U.S. patent number 3,631,848 [Application Number 04/757,365] was granted by the patent office on 1972-01-04 for extensible catheter.
This patent grant is currently assigned to United States Catheter & Instrument Corporation. Invention is credited to Wolf F. Muller.
United States Patent |
3,631,848 |
Muller |
January 4, 1972 |
EXTENSIBLE CATHETER
Abstract
A flexible cardiac or vascular catheter provided at its distal
end with a smaller extensible and retractable flexible tubular
extension particularly adapted to reach normally inaccessible
treatment locations in vessels or branches thereof, the extension
being movable axially of the catheter by means of a control wire
the proximal end of which projects from the proximal end of the
catheter.
Inventors: |
Muller; Wolf F. (Southampton,
NY) |
Assignee: |
United States Catheter &
Instrument Corporation (Glens Falls, NY)
|
Family
ID: |
25047543 |
Appl.
No.: |
04/757,365 |
Filed: |
September 4, 1968 |
Current U.S.
Class: |
600/434; 604/523;
604/95.04 |
Current CPC
Class: |
A61M
25/0905 (20130101); A61M 25/0021 (20130101); A61M
25/0068 (20130101); A61M 25/0074 (20130101) |
Current International
Class: |
A61M
25/00 (20060101); A61b 005/02 (); A61m
025/00 () |
Field of
Search: |
;128/2,2.05,214.4,240-241,276-278,343,341,348-351,356,303 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Truluck; Dalton L.
Claims
I claim:
1. A flexible catheter having a lumen extending its full length,
the diameter of the lumen being reduced adjacent its distal end to
form a proximally facing annular shoulder, a flexible tubular
extension having an outside diameter permitting free axial sliding
movement through said reduced diameter lumen, said extension being
enlarged adjacent its proximal end to form a distally facing
shoulder engageable with the first named shoulder to limit movement
of the extension distally with respect to said catheter, the length
of said extension from its distal end to its enlarged shoulder
being greater than the distance from the distal end of the catheter
to the annular shoulder in said lumen filamentary means extending
from said tubular extension to and beyond the proximal end of the
catheter for effecting sliding movement of said tubular extension
relative to said catheter, and a coupling connecting the proximal
end of said extension to the distal end of said filamentary means,
the lumen of the extension being in communication with the lumen of
the catheter proximally of both said shoulders.
2. The catheter of claim 1 in which said filamentary means is a
wire carried within said lumen and having its distal end connected
to the proximal end of said tubular extension.
3. The catheter of claim 1 in which a rigid internal tip is
positioned within the distal end of said lumen and provided with a
tube-directing passageway, said coupling for said filamentary means
having its distal end connected to the proximal end of said tubular
extension and its proximal end Swivel- connected to said means, and
in which said means is a wire carried within said lumen and having
its distal end swivel-connected to said connector.
4. The catheter of claim 1 in which said tubular extension is
radiopaque.
5. The catheter of claim 1 in which the first and second shoulders
are shaped to form, when engaged, a fluidtight seal.
6. The catheter of claim 1 in which the catheter is provided,
adjacent its distal end with a laterally directed opening from its
reduced diameter portion and with associated means for guiding the
tubular extension into and through said opening when the extension
is moved distally with respect to the catheter.
Description
This invention generally relates to new and useful improvements in
catheters and particularly seeks to provide a novel cardiac or
vascular catheter having an axially adjustable flexible tubular tip
extension.
The marked advances in cardiac and vascular surgery in the past few
years and other medical problems that require diagnostic study of
the vascular beds and systems has led to the extensive use of
cardiac or vascular catheters, particularly for retrograde
aortography and anginocardiography, and to take blood samples,
determine oxygen content, infuse or inject medicaments at internal
sites and various other uses that require the insertion of a
relatively long catheter to an internal site that requires movement
of the catheter into branch vessels at sharp angles relative to the
feeding direction of the catheter or requires the distal end of the
catheter to follow a sinuous path as it approaches the internal
site.
The most common method for insertion of such catheters is the
percutaneous technique described in 1953 by Sven Ivar Seldinger. In
this procedure a local anesthetic is administered and a skin
puncture made at a small angle to the vessel (e.g. femoral in the
leg or brachial in the arm) with an obturator positioned within a
cannula. Once the unit has been properly located in the vessel, the
obturator is removed and a flexible spring guide is then inserted
through the cannula into the vessel for a short distance. Pressure
is then applied to hold the spring guide in place while the cannula
is withdrawn. The spring guide is then fed into the vessel,
generally under a fluoroscope, to the desired point which may or
may not require considerable manipulation if there are branched
vessels or curves concerned. Thereafter a catheter is passed over
the flexible spring guide and fed into the desired position and the
spring guide is then withdrawn from the catheter.
A particularly useful spring guide for these purposes is disclosed
and claimed in my copending application for patent Ser. No.
563,927, filed June 29, 1966, now Pat No. 3,452,742. In that form
of spring guide predetermined portions of its length may be
controllably curved by manipulation of an inner tension wire from
its proximal end outside the patient and it may also be curved
after a catheter is placed thereover to cause the catheter to
curve.
However, there are many conditions where even the great
manipulative ability gained through the use of the above type of
spring guide is not adequate to enable the distal tip of a catheter
to be properly positioned, as where the desired treatment point is
located a substantial distance along a small diameter branch vessel
extending at a sharp angle from the vessel into which the catheter
is inserted or where the desired point is located a substantial
distance along a particularly sinuous portion of the vessel.
This problem is overcome through the use of a catheter constructed
in accordance with this invention.
Therefore, an object of this invention is to provide a flexible
catheter having an extensible distal end.
Another object of this invention is to provide a catheter of the
character stated in which the distal end extension comprises a
small diameter flexible tube normally housed completely within the
distal end portion of the catheter lumen and is axially or
angularly projectable therefrom through a suitably configured
catheter tip.
Another object of this invention is to provide a catheter of the
character stated in which the distal end extension is projected or
retracted from the tip of the catheter by a manipulating wire
extending through the full length of the catheter lumen with its
proximal end projecting substantially beyond the proximal end of
the catheter.
Another object of this invention is to provide a catheter of the
character stated in which the manipulating wire is connected to the
extensible tube by a swivel coupling so designed that injection or
infusion liquids can pass from the lumen of the catheter into and
through the lumen of the tubular extension.
With these and other objects, the nature of which will be apparent,
the invention will be more fully understood by reference to the
drawings, the accompanying detailed description and the appended
claims.
In the drawings:
FIG. 1 is a side elevation, partly broken, of a catheter
constructed in accordance with this invention and shows the
extensible tube in its retracted position;
FIG. 2 is a view similar to FIG. 1, but showing the extensible tube
in its fully projected position;
FIG. 3 is an enlarged fragmentary longitudinal section of the
distal end of the catheter and shows the manipulating wire
connector and one form of tip that may be used when the extension
tube is to be projected axially;
FIG. 4 is a view similar to FIG. 3 but showing a form of tip that
may be used when the extension tube is to be projected at an angle
to the axis of the catheter.
FIG. 5 is an enlarged fragmentary longitudinal section of the
distal end of a catheter modified to provide an integral tip used
for the axial projection of the extension tube; and
FIG. 6 is a view similar to FIG. 5 but showing an integral tip used
for the angular projection of the extension tube.
Referring to the drawings in detail, the invention as illustrated
is embodied in a flexible catheter generally designated 5 having a
proximal end 6 and a distal end 7, which may be formed from any
suitable material such as (irradiated) polyethylene, nylon or a
tetrafluoroethylene resin and which may be of uniform diameter or
tapered as indicated in FIGS. 1 and 2 of the drawings. Whatever the
material, it should be radiopaque in order that its progress of
advance within a vessel and the positioning of its distal end may
be observed through the use of a fluoroscope.
In one form of the invention (see FIG. 3) where the catheter is to
be provided with an axially projectable tubular extension, the
distal end 7 of the catheter is provided with a generally
cylindrical rigid tip 8 tightly secured therewithin and having a
full length longitudinal duct or lumen 9 of a diameter sufficient
to permit the catheter to be applied over a spring guide and to
permit a catheter extension tube to be passed therethrough
following removal of the spring guide. A flexible catheter
extension tube 10, preferably formed from a radiopaque silicone
rubber or similar material and having an outside diameter such that
is will freely slide within the catheter tip 9, is normally
positioned within the distal end portion of the catheter with the
distal end of the extension tube in registry with the distal end of
the catheter. The extension tube may be of any desired length, but
will generally be from 2 to 6 inches long.
The inner or proximal end of the extension tube 10 carries an
internal metal or rigid plastic dilating ring or annulus 11, having
an outside diameter substantially equal to or slightly greater than
the diameter of the tip lumen 9, which forces the formation of a
rounded shoulder 12 on the extension tube which becomes seated
against the proximal end of the tip 8 when the tube is fully
projected beyond the tip. The shoulder 12 also prevents the tube 10
from becoming expelled from the distal end of the catheter.
A cylindrical connector generally designated 13 has its distal end
turned down to define an externally corrugated stud 14 that is
inserted and retained within the proximal end of the extension tube
10 in abutting relation to the annulus 11. A heat-shrunk band or
sleeve 14a may be used to secure the extension tube 10 on the stud
14. The stud 14 is provided with an axial recess 15 extending into
communication with a radial aperture 16 to permit passage of liquid
from the lumen of the catheter into and through the lumen of the
extension tube 10.
An extension tube manipulating wire 17 is provided at its distal
end with a bead or pellet 18 securely fastened thereto and freely
fitted with a cylindrical recess 19 formed in the proximal end of
the connector 13. That end of the connector is rolled over as at 20
to retain the pellet within the recess 19 while permitting it and
the attached wire 17 to freely swivel or rotate in either direction
with respect to the connector.
The proximal end of the wire 17, which extends a substantial
distance beyond the proximal end of the catheter, carries a
manipulating knob 21 which conveniently may be in the form of a
small pin vise for ready attachment to and removal from the wire.
Thus the wire may be moved in either direction to effect a
corresponding movement of the extension tube 10.
In FIG. 4 of the drawings the distal end 7 of the catheter is
fitted with an internal tip 22 in which one side of the central
portion thereof is machined to define a curvilinear passageway 23
for forcing the distal end of the extension tube 10 to project
outwardly at an angle with respect to the axis of the tip when the
tube is advanced. The extreme distal end portion of the tip 22 is
provided with an axial bore 24 of sufficient diameter to permit the
catheter to be passed over a spring guide and to permit the spring
guide to be withdrawn. The passageway 23 is so contoured and
proportioned that the extension tube 10 will always follow the
passageway rather than the bore 24.
In FIG. 5 of the drawings there is illustrated a modification in
which the distal end of a catheter 25 is provided with an
integrally formed axially aligned tip 26 of reduced diameter to
define a curved inner shoulder 27 against which the shoulder 12 of
the extension tube 10 may be seated when the extension tube is
fully projected.
This same principle of integral tip formation may be employed where
the extension tube 10 is to be projected at an angle to the axis of
the catheter and is illustrated in FIG. 6 of the drawings. In this
instance the distal end of a catheter 28 is provided with an
integrally formed axially aligned tip extension 29 of reduced
diameter which defines at its proximal end a curved inner shoulder
30 and which terminates at its extreme distal end in a tip 31
curved to direct the extension tube 10 at the desired angle with
respect to the axis of the catheter.
In use, the manipulating wire 17 and its attached extension tube 10
is completely withdrawn from the catheter 5 and the catheter is
advanced over a previously inserted spring guide to a position such
that the distal end of the catheter approaches, but does not reach,
the desired treatment point. Then the spring guide is withdrawn and
the tubular extension 10 is reinserted into the catheter and
advanced by the wire 17 until its distal end is in registry with
the distal end of the catheter, after which the catheter may be
rotated or otherwise manipulated as the extension 10 is advanced
beyond the distal end of the catheter until its distal end reaches
the desired treatment point.
If the treatment is to be simply the rapid injection of a liquid,
it makes little or no difference whether or not the tube 10 has
been fully extended so that its shoulder 12 seats against the
proximal end of the tip 8 to prevent leakage of the injection
liquid from the distal end 7 of the catheter per se. However, if
the treatment is to be the prolonged low-volume infusion of a
liquid, it is important that the catheter 5 and its extension tube
10 be so adjusted that when the distal end of the extension tube is
at the desired treatment point it has been fully extended beyond
the distal end 7 of the catheter to firmly seat the shoulder 12
against the proximal end of the tip 8 and thus force all of the
infusion liquid to flow through the tube 10 and to prevent any
leakage of the infusion liquid from the distal end of the catheter
per se.
It is, of course, to be understood that variations in arrangements
and proportions of parts may be made within the scope of the
appended claims.
* * * * *