Guide catheter

Abstract

The catheter system may include a guide catheter having a proximal end, a distal end, an inner liner, a braid surrounding the inner liner, and a jacket surrounding the braid. The catheter system may include a guide extension catheter having a guide extension wire and a tubular body, the tubular body of the guide extension catheter having a proximal end, a distal end, an inner liner, a coil surrounding the inner liner, and a jacket surrounding the coil. The guide catheter may be configured to receive the tubular body of the guide extension catheter. The inner diameter of the guide catheter decreases in the proximal direction and the outer diameter of the tubular body increases in the distal direction. The inner diameter at the proximal most portion of the guide catheter is smaller than the outer diameter at the distal most portion of the tubular body.

Description

[Technical Field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Provisional Patent Application No. 63 / 481,598, entitled "GUIDE CATHETER," filed January 25, 2023, which is hereby incorporated by reference in its entirety.

[0002] The present invention relates generally to guiding extension catheters and / or guiding catheters that include varying outer and / or inner diameters. The guiding extension catheters and / or guiding catheters may be used in cardiovascular surgery. [Background technology]

[0003] The embodiments described herein relate to a catheter system. The catheter system may include a guiding catheter and a telescoping guiding extension catheter. In catheters, lumen space is at a premium, deployment into a vessel is a delicate endeavor for safety reasons, and the time to deployment may have severe safety and economic consequences. In current applications, the guiding extension catheter is typically a separate device that is inserted into the guiding catheter during a procedure at the physician's option. The current use of guiding extension catheters can be cumbersome and time-consuming for the physician, and may not be optimal for lumen space. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] PCT / US2022 / 074029 Summary of the Invention [Problem to be solved by the invention]

[0005] The catheter system embodiments disclosed herein address these and other issues, thereby significantly improving upon these limitations. [Means for solving the problem]

[0006] In certain aspects, the technology described herein relates to a catheter system for cardiovascular procedures, which may include a guiding catheter having a proximal end, a distal end, an inner liner, a braid surrounding the inner liner, and a jacket surrounding the braid, and a telescoping guiding extension catheter having a guiding extension wire and a tubular body, the tubular body of the telescoping guiding extension catheter having a proximal end, a distal end, an inner liner, a coil surrounding the inner liner, and a jacket surrounding the coil, the guiding catheter configured to receive the tubular body of the telescoping guiding extension catheter, wherein the inner diameter of the guiding catheter decreases in a proximal direction and the outer diameter of the tubular body increases in a distal direction, and the inner diameter of the guiding catheter at its most proximal end is smaller than the outer diameter of the tubular body at its most distal end.

[0007] The catheter system of any of the previous paragraphs and / or any of the catheter systems disclosed herein can include one or more of the following features. In certain embodiments, the distal end of the tubular body can be configured to extend beyond the distal end of the guide catheter. The tubular body can include multiple sections, each of the multiple sections including a durometer rating, the durometer rating of each of the multiple sections decreasing distally. In some cases, the inner portion of the guiding extension wire can be flush with the inner portion of the tubular body. The guiding catheter can include a marker band positioned on the distal portion of the guiding catheter. In some embodiments, the telescoping guiding extension catheter includes a marker band positioned on the tubular body. In some cases, the inner diameter of the guiding catheter at its proximal most portion can be between about 0.067 inches and about 0.077 inches, and the outer diameter of the tubular body at its distal most portion can be between about 0.068 inches and 0.078 inches. In some embodiments, the difference between the inner diameter of the guide catheter at its most proximal end and the outer diameter of the tubular body at its most distal end is between about 0.005 inches and about 0.05 inches. The outer surface of the jacket of the tubular body may comprise a hydrophilic coating. In some cases, the inner liner of the guide catheter comprises polytetrafluoroethylene (PTFE).

[0008] In one variation, the technology described herein relates to a catheter system for cardiovascular procedures. The catheter system can include a guiding catheter and a telescoping guiding extension catheter comprising a guiding extension wire and a tubular body, the guiding catheter configured to receive the tubular body of the telescoping guiding extension catheter, and the inner diameter of the guiding catheter at its proximal most portion is smaller than the outer diameter of the tubular body at its distal most portion.

[0009] The catheter system of any of the previous paragraphs and / or any of the catheter systems disclosed herein may include one or more of the following features. In some embodiments, the guide catheter may include a proximal end, a distal end, an inner liner, a braid surrounding the inner liner, and a jacket surrounding the braid. In some cases, the tubular body of the telescopic guide extension catheter may include a proximal end, a distal end, an inner liner, a coil surrounding the inner liner, and a jacket surrounding the coil. The tubular body may include multiple sections, each having a durometer rating, the durometer rating of each of the multiple sections decreasing in a distal direction. In some embodiments, the inner diameter of the guide catheter may decrease in a proximal direction. The outer diameter of the tubular body may increase in a distal direction. In some cases, the inner portion of the guide extension wire may be flush with the inner portion of the tubular body. In some embodiments, the difference between the inner diameter of the guide catheter at its most proximal point and the outer diameter of the tubular body at its most distal point can be between about 0.005 inches and about 0.05 inches. The catheter system can include a guide catheter and a guide extension catheter as shown and described herein. [Brief explanation of the drawings]

[0010] [Figure 1A] 1A-1C are diagrams of examples of guiding extension catheters. [Figure 1B] 1B is a cross-sectional view of the guiding extension catheter shown in FIG. 1A taken along line AA shown in FIG. 1A. [Figure 1C] FIG. 1C is a view of detail B from FIG. 1B. [Figure 2A] 1 is a cross-sectional view of an example guide catheter. [Figure 2B] FIG. 2B is a view of Detail A from FIG. 2A. [Figure 3A] FIG. 1 is a diagram of an example catheter system. [Figure 3B] 3B is a cross-sectional view of the catheter system shown in FIG. 3A taken along line AA shown in FIG. 3A. [Figure 3C] FIG. 3C is a view of detail B from FIG. 3B. [Figure 4A] 1 is a diagram of an example guide catheter. [Figure 4B] 1 is a diagram of an example guide catheter. [Figure 5A] 1A-1C are diagrams of examples of guiding extension catheters. [Figure 5B] FIG. 5B is a top view of the guiding extension catheter shown in FIG. 5A. [Figure 5C] FIG. 5C is a side view of the guiding extension catheter shown in FIGS. 5A and 5B. DETAILED DESCRIPTION OF THE INVENTION

[0011] The catheter system may include a guiding catheter and a guiding extension catheter. The guiding extension catheter may extend within the guiding catheter. Some of the primary benefits of the catheter system include maximizing the inner diameter (for passage of critical equipment required for the medical procedure), increased guiding support to prevent backout during the catheterization procedure, and more consistent and smooth extension and retraction of the guiding extension catheter. To maximize these benefits, the guiding catheter and guiding extension catheter may have varying wall thicknesses. The varying wall thicknesses may result in guiding catheters and guiding extension catheters of varying inner and / or outer diameters specifically designed to operate with and / or nest together. Further details of guiding catheters and guiding extension catheters including varying inner and / or outer diameters are described in connection with Figures 30A-30F of International Application No. PCT / US2022 / 074029, filed July 21, 2022 (PCT Application), which is hereby incorporated by reference in its entirety. The designs, figures, and ranges described herein may be used with 6 French catheters and systems. While reference is made to dimensions related to 6 French catheters and systems, the catheter components and systems described herein are not limited to 6 French or any particular dimensional range. Those skilled in the art can convert or scale these catheter designs and dimensions to other French sizes or sizes according to other standards.

[0012] Varying wall thicknesses of the guide catheter and / or guiding extension catheter can optimize lumen space and guiding support. For example, the tubular portions of the guide catheter and guiding extension catheter can each have a distal end, a proximal end, and multiple sections between the distal and proximal ends. In such implementations, the tubular bodies of the guide catheter and guiding extension catheter can each have a varying wall thickness throughout the length of the device. The wall thickness can result in either a varying inner diameter or a varying outer diameter of each catheter in an integrated catheter system. For example, a system can include a guide catheter with a constant outer diameter and a varying inner diameter. A system can include a guiding extension catheter with a tubular body having a constant inner diameter and a varying outer diameter.

[0013] 1A-1C show examples of guiding extension catheters. The guiding extension catheter 100 may include a tubular body 101, a proximal portion 102 including a guiding extension wire 106, and a distal portion 104 with a cylindrical braided and / or coiled section. The guiding extension catheter 100 may include a transition portion 118 that can accommodate a transition feature between the proximal portion 102 including the guiding extension wire 106 and the distal portion 104 with a cylindrical braided and / or coiled section. FIG. 1B shows a cross section of the guiding extension catheter 100 taken along line AA shown in FIG. 1A. In some cases, the guiding extension wire 106 may include a non-circular portion and a circular portion. In some cases, the guiding extension wire 106 may include a non-circular proximal portion that transitions into a circular portion before being coupled to the tubular body portion of the guiding extension catheter. The design of the tubular body is important to performance in many ways, including length, strength (radial or otherwise), pushability, lubricity, functional space, and a variety of other well-known catheter performance characteristics. The details described herein relate to the collective optimization of those factors.

[0014] 1B, the tubular body 101 of the guiding extension catheter 100 may comprise multiple segments. For example, the tubular body 101 may comprise a first segment 110a, a second segment 110b, a third segment 110c, a fourth segment 110d, and a fifth segment 110e. Although reference is made to the tubular body 101 comprising five segments, the tubular body 101 may comprise fewer or more than five segments (e.g., 1, 2, 3, 4, 6, 7, 8 segments, etc.).

[0015] The first section 110a can include a length L1 that can be less than, equal to, and / or greater than 5 cm. In some cases, the length L1 can be from 2 cm to 8 cm (about 2 cm to about 8 cm). In some cases, the length L1 can be from 2 cm to 6 cm (about 2 cm to about 6 cm), from 2 cm to 5 cm (about 2 cm to about 5 cm), from 4 cm to 8 cm (about 4 cm to about 8 cm), from 5 cm to 8 cm (about 5 cm to about 8 cm), or from 6 cm to 8 cm (about 6 cm to about 8 cm).

[0016] The second section 110b can include a length L2 that can be less than, equal to, and / or greater than 20 cm. In some cases, the length L2 can be from 10 cm to 30 cm (about 10 cm to about 30 cm). In some cases, the length L2 can be from 10 cm to 25 cm (about 10 cm to about 25 cm), from 10 cm to 20 cm (about 10 cm to about 20 cm), from 15 cm to 30 cm (about 15 cm to about 30 cm), from 20 cm to 30 cm (about 20 cm to about 30 cm), or from 25 cm to 30 cm (about 25 cm to about 30 cm).

[0017] The third section 110c can include a length L3 that can be less than, equal to, and / or greater than 10 cm. In some cases, the length L3 can be from 5 cm to 15 cm (about 5 cm to about 15 cm). In some cases, the length L3 can be from 5 cm to 12 cm (about 5 cm to about 12 cm), from 5 cm to 10 cm (about 5 cm to about 10 cm), from 8 cm to 15 cm (about 8 cm to about 15 cm), from 10 cm to 15 cm (about 10 cm to about 15 cm), or from 12 cm to 15 cm (about 12 cm to about 15 cm).

[0018] The fourth section 110d can include a length L4 that can be less than, equal to, and / or greater than 19.7 cm. In some cases, the length L4 can be from 10 cm to 30 cm (about 10 cm to about 30 cm). In some cases, the length L4 can be from 10 cm to 25 cm (about 10 cm to about 25 cm), from 10 cm to 20 cm (about 10 cm to about 20 cm), from 15 cm to 30 cm (about 15 cm to about 30 cm), from 15 cm to 20 cm (about 15 cm to about 20 cm), from 15 cm to 25 cm (about 15 cm to about 25 cm), from 20 cm to 30 cm (about 20 cm to about 30 cm), or from 25 cm to 30 cm (about 25 cm to about 30 cm).

[0019] The fifth section 110e can include a length L5 that can be less than, equal to, and / or greater than 3 cm. In some cases, the length L5 can have a length of 0.1 cm to 0.5 cm (about 0.1 cm to about 0.5 cm). In some cases, the length L5 can have a length of 0.1 cm to 0.4 cm (about 0.1 cm to about 0.4 cm), 0.1 cm to 0.3 cm (about 0.1 cm to about 0.3 cm), 0.2 cm to 0.3 cm (about 0.2 cm to about 0.3 cm), 0.2 cm to 0.4 cm (about 0.2 cm to about 0.4 cm), 0.2 cm to 0.5 cm (about 0.2 cm to about 0.5 cm), 0.3 cm to 0.5 cm (about 0.3 cm to about 0.5 cm), or 0.4 cm to 0.5 cm (about 0.4 cm to about 0.5 cm). In some cases, the overall length of the five segments 110a-110e of the guiding extension catheter can be less than, equal to, and / or longer than 55 cm. In some cases, the total length of the five sections 110a-110e of the guiding extension catheter 100 may be 55 cm (approximately 55 cm), or any length necessary to provide the necessary guiding catheter extension length and stability within the guiding catheter system. In some cases, the length of the guiding extension catheter may extend the entire length of the guiding catheter.

[0020] The tubular body 101 may be extruded, molded, or made using any technique for making catheter systems. For example, one or more sections 110a-110e of the tubular body 101 may be made from a thermoplastic elastomer. In some cases, the distal section of the tubular body 101 may be softer than the more proximal sections of the tubular body 101. For example, without limitation, the fifth section 110e may be made from an extruded thermoplastic elastomer tubing having a hardness of less than or at least 40D (on the Shore D durometer). In some cases, the first, second, third, and fourth sections 110a-110d may be made from an extruded thermoplastic elastomer tubing having a hardness of less than or at least 72D (on the Shore D durometer).

[0021] In some cases, the guiding extension catheter 100 comprises a radiopaque band 113. The radiopaque band 113 may be positioned along the distal and / or proximal segments of the tubular body 101. For example, the radiopaque band 113 may be positioned along the fourth segment 110d of the tubular body 101. The radiopaque band 113 may beneficially provide an indication of the location of the guiding catheter or guiding extension catheter 100 along the patient's vasculature.

[0022] In some cases, the tubular body 101 may be braided and / or coiled for additional stability. For example, as shown in FIG. 1C, the interior 103 of the tubular body 101 may include a braided section 105. Additionally or alternatively, the tubular body 101 may include a coil. For example, the tubular body 101 may include both a braid and a coil, only a braid, and / or only a coil. The coil may include a stainless steel material. The braided section 105 may include a 0.005 inch by 0.007 inch braid with a braid density of less than or at least 70 PPI. The braided section 105 is not limited to this braid density and braid type, but may be any braid density and braid type used in catheter systems. In some cases, the interior of the tubular body 101 may also include a liner 107. The braided section 105 may be disposed between the liner 107 and the interior of the tubular body 101. The braided section 105 and the liner 107 may extend along the entire length of the tubular body 101. However, in some cases, the braided section 105 and the liner 107 extend along only a section of the tubular body 101. For example, the braided section 105 and the liner 107 may extend along only the fifth section 110e of the tubular body 101. In some cases, the liner 107 may be formed from PTFE or any material used for liners in catheter systems.

[0023] The tubular body 101 of the guide catheter 100 may have a varying wall thickness, which may result in a varying inner diameter and / or outer diameter. In some cases, the wall thickness of the tubular body 101 can vary. For example, the tubular body 101 may have a constant inner diameter and a varying outer diameter. The tubular body 101 may have an inner diameter D1 that is less than, equal to, and / or greater than 0.063 inches. The inner diameter D1 may range from about 0.062 inches to about 0.064 inches (about 0.062 inches to about 0.064 inches), 0.062 inches to 0.063 inches (about 0.062 inches to about 0.063 inches), or 0.063 inches to 0.064 inches (about 0.063 inches to about 0.064 inches). In some cases, the outer diameter of the tubular body 101 may vary from the proximal portion 102 to the distal portion 104. In some cases, the tubular body 101 may include a transition region 111 where the wall thickness of the tubular body changes. The transition region 111 may extend along one or more of the sections 110a-110e. In some cases, the transition region 111 may extend along the third section 110c. Depending on the length of the third section 110c, the transition region may include a length ranging from about 5 cm to about 20 cm. The wall thickness of the tubular body may increase along the transition region 111 in the distal direction. This may result in the outer diameter D2 of the proximal portion 102 of the tubular body 101 being smaller than the outer diameter D3 of the distal portion 104 of the tubular body 101. For example, the outer diameter D2 may be less than, equal to, and / or greater than 0.070 inches, and the outer diameter D3 may be less than, equal to, and / or greater than 0.073 inches.In some cases, the outer diameter D2 can range from about 0.068 inches to about 0.071 inches (about 0.068 inches to about 0.071 inches), 0.068 inches to 0.070 inches (about 0.068 inches to about 0.070 inches), 0.068 inches to 0.069 inches (about 0.068 inches to about 0.069 inches), or 0.070 inches to 0.071 inches (about 0.070 inches to about 0.071 inches), and the outer diameter D3 can range from about 0.073 inches to about The thickness can range from 0.076 inches (about 0.073 inches to about 0.076 inches), 0.073 inches to 0.075 inches (about 0.073 inches to about 0.075 inches), 0.073 inches to 0.074 inches (about 0.073 inches to about 0.074 inches), 0.074 inches to 0.076 inches (about 0.074 inches to about 0.076 inches), or 0.075 inches to 0.076 inches (about 0.075 inches to about 0.076 inches). The section of tubular body 101 adjacent transition region 111 can have a constant wall thickness, which can result in a constant diameter. For example, first section 110a and second section 110b can have constant inner and outer diameters. Additionally, fourth section 110d and fifth section 110e may have constant inner and outer diameters. In some cases, the wall thickness at the proximal end of transition region 111 may be the same as or similar to the wall thickness of section 110b, and the wall thickness at the distal end of transition region 111 may be the same as or similar to the wall thickness of section 110d.

[0024] 2A-2B show an example of a guide catheter. The guide catheter 150 may include a tubular body 151, a proximal portion 152, and a distal portion 154. The tubular body 151 of the guide catheter 150 may include multiple segments. For example, the tubular body 151 may include a first segment 160a, a second segment 160b, a third segment 160c, a fourth segment 160d, and a fifth segment 160e. While a tubular body 151 including five segments is referenced, the tubular body 151 may include fewer or more than five segments (e.g., one, two, three, four, six, seven segments, etc.). The combined length L6 of the first segment 160a and the second segment 160b may be less than, equal to, and / or greater than 84 cm. In some cases, length L6 can be 60 cm to 100 cm (about 60 cm to about 100 cm). In some cases, length L6 can be 60 cm to 80 cm (about 60 cm to about 80 cm), 60 cm to 70 cm (about 60 cm to about 70 cm), 70 cm to 100 cm (about 70 cm to about 100 cm), 70 cm to 90 cm (about 70 cm to about 90 cm), 80 cm to 100 cm (about 80 cm to about 100 cm), 80 cm to 90 cm (about 80 cm to about 90 cm), or 90 cm to 100 cm (about 90 cm to about 100 cm).

[0025] The third section 160c can include a length L7 that can be less than, equal to, and / or greater than 20 cm. In some cases, the length L7 can be from 10 cm to 30 cm (about 10 cm to about 30 cm). In some cases, the length L7 can be from 10 cm to 25 cm (about 10 cm to about 25 cm), 10 cm to 20 cm (about 10 cm to about 20 cm), 10 cm to 15 cm (about 10 cm to about 15 cm), 15 cm to 20 cm (about 15 cm to about 20 cm), 15 cm to 25 cm (about 15 cm to about 25 cm), 15 cm to 30 cm (about 15 cm to about 30 cm), 20 cm to 30 cm (about 20 cm to about 30 cm), or 25 cm to 30 cm (about 25 cm to about 30 cm).

[0026] The fourth section 160d can include a length L8 that can be less than, equal to, and / or greater than 0.5 mm. In some cases, the length L8 can be 0.2 cm to 0.8 cm (about 0.2 cm to about 0.8 cm). In some cases, the length L8 can be 0.2 cm to 0.6 cm (about 0.2 cm to about 0.6 cm), 0.2 cm to 0.4 cm (about 0.2 cm to about 0.4 cm), 0.4 cm to 0.6 cm (about 0.4 cm to about 0.6 cm), 0.4 cm to 0.8 cm (about 0.4 cm to about 0.8 cm), or 0.6 cm to 0.8 cm (about 0.6 cm to about 0.8 cm).

[0027] The fifth section 160e can include a length L9 that can be less than, equal to, and / or greater than 0.5 mm. In some cases, the length L9 can be 0.2 cm to 0.8 cm (about 0.2 cm to about 0.8 cm). In some cases, the length L9 can be 0.2 cm to 0.6 cm (about 0.2 cm to about 0.6 cm), 0.2 cm to 0.4 cm (about 0.2 cm to about 0.4 cm), 0.4 cm to 0.6 cm (about 0.4 cm to about 0.6 cm), 0.4 cm to 0.8 cm (about 0.4 cm to about 0.8 cm), or 0.6 cm to 0.8 cm (about 0.6 cm to about 0.8 cm). In some cases, the overall length of the five sections 110a-110e of the tubular body 151 can be less than, equal to, and / or longer than 104 cm. In some cases, the overall length of the five sections 110a-110e of the guide catheter 150 can be 104 cm (approximately 104 cm), or any length necessary to provide the necessary guide catheter length and stability within the guide catheter system or for the procedure. In some cases, the guide catheter length can extend the entire length of the guiding extension catheter 100 and / or can be longer or equal to the length of the guiding extension catheter 100.

[0028] The tubular body 151 may be extruded, molded, or made using any technique for making catheter systems. For example, one or more sections 160a-160e of the tubular body 151 may be made from a thermoplastic elastomer. In some cases, the distal section of the tubular body 151 may be softer than the more proximal section of the tubular body 151. For example, without limitation, the fifth section 160e may be made from an extruded thermoplastic elastomer tubing having a hardness of less than or at least 40D (on the Shore D durometer). The fourth section 160d may be made from an extruded thermoplastic elastomer tubing having a hardness of less than or at least 55D. In some cases, the first, second, and third sections 160a-160c may be made from an extruded thermoplastic elastomer tubing having a hardness of less than or at least 63D.

[0029] In some cases, the guide catheter 150 includes a radiopaque band 163, as shown in Figure 2B. The radiopaque band 163 can be positioned along a distal section of the tubular body 151. For example, the radiopaque band 163 can be positioned along at least one of the fourth section 160d and the fifth section 160e of the tubular body 151. The radiopaque band 163 can beneficially provide an indication of the location of the guide catheter 150 along the patient's vasculature.

[0030] In some cases, the tubular body 151 may be braided for additional stability. For example, as shown in FIG. 2B , the interior portion of the tubular body 151 may include a braided section 155. In some cases, the braided section 155 may include a 0.005 inch by 0.007 inch braid with a braid density of less than or at least 70 PPI. The braided section 155 is not limited to this braid density and braid type, but may be any braid density and braid type used in catheter systems. In some cases, the interior of the tubular body 151 may also include a liner 157. The braided section 155 may be disposed between the liner 157 and the interior portion of the tubular body 151. The braided section 155 and the liner 157 may extend along the entire length of the tubular body 151. However, in some cases, the braided section 155 and the liner 157 extend along only a section of the tubular body 151. For example, braided section 155 and liner 157 may extend along only third section 160c, fourth section 160d, and fifth section 160e of tubular body 151. In some cases, liner 157 may be formed from PTFE or any material used for liners in catheter systems.

[0031] The tubular body 151 of the guide catheter 150 may have a varying wall thickness, which may result in a varying inner and / or outer diameter. In some cases, the wall thickness of the tubular body 151 can vary. For example, the tubular body 151 may have a constant outer diameter and a varying inner diameter. The tubular body 151 may have an outer diameter D4 that is less than, equal to, and / or greater than 0.082 inches. The outer diameter D4 may range from about 0.081 inches to about 0.083 inches (about 0.081 inches to about 0.083 inches), 0.081 inches to 0.082 inches (about 0.081 inches to about 0.082 inches), or 0.082 inches to 0.083 inches (about 0.082 inches to about 0.083 inches). In some cases, the inner diameter of the tubular body 151 may vary from the proximal portion 152 to the distal portion 154. In some cases, tubular body 151 may include a transition region 161 where the wall thickness of the tubular body changes. Transition region 161 may extend along one or more of sections 160a-160e. In some cases, transition region 161 may extend along second section 160b. Transition region 161 may include a length ranging from about 5 cm to about 20 cm. The wall thickness of tubular body 151 may decrease along transition region 161 in the distal direction. This may result in inner diameter D5 of proximal portion 152 being smaller than inner diameter D6 of distal portion 154. For example, inner diameter D5 may be less than, equal to, and / or greater than 0.072 inches, and inner diameter D6 may be less than, equal to, and / or greater than 0.075 inches.In some cases, inner diameter D5 can be in the range of about 0.070 inches to about 0.072 inches (about 0.070 inches to about 0.072 inches), 0.070 inches to 0.071 inches (about 0.070 inches to about 0.071 inches), or 0.071 inches to 0.072 inches (about 0.071 inches to about 0.072 inches), and inner diameter D6 can be in the range of about 0.074 inches to about 0.078 inches (about 0.074 inches to about 0.078 inches), 0.074 inches to 0.076 inches (about 0.074 inches to about 0.076 inches), or 0.076 inches to 0.078 inches (about 0.076 inches to about 0.078 inches). The section of tubular body 151 adjacent transition region 161 can have a constant wall thickness, which can result in a constant diameter. In some cases, the wall thickness at the proximal end of transition region 161 can be the same as or similar to the wall thickness of section 160a, and the wall thickness at the distal end of transition region 161 can be the same as or similar to the wall thickness of section 160c. For example, at least a portion of each of sections 160a-160e can have constant inner and outer diameters.

[0032] The guiding extension catheter 100 and the guiding catheter 150 can be combined to form a catheter system 180. For example, as shown in FIG. 3B, the guiding extension catheter 100 can extend through the guiding catheter 150. To allow the guiding extension catheter 100 to move within the guiding catheter 150, the inner diameter of the guiding catheter 150 can be larger than the outer diameter of the guiding extension catheter 100 along the length of the device, or can be as close as possible to the outer diameter of the guiding extension catheter 100. This arrangement allows for a close-fitting concentric arrangement as shown in FIG. 3B, while still allowing the guiding extension catheter 100 to be advanced and / or retracted within the guiding catheter 150 without resistance. In some cases, the guiding extension catheter 100 can extend beyond the distal portion 154 of the guiding catheter 150.

[0033] The varying outer / inner diameters of the guiding extension catheter 100 and the guiding catheter 150 can beneficially provide additional support as the guiding extension catheter 100 extends further into the guiding catheter 150. For example, the inner diameter at the proximal portion of the guiding catheter 150 can be similar to the outer diameter at the distal portion of the guiding extension catheter 100, thus providing guiding support for the guiding extension catheter. Furthermore, the varying thickness design optimizes the maximum possible inner diameter of the guiding extension catheter so that the guiding extension catheter does not need to be removed throughout the procedure, while not compromising the practicality, feel, or use of the device. This improves guiding support by allowing both catheters to nest together throughout the procedure and preventing them from backing out.

[0034] 3C, the wall thickness of the guiding extension catheter 100 and the wall thickness of the guide catheter 150 may taper along a transition region 181. In the transition region 181, the outer diameter of the guiding extension catheter 100 increases in the proximal to distal direction as the thickness of the tubular body 101 increases in the proximal to distal direction, and the inner diameter of the guide catheter 150 increases in the proximal to distal direction as the thickness of the tubular body 151 decreases in the proximal to distal direction. The transition region 181 may have a length less than, equal to, and / or greater than 10 cm. In some cases, the transition region 181 may have a length of 5 cm to 20 cm (approximately 5 cm to approximately 20 cm). In some cases, the transition region 181 may have a length of 5 cm to 15 cm (about 5 cm to about 15 cm), 5 cm to 10 cm (about 5 cm to about 10 cm), 10 cm to 15 cm (about 10 cm to about 15 cm), 10 cm to 20 cm (about 10 cm to about 20 cm), or 15 cm to 20 cm (about 15 cm to about 20 cm).

[0035] 4A-4B show another example of a guide catheter 400. The guide catheter 400 may include a proximal end 400a, a distal end 400b, an inner liner 410, a braid 420 surrounding the inner liner, a jacket 430 surrounding the braid 420, and a marker band 440. In some cases, the guide catheter 400 may include multiple sections. For example, the guide catheter 400 may include a first section 430a, a second section 430b, a third section 430c, and a fourth section 430d. Although a guide catheter 400 including four sections is referenced, the guide catheter 400 may include fewer or more than four sections (e.g., one, two, three, five, six, seven sections, etc.). The braid 420 may extend the entire length of the guide catheter 400, or it may extend less than the entire length of the guide catheter 400. For example, in some cases, the braid 420 may extend the entire length of the first section 430a, the second section 430b, and a portion of the third section 430c. As shown in FIG. 4B, the length BL of the braid 420 may extend along the guide catheter 400. In some cases, the braid 420 may extend from the first section 430a to the proximal end of the marker band 440.

[0036] The guide catheter 400 may be made from materials including VESTAMID, Aethno, Pebax, polytetrafluoroethylene (PTFE), stainless steel, or combinations thereof. The exterior of the jacket 430 may include a hydrophilic coating. In some cases, multiple sections of the jacket 430 may include the same or different materials. For example, the first section 430a may include a VESTAMID material, the second section 430b may include an Aethno material, and the third and fourth sections 430c and 430d may include Pebax material. In some cases, the third and fourth sections 430c and 430d may include materials with different durometer ratings. For example, the third section 430c may include a Pebax material having a durometer rating less than, equal to, and / or greater than about 63D, and the fourth section 430d may include a Pebax material having a durometer rating less than, equal to, and / or greater than about 40D. Although reference is made to third segment 430c having a durometer rating of approximately 63D, third segment 430c can include durometer ratings greater than or less than 63D (e.g., 60D, 61D, 62D, 64D, 65D, 66D, etc.). Although reference is made to fourth segment 430d having a durometer rating of approximately 40D, fourth segment 430d can include durometer ratings greater than or less than 40D (e.g., 35D, 36D, 37D, 38D, 39D, 41D, 42D, 43D, 44D, 45D, etc.).

[0037] In some cases, the inner liner may be made from a PTFE material. The braid 420 may include a braid pick count of approximately 60. While reference is made to the braid 420 having a braid pick count of approximately 60, the braid 420 may include a braid pick count greater than or less than 60 (e.g., 40, 45, 50, 55, 65, 70, 75, 80, etc.). The braid 420 may include stainless steel with a thickness of approximately 0.007 inches and a width of approximately 0.005 inches. In some cases, the marker band 440 may be made from platinum, iridium, or a combination thereof (Pt90 / Ir10).

[0038] The combined length L10 of segments 430a-430d can be less than, equal to, and / or greater than 104 cm. In some cases, length L10 can be between about 60 cm and about 140 cm, between about 70 cm and about 130 cm, between about 80 cm and about 120 cm, between about 90 cm and about 110 cm, and / or between about 95 cm and about 105 cm. Guide catheter 400 can have an outer diameter OD1 less than, equal to, and / or greater than about 0.082 inches. In some cases, the outer diameter of jacket 430 can be between about 0.040 inches and about 0.12 inches, between about 0.050 inches and about 0.11 inches, between about 0.060 inches and about 0.10 inches, between about 0.070 inches and about 0.090 inches, between about 0.075 inches and about 0.085 inches, and / or between about 0.0775 inches and about 0.0825 inches. The outer diameter OD1 can be constant throughout the entire length of guide catheter 400.

[0039] In some cases, one of the inner and outer diameters OD1 of the guide catheter 400 can be constant and the other can vary. For example, the outer diameter OD1 of the guide catheter 400 can be constant (e.g., the same) throughout the entire length of the guide catheter 400, while the inner diameter can vary. However, in some cases, the inner and / or outer diameters OD1 of the guide catheter 400 can vary along multiple segments 430a-430d. For example, the inner diameter of the guide catheter 400 can increase in the proximal-to-distal direction, such that the inner diameter along the first segment 430a is smaller than the inner diameter along the fourth segment 430d. In some cases, the inner diameter of the guide catheter 400 can decrease in the proximal-to-distal direction, such that the inner diameter along the first segment 430a is larger than the inner diameter along the fourth segment 430d. The outer diameter OD1 of the guide catheter 400 may increase in the proximal-to-distal direction such that the outer diameter OD1 along the first section 430a is smaller than the outer diameter along the fourth section 430d. In some cases, the outer diameter OD1 of the guide catheter 400 may decrease in the proximal-to-distal direction such that the outer diameter OD1 along the first section 430a is larger than the outer diameter OD1 along the fourth section 430d. The thickness of the inner liner 410, the thickness of the braid 420, and / or the thickness of the jacket 430 may vary across the multiple sections 430a-430d, thereby resulting in a guide catheter 400 with varying inner and / or outer diameters.

[0040] The first section 430a of the guide catheter 400 may have a length L11 that can be less than, equal to, and / or greater than about 75 cm. In some cases, the length L11 may be between about 50 cm and about 100 cm, between about 60 cm and about 90 cm, between about 65 cm and about 85 cm, and / or between about 70 cm and about 80 cm. The first section 430a may have an inner diameter that is less than, equal to, and / or greater than about 0.072 inches. In some cases, the inner diameter of the first section 430a may be between about 0.050 inches and about 0.10 inches, between about 0.06 inches and about 0.09 inches, between about 0.065 inches and about 0.085 inches, and / or between about 0.070 inches and about 0.080 inches.

[0041] The second section 430b of the guide catheter 400 may have a length L12 that can be less than, equal to, and / or greater than about 27.5 cm. In some cases, the length L12 may have a length between about 5 cm and about 50 cm, between about 10 cm and about 45 cm, between about 15 cm and about 40 cm, between about 20 cm and about 35 cm, and / or between about 25 cm and about 30 cm. The second section 430b may have an inner diameter less than, equal to, and / or greater than about 0.075 inches. In some cases, the inner diameter of second section 430b can be between about 0.050 inches and about 0.10 inches, between about 0.060 inches and about 0.090 inches, between about 0.065 inches and about 0.085 inches, between about 0.070 inches and about 0.080 inches, and / or between about 0.0725 inches and about 0.0775 inches.

[0042] The third section 430c of the guide catheter 400 may have a length L13 that can be less than, equal to, and / or greater than about 1 cm. In some cases, the length L13 may be between about 0.2 cm and about 1.8 cm, between about 0.4 cm and about 1.6 cm, between about 0.6 cm and about 1.4 cm, between about 0.8 cm and about 1.2 cm, and / or between about 0.9 cm and about 1.1 cm. The third section 430c may have an inner diameter that is less than, equal to, and / or greater than about 0.075 inches. In some cases, the inner diameter of third section 430c can be between about 0.050 inches and about 0.10 inches, between about 0.060 inches and about 0.090 inches, between about 0.065 inches and about 0.085 inches, between about 0.070 inches and about 0.080 inches, and / or between about 0.0725 inches and about 0.0775 inches.

[0043] The fourth section 430d of the guide catheter 400 may have a length L14 that can be less than, equal to, and / or greater than about 0.5 cm. In some cases, the length L14 may have a length between about 0.1 cm and about 0.9 cm, between about 0.2 cm and about 0.8 cm, between about 0.3 cm and about 0.7 cm, between about 0.4 cm and about 0.6 cm, and / or between about 0.45 cm and about 0.55 cm. The fourth section 430d may have an inner diameter less than, equal to, and / or greater than about 0.075 inches. In some cases, the inner diameter of fourth section 430d can be between about 0.050 inches and about 0.10 inches, between about 0.060 inches and about 0.090 inches, between about 0.065 inches and about 0.085 inches, between about 0.070 inches and about 0.080 inches, and / or between about 0.0725 inches and about 0.0775 inches.

[0044] In some cases, the marker band 440 may be positioned along one of the sections of the jacket 430. For example, the marker band 440 may be positioned along the fourth section 430d of the guide catheter 400. The marker band 440 may beneficially provide an indication of the location of the guide catheter 400 along the patient's vasculature.

[0045] 5A-5C illustrate another example of a guiding extension catheter 500 (also referred to herein as a telescoping guiding extension catheter). The guiding extension catheter 500 may include a proximal end 500a, a distal end 500b, a guiding extension wire 502 (also referred to as a pusher rod), and a tubular body 504. The distal end of the guiding extension wire 502 may be secured to the tubular body 504.

[0046] The guide extension wire 502 may include a tab 502a and one or more location markers 502b. The tubular body 504 may include an inner liner 510, a coil 520 surrounding the inner liner 510, a jacket 530 surrounding the coil 520, and a marker band 540. Additionally or alternatively, the tubular body 504 may include a braid. For example, the tubular body 504 may include both a braid and a coil, only a braid, and / or only a coil. In some cases, the tubular body 504 may include multiple segments. For example, the tubular body 504 may include a first segment 504a, a second segment 504b, a third segment 504c, a fourth segment 504d, and a fifth segment 504e. Although reference is made to tubular body 504 including five segments, tubular body 504 may include fewer or more than five segments (e.g., 1, 2, 3, 4, 6, 7, 8, 9 segments, etc.). Coil 520 may extend the entire length of tubular body 504, but may also extend less than the entire length of tubular body 504. For example, in some cases, coil 520 can extend along at least a portion of second segment 504b, third segment 504c, fourth segment 504d, and / or fifth segment 504e. As shown in FIGS. 5B-5C , a length CL of coil 520 can extend along tubular body 504. In some cases, coil 520 can extend from the proximal end of second segment 504b to the proximal end of marker band 540. CL can be less than, equal to, and / or greater than about 42.5 cm. In some cases, the length CL can be between about 20 cm and about 60 cm, between about 30 cm and about 50 cm, between about 35 cm and about 45 cm, and / or between about 37 cm and about 43 cm.

[0047] The tubular body 504 may be made from materials including VESTAMID, AESNO, Pebax, polytetrafluoroethylene (PTFE), stainless steel, or combinations thereof. The exterior of the jacket 530 may include a hydrophilic coating. In some cases, multiple segments of the tubular body 504 may include the same or different materials. For example, multiple segments of the tubular body may include different materials and / or different durometer ratings. For example, multiple segments 504a-504e may include Pebax material. The first segment 504a and / or the second segment 504b may include a durometer rating less than, equal to, and / or greater than about 72D. The third segment 504c may include a durometer rating less than, equal to, and / or greater than about 55D. The fourth segment 504d may include a durometer rating less than, equal to, and / or greater than about 40D. The fifth section 504e may comprise a durometer rating less than, equal to, and / or greater than about 35D.

[0048] Although reference is made to multiple segments of tubular body 504 having particular durometers, multiple segments may have durometer ratings greater or less than those specified above. For example, first segment 504a and / or second segment 504b can have a durometer rating of between about 62D and about 82D, between about 64D and about 80D, between about 66D and about 78D, between about 68D and about 76D, between about 70D and about 74D, and / or between about 71D and about 73D. Third segment 504c can have a durometer rating of between about 45D and about 65D, between about 47D and about 63D, between about 49D and about 61D, between about 51D and about 59D, between about 53D and about 57D, and / or between about 54D and about 56D. The fourth section 504d can have a durometer rating of between about 30D and about 50D, between about 32D and about 48D, between about 34D and about 46D, between about 36D and about 44D, between about 38D and about 42D, and / or between about 39D and about 41 D. The fifth section 504e can have a durometer rating of between about 25D and about 45D, between about 27D and about 43D, between about 29D and about 41D, between about 31D and 39D, between about 33D and about 37D, and / or between about 34D and about 36D.

[0049] In some cases, the inner liner 510 may be made from a PTFE material. The coil 520 may include a stainless steel material. The coil 520 may have a width less than, equal to, and / or greater than about 0.005 inches, a pitch less than, equal to, and / or greater than about 0.001 inches, and / or a gap size less than, equal to, and / or greater than about 0.012 inches. Although reference is made to a coil 520 having a particular width, pitch, and / or gap size, the coil 520 may have a width, pitch, and / or gap size greater than those specified above. In some cases, the marker band 540 may be made from platinum, iridium, or a combination thereof (Pt90 / Ir10). In some cases, the position marker 502b of the guide extension wire 502 may be laser marked on the guide extension wire 502.

[0050] In some cases, at least a portion of the guiding extension wire 502 may be positioned between the coil 520 and the jacket 530, as shown in FIG. 5A . Pushing and / or pulling the tab 502 a and / or the guiding extension wire 502 can beneficially advance or retract the tubular body 504 along the patient's vessels and / or other medical devices (such as the guiding catheter 400) during a procedure. In some cases, the inner portion 502 c of the guiding extension wire 502 may be flush or substantially flush with the inner liner 510. For example, the inner portion 502 c may include a flat or substantially flat surface. The flat surface of the inner portion 502 c can beneficially provide an unobstructed transition from the inner liner 510 to the guiding extension wire 502 or from the guiding extension wire 502 to the inner liner 510. This can prevent the guide extension wire 502 from interfering with the interior portion 505 of the tubular body 504, which can be beneficial when advancing and / or retracting wires and / or other medical instruments through the tubular body 504. In some cases, the interior portion 502c can include a recessed surface that can conform to the curvature of the interior portion 502c of the interior portion 505 of the tubular body 504 and / or the inner liner 510.

[0051] The combined length L20 of the guide extension wire 502 and tubular body 504 can be less than, equal to, and / or greater than 132 cm. In some cases, the length L20 can be between about 90 cm and about 170 cm, between about 100 cm and about 160 cm, between about 110 cm and about 150 cm, between about 120 cm and about 140 cm, and / or between about 125 cm and about 135 cm. The tubular body 504 can include an inner diameter ID1 less than, equal to, and / or greater than about 0.061 inches. Inner diameter ID1 can be between about 0.020 inches and about 0.10 inches, between about 0.030 inches and about 0.090 inches, between about 0.040 inches and about 0.080 inches, between about 0.050 inches and about 0.070 inches, and / or between about 0.055 inches and about 0.065 inches. Inner diameter ID1 can be constant throughout the entire length of tubular body 504. In some cases, the outer diameter of tubular body 504 can be between about 0.020 inches and about 0.10 inches, between about 0.030 inches and about 0.090 inches, between about 0.040 inches and about 0.080 inches, between about 0.050 inches and about 0.070 inches, between about 0.055 inches and about 0.065 inches, and / or between about 0.0575 inches and about 0.0625 inches.

[0052] In some cases, one of the inner diameter ID1 and the outer diameter of the tubular body 504 can be constant, while the other can vary. For example, the inner diameter ID1 of the tubular body 504 can be constant (e.g., the same) throughout the entire length of the tubular body 504, while the outer diameter can vary. However, in some cases, the inner diameter ID1 and / or the outer diameter of the tubular body 504 can vary along multiple segments 504a-504e. For example, the inner diameter ID1 of the tubular body 504 can increase in the proximal-to-distal direction, such that the inner diameter ID1 along the first segment 504a is smaller than the inner diameter ID1 along the fifth segment 504e. In some cases, the inner diameter ID1 of the tubular body 504 can decrease in the proximal-to-distal direction, such that the inner diameter ID1 along the first segment 504a is larger than the inner diameter ID1 along the fifth segment 504e. The outer diameter of tubular body 504 may increase in the proximal-to-distal direction such that the outer diameter along the first section 504a is smaller than the outer diameter along the fifth section 504e. In some cases, the outer diameter of tubular body 504 may decrease in the proximal-to-distal direction such that the outer diameter along the first section 504a is larger than the outer diameter along the fifth section 504e. The thickness of inner liner 510, the thickness of coil 520, and / or the thickness of jacket 530 may vary across multiple sections 504a-504e, thereby resulting in tubular body 504 with varying inner and / or outer diameters.

[0053] The first section 504a of the tubular body 504 may have a length L21 that may be less than, equal to, and / or greater than about 7.5 cm. In some cases, the length L21 may be between about 5 cm and about 10 cm, between about 6 cm and about 9 cm, between about 6.5 cm and about 8.5 cm, and / or between about 7 cm and about 8 cm.

[0054] The second section 504b of the tubular body 504 can have a length L22 that can be less than, equal to, and / or greater than about 2.5 cm. In some cases, the length L22 can be between about 0.5 cm and about 4.5 cm, between about 1 cm and about 4 cm, between about 1.5 cm and about 3.5 cm, and / or between about 2 cm and about 3 cm. The second section 504b can have an outer diameter that is less than, equal to, and / or greater than about 0.070 inches. In some cases, the outer diameter of the second section 504b can be between about 0.030 inches and about 0.11 inches, between about 0.040 inches and about 0.10 inches, between about 0.050 inches and about 0.090 inches, between about 0.060 inches and about 0.080 inches, and / or between about 0.065 inches and about 0.075 inches.

[0055] The third segment 504c of the tubular body 504 may have a length L23 that can be less than, equal to, and / or greater than about 10 cm. In some cases, the length L23 may be between about 5 cm and about 15 cm, between about 6 cm and about 14 cm, between about 7 cm and about 13 cm, between about 8 cm and about 12 cm, and / or between about 9 cm and about 11 cm. The third segment 504c may have an outer diameter that is less than, equal to, and / or greater than about 0.070 inches. In some cases, the outer diameter of the third section 504c can be between about 0.030 inches and about 0.11 inches, between about 0.040 inches and about 0.10 inches, between about 0.050 inches and about 0.090 inches, between about 0.060 inches and about 0.080 inches, and / or between about 0.065 inches and about 0.075 inches.

[0056] The fourth segment 504d of the tubular body 504 may have a length L24 that can be less than, equal to, and / or greater than about 18 cm. In some cases, the length L24 may be between about 10 cm and about 26 cm, between about 12 cm and about 24 cm, between about 14 cm and about 22 cm, between about 16 cm and about 20 cm, and / or between about 17 cm and about 19 cm. The fourth segment 504d may have an outer diameter that is less than, equal to, and / or greater than about 0.070 inches. In some cases, the outer diameter of the fourth section 504d can be between about 0.030 inches and about 0.11 inches, between about 0.040 inches and about 0.10 inches, between about 0.050 inches and about 0.090 inches, between about 0.060 inches and about 0.080 inches, and / or between about 0.065 inches and about 0.075 inches.

[0057] The fifth segment 504e of the tubular body 504 may have a length L25 that can be less than, equal to, and / or greater than about 12 cm. In some cases, the length L25 may have a length between about 5 cm and about 19 cm, between about 7 cm and about 17 cm, between about 9 cm and about 15 cm, between about 11 cm and about 13 cm, and / or between about 11.5 cm and about 12.5 cm. The fifth segment 504e may have an outer diameter less than, equal to, and / or greater than about 0.073 inches. In some cases, the outer diameter of fifth section 504e can be between about 0.050 inches and about 0.10 inches, between about 0.06 inches and about 0.09 inches, between about 0.065 inches and about 0.085 inches, between about 0.070 inches and about 0.080 inches, and / or between about 0.0725 inches and about 0.0775 inches.

[0058] The length L26 of the guiding extension wire 502 from the proximal end 500a of the guiding extension catheter 500 to the proximal end of the first section 504a can be less than, equal to, and / or greater than about 82 cm. In some cases, the length L26 can be between about 60 cm and about 105 cm, between about 70 cm and about 95 cm, between about 75 cm and about 90 cm, and / or between about 80 cm and about 85 cm.

[0059] In some cases, the marker band 540 can be positioned along one of multiple segments of the tubular body 504. For example, the marker band 540 can be positioned along the fifth segment 504e of the tubular body 504. The marker band 540 can beneficially provide an indication of the location of the guiding extension catheter 500 along the patient's vasculature.

[0060] In some cases, the guiding catheter 400 and the guiding extension catheter 500 can be combined to form a catheter system. For example, the guiding extension catheter 500 can extend through the guiding catheter 400. To allow the guiding extension catheter 500 to move within the guiding catheter 400, the inner diameter of the guiding catheter 400 can be larger than the outer diameter of the guiding extension catheter 500 along the length of the device, or can be as close as possible to the outer diameter of the guiding extension catheter 500. This arrangement allows for a close-fitting concentricity while still allowing the guiding extension catheter 500 to be advanced and / or retracted within the guiding catheter 400 without resistance. In some cases, the guiding extension catheter 500 can extend beyond the distal end 400b of the guiding catheter 400. In some cases, the inner diameter of the guiding catheter 400 at its most proximal end can be smaller than the outer diameter of the tubular body 504 of the guiding extension catheter 500 at its most distal end. This can beneficially prevent the tubular body 504 from being completely retracted from the guide catheter 400 when the guide extension catheter 500 is positioned within the guide catheter 400 .

[0061] The varying outer and / or inner diameters of the guide catheter 400 and the guiding extension catheter 500 can provide varying thicknesses for the guide catheter 400 and / or the guiding extension catheter 500. For example, as the outer and / or inner diameters of the guide catheter 400 and / or the guiding extension catheter 500 increase or decrease, the thickness of multiple sections of the guide catheter 400 and / or the tubular body 504 can increase and / or decrease (e.g., the thickness need not be the same in all multiple sections). This can beneficially provide additional support as the tubular body 504 of the guiding extension catheter 500 extends further into the guide catheter 400. For example, the inner diameter at a proximal portion of the guiding catheter 400 can be similar to the outer diameter at a distal portion of the guiding extension catheter 500 such that the thickness of the guiding catheter 400 and the tubular body 504 provides support to the guiding extension catheter 500, such as when the guiding tubular body 504 of the guiding extension catheter 500 is fully nested within the guiding catheter 400. In some cases, the outer diameter at the proximal portion of the guiding extension catheter 500 can be similar to the inner diameter at the distal portion of the guiding catheter 400, such that the thickness of the guiding catheter 400 and tubular body 504 provides support to the guiding extension catheter 500, such as when the guiding extension catheter 500 extends beyond the distal end 400b of the guiding catheter 400. Furthermore, the varying thickness design optimizes the maximum possible inner diameter of the guiding extension catheter so that the guiding extension catheter does not need to be removed throughout the procedure, while not compromising the practicality, feel, or use of the device. This improves guiding support by allowing both catheters to nest together throughout the procedure and / or by preventing them from backing out.

[0062] In some cases, the guiding extension catheter 500 may be pre-assembled into the guide catheter 400 such that the tubular body 504 of the guiding extension catheter 500 is positioned within the guide catheter 400. The tubular body 504 may be translated along the guide between at least two positions by extending and retracting the tubular body 504 distally and / or proximally along the guide catheter 400. In the first position, the tubular body 504 may be retracted so that its entire length is positioned within the guide catheter 400. In the second position, the tubular body 504 may be extended so that at least a portion of the tubular body 504 extends beyond the distal end 400b of the guide catheter 400. In the second position, the varying thickness / outer diameter of the tubular body 504 and the thickness / inner diameter of the guide catheter 400 may provide stiffening and support along the entire overlapping length of the tubular body 504 and the guide catheter.

[0063] For example, in some cases, the outer diameter of the guiding catheter 400 can be the same or substantially the same along the entire length of the guiding catheter 400, and the inner diameter of the tubular body 504 of the guiding extension catheter 500 can be the same or substantially the same along the entire length of the guiding tubular body 504 of the guiding extension catheter 500. In such an example, as the inner diameter of the guiding catheter 400 increases from the proximal end to the distal end of the guiding catheter 400, the wall thickness of the guiding catheter 400 can decrease from the proximal end to the distal end of the guiding catheter 400. Also, as the outer diameter of the tubular body 504 of the guiding extension catheter 500 increases from the proximal end to the distal end of the guiding extension catheter 500, the wall thickness of the tubular body 504 can increase from the proximal end to the distal end of the guiding extension catheter 500. Thus, in the first position or nested configuration, the thinner wall thickness of the tubular body 504 can be aligned with the thicker wall thickness of the guide catheter 400, and the thinner wall thickness of the guide catheter 400 can be aligned with the thicker wall thickness of the tubular body 504. This allows the device to have similar stability throughout its entire length, regardless of the individual wall thicknesses of any portion of the guide catheter 400 and the guiding extension catheter 500. Also, when the guiding extension catheter 500 is in the second position and the guiding extension catheter 500 is extended or stretched from the guiding catheter 400, the thinner wall thickness of the guiding catheter 400 comes into contact with the thinner wall thickness portion of the guiding extension catheter 500, and the combined wall thicknesses can provide the necessary support for the device to enable movement and delivery of devices and instruments through the guiding catheter 400 and the guiding extension catheter 500.

[0064] Further details of guide catheters and guide extension catheters including varying inner and / or outer diameters can be found in International Application No. PCT / US2022 / 074029, filed July 21, 2022 (PCT Application), which is hereby incorporated by reference in its entirety.

[0065] Other Variations Although some embodiments describe vascular procedures, the systems, devices, and / or methods disclosed herein may be applied to other types of treatments that can be used alone or in addition to vascular procedures. While the foregoing diagrams and dimensions apply to coronary interventions, the innovations herein may be transferred and adapted for any other use, such as peripheral interventions.

[0066] Any values, such as thresholds, limits, time periods, etc., provided herein are not intended to be absolute and may therefore be approximate. Also, any thresholds, limits, time periods, etc. provided herein can be fixed or can be varied, either automatically or by the user. Furthermore, as used herein, relative terms such as exceeding, greater than, and less than in relation to a reference value are intended to encompass being equal to the reference value. For example, exceeding a positive reference value can encompass being equal to or greater than the reference value. Also, as used herein, relative terms such as exceeding, greater than, and less than in relation to a reference value are intended to encompass the inverse of the disclosed relationship, such as being less than, less than, or greater than the reference value.

[0067] It is understood that features, materials, properties, or groups described in combination with a particular aspect, embodiment, or example are applicable to any other aspect, embodiment, or example described herein, where not inconsistent. The varying thickness of a particular example can be applied to any of the various layers using any of the various materials, not just those disclosed herein. One skilled in the art can use various design alternatives or manufacturing techniques within the novel varying thickness concept disclosed. All of the features disclosed in this specification (including the accompanying claims, abstract, and drawings) and / or all of the method or process steps so disclosed can be combined in any combination, except combinations in which at least some of such features and / or steps are mutually exclusive. Protection is not limited to the details of any of the foregoing embodiments. Protection extends to any novel or any novel combination of features disclosed in this specification (including the accompanying claims, abstract, and drawings), or to any novel or any novel combination of any method or process steps so disclosed.

[0068] While specific embodiments have been described, these embodiments are presented by way of example only and are not intended to limit the scope of protection. Indeed, the novel methods and systems described herein may be embodied in a variety of other forms. Additionally, various omissions, substitutions, and modifications may be made in the form of the methods and systems described herein. Those skilled in the art will understand that in some embodiments, the actual steps taken in the illustrated and / or disclosed processes may differ from those shown in the figures. Depending on the embodiment, some of the steps described above may be eliminated, and other steps may be added. For example, the actual steps and / or the order of steps taken in the disclosed processes may differ from those shown in the figures. Depending on the embodiment, some of the steps described above may be eliminated, and other steps may be added. For example, various components shown in the figures or described herein may be implemented as software and / or firmware in a processor, controller, ASIC, FPGA, and / or dedicated hardware. The software or firmware may include instructions stored in a non-transitory computer-readable memory. The instructions may be executed by a processor, controller, ASIC, FPGA, and / or dedicated hardware. Hardware components such as controllers, processors, ASICs, and FPGAs may include logic circuitry. Furthermore, the features and attributes of the specific embodiments disclosed above can be combined in different ways to form additional embodiments, all of which are within the scope of the present disclosure.

[0069] Conditional phrases used herein, such as "can," "could," "could," "may," or "for example," among others, are generally intended to convey that certain embodiments include certain features, elements, and / or conditions but not others, unless expressly stated otherwise or understood within the context in which they are used. Thus, such conditional phrases are generally not intended to imply that features, elements, and / or conditions are in any way required for one or more embodiments, or that one or more embodiments necessarily include logic for determining, with or without author input or prompting, whether those features, elements, and / or conditions are included in or implemented in any particular embodiment. Terms such as "comprising," "including," and "having" are synonymous and used inclusively in an open-ended manner and do not exclude additional elements, features, acts, operations, etc. Additionally, the term "or," when used to connect a list of elements, for example, is used in its inclusive sense (and not its exclusive sense) to mean one, some, or all of the elements in the list. Furthermore, the term "each," as used herein, in addition to having its ordinary meaning, can refer to any subset of the set of elements to which the term "each" applies. Also, the words "herein," "above," "below," and words of similar import, when used in this application, refer to this application as a whole and not to any specific portion of this application.

[0070] Transitional language, such as the phrase "at least one of X, Y, or Z," is to be understood in conjunction with the context as generally used to convey that an item, term, etc., can be either X, Y, Z, or combinations thereof, unless expressly stated otherwise. Thus, such transitional language is generally not intended to imply that a particular embodiment requires that at least one X, at least one Y, and at least one Z each be present.

[0071] As used herein, degree language, such as the terms "approximately," "about," "generally," and "substantially," refers to a value, amount, or characteristic that is close to the stated value, amount, or characteristic yet performs a desired function or achieves a desired result. For example, the terms "approximately," "about," "generally," and "substantially" can refer to an amount that is within less than 10%, less than 5%, less than 1%, less than 0.1%, and less than 0.01% of the stated amount. As another example, in certain embodiments, the terms "generally parallel" and "substantially parallel" refer to a value, amount, or characteristic that deviates from exact parallelism by no more than 15 degrees, no more than 10 degrees, no more than 5 degrees, no more than 3 degrees, no more than 1 degree, or no more than 0.1 degrees.

[0072] Unless otherwise stated, articles such as "a" and "an" should generally be construed to include one or more of the described items. Thus, "a device configured to" is intended to include one or more of the described devices. Such one or more described devices may also be collectively configured to perform the described description.

[0073] While the present disclosure includes particular embodiments, examples, and applications, it will be understood by those skilled in the art that the present disclosure extends beyond the explicitly disclosed embodiments to other alternative embodiments and / or uses, including embodiments that do not provide all of the features and advantages set forth herein, as well as obvious modifications and equivalents of the embodiments. Accordingly, the scope of the present disclosure is not intended to be limited by the specific disclosure of preferred embodiments herein, but may be defined by the claims, as set forth herein or as set forth in the features. [Explanation of symbols]

[0074] 100 Guiding extension catheter 101 Tubular body 102 Proximal part 103 Internal 104 Distal portion 105 Braided Area 106 Guide extension wire 107 Liner 110a First Division 110b Second division 110c Third Division 110d Fourth Division 110e Fifth Division 111 Transition Zone 113 Radiopaque band 118 Transition 150 Guiding catheter 151 Tubular body 152 proximal part 154 Distal portion 155 Braided Area 157 Lina 160a First Division 160b Second Division 160c Third Division 160d Fourth Division 160e Fifth Division 161 Transition Zone 163 Radiopaque band 180 Catheter System 181 Transition Zone 400 Guide Catheter 400a proximal end 400b distal end 410 Inner liner 420 Braid 430 Jacket 430a First Division 430b Second division 430c Third Division 430d Fourth Division 440 Marker Band 500 Guiding Extension Catheter 500a proximal end 500b distal end 502 Guide extension wire 502a Tab 502b Position Marker 502c internal part 504 Tubular body 504a First Division 504b Second Division 504c Third Division 504d Fourth Division 504e Fifth Division 505 Internal part 510 Inner liner 520 coil 530 Jacket 540 Marker Band BL Braid 420 Length CL Coil 520 Length D1: Inner diameter of tubular body 101 D2 outer diameter of proximal portion 102 D3 outer diameter of distal portion 104 D4: Outer diameter of tubular body 151 D5 Inner diameter of proximal portion 152 D6 Inner diameter of distal portion 154 ID1: Inner diameter of tubular body 504 L1: Length of the first section 110a L2: Length of the second section 110b L3 Length of the third segment 110c L4 Length of the fourth segment 110d L5: Length of the fifth segment 110e L6: The combined length of the first and second sections 160a and 160b. L7 Length of the third segment 160c L8 Length of the fourth segment 160d L9 Length of the fifth segment 160e L10: Combined length of segments 430a-430d L11 Length of the first section 430a L12 Length of second section 430b L13 Length of the third segment 430c L14 Length of fourth segment 430d L20: Combined length of the guide extension wire 502 and tubular body 504 L21 Length of the first section 504a L22 Length of second section 504b L23 Length of third segment 504c L24 Length of fourth section 504d L25 Length of fifth segment 504e L26 Length of guide extension wire 502 OD1 outer diameter of the guide catheter 400

Claims

1. a guide catheter having a proximal end, a distal end, an inner liner, a braid surrounding the inner liner, and a jacket surrounding the braid; a telescoping guiding extension catheter comprising a guiding extension wire and a tubular body, the tubular body of the telescoping guiding extension catheter comprising a proximal end, a distal end, an inner liner, a coil surrounding the inner liner, and a jacket surrounding the coil; Equipped with the guide catheter is configured to receive the tubular body of the telescopic guide extension catheter; the inner diameter of the guide catheter decreases in a proximal direction; the outer diameter of the tubular body increases in a distal direction; A catheter system wherein the inner diameter of the guide catheter at its proximal most portion is smaller than the outer diameter of the tubular body at its distal most portion.

2. The catheter system of claim 1 , wherein the distal end of the tubular body is configured to extend beyond the distal end of the guide catheter.

3. 10. The catheter system of claim 1, wherein the tubular body comprises a plurality of segments, each of the plurality of segments having a durometer rating, the durometer rating of each of the plurality of segments decreasing in a distal direction.

4. The catheter system of claim 1 , wherein the inner portion of the guide extension wire is flush with the inner portion of the tubular body.

5. The catheter system of claim 1 , wherein the guide catheter comprises a marker band positioned on a distal portion of the guide catheter.

6. The catheter system of claim 1 , wherein the telescoping guide extension catheter includes a marker band positioned on the tubular body.

7. 10. The catheter system of claim 1, wherein the proximal-most inner diameter of the guide catheter is between 0.067 inches and 0.077 inches.

8. 10. The catheter system of claim 1, wherein the distal-most outer diameter of the tubular body is between 0.068 inches and 0.078 inches.

9. 10. The catheter system of claim 1, wherein the difference between the inner diameter of the guide catheter at its proximal most point and the outer diameter of the tubular body at its distal most point is between about 0.005 inches and about 0.05 inches.

10. The catheter system of claim 1 , wherein the outer surface of the jacket of the tubular body is provided with a hydrophilic coating.

11. 10. The catheter system of claim 1, wherein the inner liner of the guide catheter comprises polytetrafluoroethylene (PTFE).

12. 1. A cardiovascular catheter system comprising: a guide catheter; a telescoping guiding extension catheter comprising a guiding extension wire and a tubular body; Equipped with the guide catheter is configured to receive the tubular body of the telescopic guide extension catheter; A catheter system wherein the inner diameter of the guide catheter at its proximal most portion is smaller than the outer diameter of the tubular body at its distal most portion.

13. 13. The catheter system of claim 12, wherein the guide catheter comprises a proximal end, a distal end, an inner liner, a braid surrounding the inner liner, and a jacket surrounding the braid.

14. 13. The catheter system of claim 12, wherein the tubular body of the telescoping guiding extension catheter comprises a proximal end, a distal end, an inner liner, a coil surrounding the inner liner, and a jacket surrounding the coil.

15. 15. The catheter system of claim 14, wherein the tubular body comprises a plurality of segments, each of the plurality of segments having a durometer rating, the durometer rating of each of the plurality of segments decreasing in a distal direction.

16. 13. The catheter system of claim 12, wherein the inner diameter of the guide catheter decreases proximally.

17. The catheter system of claim 12, wherein the outer diameter of the tubular body increases in a distal direction.

18. 13. The catheter system of claim 12, wherein the inner portion of the guide extension wire is flush with the inner portion of the tubular body.

19. 13. The catheter system of claim 12, wherein the difference between the inner diameter of the guide catheter at its most proximal end and the outer diameter of the tubular body at its most distal end is between about 0.005 inches and about 0.05 inches.

20. 10. A catheter system comprising a guide catheter and a telescoping guide extension catheter as herein shown and described.

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