] These and other objects of the invention will become more
apparent from the discussion below.
SUMMARY OF THE INVENTION
[0015] In an intravascular brain cooling procedure, a catheter is
advanced into the common carotid artery and the distal tip of the
catheter is positioned within the internal carotid artery.
Preferably the distal tip of the catheter has one or more
inflatable balloons or other structures to obstruct the annular
space between the outer surface of the catheter and the inner
surface of the internal carotid artery. Cooled blood is provided to
the brain through one or more lumens in the catheter.
[0016] A catheter for corporeal cooling may have a pressure
sensitive valve to provide relief in the event of pressure build-up
within the catheter. Also, the catheter may be insulated to avoid
systemic cooling and related cardiac complications. At the proximal
section of a corporeal cooling catheter system where the patient's
blood is removed for cooling, an outer catheter sheath may comprise
variable fenestrations to facilitate blood withdrawal. Optionally a
catheter according to the invention may have one or more pressure
sensors to sense blood pressure within or without the catheter.
[0017] In addition, it has been found that brain cooling may be
beneficial when applied to stroke patients. Further, cooling a
kidney by providing cooled blood into a renal artery can be
effective in treating renal failure.
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] FIG. 1 is a schematic representation of an embodiment of the
invention having a pressure-dependent valve;
[0019] FIG. 2 is a schematic representation of an embodiment of the
invention having variable inflation;
[0020] FIG. 3 is a partially cross-sectional view of an embodiment
of the invention wherein the intravascular system is insulated;
[0021] FIG. 4 is an oblique view of one end of the intravascular
system shown in FIG. 3;
[0022] FIG. 5 is a partially cross-sectional view of an embodiment
of the invention wherein intravascular system is partly
insulated;
[0023] FIGS. 6 and 7 are each a partially cross-sectional view of a
portion of an insulated intravascular catheter;
[0024] FIG. 8 is a partially cross-sectional view of another
embodiment of an insulated intravascular system according to the
invention;
[0025] FIG. 9 is a partly cross-sectional view of another
embodiment of the invention; and
[0026] FIG. 10 is an oblique, schematic view of an embodiment of
the invention having fenestrations.
DETAILED DESCRIPTION OF THE INVENTION
[0027] The invention herein can perhaps best be appreciated from
the drawings. In FIG. 1, the distal end 10 of an intravascular
corporeal catheter 12 is positioned within the internal carotid
artery 14. Distal end 10 comprises at least one inflatable balloon
16 to seal the annular space 18 between the outer surface 20 of
catheter 12 and the inner surface 22 of internal carotid artery
14.
[0028] Catheter 12 comprises two or more lumens, at least an
inflation lumen 24 for inflation of balloon 16 and a lumen 26 for
providing cooled blood in the direction of arrow 28. Proximal to
distal end 10 and preferably within common carotid artery 30 is a
pressure-dependent valve or relief means 32. Valve 32, which is
intended to be in the wall of, or otherwise in fluid communication
with, lumen 26, is intended to rupture in the event the pressure of
blood within lumen 26 exceeds a pre-determined value, to avoid any
problem associated with supplying blood under too much pressure to
the brain.
[0029] Valve 32 can be comprised of any of several known one-way
valving means, which include, for example, slits, fissures, caps,
flaps, friable membranes, and the like.
[0030] The intravascular corporeal catheter 40 shown in FIG. 2
comprises a distal section 42 positioned within internal carotid
artery 44. Distal section 42 comprises two or more, preferably 3 or
4, inflatable balloons 46 positioned in the annular space 48
between the outer surface 50 of catheter 40 and the inner surface
52 of internal carotid artery 44. Preferably each balloon 46 has a
separate inflation lumen 54 extending in the proximal direction to
an inflator (not shown). However, it is within the scope of the
invention that two or more, adjacent or non-adjacent, balloons
could be in fluid communication with a single inflation lumen. The
inflator is capable of inflating balloons 46 in a desired sequence
and/or pressure to obstruct flow within annular space 48. An
example of inflator technology useful according to the invention is
described in U.S. Pat. No. 3,931,822, incorporated herein by
reference.
[0031] Catheter 40 also comprises at least one lumen 56 to provide
cooled blood to the brain in the direction of arrow 58.
[0032] FIG. 3 is a cross-sectional view of a portion of a catheter
60 especially useful for intravascular corporeal cooling. Catheter
60 comprises an outer cylindrical wall 62 and an inner cylindrical
wall 64, which inner wall preferably comprises at least one lumen
66 for providing cooled blood. The annular or substantially annular
space 68 between inner wall 64 and outer wall 62 should provide
insulative properties. For example, the annular space may comprise
a fluid, preferably a gaseous fluid such as air, or other
insulation material such as any of the known synthetic insulation
materials, silica gel, or thermal insulating materials such as are
disclosed in U.S. Pat. Nos. 2,967,152, 3,007,596, and 3,009,600,
all of which are incorporated herein by reference. The insulation
used should not restrict, or should have only minimal impact upon,
the flexibility of catheter 60.
[0033] A schematic, oblique cross-section of catheter 60 is shown
in FIG. 4. Annular space 68 between outer wall 62 and inner wall 64
can be filled with fluid or insulation.
[0034] The insulation construction described may extend for the
entire length or for only a portion of an intravascular corporeal
catheter. For example, as shown in FIG. 5, the annular space 68 may
terminate at surface 70 and inner wall 64 will continue as an
uninsulated catheter. Also, as shown in FIGS. 6 and 7, either or
both of the proximal and distal ends, especially the distal end, of
catheter 60, then the annular space 68 may taper to a distal point
72 of catheter 60.
[0035] According to the embodiment of the invention shown in FIG.
8, an intravascular corporeal catheter 80 comprises a longitudinal
tubular member 82 that has a partially co-extensively extending
inflatable insulation member 84. Insulation member 84 is sealed to
the extension of tubular member 82 at distal position 86 and
proximal position 88, the interior 90 of inflatable insulation
member 84 being in fluid connection through inflation lumen 92 with
an inflator (not shown). Inflatable insulation member 84 is
intended to have a low profile and facilitate insertion through the
femoral artery 94 into the aorta 96, which is larger in diameter.
Once inflatable insulation member 84 is positioned within aorta 96,
inflatable insulation member 84 is inflated to provide insulation
when cooled blood is passed through one or more lumens 98 in
catheter 82 in the direction of arrow 100.
[0036] Intravascular corporeal catheters 12, 40, 60, and 80 as
shown in FIGS. 1 to 8 are especially useful in brain cooling, where
cooled blood is provided to a patient's brain. However, it is
within the scope of the invention that each of said catheters may
have broader use in cooling other organs, tissue, or limbs, or even
in the delivery of substances such as pharmaceuticals or other
agents to desired sites within a patient's body.
[0037] FIG. 9 is a schematic representation of an embodiment of the
invention particularly useful when the internal carotid artery 134
has plaque 122. A catheter 124 comprises a through lumen 126 for
passage of a guidewire (not shown) and optionally blood for the
external carotid artery. Catheter 124 also comprises at least one
blood flow lumen 128 having a closed distal end 130 and a lateral
opening 132 for providing cooled blood to the internal carotid
artery 134. Inflatable balloons 136,138 are positioned in the
external carotid artery 120 and the common carotid artery 140,
respectively. Cooled blood flows in the direction of arrow 142
through lateral opening 132 and within plaque 122 into internal
carotid artery 134.
[0038] It is within the scope of the invention that a corporeal
cooling catheter could have additional capability, such as pressure
and/or temperature measurement. For example, in FIG. 1 catheter 12
may comprise a lumen 34 having a distal end 36. Distal end 36 could
be open or optionally it could comprise an element 38 which is a
transducer or diaphragm, optionally with fiber optic cable 160. A
number of known techniques for measuring pressure and/or
temperature can be used, including, but not limited to, a
configuration where there is no lumen 34 and a transducer element
38 could be electrically connected via wires (not shown) to a
controller (not shown). Also, there could be more then one pressure
and/or temperature sensor, located at different positions on the
distal section of a corporeal cooling catheter. For example, in
FIG. 1, a pressure sensor element 38 could be located where shown
or on the surface of catheter 10 distal or proximal to balloon 16.
For representative examples of pressure and/or temperature sensor
technology, see, for example, U.S. Pat. Nos. 4,487,206, 4,641,654,
5,427,114, 5,456,251, 5,325,865, 5,647,847, 5,866,821, and
5,899,927, all of which are incorporated herein by reference.
Measurement of pressure is of particular interest. Flow and
pressure greater than the desired range may lead to brain injury,
and flow and pressure less than the desired range may be
insufficient to achieve organ cooling.
[0039] As part of the brain cooling process blood has to be removed
from the patient for cooling and then returned to the patient.
Preferably this can be done in a single site to minimize trauma to
the patient. It is known to use a catheter set wherein an outer
catheter extends only shortly distally into the patient's artery,
blood is removed proximally through an annular space between the
outer catheter and a distally-extending inner catheter, and cooled
blood is returned through the inner catheter. However, since the
available surface area for proximal blood flow is only a profile
corresponding to said annular space, there are sometimes problems
that develop due to pressure or fluid build-up in this area.
According to an embodiment of the invention, and as shown in FIG.
10, the distal end 150 of an introducer sheath 152 contains
fenestrations 154 of varied, uniform, or variable size. Cooled
blood is returned in the direction represented by arrows 156, 157
through catheter 158. Body temperature blood enters introducer
sheath 152 in the direction of arrows 164 at distal end 150 and
through fenestrations 154, to exit at outlet 164 in the direction
of arrows 162. Fenestrations 154 preferably are circular,
substantially circular, or oval, and have a diameter or effective
diameter of from about 0.5 to 5 mm. It is within the scope of the
invention that introducer sheath 152 comprise two concentric,
slidably and/or rotably arranged tubular members so that the member
and/or size of the fenestrations can be varied by rotating or
sliding the outer of the two concentric members.
[0040] Another aspect of the invention concerns the use of brain
cooling to treat stroke victims. When the cerebral vasculature of a
stroke victim is flushed with cooled blood, the insult or damage
normally associated with a stroke is either minimized or avoided
altogether. The effectiveness of the brain cooling will depend upon
several factors, including the severity of the stroke, the length
of time after the stroke that the patient is treated, the duration
of the treatment, the temperature of the cooled blood, the volume
of cooled blood administered, etc. For example, the duration of the
treatment could be from about 6 to 18 hours, the temperature of the
cooled blood could be from about 16.degree. to 24.degree. C., and
the volume of the cooled blood could be from about 100 to 900
ml/min. It is significant that the flow rate and/or pressure of the
cooled blood should be adjusted so that the blood pressure in the
stroke patient's internal carotid artery is slightly greater than
systemic blood pressure.
[0041] It would be advantageous to treat a stroke victim as soon as
possible after the stroke, it being understood that the treatment
is likely to be most effective if the patent is treated within 12
hours after the stroke. It is preferred that brain cooling be
administered no more than 12 hours after the stroke, although
treatment up to 18 hours or even more may still be of limited
effectiveness, dependent upon all the factors involved.
[0042] In a preferred embodiment of the invention the brain cooling
is administered in conjunction with a thrombolytic agent such as
TPA, heparin, streptokinase, or the like. The thrombolytic agent
could be administered according to known protocols prior to,
during, and/or subsequent to the brain cooling. Similarly, in the
event that surgical or endovascular intervention is indicated in a
stroke victim, brain cooling could be administered in conjunction
with such a procedure.
[0043] To effect vascular brain cooling according to the invention,
normal procedures are followed. First, a guide catheter is
established and then the distal tip of a brain cooling catheter is
advanced through the femoral artery, through the aorta, into the
common carotid artery. Then, dependent upon which embodiment of the
invention described herein is employed, the distal tip of the brain
cooling catheter is then positioned in either the internal carotid
or the external carotid artery, whereupon the inflation balloons
are inflated. Cooled blood is perfused through one or more lumens
in the brain cooling catheter to the internal carotid artery.
[0044] According to one embodiment of the invention, cooled blood
is provided to one or more kidneys to treat, minimize, or avoid
renal failure. A catheter according to the invention, preferably a
catheter such as described in FIG. 1, is advanced through the aorta
and then into the left or right renal artery. The distal tip of the
catheter is then positioned in the left or right renal artery at a
point between the aorta and the left or right kidney, respectively.
Once the annular balloon is inflated, cooled blood perfuses the
kidney. While preferably one kidney is treated at a time, possibly
sequentially, it is within the scope of the invention that both
kidneys could be treated simultaneously, dependent upon the
equipment used. The conditions of treatment in terms of blood
temperature, blood flow, and duration would be similar to those for
brain cooling, with the exception that such renal treatment is
likely to be of less duration.
[0045] Any of the known devices for cooling blood during cardiac
procedures could be used. One example of such available equipment
to cool the patient's blood is the SARNS TCM water bath available
from the SARNS Corp. of Ann Arbor, Mich. Such a water bath is used
with a cardiopulmonary bypass machine such as the BP40, available
from Biomedicus, Minneapolis, Minn. Details regarding brain cooling
procedures are readily available See, for example, A. E. Schwartz
et al., "Isolated Cerebral Hypothermia by Single Carotid Artery
perfusion of Extracorporeally Cooled Blood in Baboons",
Neurosurgery, Vol. 39, No. 3, September 1996, pp. 577-582, and A.
E. Schwartz et al., "Selective Cerebral Hypothermia by Means of
transfemoral Internal Carotid Artery Catherization", Radiology,
Vol. 201, No. 2, November 1996, pp. 571-572, both of which are
incorporated herein by reference.
[0046] The catheters described above comprise conventional
bio-compatible materials used in the catheter field. For example,
the catheters may be comprised of suitable low-friction
bio-compatible polymers such as, for example, extruded polyethylene
polyvinyl chloride, polystyrene, or polypropylene or copolymers
thereof. Inflatable balloons would be comprised of polymers or
polypropylenes or copolymers thereof. The catheters may have a
hardness of, for example, from 60 to 90 Shore A duramter. The inner
elongated tubular members of the invention would typically have an
i.d. of from about 7.5 to 10.5 F and an o.d. of from about 8 to 11
F, where an outer tubular member would typically have an i.d. of
from about 8.5 to 11.5 F and an o.d. of from about 9 to 12 F.
[0047] The catheters useful according to the invention may
optionally have one or more radiopaque markers in their distal
sections, the markers preferably comprising rings comprised of
tantalum, platinum, or gold. Also, the catheter may have any of the
well-known anti-thrombotic or lubricious coatings.
[0048] The preceding specific embodiments are illustrative of the
practice of the invention. It is to be understood, however, that
other expedients known to those skilled in the art or disclosed
herein, may be employed without departing from the spirit of the
invention or the scope of the appended claims.
* * * * *