Catheter For Media Injection

Abstract

An improved endocardial catheter includes a plurality of longitudinally extending openings adjacent intermediate portions at its distal end. The catheter is actuable from a retracted or collapsed mode, wherein the sealed openings are arranged around the tubular catheter surface, to an expanded mode. The plurality of longitudinal openings in the catheter wall enable radial expansion of the tubular surface at the distal end so that intermediate portions of the tubular catheter surface are moved to an operative position radially outward from their position in the retracted mode. In the expanded position, the intermediate portions form wings around the distal end, revealing a cavity within the tubular catheter for the release of contrast material or other fluid into endocardial sites through the longitudinal openings.

Description

CROSS REFERENCE TO RELATED APPLICATIONS[0001]This application is a continuation of application Ser. No. 10 / 764,189, filed on Jan. 23, 2004, which in turn is a continuation of application Ser. No. 09 / 550,692, filed on Apr. 17, 2000, now U.S. Pat. No. 6,701,180, which in turn is a continuation of application Ser. No. 09 / 049,841, filed Mar. 27, 1998, now U.S. Pat. No. 6,052,612, which in turn is a continuation of application Ser. No. 08 / 476,122, filed Jun. 7, 1995, now U.S. Pat. No. 5,857,464, which applications and patents are incorporated herein in their entirety by this reference.BACKGROUND OF THE INVENTION[0002]This invention relates to medical devices, and in particular to angiographic catheters. Angiographic catheters are long, narrow, thin-walled tubes that are percutaneously inserted into the human or animal vascular system for therapeutic or diagnostic purposes. Most diagnostic catheters have a series of side-holes in varied configurations near the distal end, as well as an op...

AI Technical Summary

Benefits of technology

"This patent describes an endocardial catheter with a unique design that reduces the amount of contrast material and radiation required for optimal angiographic results. The catheter has a plurality of circumferentially-spaced slits near the distal end, which form flexible intermediate portions that can form wings to discharge fluid from the catheter. The catheter can also have a valve at the distal end to control the flow of fluid. The invention decreases the likelihood of complications and damage to the heart, while still being able to navigate through highly tortuous procedures."

Problems solved by technology

Problems with forceful discharge of contrast material through the end-hole and smaller side-holes of an angiographic catheter are manifest.

The end-hole jet effect produces undesirable recoil of the catheter, thereby shifting the catheter from a desired position within a chamber or a vessel, e.g. aortic root.

Catheter jets can also produce a dangerous complication, subintimal injection of the contrast material, in which the jets tunnel into the wall of the blood vessel, sometimes resulting in acute occlusion of the vessel and in a chamber like left ventricle can cause subintimal injection resulting in significant damage to endothelium.

When dye is injected in a chamber like left ventricle, an end-hole or side-hole jet can also cause premature ventricular contractions (PVCs), ventricular tachycardias (groups of three or more PVCs) and other arrhythmias which endanger the patient, lengthen the time of exposure to X-rays required for satisfactory opacification, and often result in unintelligible chamber opacification in an angiogram made during their occurrence.

A further complication resulting from pressurized discharge of contrast material through the end and side-holes of known catheters is the need for more contrast material than is optimally desired to produce the angiogram.

Currently available contrast material can cause undesirable generalized allergic reactions like anaphylaxis and renal failure.

Also, the amount of material used dictates the time required to inject the material and, therefore, affects both the required length of exposure to dangerous X-rays as well as the probability of obtaining a satisfactory angiogram.

However, these modifications have not satisfactorily alleviated the problems associated with the use of any catheter which has an open end-hole.

Such side-holes allow a very limited volume of material to form the bolus needed for opacification of the chamber, thereby elongating the time needed to adequately outline the chamber in the angiogram.

Longer X-ray exposure endangers the patient and decreases the likelihood of obtaining satisfactory angiogram results.

Moreover, side-holes can cause pressure jets leading to PVCs and other arrhythmias, as outlined above.

Although adding additional side-holes may increase the volume of material allowed into the vessel while dissipating pressure jets, such an increase may result in a distal region of less strength than the main body of the catheter tube.

As a result of this reduced strength, complaints have arisen as to some currently-available angiographic catheters from physicians, who have reported that in clinical use, as they have attempted to put the pigtail tip through the aortic valve, the distal tip area in which the side-holes reside sometimes buckles.

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