Methods using a dual balloon telescoping guiding catheter

Abstract

A guiding catheter comprises an outer guide having a guide lumen and an annular balloon mounted to a distal end of the outer guide, and an inner guide movably disposed within the guide lumen of the outer guide, the inner guide comprising a fluted balloon mounted to a distal end of the inner guide. A method involves selectably pressurizing and depressurizing the annular balloon to control occlusion of fluid flow relative to the annular balloon, and selectably pressurizing and depressurizing the fluted balloon independently of pressurizing and depressurizing the annular balloon to permit perfusion of fluid flow relative to the fluted balloon and control anchoring of the fluted balloon within a generally tubular structure.

1 . A method, comprising: 
 providing a guiding catheter comprising an outer guide having a guide lumen and an annular balloon mounted to a distal end of the outer guide, and an inner guide movably disposed within the guide lumen of the outer guide, the inner guide comprising a fluted balloon mounted to a distal end of the inner guide;    selectably pressurizing and depressurizing the annular balloon to control occlusion of fluid flow relative to the annular balloon; and    selectably pressurizing and depressurizing the fluted balloon independently of pressurizing and depressurizing the annular balloon to permit perfusion of fluid flow relative to the fluted balloon and control anchoring of the fluted balloon within a generally tubular structure.    
   
   
       2 . The method of  claim 1 , wherein the outer guide comprises a flexible pre-formed curve proximal to the annular balloon.  
   
   
       3 . The method of  claim 1 , wherein the inner guide comprises a flexible pre-formed curve proximal to the fluted balloon, the pre-formed curve of the inner guide conforming to a shape of the outer guide when retracted within the outer guide and assuming its original shape when the pre-formed curve is extended beyond a distal tip of the outer guide.  
   
   
       4 . The method of  claim 1 , further comprising advancing a payload through at least the guide lumen of the outer guide.  
   
   
       5 . The method of  claim 1 , further comprising advancing a guide wire through at least the guide lumen of the outer guide.  
   
   
       6 . The method of  claim 1 , further comprising injecting a contrast media into the guide lumen of the outer guide and a guide lumen of the inner guide.  
   
   
       7 . The method of  claim 1 , further comprising sensing a physiologic parameter from a distal end of the outer guide.  
   
   
       8 . The method of  claim 1 , further comprising sensing a physiologic parameter from a distal end of the inner guide.  
   
   
       9 . A method, comprising: 
 introducing a distal end of a guiding catheter into a patient's access vessel, the guiding catheter comprising: 
 an outer guide comprising a guide lumen and an annular balloon mounted to a distal end of the outer guide; and  
 an inner guide movably disposed within the guide lumen of the outer guide, the inner guide comprising a fluted balloon mounted to a distal end of the inner guide;  
   advancing the distal end of the guiding catheter through a circulatory pathway;    distally extending the inner guide to engage a destination vessel with the distal end of the inner guide;    distally extending the inner guide to seat the inner guide in the destination vessel; and    inflating the fluted balloon to anchor the inner guide in the destination vessel.    
   
   
       10 . The method of  claim 9 , further comprising mapping a cardiac structure or vasculature using the guiding catheter.  
   
   
       11 . The method of  claim 9 , further comprising, after engaging the destination vessel with the inner guide: 
 distally advancing the outer guide over the inner guide to engage the destination vessel with the outer guide;    inflating the annular balloon to occlude blood flow; and    injecting a contrast media into the guiding catheter for mapping blood vessels.    
   
   
       12 . The method of  claim 9 , further comprising using optical sensing at the distal end of the catheter to assist in locating the destination vessel.  
   
   
       13 . The method of  claim 9 , further comprising using ultrasonic sensing at the distal end of the catheter to assist in locating the destination vessel.  
   
   
       14 . The method of  claim 9 , further comprising using infrared sensing at the distal end of the catheter to assist in locating the destination vessel.  
   
   
       15 . The method of  claim 9 , further comprising using temperature sensing at the distal end of the catheter to assist in locating the destination vessel.  
   
   
       16 . The method of  claim 9 , further comprising using pressure sensing at the distal end of the catheter to assist in locating the destination vessel.  
   
   
       17 . The method of  claim 9 , further comprising using flow sensing at the distal end of the catheter to assist in locating the destination vessel.  
   
   
       18 . The method of  claim 9 , further comprising using oxygen sensing at the distal end of the catheter to assist in locating the destination vessel.  
   
   
       19 . The method of  claim 9 , wherein the destination vessel includes the coronary sinus of the patient's heart.  
   
   
       20 . The method of  claim 9 , wherein the circulatory pathway includes the right atrium of the patient's heart accessed via the superior vena cava.