Multi-mode vascular catheter system

Abstract

An intravascular catheter, comprising a catheter shaft having a proximal end and a distal end, and a guidewire lumen extending through the shaft for receiving a steerable guidewire, wherein the guidewire lumen has a proximal opening at the proximal end of the shaft for insertion of a guidewire into the lumen, and a side port for insertion of a guidewire into the lumen through the side of the catheter shaft, the side port located distally of the proximal opening and inside the patient during use, the side port being adapted to direct a guidewire to extend through the side port distally into the guidewire lumen while preventing a guidewire from extending through the side port proximally into the guidewire lumen. Also disclosed are methods for using the catheter.

1 . An intravascular catheter, comprising; 
 a catheter shaft having a proximal end, a side, and a distal end, wherein a portion of said catheter shaft including said distal end is adapted for insertion into and use within the vasculature of a patient;    a guidewire lumen extending through said shaft constructed for receiving a steerable guidewire extending the entire length of said guidewire lumen, wherein said guidewire lumen has a proximal opening at the proximal end of said shaft adapted for insertion of a guidewire into said guidewire lumen, a distal opening at the distal end of said shaft, and a side port comprising a permanently formed opening through the side of said catheter shaft into said guidewire lumen which is adapted for passage of a guidewire into said guidewire lumen through the side of said catheter shaft, said side port being located distally of said proximal opening; and    a guidewire extending through said side port distally into said guidewire lumen and out of said distal opening.    
     
     
         2 . The catheter of  claim 1 , wherein at least a portion of the guidewire lumen proximal of the side port is collapsible when a guidewire is not located in the guidewire lumen.  
     
     
         3 . The catheter of  claim 1 , further comprising a guidewire running generally parallel to the axis of said catheter shaft, wherein said guidewire is outside of the guidewire lumen at points proximal to said side port and extends through said side port and is inside said guidewire lumen at points distal to said side port.  
     
     
         4 . The catheter of  claim 1 , wherein the outside wall of the guidewire lumen distal to the side port is noncollapsible.  
     
     
         5 . The catheter of  claim 4 , wherein the outside wall of the guidewire lumen distal to the side port is noncollapsible.  
     
     
         6 . A method of exchanging a catheter while performing a procedure involving vascular catheterization, comprising the steps of: 
 positioning a guidewire in the vascular system of a patient;    providing first and second angioplasty catheters, said catheters each comprising: 
 a catheter shaft having a proximal end and a distal end;  
 an angioplasty balloon attached to said shaft at said distal end;  
 a balloon inflation lumen extending through said shaft and communicating with the interior of said balloon; and  
 a guidewire lumen extending through said shaft and through said balloon for receiving a steerable guidewire, wherein said guidewire lumen has a proximal opening at the proximal end of said shaft for insertion of a guidewire into said lumen, and a side port for passage of a guidewire into said lumen through the side of said catheter shaft, said side port located distally of said proximal opening,  
 positioning said first catheter on said guidewire so that said guidewire is outside the guidewire lumen proximally of said side port and inside the guidewire lumen distally of said side port;  
 advancing said first catheter along said guidewire into said vascular system;  
 removing said first catheter while maintaining said guidewire in said vascular system;  
 positioning said second catheter on said guidewire with said guidewire inside said guidewire lumen distally of said side port and outside the guidewire lumen proximally of said side port; and  
 advancing said second catheter along said guidewire into said vascular system.  
   
     
     
         7 . A method of exchanging a guidewire during a procedure involving vascular catheterization, comprising the steps of: 
 positioning a guidewire in the vascular system of a patient;    providing a catheter, said catheter comprising: 
 a catheter shaft having a proximal end and a distal end;  
 an angioplasty balloon attached to said shaft at said distal end;  
 a balloon inflation lumen extending through said shaft and communicating with the interior of said balloon; and  
 a guidewire lumen extending through said shaft and through said balloon for receiving a steerable guidewire, wherein said guidewire lumen has a proximal opening at the proximal end of said shaft for insertion of a guidewire into said lumen, and a side port for passage of a guidewire into said lumen through the side of said catheter shaft, said side port located distally of said proximal opening;  
 positioning said catheter on said guidewire so that said guidewire passes through said side port and is outside the catheter shaft proximally of said side port and inside the catheter shaft distally of said side port;  
 advancing the catheter along said guidewire into said vascular system;  
 removing said guidewire while maintaining said catheter in said vascular system; and  
 inserting a second guidewire into said catheter distally through said proximal opening of said guidewire lumen, through said guidewire lumen past said side port, and out of the distal end of said catheter.  
   
     
     
         8 . A method of exchanging a catheter during a procedure involving vascular catheterization, comprising the steps of: 
 providing first and second angioplasty catheters, each of said catheters comprising: 
 a catheter shaft having a proximal end and a distal end;  
 an angioplasty balloon attached to said shaft at said distal end;  
 a balloon inflation lumen extending through said shaft and communicating with the interior of said balloon; and  
 a guidewire lumen extending through said shaft and through said balloon for receiving a steerable guidewire, wherein said guidewire lumen has a proximal opening at the proximal end of said shaft for insertion of a guidewire into said lumen, and a side port for passage of a guidewire into said lumen through the side of a said catheter shaft, said side port located distally of said proximal opening,  
 said first catheter having a guidewire passing through said guidewire lumen from the proximal opening to the distal opening thereof and positioning said catheter in a patient;  
 removing said catheter from said patient while maintaining said guidewire in said patient;  
 positioning said second catheter on said guidewire so that said guidewire passes through said side port and is inside said guidewire lumen distally of said side port and outside said guidewire lumen proximally of said side port; and  
 advancing said second catheter along said guidewire into said patient while maintaining the positioning of the guidewire.  
   
     
     
         9 . A readily exchangeable dilation catheter which is suitable for performing angioplasty procedures within a patient's vasculature and which permits the exchange of a guidewire during an angioplasty procedure, comprising: 
 (a) an elongated catheter body having proximal and distal ends, a first lumen adapted to receive a guidewire and extending within said catheter body to the distal end thereof, and a second lumen adapted to direct inflation fluid therethrough and extending within said catheter body to a distal portion thereof;    (b) an inflatable member on a distal portion of said catheter body, said inflatable member having an interior in fluid communication with said second lumen;    (c) a first guidewire port in said catheter body and located at the proximal end of said catheter body, said first guidewire port being in communication with said first lumen;    (d) a second guidewire port in said catheter body being spaced at least 10 cm from said distal end of said catheter body and a substantial distance from the proximal end of said catheter body, and being in communication with said first guidewire-receiving inner lumen;    (e) a third guidewire port in the distal end of said catheter body distal to said inflatable member, said third guidewire port being in communication with said first lumen; and    (f) means on the proximal end of said catheter body for directing inflation fluid to the interior of said inflatable member through said second lumen.    
     
     
         10 . The intravascular catheter of  claim 9 , wherein the second guidewire port is spaced no more than 40 cm from the distal end of the catheter body.  
     
     
         11 . A method of exchanging a guidewire during an intravascular procedure within a patient's vascular system, comprising: 
 (a) providing an intravascular catheter which includes: 
 (i) an elongated catheter body having proximal and distal ends, a guidewire-receiving inner lumen extending within said catheter body to the distal end thereof;  
 (ii) diagnostic or therapeutic means on the distal portion of said catheter body;  
 (iii) a first guidewire port in said catheter body at the proximal end of said catheter body and in communication with said guidewire-receiving inner lumen;  
 (iv) a second guidewire port in said catheter body being spaced proximally from said diagnostic and therapeutic means at least 10 cm from the distal end of said catheter body and being in communication with said guidewire-receiving inner lumen; and  
 (v) a third guidewire port in the distal end of said catheter body and which is in communication with said guidewire-receiving inner lumen;  
   (b) disposing said intravascular catheter within the vascular system of the patient with an in-place guidewire disposed within said guidewire-receiving inner lumen with the distal end thereof extending out said third guidewire port into the patient's vascular system and the proximal end extending out said second guidewire port;    (c) withdrawing said in-place guidewire from the patient's vascular system by pulling on the proximal end thereof while holding the intravascular catheter in place, so as to maintain access to the location of said in-place guidewire within the patient's vascular system; and    (d) advancing within said guidewire-receiving inner lumen of the intravascular catheter a replacement guidewire, which is disposed within said guidewire-receiving inner lumen with the proximal end of said replacement guidewire extending proximally out of said first guidewire port and distally out of said third guidewire port into the patient's vascular system, until the distal end of said replacement guidewire extends beyond the location of the intravascular procedure.    
     
     
         12 . The method of  claim 11 , wherein said diagnostic or therapeutic means is an inflatable balloon suitable for angioplasty procedures.  
     
     
         13 . The method of  claim 12 , wherein said intravascular catheter has an inner lumen extending within said catheter body for directing inflation fluid from the proximal end of said catheter body to the interior of said inflatable balloon.  
     
     
         14 . A method of exchanging a guidewire during a procedure involving vascular catheterization comprising the steps of: 
 positioning a guidewire in the vascular system of a patient;    providing an intravascular catheter, comprising: 
 a catheter shaft having a proximal end and a distal end, wherein a portion of said distal end is inside a patient during use;  
 a guidewire lumen extending through said shaft for receiving a steerable guidewire, wherein said guidewire lumen has a proximal opening at the proximal end of said shaft for insertion of a guidewire into said lumen, and a side port for passage of a guidewire into said lumen through the side of said catheter shaft, said side port located distally of said proximal opening,  
 positioning said catheter on said guidewire so that said guidewire passes through said side port and is outside the catheter shaft proximally of said side port and inside the catheter shaft distally of said side port;  
 advancing said catheter along said guidewire into said vascular system;  
 removing said guidewire while maintaining said catheter in said vascular system; and  
 inserting a second guidewire into said catheter distally through said proximal opening of said guidewire lumen, through said guidewire lumen past said side port, and out of the distal end of said catheter.