Anti-thrombogenic catheter and method

Abstract

A medical catheter assembly is provided including an inner catheter member, where that inner catheter member includes a plurality of inner catheter lumens, and an outer sheath with at least one patent sheath lumen. The inner catheter is slidably disposed through a length of the at least one patent sheath lumen in a manner providing a substantially sealing contact between an exterior surface of the inner catheter and an inward surface of the at least one patent sheath lumen. A first of the plurality of inner catheter lumens includes a plurality of apertures to the exterior surface of the inner catheter, and a second of the plurality of inner catheter lumens includes at least one distal end-tip opening. A method of using the assembly is also provided.

1 . A medical catheter assembly comprising:
 an inner catheter member comprising a plurality of inner catheter lumens, and an outer sheath comprising at least one patent sheath lumen;   where the inner catheter is slidably disposed through a length of the at least one patent sheath lumen in a manner providing a substantially sealing contact between an exterior surface of the inner catheter and an inward surface of the at least one patent sheath lumen;   a first of the plurality of inner catheter lumens comprising a plurality of apertures to the exterior surface of the inner catheter; and   a second of the plurality of inner catheter lumens comprising at least one distal end-tip opening.   
     
     
         2 . The medical catheter assembly of  claim 1 , wherein a selected one of the inner catheter, the outer sheath, and a combination thereof comprises a coating of an anti-thrombogenic material. 
     
     
         3 . The medical catheter assembly of  claim 2 , wherein the anti-thrombogenic material comprises heparin. 
     
     
         4 . The medical catheter assembly of  claim 1 , wherein the plurality of apertures is non-uniformly distributed along a distal portion of the inner catheter. 
     
     
         5 . The medical catheter assembly of  claim 1 , wherein only the first of the plurality of inner catheter lumens comprises a plurality of apertures open to the exterior surface of the inner catheter and configured for fluid communication of a first therapeutic agent. 
     
     
         6 . The medical catheter of  claim 1 , wherein at least one of the plurality of apertures comprises a non-circular geometry. 
     
     
         7 . The medical catheter assembly of  claim 1 , wherein the second of the plurality of inner catheter lumens comprising at least one distal end-tip opening is configured for fluid communication of a second therapeutic agent. 
     
     
         8 . The medical catheter assembly of  claim 1 , further comprising a third inner catheter lumen. 
     
     
         9 . The medical catheter assembly of  claim 8 , wherein the third inner catheter lumen comprises a plurality of apertures to the exterior surface of the inner catheter, said apertures configured to be sealingly covered by an inward surface of the at least one patent sheath lumen. 
     
     
         10 . The medical catheter assembly of  claim 8 , wherein the third inner catheter lumen comprises a second distal end-tip opening. 
     
     
         11 . The medical catheter assembly of  claim 1 , further comprising a first proximal catheter structure and a second proximal catheter structure, each having a longitudinal lumen, wherein the first of the plurality of inner catheter lumens is in fluid communication with a first proximal catheter structure lumen and the second of the plurality of inner catheter lumens is in fluid communication with a second proximal catheter structure lumen. 
     
     
         12 . The medical catheter assembly of  claim 11 , wherein a portion of at least one of the proximal catheter structures comprises visual indicia configured to distinguish it from another of the proximal catheter structures. 
     
     
         13 . A medical catheter assembly configured for use as an indwelling central venous catheter and comprising:
 an elongate inner catheter body comprising:
 a central first lumen including a distal end-tip opening; 
 an outer second lumen; and 
 wherein a plurality of apertures opens from the outer second lumen to an exterior surface of the elongate inner catheter body to provide a path of fluid communication; 
   an outer sheath comprising a sheath lumen through which at least a portion of the elongate inner catheter body is slidably disposed;   wherein a surface of the sheath lumen sealingly contacts the exterior surface of the elongate catheter body such that fluid communication through any of the plurality of apertures is substantially prevented for apertures covered by the outer sheath.   
     
     
         14 . A method for installing a catheter, the method comprising the steps of:
 providing a catheter assembly according to  claim 1 ;   directing the assembly into proximity with a blood vessel;   further directing the inner catheter member through a wall of the blood vessel into a vessel lumen thereof, and further directing the outer sheath into close proximity with the blood vessel such that substantially none of the plurality of inner catheter apertures are open outside the blood vessel, said inner catheter apertures being open into the vessel lumen or sealingly covered by the outer sheath;   directing a first therapeutic agent though the first inner catheter lumen and at least one inner catheter aperture; and   directing a second therapeutic agent through the second inner catheter lumen.   
     
     
         15 . The method of  claim 14 , wherein the step of providing a catheter assembly further comprises aligning distal ends of the inner catheter member and the outer sheath. 
     
     
         16 . The method of  claim 14  further comprising a step of directing a distal portion of the outer sheath into the blood vessel. 
     
     
         17 . The method of  claim 16  further comprising a step of longitudinally adjusting the position of the inner catheter relative to the outer sheath in a manner controlling the number of apertures not covered by the outer sheath. 
     
     
         18 . The method of  claim 14 , wherein the catheter assembly is dimensioned for use as a central venous catheter, and the blood vessel is selected from one of a subclavian vein, a femoral vein, and a jugular vein. 
     
     
         19 . The method of  claim 14 , wherein at least one of the therapeutic agents is an anti-thrombotic agent. 
     
     
         20 . The method of  claim 14 , wherein each of a first sub-plurality of the apertures comprises a different surface area than each of a second sub-plurality of the apertures.