Multi-lumen catheter

Abstract

To provide devices and methods of use thereof for improving access and navigation of vascular bifurcations and other multiple tortuous pathways.SOLUTION: A medical device includes: an elongate catheter body defining a proximal segment, a distal segment, and a first lumen through the catheter body; a tube attached to the distal segment of the catheter body, the tube defining a proximal end, a distal end, and a second lumen through the tube. The proximal end of the tube is attached to the catheter body at a first joint. The distal end of the tube is attached to the catheter body at a second joint. A portion of the tube extending between the first and second joints is movable with respect to the catheter body.SELECTED DRAWING: Figure 2

Description

Technical Field

[0001] The present disclosure relates to intravascular medical devices and methods of using the same.

Background Art

[0002] To deliver medical devices such as stents or angioplasty balloons intravascularly, various catheter systems have been developed. Typically, a guidewire is introduced into a blood vessel and advanced through the vascular system to a treatment site. Next, the catheter is advanced beyond the guidewire so that the distal end of the catheter is positioned at the treatment site. Next, the catheter and / or the guidewire can be used to transport any of a variety of medical devices, such as stents, grafts, angioplasty balloons, atherectomy devices, and the like, and place them in proximity to the treatment site.

[0003]

Summary of the Invention

[0004] Effectively, the present invention includes an elongated catheter body defining a first lumen passing through a proximal segment, a distal segment, and the catheter body, and a tube attached to the distal segment of the catheter body, the tube having a proximal end, a distal end, and a second lumen passing through the tube. ​​​​​​​​​​​​​​ The catheter comprises a tube that defines the junction, and the proximal end of the tube is connected to the catheter body at the first joint. The distal end of the tube is attached to the catheter body at the second joint, and the first and A portion of the tube extending between the first and second joints is movable relative to the catheter body. We provide medical devices.

[0005] The first joint includes a first cap that is concentrically mounted on the proximal end of the tube. The first cap is attached to the catheter body. The second joint is distal to the tube. It may include a second cap that is mounted concentrically to the end, the second cap being a cat It may be attached to the main body. At least one of the first and second joints is heat-shrinkable. This may include the attachment of the tube to the catheter body by tubing. and at least one of the second joints are attached to the catheter body by adhesive. The tube may contain a patch. The tube may be constructed from polymer, at least partially. Often, at least one of the first and second joints is connected to a portion of the tube, which is connected to the catheter body. This includes attaching a tube to the catheter body by fusing it to a portion of it. This is also acceptable. The first lumen does not have to be concentric with the second lumen.

[0006] Medical devices further enhance the deflection element attached to the distal segment of the catheter body. It may also be prepared, and the deflection element is an arc shape aligned adjacent to the first lumen. A surface may be defined. An arc-shaped surface may define an arc between 45 and 135 degrees.

[0007] The deflection element has a first aperture that is substantially coaxial with the first lumen, and relative to the first aperture A second opening that is approximately vertical may be defined, and the arc-shaped surface extends between the first and second openings. It is acceptable for it to be present.

[0008] The deflection element defines a third aperture that is substantially perpendicular to each of the first and second apertures. The deflection element may be radiopaque, and / or catheter The deflection element may be movable relative to the catheter body. The deflection element is located in the longitudinal direction of the catheter body. It may be movable along an axis.

[0009] This disclosure relates to a first route through a proximal segment, a distal segment, and the catheter body. A long, slender catheter body that defines the men, and an attachment to the distal segment of the catheter body. A tube, which is not concentric with the first lumen, and which has a second lumen passing through the tube The tube is defined, and the deflection element is attached to the distal segment of the catheter body. There is a deflection that defines an arc-shaped surface that is aligned adjacent to the distal end of the first lumen. Equipped with elements, the arc-shaped surface defines an arc of 45 to approximately 135 degrees, also suitable for medical devices. provide.

[0010] The deflection element has a first aperture that is substantially coaxial with the first lumen, and relative to the first aperture A second opening that is approximately vertical may be defined, and the arc-shaped surface extends between the first and second openings. They may be present. The deflection element is a third that is substantially perpendicular to each of the first and second apertures. The aperture may be defined. The deflection element may be radiopaque, and / or The deflection element may be movable relative to the catheter body. It is movable along the longitudinal axis of the body. At least a portion of the tube is the catheter. It may be movable independently of the body.

[0011] A more complete understanding of the present disclosure, along with its attendant advantages and features, will be more readily understood by reference to the following detailed description and consideration in conjunction with the accompanying drawings.

Brief Description of the Drawings

[0012] [Figure 1] An example of a medical device constructed in accordance with the principles of the present disclosure is shown. [Figure 2] A detailed view showing the distal segment of the medical device of FIG. 1. [Figure 3] A side view showing the distal segment of the medical device of FIG. 1. [Figure 4] Another view showing the distal segment of the medical device of FIG. 1. [Figure 5] A distal end view of the medical device of FIG. 1. [Figure 6] A proximal end view of the medical device of FIG. 1. [Figure 7] A side view showing the curved shape of an example of a medical device constructed in accordance with the principles of the present disclosure. [Figure 8] A perspective view showing the curved shape of the example of the medical device shown in FIG. 7. [Figure 9] A front view showing the curved shape of the example of the medical device shown in FIG. 7. [Figure 10] Another example of a medical device constructed in accordance with the principles of the present disclosure is shown. [Figure 11] Another example of a medical device constructed in accordance with the principles of the present disclosure is shown. [Figure 12] A side view showing the distal segment of the medical device of FIG. 11. [Figure 13] A cross-sectional view showing the distal segment of the medical device of FIG. 11. [Figure 14A] A view showing an example of the deflection element of the medical device of FIG. 11. [Figure 14B]Figure 11 shows an example of a deflection element in a medical device. [Figure 15] Another example of a deflection element for a medical device constructed in accordance with the principles of this disclosure is shown. [Figure 16] Figure 11 is a proximal end view of the medical device. [Figure 17] Figure 11 is a distal end view of the medical device. [Figure 18] This is another diagram showing the distal segment of the medical device in Figure 11. [Figure 19] This is yet another diagram showing the distal segment of the medical device in Figure 11. [Figure 20] A medical device comprising the deflection element shown in Figure 15, constructed in accordance with the principles of this disclosure, is shown. [Figure 21] This is another diagram showing the distal segment of the medical device in Figure 20. [Modes for carrying out the invention]

[0013] This disclosure provides an intravascular medical device and a method of using the same. Specifically, this disclosure provides Multiple guides operated independently and / or along different segments of the vascular system Multi-lumen that can be operated to facilitate procedures using ears or other assistive devices. We provide medical devices.

[0014] Next, referring to the drawings, Figures 1 to 9 are in accordance with the principles and advantages disclosed herein. An example 10 of constructed intravascular medical devices, such as catheters, is shown. Device 10 is In interventional cardiology, assess and / or treat occlusion or other vascular disorders or vascular conditions. One or more other devices, such as those used for, as disclosed herein. It is a minimally invasive device that can be inserted and operated intravenously in conjunction with a chair. Device 10 is generally introduced and operated from outside the patient, passes through the vascular system, and is evaluated. Sufficient length, flexibility, and torque transmission to be positioned close to the area to be treated or valued. It includes an elongated catheter body 12 having hub characteristics. The catheter body 12 is generally hub A proximal segment 14 that connects to and / or terminates at hub 16, and a distal segment 18 and the catheter body 12 further extends through the catheter body 12 and The distal segment 18 includes, or defines, a first lumen 20, and lumens 2 0 allows the guidewire to pass through and / or the catheter in the distal segment 18. The body 12 has a diameter sufficient to introduce one or more fluids.

[0015] The catheter body 12 is constructed from metal, polymer, or a combination of polymer and metal. It may include one or more parts. Examples of materials that can be used include stainless steel. (SST), nickel-titanium (nitinol) or polymer may be used. Examples of metals include superelastic nickel-titanium, shape-memory nickel-titanium, Ti-Ni, and Ni Titanium, approximately 55-60% by weight: Ni, Ni-Ti-Hf, Ni-Ti-Pd, Ni- Mn-GA, 300-400 series, e.g., 304, 316, 402, 440 series SAE grade stainless steel (SST), MP35N, and 17-7 precipitation in the sieve Hardened (PH) stainless steel, other spring steels, or other high tensile strength materials, or other biocompatible materials It contains alloy metal materials.

[0016] The catheter body 12 provides axial torque transmission for pushability, kink resistance, and rotational response. , and / or bending flexibility, as measured by the torque that leads to breakage along its length. To provide a gradual transition of sex, one or more cut patterns are provided inside. It may include multiple tube components.

[0017] Modulation of flexibility / rigidity along the length of the catheter body 12 can be achieved in several ways. Yes. For example, the flexibility / rigidity of the tubular component of the catheter body 12 is determined by the spiral The variables of the spiral cut pattern (pitch, number of interruptions) are changed, and the spiral cut pattern is also changed. It may be controlled by transitioning between them. Furthermore, the spiral cut pattern is a tube When the module is bent or curved, the cross-sectional diameter of the lumen is preserved. This makes it possible. The spiral cut section, which has a different cut pattern, is a tubular module The spiral cut pattern may be distributed along the length of the catheter body 1. The length of 2 can be continuous or discontinuous. For example, the length of a device. Along this, there are 1, 2, 3, 4, 5, 6, 7, ... n spiral cut sections. This is also fine. The spiral cut section may be continuous or interrupted. Within each section So, a certain cut pattern may exist, but between different parts within the tubular module... So, the cut pattern can change, for example, the pitch.

[0018] One or more parts of the catheter body 12 also include a variable pitch pattern within a specific part. This can happen. Each spiral cut section is, for example, in the range of approximately 0.05 mm to approximately 10 mm. Within a constant pitch, for example, pitches of 0.1mm, 0.2mm, 0.3mm, 0.4mm , 0.5mm, 0.6mm, 0.7mm, 0.8mm, 0.9mm, 1.0mm, 1.5 You may have sizes such as mm, 2.0mm, 2.5mm, 3.0mm, 3.5mm, 4.0mm, and others. The pitch may also vary within each section. The pitch of different spiral cut sections is It may be the same as or different from other parts of the catheter body 12. In other words, the catheter body 12 has a spiral that changes continuously along the length of the catheter. It may be formed from a tubular module having a tread pattern. Spiral within the module The direction or orientation of the cut section may also change within the spiral cut section.

[0019] One or more parts of the catheter body 12 are cut pattern parts of the catheter body 12. Protects the component and allows the catheter body 12 to pass through the tube component. Transportation of additional tool devices such as guide wires and balloons to the location. It is possible to cover it with a lining that facilitates the outer and / or inner lining. The ning is a polymer tubular structure obtained by simultaneously extruding, for example, the tube wall from a polymer. The tubular structure is sealed in one of several layers and then heat-shrinked or immersed in a coating. It is possible to manufacture them by coating the tube walls with a coating process. The polymer jacket material is nylon, polyether block amide, PTFE (poly (Tetrafluoroethylene), FEP (Fluorinated Ethylene Propylene), PFA (Perfume Fiber) Luoroalkoxyalkanes), PET (polyethylene terephthalate) or PEEK ( It may also be polyetheretherketone. Furthermore, the distal tube portion 120 (and The entire length of the catheter 100 is made of hydrophilic polymer to enhance lubricity and conformability. It may be covered with a coating. Hydrophilic polymer coatings are not limited to this. However, it may contain polyelectrolyte polymers and / or nonionic hydrophilic polymers. The polymer electrolytes include poly(acrylamide-co-acrylic acid) salts, and Li(methacrylamide-co-acrylic acid) salts, poly(acrylamide-co-methacrylic acid) Acids, salts, and others may be included, and nonionic hydrophilic polymers include poly(lactam), for example. For example, polyvinylpyrrolidone (PVP), Polyurethane, homopolymers and copolymers of acrylic acid and methacrylic acid, polyvinyl Nyl alcohol, polyvinyl ether, sinapic anhydride copolymer (snapic Anhydride-based copolymer, polyester, hydroxypropyl It may be polycellulose, heparin, dextran, polypeptide, or others.

[0020] To facilitate the movement of the device 10 through the blood vessel, lubrication is applied to the catheter body 12. A coating or film may be added. A lubricating coating is, for example, High percentage of vinyl polymers, polyalkylene glycols, and alkoxy polyethylene glycols Silicone or hydrogel polymers or similar materials such as micromesh, It can be composed of uncrosslinked hydrogels, such as polyethylene oxide (PEO). Yes. The coatings and liners disclosed herein are dipping coating processes. By means of, or by spraying the coating onto the outer and inner surfaces of the tube. It is possible to do so.

[0021] Additional features of device 10 and catheter body 12 include "MODULAR VAS U.S. Patent Application No. 15 / 726,024, entitled "CULAR CATHETER" (as described in U.S. Patent Publication No. 2018 / 0093070), the patent application is The entirety of this is included in the disclosure by reference.

[0022] Device 10 is a secondary lumen connected to the distal segment 18 of the catheter body 12. Assembly 22 may be included. The secondary lumen assembly 22 generally consists of guide wires. It has an internal lumen of 26 that can be operated to accept other instruments / auxiliary devices. It may include a tube or tube segment 24 defined therein. 24 may be constructed in the same manner as the catheter body 12, and / or the catheter body It may have predetermined features and properties similar to those of 12. The tube segment 24 is a tube The segment 24 is not concentric or coaxial with the catheter body 12, but is instead in a parallel configuration. It may be attached to the outer surface of the catheter body 12 to achieve this.

[0023] The tube segment 24 has a certain degree of rotational freedom and movement from the catheter body 12. Partially coupled to the catheter body 12 to allow bending and / or displacement For example, the tube segment 24 may be used to form a proximal joint 28. The proximal portion of the tube segment 24 may be connected to the catheter body 12, and distal To form the joint 30, the distal portion of the tube segment 24 is connected to the catheter body 12 They may be joined to the proximal and distal joints 28, 30. A considerable portion of the remaining part of the 24 does not need to be fixed to the catheter body, and / Alternatively, it does not need to be attached to it.

[0024] The proximal and distal junctions 28 and 30 are used for various different attachment modalities. It may include one or more of these. For example, joints 28 and 30 are each tube segments It may include a pre-formed molded cap that receives a portion of the ment 24 inside, The joints 28 and 30 are sheaths and / or heat absorbers surrounding the ends of the tube segment 24. They may be formed from shrink tubing, and / or the joints 28, 30 are bonded with adhesive, etc. It may include pipes and / or welding attachments. For example, proximal joints and The distal joints 28 and 30 are tubes that make up the joints 28 and 30 or the tube segment 24. The outer polymer layer of the shaped component can be constructed from a metal such as nitinol. It may be formed by melting or fusing with the main body 12.

[0025] The partial attachment of the secondary lumen assembly 22 to the catheter body 12 is along its length. Conventional offset double lumen catheters are substantially and / or completely attached. Compared to the previous model, it provides improved rotational and torque transmission characteristics. While within a curved anatomical structure, such conventional devices are used in the primary lumen / catheter When attempting to rotate the main body of the telescope around its longitudinal axis, the distal segment... This can result in offset, discordant, and / or asymmetrical bending. Such discordant bending and rotation are debatable in a specific rotational orientation at a precise location. For doctors trying to access the chair, handle the device, or position it, it is difficult. This could potentially increase the size. In contrast, device 10 has a tube segment 24 and Due to the degree of freedom of movement between the distal segment 18 and the catheter body 12, for example, Figure 7 As shown in Figure 9, it can be bent and more quickly take on a contoured curved shape. The portion between the tube segment 24 and the distal segment 18 of the catheter body 12. Due to the adhesion, the two components shift relative to each other and in the vascular system It can follow the path with the least resistance when turning around one or more curved sections. .

[0026] In another example, the device has no tube segment 24 in between, as shown in Figure 10. The proximal joint is fixed and / or attached to the distal segment 18 of the catheter body 12. It may include a section and distal joints 28, 30. In this example, a guide wire (not shown) Or other devices through the lumens / apertures of the proximal and distal junctions 28, 30 It may be routed and exit at the distal end 36. Therefore, the guidewire is as described above. Thus, it has the same degree of freedom of movement as the catheter body 12, and during use Independent movement, bending, and rotation are enabled.

[0027] Next, referring to Figures 11 to 21, the guide wire GW and / or other auxiliary devices The catheter body 12 and lumen 20 are offset at a substantial angle from the longitudinal axis LA. Extending distal to the lumen 20 outlet, which can be directed towards or assist in steering in a different direction / Alternatively, it has a deflection element 32 adjacent to it that is connected to the catheter body 12, An additional example of Vice 10 is shown. Such an angled outlet produces 2 lumens. The angle α from the longitudinal axis LA of 0 may be 45 degrees to approximately 135 degrees, and the guide wire GW or other devices / assistive devices, represented by "100" and generally labeled as "100". This facilitates placement within the collateral branches or other vascular pathways to which the cord is attached.

[0028] As shown in Figures 14A to 14B, the deflection element 32 has a proximal end 34 and a distal end 36 Then, the guidewire or auxiliary device is moved away from the longitudinal axis of the catheter body 12. The lamp surface or uneven surface 38 that deflects the light may be included, or these may be defined. The uneven surface 38 is rounded or curved to provide the desired angular deflection. It may include a shaped form, as shown in the cross-sectional side view of Figure 14B, with an angle of approximately 45 to approximately 135 degrees. You may define an arc.

[0029] The deflection element 32 positions the guide wire or other instrument adjacent to the lumen 20. And into the first opening or guide wire entrance 41a, which is roughly coaxial, to the uneven surface 38 Extending from the undulating surface 38 to assist in directing or guiding, Alternatively, to border the uneven surface 38 and extend outward from the device 10, an entrance It is deflected toward a second opening or guidewire exit 41b that is substantially perpendicular to 41a. The side walls 39a and 39b may be included or defined. In the illustrated example, the first The second openings 41a and 41b form a continuous open region that crosses the deflection element 32. However, additional walls or other structures, guidewires or other intervention devices are needed. This forms a deflection path that can traverse and exit device 10. And / or it is intended that they may be assembled.

[0030] As shown in Figures 18 and 19, the catheter body 12 is guided by the deflection element 32. Define an opening 41d adjacent to and / or coplanar with the ear outlet opening 41b. It is permissible. The opening 41d is such that the guidewire is separated from the longitudinal axis at a certain angle from the catheter. The overall space that can exit the main body 12 is increased. The guide wire is typically its The guidewire has a stiffness that varies along its length, and the distal end of the guidewire is typically... It is more flexible than the proximal portion. A larger exit window formed by openings 41b and 41d. The stiffer part of the guidewire can withstand sharper rotations. Alternatively, it allows the catheter body 12 to exit without needing to bend. Therefore, a larger exit allows the catheter body 12 to move or pull back from the guidewire. This facilitates easier relative motion between the device 10 and the guidewire.

[0031] The rigider portion of the guidewire, via the catheter body 12, and the catheter body To further assist routing out of 12, deflection element 32 and / or route The distal exit of the men 20 is one or more flexible sections that can be stretched under the load of the guidewire. It may include a soft edge or an elastic edge. In addition to the flexible component, and / or the Instead of the component, the distal outlet of the deflection element 32 and / or lumen 20 is It is not just a simple vertical side wall, but rather a traverse for the guidewire as it exits the catheter body. It may include one or more rounded internal segments that provide a curved inner surface. For example, as shown in Figure 15, it has a vertical edge that the guide wire contacts when it exits lumen 20. The edge or side wall 41e may also include one or more elastic components, and And / or to reduce friction with the guide wire and / or prevent twisting of the guide wire. Therefore, the thickness, roundness, and other properties may be changed.

[0032] The deflection element 32 is attached to or coupled to the secondary lumen assembly 22 in a manner that allows for interaction. Even if it includes a complementary surface or segment 40 that is sized and molded in such a way, The curve may be defined. In the illustrated example, the surface 40 is the curve of the tube segment 24. It is cylindrical in shape to accommodate various shapes.

[0033] Continuing to refer to Figure 15, the deflection element 32 has a third opening within its side wall 39b Alternatively, a guidewire exit 41c may be defined. The third opening 41c is where the guidewire In the plane that replaces the plane of the first aperture 41b, the deflection element is positioned longitudinally in the direction of the lumens 20. It may be possible to extend at an angle substantially perpendicular to the axial axis. The third opening 41c is specified herein As detailed below, while reducing the displacement or displacement of the guidewire, device 1 In order to pull back to 0, the device 10 is rotated around the aligned guide wire. It makes it possible to do so.

[0034] Device 10 allows the physician to visualize the location and orientation of device 10 within the patient's vascular system. To assist in awareness, as well as by physicians, guidewires and / or other aids The ability to position instruments / devices adjacent to the desired tissue as desired via lumens. It may include one or more features that enhance the function. For example, the catheter body 12 and / Alternatively, the deflection element 32 may include one or more radiopaque markers, and or may be constructed from a radiopaque material. Deflection element 32 and / or Alternatively, the catheter body 12 is deflected by the deflection element 32. - One or more elastic, deformable elements to allow movement relative to the exit of the men 20 and / or may include a movable component, thereby allowing the physician to guide the device. A ya or other auxiliary device can be placed away from the longitudinal axis of the catheter body 12 at the side branches or It provides a degree of longitudinal maneuverability to position or direct it into other vascular pathways. .

[0035] Next, referring to Figures 20 and 21, an exemplary use of device 10 is shown. Device 10 may be routed into a primary blood vessel or vascular pathway 100a. The insertion and routing of device 10 into the next vessel 100a is described herein. Routing is performed via a second lumen assembly including tube segment 24. The first guidewire GW1 may be used to facilitate the process. Device 10 It is located adjacent to, or otherwise close to, a secondary vessel or side branch vessel pathway 100b. They may be aligned. The second guidewire GW2 is connected to the first lume of the catheter body 12. The signal may be routed to the deflection element 32 via the 20. Deflection element 32 The second opening or guidewire exit 41b is approximately aligned with the secondary vessel 100b. They may be oriented in a unidirectional manner. Such alignments and positioning may be one or more This may be achieved by medical imaging modalities. Once the desired alignment is achieved, The second guidewire GW2 is routed via the deflection element 32, and runs The guidewire may be deflected by the surface 38 from the exit 41b into the secondary vessel 100b. Device 10 then extends a second guide wire from device 10, as shown in Figure 21. The ear GW2 portion is aligned with the third opening 41c in the side wall 39b of the deflection element. The second guide wire GW2 is rotated around its longitudinal axis so that it exits outwards. Alternatively, device 10 can then be routinely inserted into secondary blood vessel 100b for subsequent use. While reducing the "tension" or deflection applied to the second guidewire GW2 which remains in place Then, it may be withdrawn from the primary vessel 100a.

[0036] This disclosure is not limited to what has been specifically shown and described herein. Those skilled in the art will understand that this is not the case. Furthermore, the opposite has been mentioned so far. Unless otherwise noted, it should be noted that not all attached drawings are to scale. The stem components can be easily understood by a person skilled in the art who has access to the information herein. To avoid obscuring the details that become apparent, the understanding of the embodiments of this disclosure will be discussed as appropriate. It is represented by conventional symbols in the diagram that show only specific details of a series. Furthermore, this detail The specific embodiments or drawings described in this document are not explicitly shown in other drawings or embodiments. Features that are not present in this specification may be exhibited, but the examples and components disclosed herein are not included. These are not necessarily mutually exclusive, and therefore, exceeding the scope and spirit of this disclosure is not permitted. It is understood that this can be encompassed in various different combinations or configurations. In light of the teachings, the scope of this disclosure and its details are limited only by the attached claims. Various modifications and transformations are possible without deviating from God.

Claims

1. A catheter body comprising a proximal segment, a distal segment, and a first lumen through which the catheter body passes; A tube attached to the distal segment of the catheter body, defining a second lumen that passes through the tube and is not concentric with the first lumen; and, A deflection element attached to the distal segment of the catheter body, which defines an arc-shaped surface located adjacent to the distal end of the first lumen, and the arc-shaped surface defines an arc of 45 to 135 degrees, and Equipped with, The deflection element is movable along the longitudinal axis of the catheter body. Medical devices.

2. The deflection element defines a first aperture that is substantially coaxial with the first lumen and a second aperture that is substantially perpendicular to the first aperture. The arc-shaped surface extends between the first and second openings, The medical device according to claim 1.

3. The medical device according to claim 1, wherein the deflection element defines a third opening substantially perpendicular to each of the first and second openings.

4. The medical device according to claim 1, wherein the deflection element is radiopaque.

5. The medical device according to claim 1, wherein at least a portion of the tube is movable independently of the catheter body.

6. The medical device according to claim 1, wherein the proximal end of the tube is attached to the catheter body at a first joint; the first joint includes a first cap that is concentrically mounted on the proximal end of the tube; and the first cap is attached to the catheter body.

7. The medical device according to claim 1, wherein the distal end of the tube is attached to the catheter body at a second joint; the second joint includes a second cap that is concentrically mounted on the distal end of the tube; and the second cap is attached to the catheter body.

8. The medical device according to claim 6 or 7, wherein at least one of the first and second joints includes an attachment of the tube to the catheter body by heat-shrink tubing.

9. The tube is constructed at least partially from a polymer, At least one of the first and second joints includes an attachment of the tube to the catheter body by fusing a portion of the tube to a portion of the catheter body. The medical device according to claim 6 or 7.

10. The medical device according to claim 6 or 7, wherein at least one of the first and second joints includes an attachment of the tube to the catheter body by adhesive.

11. The medical device according to claim 1, wherein the first lumen is not concentric with the second lumen.

12. The medical device according to claim 6 or 7, wherein a portion of the tube extending between the first and second joints is movable relative to the catheter body.

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