Concentric Catheter System

Abstract

The catheter system (10) includes an outer catheter adapter (12), an outer catheter (18) having an outer catheter lumen (24) extending therethrough, an inner catheter adapter (28), an inner catheter lumen (34) extending through the inner catheter adapter (28), and an inner catheter (36) extending distally from the inner catheter adapter (28), such that the inner catheter (36) is disposed within the outer catheter lumen (24), and the inner catheter (36) and inner catheter adapter (28) are configured to move relative to the outer catheter (18) and outer catheter adapter (12) between a proximal position and a distal position.

Description

[Background technology]

[0001] background Catheters are commonly used to infuse fluids into a patient's vascular system. For example, catheters may be used to infuse normal saline, various medications, or total parenteral nutrition. Catheters may also be used to withdraw blood from a patient.

[0002] The catheter may include an over-the-needle peripheral intravenous ("IV") catheter. In this case, the catheter may be mounted on an introducer needle having a sharpened distal tip. The catheter and introducer needle may be assembled such that the distal tip of the introducer needle extends beyond the distal tip of the catheter, with the bevel of the needle pointing away from the patient's skin. The catheter and introducer needle are inserted through the skin into the patient's vascular system at a generally shallow angle.

[0003] To confirm proper placement of the introducer needle and / or catheter within the blood vessel, the practitioner typically checks for a "flashback" of blood in the flashback chamber of the catheter assembly. Once needle placement is confirmed, the practitioner may temporarily occlude flow through the vasculature and remove the needle, leaving the catheter in place for future blood withdrawals or fluid injections. Summary of the Invention [Problem to be solved by the invention]

[0004] Drawing blood using a catheter can be challenging for several reasons, especially if the catheter remains in the blood vessel for more than a day. When a catheter remains inserted in a patient for an extended period of time, the catheter or vein may become susceptible to stenosis, collapse, kinking, blockage by deposits (e.g., fibrin or platelet clumps), and adhesion of the catheter tip to the vasculature. Over time, this can lead to problems with infusions, blood collection, and aspiration. While catheters are often used to collect blood samples at the time of catheterization, they are less frequently used to collect blood samples during the catheterization period. Therefore, when a blood sample is required, an additional needlestick is often required to provide venous access for blood collection, which can be painful for the patient and lead to higher material costs.

[0005] The subject matter claimed herein is not limited to embodiments that solve any shortcomings or that operate only in environments such as those described above. Rather, this background is provided only to illustrate one example technology area where some implementations described herein may be practiced. [Means for solving the problem]

[0006] overview The present disclosure generally relates to vascular access systems and related devices and methods. In some embodiments, a catheter system may facilitate aspiration, blood withdrawal, and infusion by opening a fluid path through the catheter system, while reducing the risk of microbial intrusion and dislodgement of the catheter system from a patient's vascular system. In some embodiments, the catheter system may include an outer catheter adapter, which may include a distal end and a proximal end. In some embodiments, the catheter system may include an outer catheter, which may include a distal end, a proximal end, an outer catheter lumen extending through the distal end of the outer catheter and the proximal end of the outer catheter, and an inner surface forming the outer catheter lumen. In some embodiments, the outer catheter may extend distally from the distal end of the outer catheter adapter, and the distal end of the outer catheter may include a distal opening.

[0007] In some embodiments, the catheter system may include an inner catheter adapter, which may include a distal end, a proximal end, and an inner catheter lumen extending through the distal end of the inner catheter adapter and the proximal end of the inner catheter adapter. In some embodiments, the inner catheter and outer catheter may be concentric. In some embodiments, the inner catheter may extend distally from the distal end of the inner catheter adapter, and the inner catheter may be disposed within the outer catheter lumen. In some embodiments, the inner catheter and inner catheter adapter may be configured to move relative to the outer catheter and outer catheter adapter between a proximal position and a distal position. In some embodiments, in response to the inner catheter and inner catheter adapter being in the distal position, the distal end of the inner catheter may be disposed distally relative to the distal end of the outer catheter.

[0008] In some embodiments, the catheter system may include a gap disposed between an outer surface of the inner catheter and an inner surface of the outer catheter. In some embodiments, in response to the inner catheter and the inner catheter adapter being in a distal position, the inner catheter may be disposed within the distal opening to restrict distal flow into the gap. In some embodiments, in response to movement of the inner catheter from the distal position to the proximal position, the inner catheter may be disposed proximal to the distal opening, and the gap may be in fluid communication with the distal opening.

[0009] In some embodiments, the inner catheter adapter may be slidable relative to the outer catheter adapter to move the inner catheter adapter and the inner catheter between a proximal position and a distal position. In some embodiments, the catheter system may include a toggle joint, which may include a distal end coupled to the outer catheter adapter and a proximal end coupled to the inner catheter adapter. In some embodiments, the toggle joint may be configured to be depressed to move the inner catheter and the inner catheter adapter to the proximal position.

[0010] In some embodiments, the inner catheter and the inner catheter adapter may be configured to move relative to the outer catheter and the outer catheter adapter between a first position and a second position. In some embodiments, the catheter system may include a plurality of fenestrations disposed in the outer catheter or the inner catheter. In some embodiments, the fenestrations may be blocked when the inner catheter is in the first position. In some embodiments, in response to movement of the inner catheter from the first position to the second position, the fenestrations may be unblocked, allowing fluid to flow through the fenestrations into the inner catheter lumen.

[0011] In some embodiments, the fenestration may be disposed in the outer catheter, and the catheter system may include multiple other fenestrations disposed in the inner catheter. In some embodiments, the inner catheter and the inner catheter adapter may be configured to rotate relative to the outer catheter and the outer catheter adapter between a first position and a second position. In some embodiments, in response to the inner catheter and the inner catheter adapter being in the second position, the fenestration and the other fenestrations may be aligned. In some embodiments, in response to the inner catheter and the inner catheter adapter being in the first position, the fenestration and the other fenestrations may be misaligned.

[0012] In some embodiments, the inner catheter and inner catheter adapter may be configured to slide relative to the outer catheter and outer catheter adapter between a first position and a second position. In some embodiments, in response to the inner catheter being in the second position, the inner catheter may extend through a distal opening of the outer catheter. In some embodiments, a fenestration may be disposed within the distal end of the inner catheter. In these and other embodiments, the fenestration may be disposed distal to the distal opening of the outer catheter in response to movement of the inner catheter from the first position to the second position.

[0013] In some embodiments, the fenestrations may be located in the outer catheter and the other fenestrations may be located in the inner catheter. In these and other embodiments, the fenestrations and the other fenestrations may be aligned in response to the inner catheter and the inner catheter adapter being in the second position, and the fenestrations and the other fenestrations may be misaligned in response to the inner catheter and the inner catheter adapter being in the first position. In some embodiments, the fenestrations may be located in the distal end of the outer catheter or in the proximal end of the outer catheter.

[0014] In some embodiments, the inner catheter and inner catheter adapter may be configured to slide relative to the outer catheter and outer catheter adapter between a first position and a second position. In these and other embodiments, a fenestration may be disposed within the outer catheter, and a distal end of the inner catheter may move distally relative to the fenestration in response to the inner catheter moving between the first and second positions.

[0015] In some embodiments, the catheter may include a plurality of fenestrations in its wall. In some embodiments, the catheter system may include a tube disposed within the catheter. In some embodiments, the tube may include a distal end and may be configured to move between a proximal position and a distal position. In some embodiments, in response to the tube moving between the proximal and distal positions, the distal end of the tube may move distal to the fenestrations in the catheter.

[0016] In some embodiments, the distal end of the tube may include a sharp edge. In some embodiments, the proximal end of the tube may be coupled to a guidewire. In some embodiments, the catheter system may include an outer catheter, and the catheter may be an inner catheter disposed within the outer catheter. In these and other embodiments, the tube may be disposed within the inner catheter lumen. In some embodiments, the catheter system may include a toggle joint, which may include a distal end of the toggle joint coupled to a catheter adapter and a proximal end of the toggle joint coupled to the tube. In some embodiments, the toggle joint may be configured to be depressed to move the tube to a proximal position.

[0017] It is understood that both the foregoing general description and the following detailed description are exemplary and explanatory and are not restrictive of the invention as claimed. It is to be understood that the various embodiments are not limited to the arrangements and instrumentality illustrated in the drawings. It is also to be understood that embodiments may be combined, other embodiments may be utilized, and structural changes may be made without departing from the scope of the various embodiments of the invention, unless so claimed. Therefore, the following detailed description is not to be taken in a limiting sense.

[0018] Brief Description of Some Drawings The illustrative embodiments will be detailed and explained with additional specificity and detail through the use of the accompanying drawings therein. [Brief explanation of the drawings]

[0019] [Figure 1A] FIG. 1A is a cross-sectional view of an exemplary catheter system showing an exemplary inner catheter and an exemplary inner catheter adapter in an exemplary distal position, according to some embodiments. [Figure 1B] FIG. 1B is a cross-sectional view of a catheter system illustrating an inner catheter and inner catheter adapter in an exemplary proximal position, according to some embodiments. [Figure 2A] FIG. 2A is a cross-sectional view of a portion of a catheter system illustrating an inner catheter and inner catheter adapter in a proximal position and an exemplary outer catheter, according to some embodiments. [Figure 2B] FIG. 2B is a cross-sectional view of a portion of a catheter system showing the inner catheter and inner catheter adapter in a distal position, according to some embodiments. [Figure 3] FIG. 3 is a top perspective view of a catheter system showing an example of a toggle joint, according to some embodiments. [Figure 4A]FIG. 4A is a top perspective view of an inner catheter and an exemplary inner catheter adapter in a distal position, illustrating an exemplary fenestration, according to some embodiments. [Figure 4B] FIG. 4B is a top perspective view of the inner catheter and inner catheter adapter of FIG. 4A in a proximal position, illustrating the inner catheter in a distal position, according to some embodiments. [Figure 4C] FIG. 4C is a top perspective view of the inner catheter and inner catheter adapter in a distal position, illustrating another exemplary fenestration, according to some embodiments. [Figure 4D] FIG. 4D is a top perspective view of the inner catheter and inner catheter adapter of FIG. 4C in a proximal position, according to some embodiments. [Figure 5] FIG. 5 is a partial cutaway view of a catheter system showing an exemplary thread, according to some embodiments. [Figure 6A] FIG. 6A is a cross-sectional view of a portion of a catheter system showing an exemplary tube in a proximal position, according to some embodiments. [Figure 6B] FIG. 6B is a cross-sectional view of a portion of a catheter system showing the tube in a distal position, according to some embodiments. [Figure 6C] FIG. 6C is a cross-sectional view of a portion of a catheter system showing a tube having one or more slots, according to some embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0020] Detailed Description As used in this disclosure, the term "distal" refers to a direction away from the practitioner who will contact the device with the patient and closer to the patient. As used in this disclosure, the term "proximal" refers to a direction closer to the practitioner who will contact the device with the patient and farther from the patient.

[0021] 1A-1B, in some embodiments, a catheter system 10 may include an outer catheter adapter 12, which may include a distal end 14 and a proximal end 16. In some embodiments, the catheter system 10 may include an outer catheter 18, which may include a distal end 20, a proximal end 22, an outer catheter lumen 24 extending through the distal end 20 and the proximal end 22 of the outer catheter 18, and an inner surface 25 forming the outer catheter lumen 24. In some embodiments, the outer catheter 18 may extend distally from the distal end 14 of the outer catheter adapter 12. In some embodiments, the distal end 20 of the outer catheter may include a distal opening 26.

[0022] In some embodiments, the catheter system 10 may further include an inner catheter adapter 28. In some embodiments, the inner catheter adapter 28 may include a distal end 30, a proximal end 32, and an inner catheter lumen 34 extending through the distal end 30 of the inner catheter adapter 28 and the proximal end 32 of the inner catheter adapter 28. In some embodiments, the inner catheter 36 may extend distally from the distal end 30 of the inner catheter adapter 28. In some embodiments, the inner catheter 36 may be disposed within the outer catheter lumen 24. In some embodiments, the inner catheter 36 and the inner catheter adapter 28 may be configured to move relative to the outer catheter 18 and the outer catheter adapter 12 between a proximal position, for example, as illustrated in FIG. 1A , and a distal position, for example, as illustrated in FIG. 1B .

[0023] In some embodiments, in response to the inner catheter 36 and the inner catheter adapter 28 being in a proximal position, such as shown in FIG. 1A, the distal end 38 of the inner catheter 36 may be disposed distally relative to the distal end 20 of the outer catheter 18. In some embodiments, in response to the inner catheter 36 and the inner catheter adapter 28 being in a distal position, such as shown in FIG. 1B, the distal end 38 of the inner catheter 36 may be disposed more distally relative to the distal end 20 of the outer catheter 18 than when in the proximal position.

[0024] In some embodiments, the outer catheter 18 may be coupled to the outer catheter adapter 12 by an interference fit, a bushing, an adhesive, or another suitable technique or device. In some embodiments, the inner catheter 36 may be coupled to the inner catheter adapter 28 by an interference fit, a bushing, an adhesive, or another suitable technique or device.

[0025] In some embodiments, the inner catheter adapter 28 may be slidable relative to the outer catheter adapter 12 to move the inner catheter adapter 28 and the inner catheter 36 between a proximal position and a distal position. In some embodiments, the outer catheter 18 may remain stationary within the patient's vasculature when the inner catheter 36 is moved, and therefore may not become dislodged from the vasculature in response to movement of the inner catheter 36.

[0026] In some embodiments, the catheter system 10 may include a toggle joint 42 to facilitate moving or sliding the inner catheter adapter 28 relative to the outer catheter adapter 12, thereby moving or sliding the inner catheter 36 relative to the outer catheter 18. In some embodiments, the toggle joint 42 may also allow a user to contact the toggle joint 42 instead of a particular catheter adapter to move the inner catheter 36 within the vasculature, thereby reducing the risk of bacterial contamination.

[0027] In some embodiments, the toggle joint 42 may include a distal end 44 coupled to the outer catheter adapter 12 and a proximal end 46 coupled to the inner catheter adapter 28. In some embodiments, the toggle joint 42 may be configured to be depressed to move the inner catheter 36 and the inner catheter adapter 28 to a proximal position. In some embodiments, the toggle joint 42 may be depressed from a first position, such as illustrated in FIG. 1A , to a second position, such as illustrated in FIG. 2B . In some embodiments, the toggle joint 42 may be more angled in the first position than in the second position. In some embodiments, the toggle joint 42 may be generally straight in the second position. In some embodiments, in response to the toggle being no longer depressed, the toggle joint 42 may remain in the second position or may return to the first position, moving the inner catheter 36 and the inner catheter adapter 28 to a distal position.

[0028] In some embodiments, the toggle joint 42 may be constructed of a flexible polymer or other suitable material. In some embodiments, the toggle joint 42 may be configured to fold at a groove or crease between the distal end 44 and the proximal end 46. In some embodiments, the toggle joint 42 may be resilient. In some embodiments, the flexible polymer or other suitable material may facilitate folding at the groove. In some embodiments, the toggle joint 42 may be monolithically formed as a single unit. In other embodiments, the toggle joint 42 may include separate components that may be joined by one or more hinges.

[0029] In some embodiments, the inner catheter adapter 28 may be disposed within or on the outer catheter adapter 12. In some embodiments, the outer catheter 18 may include an inner diameter that is larger than the outer diameter of the inner catheter 36 such that the outer catheter 18 may receive the inner catheter 36 therein.

[0030] In some embodiments, one or more sealing elements 48, such as, for example, O-rings, may be disposed between the outer catheter adapter 12 and the inner catheter adapter 28 to seal the fluid path between the outer catheter adapter 12 and the inner catheter adapter 28. In some embodiments, the sealing elements 48 may comprise silicone, rubber, an elastomer, or another suitable material. In some embodiments, the lumen of the inner catheter adapter 28 may include a septum 49 to prevent blood from flowing through the proximal end 32 of the inner catheter adapter 28.

[0031] 2A-2B, the distal end 20 of the outer catheter 18 and the distal end 38 of the inner catheter 36 are illustrated, according to some embodiments. In some embodiments, the inner catheter adapter 28 may be moved proximally relative to the outer catheter adapter 12 to retract the inner catheter 36, or may be moved distally relative to the outer catheter adapter 12 to advance the inner catheter 36. In some embodiments, a toggle joint 42 (see FIGS. 1A-1B) may be used to move the inner catheter 36, as described with respect to FIGS. 1A-1B. In some embodiments, a threaded adjuster, such as that described with respect to FIG. 5, or another suitable mechanism may be used to move the inner catheter 36.

[0032] In some embodiments, for example, as shown in Figure 2A, in response to the inner catheter 36 and the inner catheter adapter 28 being in a proximal position, the distal end 38 of the inner catheter 36 may be disposed proximal to the distal opening 26 of the outer catheter 18. In some embodiments, for example, as shown in Figure 2B, in response to the inner catheter 36 and the inner catheter adapter 28 being in a distal position, the distal end 38 of the inner catheter 36 may be disposed distal to the distal opening 26 of the outer catheter 18.

[0033] In some embodiments, a gap 50 may be disposed between the outer surface of the inner catheter 36 and the inner surface of the outer catheter 18. In some embodiments, in response to the inner catheter 36 and the inner catheter adapter 28 being in a distal and / or proximal position, the gap 50 may be in fluid communication with the distal opening 26 of the outer catheter 18 such that in response to the outer catheter 18 being inserted into a vein, blood may flow through the distal opening 26 of the outer catheter 18 and into the gap 50. In some embodiments, the gap 50 may be annular.

[0034] In some embodiments, in response to the inner catheter 36 and inner catheter adapter 28 being in a distal position, the inner catheter 36 may be disposed within the distal opening 26, partially or completely restricting distal flow to the gap 50. The distal position is illustrated in FIG. 2B, according to some embodiments. In some embodiments, in response to movement of the inner catheter 36 from the distal position to the proximal position, the inner catheter 36 may be disposed proximal to the distal opening 26, and the gap 50 may be in fluid communication with the distal opening 26. The proximal position is illustrated in FIG. 2A, according to some embodiments.

[0035] In some embodiments, the inner catheter 36 and / or the outer catheter 18 may include one or more fenestrations or holes, which may facilitate the entry and exit of fluids. In some embodiments, the distal end of the inner catheter 36 may be closed, which may prevent blockage. In some embodiments, the distal end of the inner catheter 36 may be rounded and / or lubricated to reduce the possibility of damaging the vein.

[0036] In some embodiments, contact between the distal opening 26 and the inner catheter 36 during treatment may reduce the risk of a thrombus or clot entering the gap 50. In some embodiments, the inner catheter 36 may be moved to a proximal position for blood collection and / or infusion. In some embodiments, the inner catheter 36 may be moved to a proximal position relative to the outer catheter 18, which may facilitate aspiration, blood withdrawal, and infusion by ensuring an open fluid path, while reducing the risk of outer catheter 18 dislodgement, microbial contamination, or other complications.

[0037] 3, a catheter system 10 is illustrated, according to some embodiments. In some embodiments, the catheter system 10 may include a needle hub 52, which may be removably coupled to the outer catheter adapter 12. In some embodiments, an introducer needle 53 may be coupled to the needle hub 52 and may extend through the outer catheter 18 and the inner catheter 36. In some embodiments, the outer catheter adapter 12 may include wings 54.

[0038] In some embodiments, the catheter system 10 may include an extension tube 56, which may include a distal end coupled to the inner catheter adapter 28 and be in fluid communication with the inner catheter lumen 34. In some embodiments, an adapter 58 may be coupled to the proximal end of the extension tube 56. In some embodiments, a fluid infusion device may be coupled to the adapter 58 to supply fluid to the patient through the inner catheter 36, which may be inserted into a vein. In some embodiments, a blood collection device may be coupled to the adapter 58 to withdraw blood from the patient through the inner catheter 36, which may be inserted into a vein. In some embodiments, the extension tube 56 may extend through a slot in the outer catheter adapter 12. In some embodiments, the catheter system 10 may not include the extension tube 56.

[0039] In some embodiments, the catheter system 10 may be vented to observe blood flashback and facilitate proximal flow of blood. In some embodiments, the catheter system 10 may be vented in any suitable manner. For example, the vent plug 60 may be coupled to the adapter 58 during insertion of the outer catheter 18 into the patient. In some embodiments, the vent plug 60 may be permeable to air but impermeable to blood. In some embodiments, the inner catheter 36, the inner catheter adapter 28, the extension tube 56, the adapter 58, and the vent plug 60 may be in fluid communication.

[0040] 4A-4B, in some embodiments, the inner catheter 36 and the inner catheter adapter 28 may be configured to move relative to the outer catheter 18 and the outer catheter adapter 12 between a first position, e.g., as illustrated in FIG. 4A, and a second position, e.g., as illustrated in FIG. 4B. In some embodiments, the first and second positions may correspond to distal and proximal positions, respectively. In some embodiments, a toggle joint 42 (see FIGS. 1A-1B) may be used to move the inner catheter 36, as described with respect to FIGS. 1A-1B. In some embodiments, a threaded adjuster, e.g., as described with respect to FIG. 5, or another suitable mechanism may be used to move the inner catheter 36.

[0041] In some embodiments, one or more fenestrations 62 may be disposed within the outer catheter 18. In some embodiments, the fenestrations 62 may be disposed within the distal end 14 of the outer catheter 18. In some embodiments, the fenestrations 62 may be configured to be blocked by the inner catheter 36 when the inner catheter 36 is in the first position. In some embodiments, in response to movement of the inner catheter 36 from the first position to the second position, the fenestrations 62 may be unblocked to allow fluid to flow through the fenestrations 62 into the inner catheter lumen 34.

[0042] In some embodiments, the inner catheter 36 and the inner catheter adapter 28 may be configured to slide relative to the outer catheter 18 and the outer catheter adapter 12 between a first position and a second position. In some embodiments, the inner catheter 36 and the inner catheter adapter 28 may be configured to slide relative to the outer catheter 18 and the outer catheter adapter 12 along an axis 63 aligned with the outer catheter 18 (see, e.g., FIG. 3 ).

[0043] In some embodiments, one or more other fenestrations 64 may be disposed within the inner catheter 36. In some embodiments, in response to the inner catheter 36 and the inner catheter adapter 28 being in the second position, the fenestration 62 and the other fenestrations 64 may be aligned. In some embodiments, the other fenestrations 64 may be moved distally or proximally to align with the other fenestrations. Additionally or alternatively, the other fenestrations may be rotated to align with the other fenestrations.

[0044] In some embodiments, the fenestrations 62 and the other fenestrations 64 may be misaligned in response to the inner catheter 36 and the inner catheter adapter 28 being in the first position. In some embodiments, alignment of the fenestrations 62 and the other fenestrations 64 may increase fluid flow through the inner catheter lumen 34, and misalignment of the fenestrations 62 and the other fenestrations 64 may prevent thrombus or other obstructions from entering the inner catheter lumen 34. In some embodiments, the outer circumference of the inner catheter 36 may be slightly smaller than the inner circumference of the outer catheter 18 to allow the inner catheter 36 to move relative to the outer catheter 18 and / or to prevent fluid leakage between the inner catheter 36 and the outer catheter 18. In some embodiments, the outer circumference of the inner catheter 36 may contact the inner circumference of the outer catheter 18 along all or a portion of the circumference.

[0045] 4C-4D, in some embodiments, in response to the inner catheter 36 being in the second position, the inner catheter 36 may extend through the distal opening 26 of the outer catheter 18. In some embodiments, the distal end 38 of the inner catheter 36 may be open or closed. In some embodiments, a fenestration 62 may be disposed within the distal end 38 of the inner catheter 36, and the fenestration 62 may be disposed distal to the distal opening 26 of the outer catheter 18 in response to movement of the inner catheter 36 from the first position to the second position. In these embodiments, the fenestration 62 may facilitate fluid flow through the fenestration into the inner catheter lumen 34 without including any fenestration within the outer catheter 18.

[0046] In some embodiments, a toggle joint 42 (see FIGS. 1A-1B), as described with respect to FIGS. 1A-1B, may be used to move the inner catheter 36. In some embodiments, a threaded adjuster, such as that described with respect to FIG. 5, or another suitable mechanism may be used to move the inner catheter 36.

[0047] 5 , in some embodiments, the inner catheter 36 may be rotated relative to the outer catheter 18 in a user-controlled manner. For example, the catheter system 10 may include a threaded adjuster 66. In some embodiments, the threaded adjuster 66 may include a threaded portion 70, which may correspond to another threaded portion 72. In some embodiments, the threaded portion 70 may be disposed on the outer surface and / or distal end 30 of the inner catheter adapter 28. In some embodiments, the other threaded portion 72 may be disposed on the inner surface of the outer catheter adapter 12. In some embodiments, the inner catheter adapter 28 may be coupled to the outer catheter adapter 12 via the threaded portion 70 and the other threaded portion 72.

[0048] In some embodiments, the inner catheter adapter 28 and the inner catheter 36 may rotate about an axis 63, which may be aligned with the outer catheter 18 between a first position and a second position. More specifically, the inner catheter adapter 28 may be threaded or unthreaded relative to the outer catheter adapter 12 from the first position to the second position and / or from the second position to the first position. In some embodiments, the outer catheter adapter 12 may remain stationary within the patient's vasculature when the inner catheter 36 is moved, and therefore may not become dislodged from the vasculature in response to movement of the inner catheter 36.

[0049] 6A-6C, in some embodiments, a tube 80 may be disposed within outer catheter 18. In some embodiments, tube 80 may correspond to inner catheter 36. In other embodiments, tube 80 may be coupled to a guidewire 82, which may be used to advance tube 80 distally and / or retract tube 80 proximally.

[0050] In some embodiments, the outer catheter 18 may include a fenestration 62 through the wall of the outer catheter 18. In some embodiments, the distal end 84 of the tube 80 may contact and / or move against the distal end of the fenestration 62 in response to the tube 80 moving between a proximal position, such as that illustrated in FIG. 6A, and a distal position, such as that illustrated in FIG. 6B.

[0051] In some embodiments, a thrombus, clot, or obstruction may be blocking one or more of the fenestrations 62. In some embodiments, the distal end 84 of the tube 80 may cut or fenestrate the thrombus, clot, or obstruction to clear the fenestrations 104 and facilitate fluid flow therethrough. In some embodiments, the distal end 84 of the tube 80 may include a sharpened edge 86. In some embodiments, the sharpened edge 86 may be annular. In some embodiments, the sharpened edge 86 may comprise metal, ceramic, high-density polyethylene, or another suitable material. In some embodiments, the sharpened edge 86 may clear the fenestrations with axial movement of the tube between the proximal and distal positions (which may be accomplished by the user).

[0052] 6C, in some embodiments, tube 80 may include one or more slots 92, which may extend from distal end 84 of tube 80. In some embodiments, slots 92 may include sharp edges 94, which may facilitate clearing fenestrations 62 in response to tube 80 and guidewire 82 being rotated about axis 63, which may be accomplished by the user. In some embodiments, the width of each of slots 92 may be greater than or equal to the width of fenestrations 62.

[0053] All examples and conditional statements described herein are for educational purposes to help the reader understand the concepts contributed by the inventor to further the invention and technology, and should not be construed as being limited to the examples and conditions so specifically described. Although embodiments of the present invention have been described in detail, it should be understood that various changes, substitutions, and alterations can be made therein without departing from the spirit and scope of the present invention.

Claims

1. The catheter system an outer catheter adapter having a distal end and a proximal end; an outer catheter having a distal end, a proximal end, an outer catheter lumen extending through the distal end of the outer catheter and the proximal end of the outer catheter, and an inner surface forming the outer catheter lumen, the outer catheter extending distally from the distal end of the outer catheter adapter, the distal end of the outer catheter having a distal opening; an inner catheter adapter disposed within the outer catheter adapter, the inner catheter adapter having a distal end, a proximal end, and an inner catheter lumen extending through the distal end of the inner catheter adapter and the proximal end of the inner catheter adapter; and a catheter system comprising an inner catheter extending distally from the distal end of the inner catheter adapter, the inner catheter being disposed within a lumen of the outer catheter, the inner catheter and the inner catheter adapter being configured to move between a proximal position and a distal position relative to the outer catheter and the outer catheter adapter.

2. 2. The catheter system of claim 1, wherein the distal end of the inner catheter is disposed distally relative to the distal end of the outer catheter in response to the inner catheter and the inner catheter adapter being in the distal position.

3. 2. The catheter system of claim 1, further comprising a gap disposed between an outer surface of the inner catheter and the inner surface of the outer catheter, wherein in response to the inner catheter and the inner catheter adapter being in the distal position, the inner catheter is disposed within the distal opening to restrict distal flow into the gap, and in response to movement of the inner catheter from the distal position to the proximal position, the inner catheter is disposed proximal to the distal opening so that the gap is in fluid communication with the distal opening.

4. 10. The catheter system of claim 1, wherein the inner catheter adapter is slidable relative to the outer catheter adapter to move the inner catheter adapter and the inner catheter between the proximal and distal positions.

5. 5. The catheter system of claim 4, further comprising a toggle joint having a distal end coupled to the outer catheter adapter and a proximal end coupled to the inner catheter adapter.

6. The catheter system of claim 5 , wherein the toggle joint is configured to be depressed to move the inner catheter and the inner catheter adapter to the proximal position.

7. The inner catheter having a distal end, a proximal end, and an inner catheter lumen extending through the inner catheter; 2. The catheter system of claim 1, further comprising a plurality of fenestrations disposed in the outer catheter or the inner catheter, the plurality of fenestrations being blocked when the inner catheter is in the first position, and in response to movement of the inner catheter from the first position to the second position, the plurality of fenestrations being unblocked to allow fluid to flow through the plurality of fenestrations into the inner catheter lumen.

8. 8. The catheter system of claim 7, wherein the plurality of fenestrations are disposed in the outer catheter and further comprising a plurality of other fenestrations disposed in the inner catheter, the inner catheter and the inner catheter adapter are configured to rotate relative to the outer catheter and the outer catheter adapter between the first position and the second position, and the plurality of fenestrations and the other plurality of fenestrations are aligned in response to the inner catheter and the inner catheter adapter being in the second position, and the plurality of fenestrations and the other plurality of fenestrations are misaligned in response to the inner catheter and the inner catheter adapter being in the first position.

9. The catheter system of claim 7 , wherein the inner catheter and the inner catheter adapter are configured to slide relative to the outer catheter and the outer catheter adapter between the first position and the second position.

10. The catheter system of claim 9 , wherein the inner catheter extends through a distal opening of the outer catheter in response to the inner catheter being in the second position.

11. 11. The catheter system of claim 10, wherein in response to movement of the inner catheter from the first position to the second position, the plurality of fenestrations are positioned within the distal end of the inner catheter and the plurality of fenestrations are positioned distally from the distal opening of the outer catheter.

12. 10. The catheter system of claim 9, wherein the plurality of fenestrations are disposed in the outer catheter and further comprising a plurality of other fenestrations disposed in the inner catheter, wherein the plurality of fenestrations and the other plurality of fenestrations are aligned in response to the inner catheter and the inner catheter adapter being in the second position, and the plurality of fenestrations and the other plurality of fenestrations are misaligned in response to the inner catheter and the inner catheter adapter being in the first position.

13. The catheter system of claim 12 , wherein the plurality of fenestrations are disposed within the distal end of the outer catheter or within the proximal end of the outer catheter.

14. 8. The catheter system of claim 7, wherein the inner catheter and the inner catheter adapter are configured to slide relative to the outer catheter and the outer catheter adapter between the first position and the second position, and the plurality of fenestrations are disposed within the outer catheter.

15. 15. The catheter system of claim 14, wherein the distal end of the inner catheter moves to the distal ends of the plurality of fenestrations in response to the inner catheter moving between the first position and the second position.

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