Vascular access instrument having fluid permeable structure and related devices

Abstract

To provide a system, a device and a method for placing an instrument through a catheter that can be placed.SOLUTION: A delivery device to deliver a guidewire through an intravenous catheter assembly may include a housing, which may include a distal end, a proximal end and a slot. The delivery device may include a guidewire, which may include a proximal end and a distal end. The delivery device may include a guidewire hub disposed within the housing. The guidewire may be secured to the guidewire hub, and the guidewire hub may be configured to move along the slot to advance the guidewire in a distal direction. The distal end of the guidewire may include a fluid permeable structure. For example, the fluid permeable structure may include an elongated core and a coil extending around the elongated core, and a space between the elongated core and the coil may be configured to receive blood in response to the guidewire being inserted into the vasculature.SELECTED DRAWING: Figure 1A

Description

[Technical field]

[0001] Infusion therapy, a common medical procedure, can be facilitated by vascular access devices. Hospitalized, homebound, and other patients receive fluids, medications, and blood products via vascular access devices inserted into the vascular system. Blood withdrawal is another common medical procedure that can be facilitated by vascular access devices. [Background technology]

[0002] Vascular access devices may access a patient's peripheral or central vasculature. Vascular access devices may be left in place for short term (days), medium term (weeks), or long term (months to years). Vascular access devices may be used for continuous infusion therapy or may be used for intermittent therapy.

[0003] A common vascular access device is the over-the-needle peripheral venous catheter (PIVC). As the name suggests, an “over-the-needle” PIVC may be mounted over an introducer needle with a sharp distal tip. The sharp tip may be used to puncture the patient’s skin and vasculature. Insertion of the PIVC into the vasculature may follow puncture of the vasculature with the needle. The needle and PIVC are typically inserted at a shallow angle through the skin into the patient’s vein with the bevel of the needle facing away from the patient’s skin. Once placement of the needle within the vein is confirmed, the clinician may temporarily block flow within the vein and withdraw the needle, leaving the PIVC in place for future fluid infusions or blood draws.

[0004] Currently, there are several limitations to the use of a PIVC for fluid infusion or blood collection. The PIVC or vein may narrow, collapse, or become clogged over time, leading to failure of the PIVC. Also, blood drawn from a PIVC may often need to be discarded due to concerns about the quality of the sample, resulting in an unusable sample and the need for repeated blood draws. Additionally, drawing blood using a PIVC is time-consuming and somewhat inefficient, especially in patients with difficult to access veins or in veins that are not easily accessible to the clinician. The subject matter claimed herein is not limited to embodiments that solve any shortcomings or that operate only in environments such as those described above. Rather, this background is only provided to illustrate one example technology area in which some implementations described herein may be practiced. Summary of the Invention

[0005] The present disclosure relates generally to vascular access systems, devices, and methods. More particularly, in some embodiments, the present disclosure relates to systems, devices, and methods for placing instruments through a catheter that may be indwelling. In some embodiments, the instrument may include a guidewire. In some embodiments, the catheter may include a PIVC, a midline catheter, or a peripherally inserted central catheter (PICC).

[0006] In some embodiments, the instrument may extend beyond the distal end or tip of the catheter, which may displace or push aside anything in the patient's vasculature that may occlude the catheter during blood collection. For example, the instrument may displace or push aside fibrin material, a blood clot, or even a vein wall. In some embodiments, the instrument may push open a valve in the vasculature, allowing blood to flow back into the catheter. In some embodiments, the instrument may open the distal tip of the catheter. In some embodiments, the instrument may reduce catheter kinking and flow restrictions that result from catheter kinking. In some embodiments, the instrument may extend beyond the distal tip of the catheter and the catheter insertion site, which may facilitate bypass of local venous diameter restrictions due to blood clots and / or venous structure. In some embodiments, the instrument may move the distal tip of the catheter away from the venous wall toward the center of the vein, which may reduce the chance of occlusion and / or damage to the venous wall due to shear stress from flow.

[0007] In some embodiments, the device may include a fluid-permeable structure that may provide an elongated or multiple inlet pathway to the distal tip of the catheter. In some embodiments, the fluid-permeable structure may prevent fibrin material, thrombus, or another material from occluding the distal tip of the catheter. In some embodiments, the device may increase the dwell time of the catheter. In some embodiments, the device may allow the catheter to be constructed of a softer and / or more flexible material, which may be gentler on the blood vessel. In some embodiments, the device may allow blood to enter the catheter from a longer portion of the vein, reducing the fill time of blood draws, especially for small gauge catheters.

[0008] In some embodiments, the guidewire may be delivered through the intravenous catheter assembly via any suitable delivery device. In some embodiments, a delivery device that delivers the guidewire through the intravenous catheter assembly may include a housing that may include a distal end, a proximal end, and a slot. In some embodiments, the delivery device may include a guidewire that may include a proximal end and a distal end. In some embodiments, the distal end of the guidewire may include a fluid permeable structure.

[0009] In some embodiments, the delivery device may include a guidewire hub that may be disposed within the housing. In some embodiments, the guidewire may be secured to the guidewire hub. In some embodiments, the guidewire hub may be configured to move along a slot to advance the guidewire distally and to the distal end of the housing. In some embodiments, the guidewire may be advanced distally and / or retracted proximally.

[0010] In some embodiments, the fluid permeable structure may include an elongate core and a coil extending around the elongate core. In some embodiments, the coil may be coupled to the elongate core. In some embodiments, in response to the guidewire being inserted into a blood vessel, blood may flow within a space between the elongate core and the coil. In some embodiments, the delivery device may include a gap between an outer diameter of the guidewire and an inner diameter of the catheter, which may allow blood to flow proximally from the vasculature through the gap.

[0011] In some embodiments, the guidewire may include a rounded distal tip, which may reduce the risk of damaging the vasculature when inserting the guidewire into the vasculature. In some embodiments, the rounded distal tip may reduce the risk of thrombus development or other complications. In some embodiments, the rounded distal tip may be formed via spot welding, adhesive, or another suitable means. In some embodiments, the rounded distal tip may be constructed of metal, plastic, elastomer, or other suitable material.

[0012] In some embodiments, the coil may be secured to the elongated core at one or more locations along the length of the elongated core. For example, one or more bridges may extend from the coil to the elongated core to secure the coil to the elongated core. In some embodiments, the distal end of the coil may be coupled to the elongated core via a rounded distal tip. More specifically, in some embodiments, the distal end of the coil may be directly coupled to a rounded distal tip, which may be directly coupled to the elongated core.

[0013] In some embodiments, the coil may be tightly wound around the elongated core at one or more locations to couple the coil to the elongated core. In some embodiments, the coil may include a distal end and a proximal end. In some embodiments, the distal end of the coil and / or the proximal end of the coil may be tightly wound around the elongated core. In some embodiments, the elongated core may include a first portion that may include a first outer diameter and a second portion that may include a second outer diameter. In some embodiments, the second outer diameter may be greater than the first outer diameter. In some embodiments, the coil may be tightly wound around the second portion.

[0014] In some embodiments, the spacing between the rings of the coil may be generally uniform. In some embodiments, the spacing between the rings of the coil may vary. In some embodiments, along one or more portions of the coil, the spacing of the rings may be narrower. For example, the rings may touch each other or may be close to each other. In some embodiments, along other portions of the coil, the spacing of the rings may be wider apart than along portions of the coil. In some embodiments, the distal end of the coil may be disposed distally relative to the distal end of the elongate core. In these and other embodiments, the distal end of the coil may be open or closed.

[0015] In some embodiments, the delivery device may include a tube that may include a proximal end and a distal end. In some embodiments, the guidewire may be delivered through the catheter assembly via any suitable delivery device. In some embodiments, the tube may be configured to extend into the catheter and / or into the patient's vasculature. In some embodiments, the guidewire may be disposed within the tube. In some embodiments, the distal end of the tube may include a fluid-permeable structure. In some embodiments, the guidewire and / or tube may reduce the number of needle sticks experienced by the patient due to less frequent catheter replacement. In some embodiments, the tube may allow the user to draw blood samples or inject fluids through the catheter, for example, when debris accumulates at the distal end of the catheter or the catheter collapses, causing the catheter to become ineffective or less effective.

[0016] In some embodiments, the delivery device may include a tube hub disposed within the housing. In some embodiments, the tube may be secured to the tube hub. In some embodiments, the tube hub may be configured to move along a slot to advance the tube distally to a distal end of the housing. In some embodiments, the tube may be advanced distally and / or retracted proximally any number of times.

[0017] In some embodiments, the catheter system may include a delivery device and a catheter assembly. In some embodiments, the catheter assembly may include a catheter adapter that may include a distal end, a proximal end, and a lumen extending between the distal end and the proximal end. In some embodiments, the catheter may be secured to the catheter adapter and may extend distally from the catheter adapter. In some embodiments, the catheter may include one or more diffusion holes that may provide additional pathways for blood to enter the catheter.

[0018] In some embodiments, the catheter adapter may include a side port that may be angled relative to a distal end of the catheter adapter. In some embodiments, the catheter system may include an extension tube that may include a distal end and a proximal end. In some embodiments, the distal end of the extension tube may be coupled to the side port. In some embodiments, the distal end of the extension tube may be integral with the side port. In some embodiments, the fluid permeable structure may facilitate entry of blood into the catheter in response to application of negative pressure to the side port of the catheter adapter.

[0019] In some embodiments, a connector may be coupled to the proximal end of the extension tube. In some embodiments, the proximal end of the extension tube may be integral with the connector. In some embodiments, the connector may include a first port and a second port. In some embodiments, the connector may include two or more ports. In some embodiments, a delivery device may be coupled to a first port of the connector. In some embodiments, another extension tube may be coupled to a second port of the connector. In some embodiments, a blood collection device may be coupled to the proximal end of the other extension tube.

[0020] In some embodiments, blood may be prevented from entering the delivery device. For example, the distal end of the housing may include a septum to prevent fluid from flowing into the distal end of the housing. In some embodiments, the fluid path of the catheter system may include one or more of a catheter, a catheter adapter, an extension tube, and another extension tube. In some embodiments, blood may be collected through a fluid path that may not extend through the housing of the delivery device. In some embodiments, the fluid path may not include or be disposed within most or the entirety of the housing. In some embodiments, blood may not flow in or through the housing of the delivery device. In some embodiments, the delivery device may not be a blood collection device, and instead, the delivery device may facilitate the flow of blood through the catheter and enable blood collection through a fluid path that may include the catheter assembly and / or may not include the housing of the delivery device.

[0021] In some embodiments, the delivery device may be coupled to a proximal end of the catheter adapter. In these embodiments, the fluid path of the catheter system may include the catheter, the catheter adapter, and the extension tube. In some embodiments, the blood collection device may be coupled to a proximal end of the extension tube.

[0022] In some embodiments, the instruments of the catheter system may include an extension device that may include an elongated body. In some embodiments, the extension device may be like an obturator, except that the extension device may not block the fluid path through the catheter; instead, the extension device may facilitate the flow of fluid through the catheter. In some embodiments, the elongated body may include a fluid-permeable structure that may be configured to allow fluid to enter the distal end of the catheter in response to the extension device being inserted through the catheter. In some embodiments, the fluid-permeable structure of the extension device may include one or more grooves, one or more flat areas, one or more side holes, or one or more axially running channels. In some embodiments, the extension device may include a rod that includes one or more grooves, one or more flat areas, one or more side holes, or one or more axially running channels.

[0023] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory, and are not restrictive of the invention as claimed. It is to be understood that the various embodiments are not limited to the arrangement and instrumentality shown in the drawings. It is also to be understood that the embodiments may be combined, other embodiments may be utilized, and structural changes not recited in the claims may be made without departing from the scope of the various embodiments of the present invention. Therefore, the following detailed description is not to be taken in a limiting sense. [Brief description of the drawings]

[0024] Example embodiments are described with additional specificity and detail through the use of the accompanying drawings, in which:

[0025] [Figure 1A] FIG. 1A is a top perspective view of an exemplary catheter system, according to some embodiments. [Figure 1B]FIG. 1B is a top perspective view of an exemplary delivery device of the catheter system of FIG. 1A illustrating an exemplary guidewire in a retracted position, according to some embodiments. [Figure 1C] FIG. 1C is a top perspective view of a delivery device of the catheter system of FIG. 1A illustrating a guidewire in an advanced position, according to some embodiments. [Figure 1D] FIG. 1D is a cross-sectional view of a delivery device of the catheter system of FIG. 1A illustrating a guidewire in a retracted position, according to some embodiments. [Figure 1E] FIG. 1E is a cross-sectional view of a delivery device of the catheter system of FIG. 1A illustrating a guidewire in an advanced position, according to some embodiments. [Figure 1F] FIG. 1F is an enlarged top perspective view of a portion of the catheter system of FIG. 1A illustrating a guidewire in an advanced position, according to some embodiments. [Figure 1G] FIG. 1G is a top perspective view of an exemplary distal end of the catheter system of FIG. 1A illustrating a guidewire in an advanced position, according to some embodiments. [Figure 1H] FIG. 1H is a cross-sectional view of an exemplary distal end of the catheter system of FIG. 1A illustrating a guidewire in an advanced position and positioned within a patient's vasculature, according to some embodiments. [Figure 2A] FIG. 2A is a top perspective view of an exemplary distal end of a guidewire of the catheter system of FIG. 1A, according to some embodiments. [Figure 2B] FIG. 2B is a top perspective view of another exemplary distal end of a guidewire of the catheter system of FIG. 1A, according to some embodiments. [Figure 2C] FIG. 2C is a top perspective view of another exemplary distal end of a guidewire of the catheter system of FIG. 1A, according to some embodiments. [Figure 2D] FIG. 2D is a top perspective view of another exemplary distal end of a guidewire of the catheter system of FIG. 1A, according to some embodiments. [Figure 2E]FIG. 2E is a top perspective view of another exemplary distal end of a guidewire of the catheter system of FIG. 1A, according to some embodiments. [Figure 2F] FIG. 2F is a top perspective view of another exemplary distal end of a guidewire of the catheter system of FIG. 1A, according to some embodiments. [Figure 2G] FIG. 2G is a top perspective view of another exemplary distal end of a guidewire of the catheter system of FIG. 1A, according to some embodiments. [Figure 3A] FIG. 3A is a top perspective view of another exemplary distal end of the catheter system of FIG. 1A illustrating a guidewire in an advanced position and an exemplary diffusion hole, according to some embodiments. [Figure 3B] FIG. 3B is a top perspective view of another exemplary distal end of the catheter system of FIG. 1A illustrating a guidewire and diffusion lumen in an advanced position, according to some embodiments. [Figure 4A] FIG. 4A is a top perspective view of another exemplary catheter assembly of the catheter system of FIG. 1A, according to some embodiments. [Figure 4B] FIG. 4B is a top perspective view of a delivery device of the catheter system of FIG. 1A, according to some embodiments. [Figure 5A] FIG. 5A is a top perspective view of the catheter system of FIG. 1A illustrating an exemplary syringe, according to some embodiments. [Figure 5B] FIG. 5B is a top perspective view of the catheter system of FIG. 1A illustrating the syringe replaced with a blood collection tube, according to some embodiments. [Figure 6A] FIG. 6A is a top perspective view of another delivery device that can be used with the catheter system of FIG. 1A, according to some embodiments. [Figure 6B] FIG. 6B is a cross-sectional view of the alternative delivery device of FIG. 6A, according to some embodiments. [Figure 6C]FIG. 6C is a cross-sectional view of another delivery device of FIG. 6A coupled to another exemplary catheter assembly, illustrating a partially advanced guidewire, according to some embodiments. [Figure 7A] FIG. 7A is a top perspective view of another delivery device coupled with the catheter system of FIG. 1A, according to some embodiments. [Figure 7B] FIG. 7B is a cross-sectional view of the delivery device of FIG. 7A illustrating the guidewire and exemplary tube in an advanced position, according to some embodiments. [Figure 7C] FIG. 7C is a top perspective view of the delivery device of FIG. 7A coupled to the catheter system of FIG. 1A, according to some embodiments. [Figure 7D] FIG. 7D is a cross-sectional view of the delivery device of FIG. 7A coupled to the catheter system of FIG. 1A, according to some embodiments. [Figure 7E] FIG. 7E is a top perspective view of another exemplary distal end of the catheter system of FIG. 1A, according to some embodiments. [Figure 7F] FIG. 7F is an enlarged top perspective view of the other distal end of FIG. 7E according to some embodiments. [Figure 7G] FIG. 7G is a top perspective view of another exemplary distal end of the catheter system of FIG. 1A, according to some embodiments. [Figure 7H] FIG. 7H is an enlarged top perspective view of the other distal end of FIG. 7G according to some embodiments. [Figure 8A] FIG. 8A is a top perspective view of an exemplary distal end of an exemplary extension device, according to some embodiments. [Figure 8B] FIG. 8B is a cross-sectional view of the distal end along line 8B-8B of FIG. 8A, according to some embodiments. [Figure 8C] FIG. 8C is a top perspective view of another exemplary distal end of the extension device of FIG. 8A, according to some embodiments. [Figure 8D] FIG. 8D is a cross-sectional view of the other distal end along line 8D-8D of FIG. 8C, according to some embodiments. [Figure 8E] FIG. 8E is a top perspective view of another exemplary distal end of the extension device of FIG. 8A, according to some embodiments. [Figure 8F] FIG. 8F is a cross-sectional view of the other distal end along line 8F-8F of FIG. 8E, according to some embodiments. [Figure 8G] FIG. 8G is a top perspective view of another exemplary distal end of the extension device of FIG. 8A, according to some embodiments. [Figure 8H] 8H is a top perspective view of another exemplary distal end of the extension device of FIG. 8A, according to some embodiments. [Figure 8I] FIG. 8I is a cross-sectional view of the other distal end along line 8I-8I of FIG. 8H, according to some embodiments. [Figure 8J] FIG. 8J is a cross-sectional view of an exemplary catheter assembly illustrating another exemplary extension device, according to some embodiments. [Figure 9A] FIG. 9A is a top perspective view of another delivery device illustrating the guidewire in a retracted position, according to some embodiments. [Figure 9B] FIG. 9B is a top perspective view of the delivery device of FIG. 9A illustrating the guidewire in an advanced position, according to some embodiments. [Figure 10A] FIG. 10A is a top perspective view of another delivery device illustrating a guidewire and an exemplary tube in a retracted position, according to some embodiments. [Figure 10B] FIG. 10B is a top perspective view of the delivery device of FIG. 10A illustrating the guidewire and exemplary tube in an advanced position, according to some embodiments. [Figure 10C] FIG. 10C is a cross-sectional view illustrating an exemplary hub of the delivery device of FIG. 10A, according to some embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0026] In this disclosure, the term "distal" refers to that portion of the catheter system or component thereof that is farther from the user, and the term "proximal" refers to that portion of the catheter system or component thereof that is closer to the user. As used in this disclosure, the term "user" may refer to a clinician, physician, nurse, or other care provider, and may include support personnel.

[0027] 1A-1E, in some embodiments, a catheter system 10 can include a delivery device 12 and a catheter assembly 14. In some embodiments, the delivery device 12 can include any suitable delivery device, which can include any suitable housing. In some embodiments, the housing can include a collapsible or flexible tube, or any other suitable element, that generally surrounds the instrument to promote a sterile environment. For example, the delivery device 12 can include a linear or rotational mechanism, or any other suitable mechanism. In some embodiments, the delivery device 12 is described, for example, in U.S. patent application Ser. No. 62 / 660,661, filed April 20, 2018, entitled "Instrument Delivery Device Having a Rotating Body," U.S. patent application Ser. No. 62 / 773,029, filed November 29, 2018, entitled "Syringe-Type Delivery Device for Vascular Access Device," and U.S. patent application Ser. No. 62 / 696,229, filed July 10, 2018, entitled "Delivery Device for Vascular Access Device," each of which is incorporated by reference in its entirety.

[0028] In some embodiments, the catheter assembly 14 may include a catheter adapter 16 that may include a distal end 18, a proximal end 20, and a lumen 22 extending between the distal end 18 and the proximal end 20. In some embodiments, a catheter 24 may be secured to the catheter adapter 16 and extend distally from the catheter adapter 16. In some embodiments, the catheter 24 may include a PIVC, a midline catheter, or a peripherally inserted central catheter (PICC).

[0029] In some embodiments, the delivery device 12 may be coupled to any suitable catheter assembly. In these and other embodiments, the catheter assembly 14 may include a linear or non-integral catheter assembly. In some embodiments, the catheter assembly 14 may include an integrated catheter assembly. More specifically, in some embodiments, the catheter adapter 16 of the catheter assembly 14 may include an integrated extension tube, such as, for example, the BD NEXIVA™ Closed IV Catheter System, the BD NEXIVA™ DIFFUSICS™ Closed IV Catheter System, or the Becton Dickinson PEGASUS™ Safety Closed IV Catheter System.

[0030] As shown in FIG. 1A, in some embodiments, the catheter adapter 16 may include a side port 26, which may be angled relative to the distal end 18 of the catheter adapter 16. In some embodiments, the catheter assembly 14 may include an extension tube 28, which may include a distal end 30 and a proximal end 32. In some embodiments, the extension tube 28 may be short to provide closer access to the patient. However, in some embodiments, the length of the extension tube 28 may vary. In some embodiments, the distal end 30 of the extension tube 28 may be coupled to the side port 26. In some embodiments, the distal end of the extension tube 28 may be integral with the side port 26.

[0031] In some embodiments, the connector 34 may be coupled to the proximal end 32 of the extension tube 28. In some embodiments, the proximal end 32 of the extension tube 28 may be integral with the connector 34. In some embodiments, the connector 34 may include a Y-adapter, a T-port, or other suitable connector. In some embodiments, the connector 34 may include a male or female Luer connector with Luer slip or Luer lock features. In some embodiments, the connector 34 may include two or more ports.

[0032] In some embodiments, the connector 34 may include a first port 36 and a second port 38. In some embodiments, the delivery device 12 may be coupled to the first port 36 of the connector 34. In some embodiments, another extension tube 40 may be coupled to the second port 38 of the connector 34. In some embodiments, the catheter assembly 14 may include a needleless connector 39, and the delivery device 12 may be coupled to the first port 36 of the connector 34 via the needleless connector 39, which may be disposed between the delivery device 12 and the connector 34. In some embodiments, the connector 34 and the needleless connector 39 may be integrally formed. In some embodiments, the needleless connector 39 may include any suitable needleless connector.

[0033] In some embodiments, the proximal end 42 of the other extension tube 40 may include a connector 44, which may be coupled to any suitable blood collection device, such as a syringe, vacuum tube, blood collection tube, holder, etc. In some embodiments, the blood collection device may include or accommodate a fluid reservoir. In some embodiments, the connector 44 may include a male or female luer connector with luer slip or luer lock features. In some embodiments, the connector 44 may be coupled to a holder 46, which may be configured to receive another blood collection device. In some embodiments, the holder 46 may include a cannula configured to pierce a seal of the particular blood collection device. In some embodiments, the connector 44 may be coupled to a needleless connector 39, which may be coupled to the holder 46 or another blood collection device.

[0034] In some embodiments, the instrument, which may include a guidewire 48, may be delivered through the catheter assembly 14 via any suitable delivery device. In some embodiments, the delivery device 12 may include a housing 50, which may include a distal end 52, a proximal end 54, and a slot 56 that may extend between the distal and proximal ends 52, 54. In some embodiments, the delivery device 12 may include a guidewire 48, which may include a proximal end 58 and a distal end 60.

[0035] In some embodiments, delivery device 12 may include a guidewire hub 62 that may be disposed within housing 50. In some embodiments, guidewire 48 may be secured to guidewire hub 62. In some embodiments, guidewire hub 62 may be configured to move along slot 56 to advance guidewire 48 distally and distal to distal end 52 of housing 50. In some embodiments, guidewire 48 may be advanced distally and / or retracted proximally. In some embodiments, guidewire hub 62 and one or more other components of delivery device 12 may be further described in U.S. Patent Application No. 62 / 660,646, filed April 20, 2018, entitled "Multiple Diameter Catheters and Related Devices and Methods," which is incorporated herein by reference in its entirety.

[0036] In some embodiments, blood may flow proximally from the catheter 24, through the catheter adapter 16, the extension tube 28, and the other extension tube 40. In some embodiments, blood may be prevented from entering the delivery device 12. For example, the distal end 52 of the housing 50 may include a septum 65 to prevent fluids, such as blood, from entering the distal end 52 of the housing 50. In other embodiments, blood may be allowed to flow proximally through the housing 50, and the housing 50 may include a tube coupled to a blood collection device. In some embodiments, the distal end 52 of the housing 50 may be coupled to a connector, which may include a male or female Luer connector with Luer slip or Luer lock features, or another suitable connector. In some embodiments, the septum 65 may be disposed within a connector coupled to the distal end 52 of the housing 50, for example, as illustrated in FIG. 1D.

[0037] 1F-1H, in some embodiments, the distal end 60 of the guidewire 48 may include a fluid-permeable structure 64. In some embodiments, the fluid-permeable structure 64 may include an elongated core 66 and a coil 68 extending about the elongated core 66. In some embodiments, blood may flow into the space between the elongated core 66 and the coil 68 in response to the guidewire 48 being inserted into the patient's vasculature.

[0038] In some embodiments, the guidewire 48 may be advanced beyond the distal tip 70 of the catheter 24, which may move or push something within the patient's vasculature that may occlude the catheter 24 during blood draw. For example, the guidewire 48 may move, push away, or move past fibrin material or a clot, or move the distal tip 70 of the catheter 24 away from a vein wall or valve. As shown in FIG. 1H, in some embodiments, the guidewire 48 may push open a valve within the vasculature to allow blood to flow back into the catheter 24. In some embodiments, the guidewire 48 may be left within the catheter 24 and extend beyond the distal tip 70 of the catheter during blood draw and / or fluid infusion.

[0039] In some embodiments, the fluid-permeable structure 64 may include an elongated inlet path or multiple inlet paths to the distal tip 70 of the catheter 24. In some embodiments, the fluid-permeable structure 64 may prevent fibrin material, thrombus, or another material from occluding the distal tip 70 of the catheter 24. In some embodiments, the delivery device 12 may include a gap between the outer diameter of the guidewire 48 and the catheter 24, which may allow blood to flow proximally from the vasculature through the gap. In some embodiments, the delivery device 12 may include a gap between the outer diameter of the guidewire 48 and the distal tip 70 of the catheter 24, which may allow blood to flow proximally from the vasculature through the gap.

[0040] In some embodiments, the catheter 24 and / or the catheter adapter 16 may be constructed from FEP, TEFLON, silicone, TPE, TPU, fluoropolymers, or other suitable materials. In some embodiments, the catheter 24 may be hydrophilic or hydrophobic. In some embodiments, the distal tip of the catheter 70 may be asymmetric. In some embodiments, the catheter 24 may include an anti-thrombogenic coating and / or an anti-fouling material.

[0041] 2A-2G, in some embodiments, the coil 68 may include a metal wire helically arranged around the elongated core 66. In some embodiments, the elongated core 66 may be solid and / or constructed of a metal or other suitable material. In some embodiments, the elongated core 66 may be thin to provide some flexibility. In some embodiments, the elongated core 66 may be constructed of Nitinol. In some embodiments, the coil 68 may be bonded to the elongated core 66.

[0042] In some embodiments, the guidewire 48 may include a rounded distal tip 72, which may reduce the risk of damaging the vasculature when the guidewire 48, which may be flexible, is inserted therein. In some embodiments, the rounded distal tip 72 may reduce the risk of developing thrombus or other complications. In some embodiments, the rounded distal tip 72 may be spot welded or formed via another suitable means and / or material.

[0043] In some embodiments, the coil 68 may include a distal end 74 and a proximal end 76. In some embodiments, the distal end 74 of the coil 68 may be coupled to the elongated core 66 via a rounded distal tip 72. More specifically, in some embodiments, the distal end of the coil 68 may be directly coupled to the rounded distal tip 72, which may be directly coupled to the elongated core 66.

[0044] In some embodiments, the coil 68 may be tightly wound around the elongated core 66 at one or more locations to couple the coil 68 to the elongated core 66. In some embodiments, a distal end 74 of the coil 68 may be tightly wound around the elongated core 66. In some embodiments, a proximal end 76 of the coil 68 may be tightly wound around the elongated core 66, as illustrated in, for example, FIG. 2A.

[0045] In some embodiments, the elongated core 66 may include a first portion 78, which may include a first outer diameter, and a second portion 80, which may include a second outer diameter. In some embodiments, the second outer diameter may be greater than the first outer diameter. In some embodiments, the coil 68 may be tightly wound around the second portion 80, as illustrated, for example, in FIG. 2F. In some embodiments, the elongated core 66 may be tapered or stepped between the first portion 78 and the second portion 80. In some embodiments, the guidewire 48 may include multiple diameters along its length, depending, for example, on the corresponding inner diameter of the catheter assembly 14. In some embodiments, the elongated core 66 may include a uniform outer diameter along its entire length, as illustrated, for example, in FIG. 2G.

[0046] In some embodiments, the spacing between the rings 82 of the coil 68 may be generally uniform, for example, as illustrated in Figures 2A-2B. In some embodiments, the spacing between the rings 82 of the coil 68 may vary. For example, as illustrated in Figure 2D, in some embodiments, along one or more portions of the coil, the rings 82 may be closely or tightly spaced (e.g., the rings 82 may be touching or close to one another), while along other portions of the coil 68, the rings may be spaced farther apart than along the portions of the coil 68.

[0047] As illustrated in FIG. 2E, for example, in some embodiments, the distal end 74 of the coil 68 may be disposed distally relative to the distal end 84 of the elongated core 66. In these and other embodiments, the distal end 74 of the coil 68 may be open or closed. In some embodiments, the distal end 74 of the coil 68 may be closed, for example, by a rounded distal tip 72. In some embodiments, the distal end 74 of the coil 68 may be closed by spot welding, adhesive, overmolding, bonding with a plastic or elastomeric tip, or another suitable method. In some embodiments, the distal end 84 of the elongated core 66 may be blunt or rounded.

[0048] As illustrated in FIG. 2F, for example, in some embodiments, the coil 68 may be secured to the elongated core 66 at one or more locations along the length of the elongated core 66. For example, one or more bridges 86 may extend from the coil 68 to the elongated core 66 to secure the coil 68 to the elongated core 66 at one or more points along the length of the coil 68. In these and other embodiments, the elongated core 66 may extend along the central axis of the coil 68. In some embodiments, the delivery device 12 may include any suitable elongated core and / or any suitable coil. In some embodiments, the bridges 86 may be formed by welding, adhesive, or another suitable means.

[0049] In some embodiments, the elongated core 66 may not extend along the central axis of the coil 68. In these embodiments, the elongated core 66 may be offset from the central axis of the coil 68. In these and other embodiments, the elongated core 66 may contact the coil 68 at multiple contact points along the length of the coil 68 and / or may be coupled to the coil 68 at one or more contact points. In some embodiments, the elongated core 66 may be coupled to the coil 68 by welding, adhesive, or other suitable means.

[0050] 3A-3B, in some embodiments, the catheter 24 may include one or more diffusion holes 88, which may provide additional pathways for blood to enter the catheter 24. In some embodiments, the coil 68 may extend into the catheter 24. In some embodiments, the coil 68 may extend through all or a portion of the catheter 24. In some embodiments, the coil 68 may extend proximally beyond the diffusion holes 88. In some embodiments, the coil 68 may not extend proximally beyond the diffusion holes 88.

[0051] In some embodiments, the second portion 80 may be disposed proximal to the distal opening 90 of the catheter 24. In some embodiments, the delivery device 12 may include a gap 93 between the outer diameter of the guidewire 48 and the distal opening 90 of the catheter 24, which may allow blood to flow proximally from the vasculature through the gap 93. In some embodiments, the elongated core 66 may be sized according to the particular catheter gauge size with which it may be used.

[0052] In some embodiments, the outer diameter of the coil 68 and / or the elongated core 66 may be variable, tapered, or straight. In some embodiments, the outer diameter of the coil 68 may be larger than the diameter of the distal opening 90 of the catheter 24, and the coil 68 may be compressible.

[0053] 4A, in some embodiments, the delivery device 12 may be coupled to a proximal port of a T-connector 91, which may include a needleless connector. In some embodiments, the distal port of the T-connector 91 may be coupled to the proximal end 20 of the catheter adapter 16. In these and other embodiments, the catheter adapter 16 may not include a side port 26 and / or an integral extension tube. In some embodiments, the extension tube 28 may be coupled to a side port of the T-connector, which may be angled relative to the proximal and distal ports.

[0054] In some embodiments, the fluid path of the catheter system 10 may include the catheter 24, the catheter adapter 16, a T-connector, and an extension tube 28. In some embodiments, the proximal end 32 of the extension tube 28 may be coupled to a connector 92, which may be coupled to any suitable blood collection device. In some embodiments, the connector 92 may include a male or female Luer connector having a Luer slip or Luer lock feature. In some embodiments, the connector 92 may be coupled to a needleless connector 39, which may be coupled to a holder 46 or other blood collection device.

[0055] In some embodiments, connector 92 may be coupled to holder 46 configured to receive a particular blood collection device, such as a blood collection tube, vacuum tube, or syringe. In some embodiments, holder 46 may include a cannula configured to pierce a seal on the particular blood collection device.

[0056] 4B, in some embodiments, the extension tube 40 may extend from the delivery device 12. For example, a connector coupled to a distal end 52 of the housing 50 may include a port, or the housing 50 may include a port. In some embodiments, the extension tube 40 may be coupled to the port and / or may be integral with the port. In some embodiments, the delivery device 12 may include a septum at the distal end of the housing 20 or within the connector. In some embodiments, the septum may be proximal to the port, which may prevent blood from migrating proximal to the septum and passing through the majority of the housing 50.

[0057] 5A, holder 46 is illustrated coupled to an exemplary flush syringe 94, which may be pre-filled with saline. With reference to FIG. 5B, holder 46 is illustrated coupled to an exemplary blood collection tube 96. In some embodiments, after flush syringe 94 is used to flush catheter 24 to ensure patency and draw an initial waste sample into flush syringe 94, flush syringe 94 may be disconnected from connector 34 (or connector 92 as described with respect to FIG. 4) and blood collection tube 96 or another suitable blood collection device may be coupled to connector 92.

[0058] 6A-6C, a delivery device 100 is illustrated, according to some embodiments. In some embodiments, the delivery device 100 may be similar or identical in one or more included components and / or operation to the delivery device 12 disclosed in FIGS. 1-5 of the present disclosure. In some embodiments, the delivery device 100 may include a tube 102, which may include a proximal end 104 and a distal end 106.

[0059] In some embodiments, tube 102 may be configured to extend within and / or through catheter 24 into the patient's vasculature. In some embodiments, guidewire 48 may be disposed within tube 102 and / or may extend distally through tube 102 as guidewire 48 is advanced. In some embodiments, guidewire 48 may be fully retracted as tube 102 is advanced, for example, as illustrated in FIGS. 6A-6B. In some embodiments, guidewire 48 and tube 102 may be advanced and / or retracted simultaneously.

[0060] In some embodiments, the guidewire and / or tube 102 may reduce the number of needle sticks experienced by a patient because the catheter may be replaced less frequently. In some embodiments, the tube 102 may allow a user to withdraw blood samples or inject fluids through the catheter 24 when, for example, debris accumulates at the distal end of the catheter 24 or the catheter 24 collapses, causing the catheter 24 to become inoperative or less effective.

[0061] In some embodiments, the delivery device 100 may include a tube hub 107 disposed within the housing 50. In some embodiments, the tube 102 may be secured to the tube hub 107. In some embodiments, the tube hub 107 may be configured to move along the slot 56 to advance the tube 102 in a direction distal to the distal end 52 of the housing 50. In some embodiments, the tube 102 may be advanced distally and / or retracted proximally. In some embodiments, the tube 102, guidewire hub 62, tube hub 107, and one or more other components of the delivery device 100 may be further described in U.S. Patent Application No. 62 / 660,646, filed April 20, 2018, entitled "Multiple Diameter Catheters and Related Devices and Methods," which is incorporated herein by reference in its entirety.

[0062] 7A-7D, there is illustrated, in some embodiments, a delivery device 108. In some embodiments, the delivery device 108 may be similar or identical in one or more included components and / or operation to the delivery device 12 disclosed in FIGS. 1-5 and / or the delivery device 100 disclosed in FIG. 6 of the present disclosure.

[0063] In some embodiments, the delivery device 108 may include a tube 110 that may include a proximal end 112 and a distal end 114. In some embodiments, the proximal end 112 of the tube 110 may be coupled to a connector 116 that may include a male or female luer connector having a luer slip or luer lock feature. In some embodiments, the connector 116 may be coupled to any suitable blood collection device. In some embodiments, the connector 116 may be coupled to a holder 46 that may be configured to receive another blood collection device. In some embodiments, the proximal end 58 of the guidewire 48 and / or the distal end 114 of the tube 110 may be secured within a hub 115.

[0064] In some embodiments, the proximal end of the tube 102 may be secured within the hub 115. In some embodiments, the guidewire 48 may be longer than the tube 102 and extend distally beyond the distal end 52 of the housing 50.

[0065] In some embodiments, the hub 115 may include an advancement tab 119 within the slot 56. In some embodiments, the hub 115 may be moved distally within the slot 56 to simultaneously advance the guidewire 48 and the tube 102 distally. FIGS. 7B-7D illustrate the guidewire 48 and the tube 102 fully advanced distally, according to some embodiments. In some embodiments, the hub 115 may be moved proximally to retract the guidewire 48 and the tube 102. In some embodiments, in response to the tube 102 being fully advanced distally, the distal end 106 of the tube 102 may be disposed or terminated proximal to the distal end 70 of the catheter 24, which may allow the tube 102 to include a larger outer diameter and / or improve visualization of the distal end 114 in the fully advanced position.

[0066] In some embodiments, in response to the tube 102 being fully advanced distally, the distal end 106 of the tube 102 may be disposed or terminated distal to the distal tip 70 of the catheter 24, may be disposed or terminated proximal to the distal tip 70, proximal to a catheter wedge, or proximal to a catheter wedge in the catheter adapter 16. In some embodiments, the outer diameter of the distal end 106 may provide a seal wherever it terminates, which may reduce mixing of the drawn blood with the fluid in the catheter assembly 14 and may reduce the amount of waste. In some embodiments, in response to the tube 102 being fully advanced distally, the distal end 106 of the tube 102 may be disposed anywhere in the fluid pathway. In some embodiments, the coil 68 may be disposed within the tube 102.

[0067] 7E-7H, in some embodiments, the guidewire 48 may include a tube 118 in addition to or instead of the coil 68. In some embodiments, the tube 118 may include a fluid-permeable structure 64. For example, in some embodiments, the tube 118 may be porous. As illustrated in FIG. 7E, in some embodiments, the tube 118 may include a plurality of holes 120 that may be arranged in various patterns and numbers and may include various sizes. In some embodiments, the holes 120 may be disposed at a distal end 122 of the tube 118. In some embodiments, the holes 120 may be arranged in a staggered array.

[0068] In some embodiments, the distal end 122 of the tube 118 may be open or closed. In some embodiments, the distal end 122 of the tube 118 may be coupled to a rounded distal tip 72. In some embodiments, the proximal end 123 of the tube 118 may be disposed within the catheter 24 and / or may be tapered. In some embodiments, the proximal end 123 of the tube 118 may include one or more holes 125, which may be larger and / or smaller than the holes 120. In some embodiments, the proximal end 123 of the tube 118 may be coupled to the elongated core 66.

[0069] As illustrated in FIG. 7G, in some embodiments, the tube 118 may include a plurality of slits 124, which may be arranged in various patterns and numbers and may include various sizes. In some embodiments, the slits 124 may be located at the distal end 122 of the tube 118. In some embodiments, the slits 124 may be arranged in a staggered row. In some embodiments, the slits 124 may be cut generally perpendicular to the longitudinal axis of the catheter 24, although in some embodiments, the angle of the slits 124 may vary. In some embodiments, the elongated core 66 may extend partially or completely through the tube 118.

[0070] 8A-8J, the catheter system 10 can include an extension device 126, which can include an elongate body 128. In some embodiments, the elongate body 128 can include a fluid permeable structure 130, which can be configured to allow fluid to enter the distal end 18 of the catheter 24 in response to the extension device 126 being inserted through the catheter 24.

[0071] In some embodiments, the fluid-permeable structure 130 of the extension device 126 may include grooves, for example, as illustrated in FIGS. 8A-8D. In some embodiments, the fluid-permeable structure 130 of the extension device 126 may include flat regions, for example, as illustrated in FIGS. 8E-8F. In some embodiments, the flat regions may include a generally planar upper surface 132 opposed to a generally planar lower surface 134. In some embodiments, the flat regions may provide two inlets into the catheter 24. In some embodiments, the fluid-permeable structure 130 of the extension device 126 may include multiple side holes 136 that may be connected by a lumen of the elongate body 128.

[0072] In some embodiments, the extension device 126 can be solid. In some embodiments, the elongated body 128 can include a shape having multiple arms 138 that extend away from one another and are angled relative to one another, for example as illustrated in FIGS. 8H-8I. In some embodiments, the shape of the elongated body 128 can vary. In some embodiments, a gap 140 can be disposed between the outer diameter of the extension device 126 and the distal opening 90 of the catheter 24, which can allow blood to flow proximally from the vasculature through the gap 140. In some embodiments, a blood collection device can be coupled to the proximal end of the extension tube 40.

[0073] 9-10, delivery device 146 may include a hub 115 disposed within housing 50, which may include guide features. In some embodiments, delivery device 146 may be similar or identical in one or more included components and / or operation to delivery device 12 disclosed in FIGS. 1-5, delivery device 100 disclosed in FIG. 6, or delivery device 108 disclosed in FIG. 7.

[0074] In some embodiments, the hub 115 may extend through the slot 56. In some embodiments, the guide feature may include a channel that may be generally U-shaped. In some embodiments, the guide features, hub 115, channel, and other features of the delivery device 146 may be further illustrated in, for example, U.S. Patent Application No. 62 / 696,229, filed July 10, 2018, entitled "Delivery Apparatus for a Vascular Access Device," which is incorporated herein by reference in its entirety. In some embodiments, the guide feature may include an advancement tab 119 configured to be actuated by a user's hand.

[0075] In some embodiments, the delivery device 146 may include a guidewire 48 disposed within the housing 50 and extending through the guide feature. For example, in some embodiments, the guidewire 48 may extend through a channel. In some embodiments, in response to distal movement of the guide feature along the slot 56 a first distance, the distal end 60 of the guidewire 48 may be advanced distally a second distance, which may be greater than the first distance. In some embodiments, the second distance may be twice the first distance.

[0076] In some embodiments, the proximal end 58 of the guidewire 48 may be stationary relative to the housing 50. In some embodiments, the proximal end 58 may be fixed within the housing 50. In some embodiments, the distal end 60 may be advanced distally beyond the distal end of the housing 50 in response to the guide feature being advanced partially and / or fully distally along the slot 56. In these and other embodiments, the housing 50 may include an extension tube 40 that may extend outwardly from a distal portion of the housing 50 and may be coupled to a blood collection device.

[0077] 10A-10B, in some embodiments, the delivery device 146 may include a tube 102 that may extend from and be coupled to a hub 115. In some embodiments, in response to distal movement of the guide feature along the slot 56, the guidewire 48 may move through the tube 102. In some embodiments, in response to distal movement of the guide feature along the slot 56 a first distance, the distal end 106 of the tube 102 may be advanced distally a distance equal to the first distance (a "1:1 advance ratio"), while the distal end 60 of the guidewire 48 may be advanced a distance greater than the first distance, such as, for example, twice the first distance (a "1:2 advance ratio"). In some embodiments, when the guidewire 48 and the tube 102 are fully advanced, the distal end 60 of the guidewire 48 may be distal to the distal tip 70 of the catheter 24. In these and other embodiments, the distal end 60 of the tube 102 may be positioned distal to the distal tip 70 of the catheter 24, may be positioned even with the distal tip 70 of the catheter 24, or may be positioned proximal to the distal tip 70 of the catheter 24.

[0078] In some embodiments, the septum 65 may be disposed at various locations within the distal end of the delivery device 146. For example, as illustrated in FIGS. 9A-9B, the septum 65 may be disposed proximal to the attachment point of the extension tube 40 and / or distal to the distal end of the slot 56. For example, as illustrated in FIGS. 10A-10B, the septum 65 may be disposed within the distal end of the housing 50 or a connector coupled to the distal end of the housing 50. In some embodiments, the septum 65 may be disposed within the hub 115, for example, as illustrated in FIG. 10C. In some embodiments, the extension tube 40 may extend proximally from the hub 115 and / or through the proximal end of the housing 50, as illustrated in FIG. 10C.

[0079] All examples and conditional language described herein are for educational purposes to aid the reader in understanding the invention and the concepts the inventor has contributed to further the art, and are to be construed as being limited to such specifically described examples and conditions. Although embodiments of the invention have been described in detail, it should be understood that various changes, substitutions, and alterations may be made herein without departing from the spirit and scope of the invention. It should be understood that any of the delivery device and / or one or more included components may be combined with one or more components of the catheter assembly described in this disclosure. It should be understood that one or more components of a particular delivery device may be combined with one or more components of another particular delivery device. For example, any fluid-permeable structure described with respect to a particular delivery device may be combined with one or more components of another particular delivery device.

Claims

1. 1. A delivery device for delivering an instrument through an intravenous catheter assembly, comprising: a housing having a slot formed therein extending along a length of the housing; An instrument configured to be advanced distally from the housing, the instrument comprising: a tube; a guidewire disposed within the tube and movable within the tube, the guidewire having a proximal end and a distal end, the distal end of the guidewire comprising a fluid permeable structure comprising an elongated core and a coil extending around and coupled to the elongated core, the fluid permeable structure configured to extend beyond a distal end of a catheter of the intravenous catheter assembly, the fluid permeable structure being positionable to extend distally beyond the tube; a hub disposed within the housing and extending through the slot, the hub configured to move along the slot to advance the guidewire and the tube distally and distal to a distal end of the housing; A delivery device comprising:

2. the hub comprises a guidewire hub, a proximal end of the guidewire is secured to the guidewire hub, and the guidewire is movable distally of the guidewire hub as the guidewire hub moves distally along the slot; 2. The delivery device of claim 1, further comprising a tube hub disposed within the housing and extending along the slot, a proximal end of the tube being secured to the tube hub, and the tube being movable in a forward distal direction as the tube hub moves along the slot.

3. The delivery device of claim 2 , wherein the tube hub is located distally from the guidewire hub, and the guidewire extends through the tube hub and into the tube.

4. 2. The delivery device of claim 1, wherein both the guidewire and the tube are secured to the hub, and the hub is configured to move distally along the slot to simultaneously advance the guidewire and the tube distally and to a distal end of the housing.

5. The delivery device of claim 4 , wherein the hub includes a U-shaped channel formed therethrough through which the guidewire is passed.

6. 5. The delivery device of claim 4, wherein in response to distal movement of the hub along the slot a first distance, the tube advances distally a distance equal to the first distance and the guidewire advances a second distance greater than the first distance.

7. The delivery device of claim 1 , wherein the instrument has a rounded distal tip.

8. The delivery device of claim 1 , wherein the coil is secured to the elongate core at multiple locations along the length of the elongate core.

9. The delivery device of claim 1 , wherein the spacing between the rings of the coil is uniform or varies.

10. The delivery device of claim 1 , wherein the elongate core includes a first portion having a first outer diameter and a second portion having a second outer diameter.

11. The delivery device of claim 1 , wherein the coil comprises a distal end and a proximal end, the distal end of the coil being disposed distal to the distal end of the elongate core.

12. The delivery device of claim 11 , wherein the distal end of the coil is open or closed.

13. The delivery device of claim 1 , wherein the distal end of the housing comprises a connector, and the distal end of the housing or the connector comprises a septum to prevent fluid from entering the distal end of the housing.

14. 1. A catheter system comprising: An apparatus comprising: A tube and a guidewire disposed within the tube and movable within the tube, the guidewire having a proximal end and a distal end, the distal end of the guidewire comprising a fluid permeable structure comprising an elongated core and a coil extending around and coupled to the elongated core, the fluid permeable structure configured to extend beyond a distal end of a catheter of the intravenous catheter assembly, the guidewire positionable such that the fluid permeable structure extends distally beyond the tube; 1. A catheter assembly comprising: a catheter assembly comprising a catheter adapter having a distal end and a proximal end and a lumen extending between the distal end and the proximal end; a catheter assembly comprising: a catheter secured to the catheter adapter and extending distally from the catheter adapter, the catheter having a distal end and a proximal end; a delivery device coupled to the catheter assembly, the delivery device comprising: a housing movably disposed within the instrument, the housing having a blood collection path of the catheter system not extending through the housing; a delivery device comprising: a hub disposed within the housing and extending through a slot formed in the housing, the hub configured to move along the slot to advance the guidewire and the tube in a distal direction and distal to a distal end of the housing; A catheter system comprising:

15. the hub comprises a guidewire hub, a proximal end of the guidewire is secured to the guidewire hub, and the guidewire is movable distally of the guidewire hub as the guidewire hub moves distally along the slot; 15. The catheter system of claim 14, wherein the delivery device further comprises a tube hub disposed within the housing and extending along the slot, a proximal end of the tube being secured to the tube hub, and the tube being movable in a forward distal direction as the tube hub moves along the slot.

16. 16. The catheter system of claim 15, wherein the tube hub is located distally from the guidewire hub, and the guidewire extends through the tube hub and into the tube.

17. 15. The catheter system of claim 14, wherein both the guidewire and the tube are secured to the hub, and the hub is configured to move distally along the slot to simultaneously advance the guidewire and the tube distally and to a distal end of the housing.

18. 18. The catheter system of claim 17, wherein the hub includes a U-shaped channel formed therethrough through which the guidewire is threaded, and in response to distal movement of the hub along the slot a first distance, the tube advances distally a distance equal to the first distance and the guidewire advances a second distance greater than the first distance.

19. 15. The catheter system of claim 14, wherein the fluid permeable structure is configured such that the coil has a distal end and a proximal end, the distal end of the coil and the distal end of the elongate core being disposed distally relative to the distal end of the catheter.

20. 15. The catheter system of claim 14, further comprising a gap between an outer diameter of the device and an inner diameter of the catheter.

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