Dual Balloon Telescoping Guiding Catheter

Abstract

A guiding catheter includes an inner guide movably disposed within an outer guide. Both inner and outer guides include inner and outer balloons, respectively, located at the distal tip of the guides. The inner guide balloon is fluted, thereby allowing blood to flow past the implanted balloon when inflated. The outer balloon is substantially annular in shape and is deployable as an occlusion balloon. Various sensors can be provided at the distal end of the guiding catheter to assist in locating a destination vessel or structure of interest.

1 . A guiding catheter, comprising:
 an outer guide, comprising:
 an outer surface having a circumference dimensioned to navigate into the coronary sinus and engage a destination vessel distal to, and smaller than, the coronary sinus; 
 a pre-formed distal curve configured to facilitate cannulation of the coronary sinus from the right ventricle and cannulation of the destination vessel by the outer guide; 
 a guide lumen dimensioned to receive an implantable cardiac lead; 
 a distal region flexible relative to a proximal region; and 
 an inflation lumen; 
   an inner guide movably disposed within the guide lumen of the outer guide, the inner guide comprising:
 an inflation lumen; 
 a distal region flexible relative to a proximal region; 
 a pre-formed curve on a distal end of the inner guide, the distal end of the inner guide having a circumference; and 
 the inner and outer guides each configured such that the pre-formed curve of the inner guide substantially takes the shape of the outer guide when the pre-formed curve of the inner guide is retracted within the outer guide and the pre-formed curve of the inner guide assumes its pre-formed shape when extended beyond a distal end of the outer guide; 
   an annular balloon fixably mounted on the outer guide distal of the pre-formed distal curve of the outer guide and in fluid connection with the inflation lumen of the outer guide, the annular balloon configured to seal the coronary sinus and stabilize the inner guide in the coronary sinus in an inflated configuration by engagement with the coronary sinus;   a fluted perfusion balloon fixably mounted to the inner guide distal of the pre-formed curve of the inner guide, the fluted balloon in fluid connection with the inflation lumen of the inner guide and comprising:
 a plurality of flutes arranged generally parallel to a longitudinal axis of the inner guide and configured to retain a fluted configuration sufficient to permit perfusion of fluid flow relative to the fluted balloon when pressurized, and 
 the fluted perfusion balloon configured to secure the inner guide within the destination vessel in an inflated configuration by engagement of the plurality of flutes with the destination vessel sufficient to facilitate advancement of the outer guide over the inner guide to engage the destination vessel with the outer guide; and 
   at least two inflation mechanisms each independently in fluid connection with the inflation lumens of the inner and outer guides, the inflation mechanisms facilitating pressurization and depressurization of a fluid within the inflation lumens to respectively inflate and deflate the annular and fluted balloons.