Balloon anchoring guide catheter extension

Abstract

To provide a device for selectively securing one or more medical devices within and around a guide catheter extension, and a method of using the same.SOLUTION: The guide catheter extension comprises a push member having a proximal end and a distal end, a tube frame coupled to the distal end of the push member, the tube frame defining a lumen having a diameter sufficient to receive an interventional vascular device therethrough, and an expandable element coupled to the tube frame and expandable into the lumen.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present disclosure relates to a system for capturing or securing an intravascular device and a method of using the same. Regarding. [Background technology]

[0002] In coronary artery disease, the coronary arteries become narrowed or blocked by atherosclerotic plaque or other lesions. These lesions may completely block the lumen of the artery or may only partially block the lumen of the artery. Diagnosis and treatment of obstructive coronary artery disease usually requires a guidewire or other interventional device through and across a blockage or stenosis in a coronary artery; It is necessary to move forward with this.

[0003] Percutaneous coronary intervention (PCI), also known as coronary angioplasty, is a procedure that Treating narrowed or stenosed sections of the heart's coronary arteries caused by disease or blockage of the arteries Guide catheters are used as a treatment tool for PCI. Another catheter or interventional device, such as a catheter, stent, or balloon, is inserted into the target site. It can be used to assist easier passage for access. The catheter can be inserted through the aorta into the ostium of the coronary artery. Once seated in the ostium or stoma, a guidewire or other instrument may be inserted through the lumen of the guide catheter. The catheter can be inserted through the catheter and then into the artery distal to the occlusion or stenosis. .

[0004] However, guide catheters can encounter certain difficulties. The anatomy of the coronary vasculature can be tortuous, and the lesion itself is relatively Furthermore, the patient may not be compliant and may be unable to move through relatively non-compliant lesions. When the catheter is advanced, a rearward force sufficient to push the guide catheter out of the ostium of the artery being treated is applied. To improve backup support, the guide catheter The extension device can be used to extend one or more treatment devices within and around the stenotic area. In some cases, this may facilitate placement and access of the catheter.

[0005] For example, when treating a chronic total occlusion ("CTO"), a given technique involves multiple devices. The CTO is approached from both the antegrade and retrograde directions using these techniques. or other similar procedures, within the guide catheter and guide catheter extension device. and multiple devices around these for CTO or other physiological conditions / areas This disclosure provides a method for such procedures, including routing and controlling the selectively fixating one or more medical devices within and around the guide catheter extension; The present invention provides a device for determining the presence of a marker and a method for using the same. Summary of the Invention

[0006] Advantageously, the present invention comprises a pusher member having a proximal end and a distal end, and a pressure sensor connected to the distal end of the pusher member. a tubular frame adapted to receive an interventional vascular device therethrough; a tube frame defining a lumen having a diameter of 10 mm; and an expandable element coupled to the tube frame. and an inflatable element that is expandable into the lumen. The catheter extension is provided. The expandable element occupies 10% to 90% of the cross-sectional area of ​​the lumen. The expandable element may be expandable to occupy the outer surface of the tube frame. The tube frame may be configured to have an internal expansion element through which the expansion element extends. The push member may define a window that is extendable outwardly beyond the outer surface of the tube frame. The expandable element may include an inflation lumen in fluid communication with the interior of the expandable element. At least a portion of the tube frame defines an arcuate cross section having a radius of curvature equal to the radius of the lumen of the tube frame. The guide catheter extension may be a tandem extending from the proximal segment of the tube frame. The pusher may include a tongue element directly connected to a distal region of the pusher member. Good too.

[0007] a pusher member having a proximal end and a distal end; and a tube frame coupled to the distal end of the pusher member. a lumen having a diameter sufficient to receive an interventional vascular device through the tubular frame; a tube frame; and a first inflatable element coupled to the tube frame, a first expandable element expandable into the lumen; and a second expandable element coupled to the tubular frame. two expandable elements that are expandable outwardly beyond the outer surface of the tube frame; and a first inflatable element. The ment may be expandable to occupy 10% to 90% of the cross-sectional area of ​​the lumen. The first and second inflatable elements may be independently expandable. The first inflatable element may include a first inflation lumen in fluid communication with the interior of the first inflatable element. At least a portion of the inflation lumen has a radius of curvature equal to the radius of the lumen of the tube frame. The pusher member may define an arcuate cross section having a diameter of about 1 / 2 mm. It may include a communicating second inflation lumen.

[0008] a pusher member having a proximal end and a distal end; and a tube frame coupled to the distal end of the pusher member. a lumen having a diameter sufficient to receive an interventional vascular device through the tubular frame; and an expandable element movably coupled to the pusher member, the expandable element defining a tube frame. The inflatable element extends along the longitudinal axis of the pusher member, providing a guide catheter extension. The expansile element may be coaxially mounted on the pusher member. The guide catheter extension may include an inflation loop in fluid communication with the interior of the inflatable element. The inflatable element may include an inflation lumen, the inflation lumen being coaxial with the pusher member. It may be expandable to a size of 10% to 90% of the cross-sectional area of ​​the lumen of the tubular frame.

[0009] A more complete understanding of the present disclosure and its attendant advantages and features is provided in the following detailed description. The present invention will be more readily understood with reference to the following description when considered in conjunction with the accompanying drawings. [Brief explanation of the drawings]

[0010] [Figure 1] 1 illustrates an example of a vascular device constructed in accordance with the principles of the present disclosure. [Figure 2] FIG. 2 is a side view of the device shown in FIG. 1. [Figure 3] FIG. 2 is a proximal perspective view of the device shown in FIG. 1. [Figure 4] FIG. 2 is a distal perspective view of the device shown in FIG. 1. [Figure 5] FIG. 2 is a proximal end view of the device shown in FIG. 1. [Figure 6] FIG. 2 is a distal end view of the device shown in FIG. 1. [Figure 7] 1 illustrates another example of a vascular device constructed in accordance with the principles of the present disclosure. [Figure 8] FIG. 8 is a more detailed side view of the device shown in FIG. 7. [Figure 9] FIG. 8 is a bottom view of the device shown in FIG. 7. [Figure 10] FIG. 8 is a distal perspective view of the device shown in FIG. 7. [Figure 11] FIG. 8 is an additional distal perspective view of the device shown in FIG. 7. [Figure 12] FIG. 8 is a proximal perspective view of the device shown in FIG. 7. [Figure 13] 1 illustrates an example of a method of use for a vascular device constructed in accordance with the principles of the present disclosure. [Figure 14] FIG. 14 is a side view of the device shown in FIG. 13. [Figure 15] FIG. 14 is a more detailed side view of the device shown in FIG. 13. [Figure 16] FIG. 14 is a proximal end view of the device shown in FIG. 13. [Figure 17] FIG. 14 is a distal end view of the device shown in FIG. 13. [Figure 18] FIG. 14 is a longitudinal cross-sectional view of the device shown in FIG. [Figure 19] 1 illustrates another example of a vascular device constructed in accordance with the principles of the present disclosure. [Figure 20] FIG. 20 is a cross-sectional view of the expandable element of the device shown in FIG. 19. DETAILED DESCRIPTION OF THE INVENTION

[0011] The present disclosure provides, for example, May include securing or capturing a guidewire or other minimally invasive intravascular device , a system for capturing and / or anchoring an intravascular device within an anatomical structure, device The present invention provides a method for the evaluation and / or treatment of chronic total occlusions. Treatments include, for example, CART, reverse CART, and multiple device-based antegrade and The device allows for both retrograde and retrograde approach to the CTO and holds these devices in place during use. Other techniques may be included that involve the desire to capture or immobilize.

[0012] Referring now to the drawings, a method for assessing and / or treating an obstruction or other vascular disorder or condition is provided. During a medical procedure to treat, one or more guidewires and / or other minimal A guide catheter extension that can be used to secure or capture an invasive intravascular device. An example of an intravascular device in the form of a guide catheter extension 1000 is shown. 000 passes through and extends distally from the guide catheter "GC" described herein. The guide catheter extension 1000 is generally sized and configured to extend distally. The guide catheter includes a pusher member 1001 coupled to a tube frame 1005 and configured to push the guide catheter in use. The proximal region of the catheter extension 1000 (such as the proximal end or the hub of a separate guide catheter) ) accessible to the patient or positioned outside the patient, while the guide catheter The distal region of the distal extension 1000 is positioned within the patient's anatomy. It may be long enough to extend distally outward from the end of the catheter.

[0013] The pushing member 1001 may be, for example, a hypotube, a spiral cut hypotube, or the like. tubes, multi-threaded cables, intermittent spiral cut tubes, other cut geometry It may include one or more segments of a reed / shape or other elongated member, and the internal into and / or through one or more wires, devices, fluid delivery and / or one or more lumens 1002 for passage of fluid, e.g., aspiration, or the like; may include:

[0014] The pusher member 1001 is configured to reduce the amount of space that the pusher member 1001 occupies within the guide catheter. This allows one or more other devices, instruments, etc. to minimize the risk of the guide catheter The inner diameter or clearance of the guide catheter may be adjusted to allow passage through obstructions or occlusions. For example, the pusher member 10 may include a smaller diameter or cross-sectional profile than the pusher member 10. 01 is for gas pipes with an inner diameter of 1.1016 to 30.48 mm (0.04 to 1.20 inches). For use in guide catheters, from about 0.254 mm (0.010 inches) to about 2 In one preferred example, the diameter or cross-sectional width is 0.54 mm (0.100 inches). In this case, the pushing member 1001 has a length of about 0.254 mm (0.010 inches) to about 0.762 mm. The pusher member 1001 may have a diameter or cross-sectional width of 0.030 inches. Along its length, it may have circular, semicircular, square, rectangular, triangular and / or oval shapes or refers to one or more cross-sectional shapes or profiles, including but not limited to profiles Additionally and / or alternatively, the pusher member 1001 may include one or Alternatively, multiple cut patterns may be included in multiple sections.

[0015] The pusher member 1001 has an overall length that constitutes the majority of the length of the guide catheter extension 1000. The length of the pusher member 1001 may be determined by the length of the incision or patient access point ( For example, the device may include a hub, a hemostatic valve, and the like, and enter the patient's blood vessel. The system is passed through the pusher member 1001, and a portion of the pusher member 1001 remains outside the patient for access by the physician. aligning the tube frame 1005 proximate to the desired treatment site while it is operable / operable; The length may vary depending on the particular procedure or application being performed and and / or the vascular access point utilized (e.g., radial, femoral, etc.) (whether arterial, contralateral access, or similar) The pusher member and / or other proximal portions of the guide catheter extension 1000 may be may include a stop feature to prevent the extension 1000 from being inserted too far into the guide catheter. For example, the guide catheter extension 1000 may be To mechanically prevent overinsertion of the guide catheter, hemostatic valve, and / or proximal Contains raised protrusions, welds or other masses that exceed the diameter or size of the device hub Good too.

[0016] The tubular frame 1005 has an outer wall 1007 and a tubular frame 1008 sufficient to receive an interventional vascular device therethrough. An inner wall 100 surrounding a lumen 1008 having a diameter, a proximal end 1012 and a distal end 1013. 6. The tube frame 1005 includes a plurality of chambers 1006 therein. The dot patterns 1015 and 1016 are the same as those of the tube frame. This shows two possible embodiments of various cut patterns that can exist in the system. (Not too much).

[0017] The tube frame 1005 may be constructed from nitinol or stainless steel. For example, the tube frame may be made of metal, polymer, or a combination of polymer and metal. Examples of materials that can be used are stainless steel (SST), nickel titanium, Other preferred examples of metals that may be used include nitinol or polymers. is superelastic nickel titanium, shape memory nickel titanium, Ti-Ni, nickel titanium, about 55~60wt%Ni, Ni-Ti-Hf, Ni-Ti-Pd, Ni-Mn-Ga, 30 SAE in 0-400 series, e.g. 304, 316, 402, 440 series Grade stainless steel (SST), MP35N, and 17-7 precipitation hardening (PH) stainless steel stainless steel, other spring steel, or other high tensile strength material, or other biocompatible metallic material. In a preferred embodiment, the material is superelastic or shape memory (e.g., nickel). In another preferred embodiment, the material is stainless steel.

[0018] The tube frame 1005 is made of a superelastic alloy (generally referred to as a "shape memory alloy") throughout its length. Such superelastic alloys can be included in the body or in selected parts thereof. Examples include Elgiloy® and Phynox®, spring alloys, SA E-grade 316 stainless steel and MP35N (nickel-cobalt), and superelastic Contains Nitinol.

[0019] Alternatively, the tube frame may be made of, for example, polyimide, PEEK, nylon, polyurethane. , polyethylene terephthalate (PET), latex, HDHMWPE (high density polymer polyethylene), and thermoplastic elastomers, or other polyethylenes with similar mechanical properties. The polymer may be formed from a polymer, including a polymer.

[0020] The tube frame 1005 is formed from a pipe of superelastic metal, which is then formed with notches or holes. This may be made by removing the pipe section to be cut. laser (e.g., solid-state femtosecond laser, or YAG laser), electrical discharge (electrical discharge machining) (EDM), chemical etching, photoetching, mechanical cutting, or any of these techniques Any combination can be used to form the pipe.

[0021] A portion of the tube frame 1005 may have a polymer liner, and / or The outer wall of the tube frame 1005 may be covered (completely, partially, and / or intermittently) with an outer jacket. It is possible to cover the area (potentially).

[0022] The tube frame 1005 includes a tang element extending from a proximal end 1012 of the tube frame 1005. The tongue element 1017 is connected to the push member 1001. The tongue element 1017 may be integral with the tube frame 1005 and may be attached to the tube frame. The distal end of the tongue element 1017 may be formed from the same material composition as the arm 1005. The end or distal region may be aligned distal to the proximal opening of the tube frame 1005. , while the proximal end or proximal region of the tongue element 1017 is It extends proximally beyond the proximal opening.

[0023] The proximal end 1012 of the tube frame 1005 is connected to the tube frame 1005 and the guide catheter GC 1019 includes a flare or flange that can be used to close or reduce the gap between That's fine.

[0024] The guide car includes a pusher member 1001, a distal tube frame 1005, and other components. Additional features and characteristics of the catheter extension 1000 are described in the "GUIDE CATHETER U.S. Patent Application No. 62 / 729,288 entitled "EXTENSION PLATFORM" No. 2, which is incorporated by reference in its entirety.

[0025] The guide catheter extension 1000 is aligned within the lumen 1008 of the distal tube frame. The inflatable element(s) 1020 may include one or more expandable elements 1020. The inflatable element 1020 may be one or more balloons, bladders, or other inflatable devices having a fluid therein. It may also include other components that are expandable upon introduction. They may be formed in a variety of shapes and may be symmetrical, asymmetrical or otherwise contoured, or The expansile element(s) 1020 may include any geometric shape. For example, it may be constructed from silicone, nylon, Pebax and / or other polymers. Compliant and / or non-compliant surfaces and / or components The component may also include:

[0026] In the example shown in FIGS. 1-6, the inflatable element 1020 is located on or in the interior wall 1006. The inflatable element is disposed therearound towards the distal end 1013 of the tube frame 1005. The distal end 1020 is positioned to expand within the lumen 1008 of the distal tube frame 1005. Thus, the expandable element 1020 is Even if it is glued onto the inner wall 1006 of the tube frame, it is not directly aligned on the inner wall 1006. This may be done.

[0027] In the example shown in FIGS. 7-12, the inflatable element 1020 is disposed on or above the inner wall 1006. is disposed therearound toward the distal end 1013 of the tube frame 1005 and includes an inflatable The element 1020 is inserted into the lumen 1008 of the distal tube frame 1005 and into the guide catheter. into the space between the outer guide catheter GC and the outer extension 1000 surrounding it. It is positioned and operable to be extended. To accommodate this, a portion of the wall of the distal tube frame 1005 is formed so that the expandable element 1020 is It can be expanded both in and out of the guide catheter GC. The glass may be cut to form windows or spaces that allow access.

[0028] The inflatable element 1020 is inserted into the lumen 1008 and directly into the tubular frame 1005 . Between the guide catheter extension 1000 and the guide catheter GC from the outside of the diameter or outer wall Alternatively, the casing may include a single internal cavity for extending both into the space above and below the casing. The expandable element 1020 extends into the lumen 1008. 1005. The portion of the tube frame 1005 that extends outside the diameter or outer wall of the tube frame 1005 is an expansive element. The inflatable portion 1020 is independently inflatable so that it can be controlled and expanded independently and separately from the inflatable portion 1020. The expandable element 10 may include multiple internal cavities and / or reservoirs. The separate sections of 20 may have independent inflation lumens to provide independent operation. In another example, separate inflation may be provided within the lumen 1008 and outside the tubular frame 1005. To provide this, multiple separate inflatable elements may be used.

[0029] In use, the inflatable element 1020 is configured such that the inflatable element is generally flat, planar, and / or From an otherwise unexpanded first state, the expandable element 1020 is expanded to expand the distal tube. The diameter of the frame lumen 1008 is the cross section of any device passing through the lumen 1008. and can transition to a second state in which it expands to occupy a substantial portion of the surface area, but less than the surface area. For example, the expanded expansile element may be approximately 10% of the cross-sectional area of ​​the lumen 1008. % to about 90% of the expansion capacity required for a particular procedure. The expansion of the lumen 1008 may be due to the presence of an auxiliary device that the physician wishes to trap or secure within the lumen 1008. The number and size of the devices may vary depending on the size of the device. If so, a larger expansion of the expansible element 1020 may be used. To secure multiple devices with large cross-sectional areas within the lumen 1008, an inflatable element may be used. A smaller amount of expansion of the expansible element 1020 is required. and / or compatibility to accommodate the varying sizes of devices secured within lumen 1008. may vary along the longitudinal length of the expansile element 1020 (e.g., One or more of the devices to be tested has a cross section or geometry that varies along its length. (if it has dimensions).

[0030] A portion of the expandable element 1020 is connected to the guide catheter GC and the guide catheter extension. In one example, the expansile element 1020 expands outward into the space between the As described in detail herein, the guide catheter GC and the guide catheter extension 1000 may be expanded to substantially fill the cross-sectional space between them.

[0031] The expandable element 1020 is in fluid communication with the lumen 1002 of the pusher member 1001. This involves adding an inflation medium (e.g., air, saline, distilled water, or other) to the inflation engine. The expansile element 1020 may be used as a channel for introducing the expansile element 1020. The pusher 1020 may be directly coupled to the pusher member 1001 or may be directly coupled to the distal tube frame 1002. 005 and extends outward to connect proximally to the push member 1001. , and an intermediate inflation spout or channel that also distally couples with the inflation element 1020. In the illustrated example, the intermediate expansion The channel 1021 defines the working diameter of the lumen 1008 and consequently the access to other devices or instruments. Low cross-section plates are used to avoid substantially obstructing or reducing the ability of tools to pass through. The tube frame 1005 has a profile and a curvature complementary to that of the lumen 1008. A portion of the wall thickness of the To further avoid substantially obstructing or reducing the working diameter of the slit 1008, the groove may be reduced to form

[0032] The expansile element(s) 1020 are expanded by introducing a fluid therein. The fluid may be injected into the proximal hub or injection port on the guide catheter extension 1000. An inlet port (not shown) may be provided. The controllable expansion of the expansible element 1020 , pumps, syringes, media cartridges, or other fluid introduction mechanisms used in vascular surgery and may be facilitated by one or more sensors, medical imaging modalities or the like. The monitoring may be via the like.

[0033] In one use, the guide catheter extension 1000 may be inserted into one or more vessels within the patient's vasculature. It may be used to capture and secure multiple auxiliary devices, for example, to repair a CTO. When treating a vascular endovascular aorta, certain techniques utilize multiple devices to perform endovascular treatment in both antegrade and retrograde directions. In the CART technique, the guidewire is advanced antegrade toward the CTO lesion. At the same time, a retrograde balloon device is used to crack or open the CTO lesion. In the reverse CART technique, a guidewire is retrogradely approached distal to the lesion. During this time, subintimal fissure creation is performed with an antegrade balloon at the proximal part of the CTO lesion. or multiple device interventions in and around a CTO or other physiological condition / area. In any other procedure involving a catheter, the guide catheter extension 1000 may It may be used to secure the distal end of the auxiliary device(s) to be attached. The guide catheter extension 1000 is used to insert a retrograde balloon device in the CART technique, and and / or a retrograde guidewire in a reverse CART technique. One or more device portions in the antegrade and / or retrograde regions of the CTO. It may be desirable to capture

[0034] 13-18 illustrate a plurality of auxiliary devices 1022a, 1022b, 1022c (collectively In addition, the "auxiliary device 1022" is at least partially embedded in the internal lumen of the distal tube frame 1005. by an inflatable element 1020 aligned and expanded within the member 1008 The example shown shows a type of use where the tube is fixed in place. Extending auxiliary device 1022 is shown, but is not limited to antegrade and / or distal tube frame. The length and position of the retrograde assist device 1022 may be adjusted to accommodate these devices in the lumen. The auxiliary device 1022 and the expandable element 1022 overlap enough to be secured within the expandable element 1022. 0. The inflatable element 1020 may be attached to the distal tube frame. 1005 and the external guide catheter GC and guide catheter extension 1000 In embodiments where the expandable element 1020 expands into the space between the The relative positioning of the auxiliary device 1022 within the cavity 1008, as well as the guide catheter To ensure the relative alignment of the guide catheter extension 1000 within the catheter GC Guarantees both.

[0035] The relatively distal location of the inflatable element 1020 allows the physician to The auxiliary device 1001 required to advance the device into the guide catheter extension 1000 Minimize and / or shorten the length of the 022 to allow capture and This eliminates the need to incorporate the chair 1022 further proximally into the outer guide catheter GC itself. This prevents other devices from becoming trapped inside the GC. The steering and navigation required by the physician to secure the auxiliary device 1022 is The impact is reduced.

[0036] In another example, the device 1000 includes a push member 100 as shown in FIGS. 1. This example device may include an expandable element 1020 aligned on the 000 indicates that the fixing location is not inside the tube frame 1005 but inside the tube frame 100 5, one or more auxiliary devices 1022 may be secured in the same manner as described above. In the illustrated example, the expansile element 1020 is so that it can move proximally and distally along the length of the longitudinal axis of the member 1001. , may be slidably mounted or coupled to the pusher member 1001. For example, an expansive element The pusher 1020 is coaxially and / or axially mounted on the pusher member 1001 to provide slidable movement. Alternatively, it may be attached to a concentrically mounted shaft 1030. Shaft 1030 may include one or more variable length tubes along its length, and One or more portions of the element 1020 may be connected to the shaft 10 at one or more joints. 30. The shaft may have one or more inflation lumens 1032 therein. The lumen(s) 1032 may include or define the shaft 103 10. One or more segments of an inner diameter of 0.0, one or more segments aligned within shaft 1030. Multiple tubes and / or fluid paths into the interior of the expandable element 1020 1001。 The shaft 1030 and the pusher member 1001 may include one or more spaces. The inflation lumen(s) 1032 may be configured to accommodate the device, as described herein. The proximal end or hub of the tube 1000 may be attached to an inflation source.

[0037] It is intended that the present disclosure be limited to what has been particularly shown and described hereinabove. It will be understood by those skilled in the art that this is not the case. Furthermore, although previously stated to the contrary, It should be noted that all accompanying drawings are not to scale unless otherwise indicated. The stem components are readily apparent to one of ordinary skill in the art having the benefit of the description herein. Where appropriate, the following descriptions are provided to avoid obscuring the disclosure with obvious details that may be relevant to an understanding of the embodiments of the disclosure. The drawings are represented by conventional symbols that show only certain details of the series. Any particular embodiment or illustration described in this document may be expressly shown in any other illustration or embodiment. Although some features may be shown, the features and components of the examples disclosed herein may be different from those shown. are not necessarily mutually exclusive and, therefore, would fall outside the scope and spirit of the present disclosure. It is understood that the above may be included in various different combinations or configurations. In view of the teachings of the present application, the scope and spirit of the present disclosure should be limited only by the appended claims. Many changes and modifications are possible without departing from God.

Claims

1. a pusher member having a proximal end and a distal end; a tube frame coupled to the distal end of the pusher member, through which an intervention blood vessel is passed; a vascular frame defining a lumen having a diameter sufficient to receive a vascular device; an expandable element coupled to the tube frame and expandable into the lumen; an expansive element, A guide catheter extension comprising:

2. The expandable element expands to occupy 10% to 90% of the cross-sectional area of ​​the lumen. The guide catheter extension of claim 1 , wherein the guide catheter extension is extendable.

3. the expandable element is expandable outwardly beyond the outer surface of the tube frame. Item 2. A guide catheter extension according to item 1.

4. The tube frame has an internal structure through which the expansion element is inserted.

4. The guide catheter extension of claim 3, wherein the guide catheter extension defines a fenestration that is expandable outwardly beyond the surface. Department.

5. the pusher member includes an inflation lumen in fluid communication with the interior of the inflatable element.

2. The guide catheter extension of claim 1.

6. At least a portion of the inflation lumen has a radius equal to the radius of the lumen of the tubular frame.

6. The guide catheter extension of claim 5, wherein the guide catheter extension defines an arcuate cross section having a small radius of curvature.

7. a tang element extending from the proximal segment of the tube frame; The gas turbine of claim 1 , wherein the tongue element is directly connected to a distal region of the pusher member. Iodine catheter extension.

8. a pusher member having a proximal end and a distal end; a tube frame coupled to the distal end of the pusher member, through which an intervention blood vessel is passed; a vascular frame defining a lumen having a diameter sufficient to receive a vascular device; a first expandable element coupled to the tubular frame and extending into the lumen; a first inflatable element, the first inflatable element being expandable; a second expansile element coupled to the tube frame and extending from an outer surface of the tube frame; a second inflatable element that is expandable outwardly beyond the 1. A guide catheter extension comprising:

9. The first inflatable element is configured to occupy 10% to 90% of the cross-sectional area of ​​the lumen.

9. The guide catheter extension of claim 8, wherein the guide catheter extension is expandable as follows:

10. 9. The method of claim 8, wherein the first and second inflatable elements are independently expandable. Guide catheter extension.

11. The pusher member has a first inflation lumen in fluid communication with the interior of the first inflatable element. The guide catheter extension of claim 8 , including a guide catheter extension.

12. At least a portion of the first inflation lumen has a radius equal to the radius of the lumen of the tubular frame.

12. The guide catheter extension of claim 11, wherein the guide catheter extension defines an arcuate cross section having a radius of curvature equal to Long section.

13. The pusher member has a second inflation lumen in fluid communication with the interior of the second inflatable element. The guide catheter extension of claim 11 , including a guide catheter extension.

14. a pusher member having a proximal end and a distal end; a tube frame coupled to the distal end of the pusher member, through which an intervention blood vessel is passed; a vascular frame defining a lumen having a diameter sufficient to receive a vascular device; an expandable element movably coupled to the pusher member; 1. A guide catheter extension comprising:

15. the inflatable element is movable along the longitudinal axis of the pusher member.

15. The guide catheter extension of claim 14.

16. 15. The method of claim 14, wherein the inflatable element is coaxially mounted on the pusher member. The guide catheter extension is shown.

17. further comprising an inflation lumen in fluid communication with the interior of the inflatable element, 17. The guide catheter extension of claim 16, wherein the pusher member is coaxial with the pusher member.

18. The expandable element has a cross-sectional area of ​​10% to 90% of the cross-sectional area of ​​the lumen of the tubular frame.

15. The guide catheter extension of claim 14, expandable to a size.

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