Guide Extension Catheter–Dilator Engagement for Accurate Tracking
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Solution Overview
Problem
Guide extension catheters often fail to accurately track guidewires, especially in complex anatomies due to their larger distal opening, necessitating balloon-assisted tracking techniques which can be cumbersome.
Innovation Solution
An access system comprising a guide extension catheter and dilator with engagement features, such as marker bands and protrusions, that allow the dilator to remain aligned with the guide extension catheter, facilitating precise navigation through tortuous vasculature.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If the guide extension catheter has a larger distal opening to facilitate device delivery, then the ease of operation is improved, but the tracking accuracy over the guidewire deteriorates
Solution Approach 1:
The dilator serves as an intermediary component between the guidewire and the guide extension catheter. It features a distal end with a smaller opening that closely fits the guidewire for accurate tracking, while its proximal end connects to the larger-opening catheter, enabling both accurate tracking and easy device delivery
2Ease of operation
If the guide extension catheter uses a larger distal opening, then the ease of operation is improved, but the alignment with the guidewire deteriorates
Solution Approach 1:
The system is segmented into three functional components: the guidewire for navigation, the dilator for tracking and alignment, and the guide extension catheter for device delivery. This segmentation allows each component to optimize its function without compromising the others
Solution Approach 2:
The dilator acts as a mediator that maintains stable alignment with the guidewire through its closely-fitted distal opening, while simultaneously serving as a stable platform for the guide extension catheter with its larger proximal opening
3Measurement precision
If balloon-assisted tracking techniques are used to improve tracking, then the tracking accuracy is improved, but the device complexity increases
Solution Approach 1:
The tracking function is extracted from the guide extension catheter itself and assigned to a separate dilator component. This allows the catheter to maintain its simple, large-opening design for easy device delivery while the dilator provides the tracking function through its guidewire-fitted distal end
Solution Approach 2:
The dilator is designed as a simple, disposable component that is used temporarily during the procedure to establish tracking and alignment, then discarded. This avoids the complexity of reusable balloon systems while achieving the same tracking accuracy
Data Source
AI summary
An access system adapted for accessing a desired location within a patient's vasculature includes an outer catheter such as a guide extension catheter and an inner catheter such as a dilator. The outer catheter includes an outer catheter push rod, an outer catheter sheath extending distally from the outer catheter push rod, and a first engagement feature disposed within a distal region of the outer catheter sheath. The inner catheter includes an inner catheter push rod, an inner catheter body extending distally from the inner catheter push rod, and a second engagement feature disposed within a proximal region of the inner catheter body, the second engagement feature adapted to releasably engage the first engagement feature.