Abstract:
The present invention relates generally to the field of delivery catheter devices, procedures and interventions. In particular, the present invention provides a delivery catheter and a method for using a delivery catheter to deliver a distal protection device across a stenosis through use of a rapid exchange length guidewire. The delivery catheter comprises a catheter body having a first lumen receiving a guidewire reciprocating in the first lumen, a second lumen receiving a distal protection device reciprocating in the second lumen, and distal lumen connected to and in communication with the first lumen and second lumen.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS  
       [0001]    This is a regular application filed under 35 U.S.C. § 111(a) claiming priority, under 35 U.S.C. § 119(e) (1), of provisional application Serial No. 60/241,501, previously filed Oct. 18, 2000, under 35 U.S.C. § 111(b). 
     
    
     
       FIELD OF THE INVENTION  
         [0002]    The present invention relates generally to the field of delivery catheter devices, procedures and interventions. In particular, the present invention provides a delivery catheter and a method for using a delivery catheter to deliver a distal protection device across a stenosis through use of a guidewire.  
         BACKGROUND OF THE INVENTION  
         [0003]    A substantial health risk exists when deposits of fatty-like substances, referred to as atheroma or plaque, accumulate on the wall of a blood vessel. A stenosis is formed where such deposits restrict or occlude the flow of blood through the blood vessel. Various therapeutic devices may be deployed to treat a stenosis including balloon angioplasty catheters, stents, drug coated stents, atherectomy catheters, laser ablation catheters, drug delivery catheters, and the like. In some of these procedures, there is a risk that a deposit may dislodge causing particulate matter to become entrained in the blood stream. Once entrained, the particulate matter may travel downstream and cause a blockage or restrict flow to a smaller blood vessel elsewhere in the vascular system possibly causing a stroke or heart attack. This risk can be prevented by placing a distal embolic protection device downstream of the stenosis prior to the deployment of a therapeutic device to treat the stenosis.  
           [0004]    A protection device generally has a host guidewire comprising an elongate shaft, and a working member located at a distal region of the host guidewire. The working member comprises an expandable and collapsible filter or screen having a plurality of pores. In an expanded configuration, the working area expands outwardly from the host guidewire to form a screen or filter having a plurality of pores. The expanded screen has a diameter at least as large as that of the blood vessel such that it engages the wall of the blood vessel and traps and prevents passage of particulate matter while allowing passage of a fluid such as a patient&#39;s blood. The screen may take a variety of shapes such as a windsock, a basket, a basket with a lid, several shapes in series or other such suitable configurations known in the art. The screen has a collapsed configuration wherein the screen, having a periphery, is collapsed towards the host guidewire. The collapsed configuration has a smaller diameter thus allowing the distal protection device to be loaded into a delivery catheter and advanced into the blood vessel of a patient&#39;s body. The collapsed configuration has a smaller diameter yet it is still significantly larger than the diameter of a guidewire. Thus, crossing a stenosed region is more difficult with a distal protection device than with a guidewire. For this reason, it is preferable to first cross a stenosis with a guidewire to gain access to a position downstream of a stenosis.  
           [0005]    Traditional methods for gaining access downstream of a stenosis to allow the placement of a distal protection device typically require several steps. First, access to a blood vessel or artery is generally obtained by a puncture site in a blood vessel such as the femoral artery located in a patient&#39;s inner thigh. A guide catheter, typically 100 cm long, and a guidewire, typically 145-320 cm long, are then introduced into a patient&#39;s vascular system at the puncture site. The guide catheter and guidewire are then advanced into the vascular system to a position proximal to a stenosis, thus creating access to the stenosis for a vascular device, such as a catheter, for treatment or diagnosis.  
           [0006]    Many vascular devices require access distal to a stenosis. In most cases, access distal to the stenosis is obtained by advancing the guidewire across the stenosis and then feeding the vascular device over the guidewire until the device is positioned distal to the stenosis. In this sense, a device is positioned “distal” to the stenosis when the device has a distal region that is positioned “distal” to the stenosis with respect to the puncture site, wherein the puncture site is proximal to the stenosis. The crossing of the stenosis with a guidewire is preferred because a guidewire has a lower crossing profile than the delivery catheter carrying the working device.  
           [0007]    A preferred method for positioning a protection device includes use of a guidewire to cross a stenosed region. Once the stenosis is crossed with the guidewire, the guidewire is removed and a delivery catheter having a pre-loaded distal protection device is delivered into the blood vessel and across the stenosis. The distal protection device is then deployed distal to the stenosis. Once the distal protection device has been deployed, the delivery catheter is completely removed from the blood vessel.  
           [0008]    Three different methods are commonly employed for removal of the delivery catheter. The first method is termed an “over the wire” method. This method requires that a host guidewire of the distal protection device have a length, for example, greater than 3 meters, with as much as 1.5 meters of which being advanced into a patient&#39;s vascular system. With a requirement that the guidewire be more than twice the catheter length, a delivery catheter having a length of greater than 1.5 meters so as to allow an operator to position the distal protection device at the stenosis will require the host guidewire to have a length of greater than 3 meters. As a result, when the delivery catheter is removed, the operator is able to maintain the control and position of the host guidewire relative to the delivery catheter.  
           [0009]    A second commonly utilized method for removing the delivery catheter is a “rapid exchange” method. This method typically has a 21 cm rapid exchange lumen in the distal portion of the catheter only.  
           [0010]    In a third method, the delivery catheter is able to be peeled along its length. For example, for a 1.5 meter host guidewire having 0.5 meters extending outside the patient&#39;s body and therefore accessible to the operator, the delivery catheter can be removed by peeling away the catheter, thus allowing the operator to maintain control of host guidewire relative to the delivery catheter with a shorter host guidewire length than with the “over the wire” method.  
           [0011]    The greatest disadvantage of these devices and methods is that the guidewire must be removed prior to insertion of a distal protection device. Additionally, the “over the wire” method requires a long host guidewire making removal of the delivery catheter more difficult, whereas the “rapid exchange” delivery catheters that peel away upon removal tend to lack axial strength.  
         SUMMARY OF THE INVENTION  
         [0012]    The present invention provides a “rapid exchange” style delivery catheter for crossing a stenosed region using a guidewire for placement of a distal protection device. A distal protection device, suitable for use with the delivery catheter and method of the present invention, is disclosed in Mazzocchi, PCT Int&#39;l Pub. No. WO 96/01591, Int&#39;l Pub. Date Jan. 25, 1996, assigned to Microvena, Corp., and its description is hereby incorporated by reference. The delivery catheter has a catheter body that includes a distal lumen connected to and in communication with a proximal dual-lumen section. The dual-lumen section includes a first lumen, being a guidewire lumen, adjacent a second lumen, being a device lumen. The first lumen has a distal end and the second lumen has a distal end adjacent that of the first lumen. The first lumen has a length greater than that of the second lumen such that the first lumen extends proximal to the second lumen.  
           [0013]    The distal lumen has a diameter that increases as it progresses from a distal tip allowing it to connect to and communicate with the first lumen and the second lumen. The dual-lumen structure allows for the receiving of a guidewire wherein the guidewire reciprocates within the first lumen. The dual-lumen structure also allows for the receiving of a distal protection device wherein the distal protection device reciprocates within the second lumen. The guidewire may be advanced through the first lumen to a position distal to the distal tip of the catheter. Likewise, the distal protection device may be advanced through the second lumen to a position distal to the distal tip.  
           [0014]    In use, the guidewire is pre-loaded into the first lumen and the distal protection device is pre-loaded into the second lumen. The guidewire and distal protection device are advanced to the distal ends of the first lumen and second lumen, respectively. The delivery catheter is then advanced into a lumen, such as a blood vessel of a patient&#39;s body, at a position upstream of the stenosis, to a position proximal to the stenosis. Once positioned, with the delivery catheter remaining stationary, the guidewire is advanced through the distal tip of the distal lumen, and across the stenosed region, to a position downstream of and distal to the stenosis. The guidewire is then held stationary in this position while the delivery catheter is advanced over the guidewire to a position distal to the stenosis with respect to the catheter entry location. The guidewire has thus been used to cross the stenosis and position the delivery catheter distal to the stenosis. The guidewire is then retracted into the guidewire lumen while the distal tip of the delivery catheter remains stationary, distal to the stenosis. The delivery catheter is now in position to deliver the distal protection device. The distal protection device is advanced from the delivery catheter, into the patient&#39;s lumen, to a position distal to the stenosis. The distal protection device is then deployed distal to the stenosis.  
           [0015]    The distal protection device has a small diameter configuration during delivery and a larger expanded configuration upon deployment. Upon deployment the distal protection device has a peripheral diameter that expands outwardly producing a larger diameter. The lumen of a patient&#39;s body has a wall with a diameter. The diameter of the distal protection device is at least as large as the lumen diameter wherein the diameter of the distal protection device contacts the lumen wall. This secures the distal protection device in the lumen so as to prevent the passage of emboli and particulate matter distal to the stenosed region. In this expanded configuration the distal protection device acts as a filter having a plurality of pores for the passage of fluid, such as blood, through the lumen while preventing passage of particulate matter that is larger than the pores in the filter.  
           [0016]    The delivery catheter is then removed from the patient&#39;s lumen using a “rapid exchange” method of removal. The delivery catheter is removed by sliding the delivery catheter in the proximal direction, over the length of the host guidewire of the distal protection device. A proximal portion of the host guidewire protrudes externally from a patient&#39;s body. The second lumen, sliding proximally over the host guidewire, has a length shorter than the first lumen. Thus, the proximal portion of the host guidewire need only be minimally longer than the second lumen and the distal lumen in order to remove the delivery catheter from the host guidewire. The distal protection device is secured distal to the stenosed region and the host guidewire can then be used for access to the stenosed region for treatment or diagnosis with any suitable treatment or diagnostic devices known in the art.  
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0017]    [0017]FIG. 1 illustrates an embodiment of the present invention wherein a delivery catheter has two tubular bodies connected to and in communication with a distal tubular body forming a “rapid exchange” style catheter with a pre-loaded guidewire in a first lumen and a pre-loaded distal protection device in a second lumen;  
         [0018]    [0018]FIG. 2 illustrates another embodiment of the delivery catheter of the present invention having a single tubular member with a first lumen and a second lumen; and  
         [0019]    [0019]FIG. 3 illustrates another embodiment of the delivery catheter of the present invention having a first tubular member and a flared tubular member receiving a portion of the first tubular member. 
     
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS  
       [0020]    [0020]FIG. 1 illustrates a delivery catheter  10  having a catheter body comprising a first tubular member  60  defining a first lumen  12 , a second tubular member  62  defining a second lumen  14 , and a distal tubular member  64  defining a distal lumen  16 . The first tubular member  60  and first lumen  12  have a distal end  17  and a proximal end (not shown). The second tubular member  62  and second lumen  14  have a distal end  18  and a proximal end  19 . First lumen  12  and second lumen  14  are adjacent one another and have distal ends  17  and  18  adjacent one another. First lumen  12  extends proximally with respect to lumen  14 , where first lumen  12  has a length and second lumen  14  has a lesser length. The distal tubular member  64  and distal lumen  16  have a proximal end  15  and a distal end or distal tip  11 , wherein the proximal end  15  is connected to, and in communication with, the first lumen  12  and second lumen  14 . The distal lumen  16  has a diameter that is shown as increasing as it progresses proximally to encompass the first lumen distal end  17  and second lumen distal end  18 .  
         [0021]    The first lumen  12  has a predetermined length. The second lumen  14  has a length less than the predetermined length of first lumen  12 . First lumen  12  runs adjacent to second lumen  14  and terminates such that first lumen distal end  17  is adjacent second lumen distal end  18 . Distal lumen  16  is connected to, and in communication with, the distal ends of first lumen  17  and second lumen  18 . Distal lumen  16  has a diameter at proximal end  15  and a lesser diameter at distal end  11 . In one embodiment, the diameter decreases along the length of distal lumen  16  in a distal direction. In another embodiment, the diameter decreases along the length of distal lumen  16  in the distal direction until a predetermined diameter at which the diameter is maintained along the remaining length of distal lumen  16  in the distal direction. In the embodiment shown in FIG. 1, a portion of distal lumen  16  is aligned with a portion of first lumen  12  and wherein a portion of distal lumen  16  in communication with second lumen  14  tapers along at least a portion of the length of distal lumen  14  in a distal direction so as to decrease diameter of distal lumen  16  as it progresses in the distal direction.  
         [0022]    The first lumen  12  may have a tapered luer fitting at the proximal end (not shown) for receiving a device such as a guidewire  50  shown in FIG. 1. The guidewire  50  has a distal end front-loaded into first lumen  12  such that the distal end of guidewire  50  is adjacent first lumen distal end  17 . The guidewire  50  reciprocates within first lumen  12  such that guidewire  50  may advance into distal lumen  16  and advance distal to distal tip  11 . The guidewire  50  may retract into first lumen  12  and may be fully removed from the first lumen proximal end (not shown).  
         [0023]    The second lumen  14  has a proximal end  19  for receiving a working device, such as a distal protection device  40  having a distal end, as shown in FIG. 1. The distal protection device  40  is loaded into second lumen  14  such that the distal end of the distal protection device is located near the second lumen distal end  18 . The distal protection device  40  can be positioned anywhere in lumen  18  during delivery of the device. The distal protection device  40  reciprocates within second lumen  14  such that distal protection device  40  may advance into distal lumen  16  and advance distal to distal tip  11 . The delivery catheter  10  and guidewire  50  may be withdrawn over the length of the distal protection device  40  in the proximal direction thus leaving distal protection device  40  in place distal to delivery catheter  10 .  
         [0024]    The delivery catheter  10  in FIG. 1 may be used in a vessel of a human body such as a blood vessel for treatment of a stenosis. The delivery catheter  10  has a pre-loaded guidewire  50  in first lumen  12  and a pre-loaded distal protection device  40  in second lumen  14 , wherein the distal end of distal protection device  40  is adjacent to the distal end of the guidewire  50  and adjacent to the distal ends of first lumen  17  and second lumen  18 . The pre-loaded delivery catheter  10  is advanced into a patient&#39;s blood vessel to a position proximal to the stenosis. The guidewire  50  is advanced through distal lumen  16  and distal to tip  11 . The guidewire  50  then crosses the stenosis to a position distal to the stenosis. The delivery catheter  10  is then advanced over the guidewire  50  such that tip  11  is distal to the stenosis. The guidewire  50  is then retracted into the first lumen  12 . The distal protection device  40  is then advanced distal to tip  11 . The distal protection  40  device is deployed in the blood vessel. The delivery catheter  10  is withdrawn over the length of the distal protection device  40  in the proximal direction thus removing delivery catheter  10  and guidewire  50  in a “rapid exchange” style from the blood vessel and leaving the distal protection device  40  in the blood vessel. The purpose of the delivery catheter  10  is not limited to use in treatment of a stenosis.  
         [0025]    The first tubular member  60  may be attached to the second tubular member  62  using a heat shrink tubing encircling a length of the two tubular bodies. Such a method of securing said tubular members,  60  and  62 , is known to those of ordinary skill in the art. The distal tubular member  64  may also be secured to the first and second tubular bodies,  60  and  62 , by heat bond or adhesive bond, or other methods known to those of ordinary skill in the art. The delivery catheter components can be made of any suitable materials known in the art. Materials having low surface friction are preferable, such as HDPT or those lined with PTFE. Braid reinforcement may also be utilized over all or part of the length of the delivery catheter  10 .  
         [0026]    [0026]FIG. 2 illustrates another embodiment of the current invention similar to the embodiment of FIG. 1. The delivery catheter  10  in FIG. 2 has a catheter body having a dual-lumen tubular member  61  having a first lumen  12  of a length, and a second lumen  14  having a length less than that of first lumen  12 . The first lumen  12  has a distal end  17  and a proximal end (not shown). The second lumen  14  has a distal end  18  and a proximal end  19 . The first lumen  12  runs adjacent to the second lumen  14  and the distal end of the first lumen  17  is adjacent to the distal end of the second lumen  18 . The first lumen proximal end (not shown) is proximal to the second lumen proximal end  19 .  
         [0027]    The catheter body has a distal tubular member  64  having a distal lumen  16  that is connected to and in communication with first lumen  12  and second lumen  14 . The distal lumen  16  is a single lumen extending from a proximal end  15  having a diameter that decreases as it progresses towards a distal end  11 , or distal tip  11 , having a lesser diameter. The diameter may decrease over the entire length of the distal lumen  16  or only a portion of the length of the distal lumen.  
         [0028]    The first lumen  12  may have a tapered luer fitting at the proximal end (not shown) for receiving a device such as a guidewire  50  shown in FIG. 1. The guidewire  50  has a distal region that is front-loaded into first lumen  12  such that the distal region of guidewire  50  is adjacent first lumen distal end  17 . Guidewire  50  reciprocates within first lumen  12  such that the distal region of guidewire  50  may advance into distal lumen  16  and advance distal to distal tip  11 . Guidewire  50  may then retract into first lumen  12  and may be fully removed from the first lumen proximal end (not shown).  
         [0029]    The second lumen  14  has a proximal end  19  for receiving a working device such as a distal protection device  40 . The distal protection device  40  has a distal region with a working area as shown in FIG. 1. The distal protection device  40  is front-loaded into second lumen  14  such that the distal region of the distal protection  40  device is adjacent second lumen distal end  18 . The distal protection device  40  reciprocates within second lumen  14  such that the distal region of distal protection device  40  may advance into distal lumen  16  and advance distal to distal tip  11 . Once advanced, distal protection device  40  may be deployed distal to distal tip  11 . The delivery catheter  10  and guidewire  50  may then be withdrawn over the length of the distal protection device  40  by sliding delivery catheter  10  over distal protection device  40  in the proximal direction.  
         [0030]    The delivery catheter  10  in FIG. 1 may be used in a lumen of a human body such as a blood vessel for use in treatment of a stenosis. The delivery catheter  10  has a pre-loaded guidewire  50  in first lumen  12  and a pre-loaded distal protection device  40  in second lumen  14  wherein the distal region of the distal protection device  40  is adjacent to the distal region of guidewire  50  and adjacent to the distal ends of first lumen  17  and second lumen  18 . The pre-loaded delivery catheter  10  is advanced in the blood vessel to a position proximal to the stenosis. The distal region of the guidewire  50  is advanced through distal lumen  16  and distal to distal tip  11 . The guidewire  50  crosses the stenosis to a position distal to the stenosis. The guidewire  50  is then held stationary while the delivery catheter  10  is advanced over the guidewire  50  such that distal tip  11  is distal to the stenosis. The guidewire  50  is then retracted into first lumen  12 . The distal protection device is then advanced distal to distal tip  11 . The distal protection device  40  is deployed in the blood vessel. The delivery catheter  10  is then withdrawn by sliding the delivery catheter  10  in the proximal direction over the length of distal protection device  40  thus removing delivery catheter  10  and guidewire  50  in a “rapid exchange” style from the blood vessel and leaving distal protection device  40  deployed in the blood vessel. The use of the delivery catheter  10  in treatment of a stenosis merely illustrates a use of the present invention and does not limit the invention to such use.  
         [0031]    Construction of a dual-lumen tubular member  61  as depicted in FIG. 2 is common to those of ordinary skill in the art. A method of forming a single lumen section and a dual-lumen section from a dual-lumen tubular member  61  is common to those of ordinary skill in the art. The distal tubular member  64  is secured to the dual-lumen tubular member  61  by heat bond, RF, adhesive bond or other methods of which are common to those of ordinary skill in the art. The delivery catheter components can be made of any of various materials common in the art. Materials having low surface friction are preferable such as those lined with PTFE. Also, it is possible to have a braided reinforcement over all or part of the length of the delivery catheter  10 .  
         [0032]    [0032]FIG. 3 illustrates yet another embodiment of the present invention. FIG. 3 illustrates a catheter body comprising a flared tubular member  63 , having a flared lumen  24 , receiving a portion of a first tubular member  60  having a first lumen  12 , thus forming a delivery catheter  10  having a proximal section, a dual-lumen section, and a distal section.  
         [0033]    The flared tubular member  63  has a flared lumen  24  having a proximal end  30  and a distal end  11  and a length and a cross-sectional area that decreases at it progresses towards the distal end  11 . The flared tubular member  63  receives a portion of first tubular member  60  at proximal end  30 . The first tubular member  60  has a first lumen  12  and a diameter less than the cross-sectional area of the flared lumen  24 . The first tubular member  60  and first lumen  12  extend proximal to flared lumen proximal end  30  forming a proximal section. The portion of first tubular member  60  that is received by the flared lumen  63  forms a dual-lumen section comprising the first lumen  12  and a second lumen  14 . The second lumen  14  comprises the cross-sectional area of the flared lumen  24  adjacent first tubular member  60 . The second lumen  14  is adjacent the first lumen  12  and has a proximal end  19  and a distal end  18  adjacent first lumen distal end  17 . A portion of flared lumen  24  extends distal to the dual-lumen section and forms a distal lumen  16  having a distal tip  11 .  
         [0034]    The flared tubular member  63  shown in FIG. 3 has a proximal end  30  such that the portion in contact and secured to the first tubular member  60  has a greater length than the portion not in contact with the first tubular member  60 . The flared tubular member  60  has a cross-sectional area that decreases as it progresses in the distal direction. In an alternative embodiment, the cross-sectional area beginning at flared lumen proximal end  30  may remain constant for a given length in the distal direction, taper for a given length, and then remain at a constant smaller cross-sectional area extending to distal tip  11 . Other variations of decreasing the cross-sectional area of the flared lumen  24  in the distal direction may be used and are not limited to those disclosed herein.  
         [0035]    The first lumen  12  may have a tapered luer fitting at the proximal end (not shown) for receiving of a device such as a guidewire  50  shown in FIG. 1. The guidewire  50  has a distal region that is front-loaded into first lumen  12  such that the distal region of guidewire  50  is adjacent first lumen distal end  17 . The guidewire  50  reciprocates within first lumen  12  such that the distal region of guidewire  50  may advance into distal lumen  16  and advance distal to distal tip  11 . Guidewire  50  may then retract into first lumen  12  and may be fully removed from the first lumen proximal end (not shown).  
         [0036]    The second lumen  14  has a proximal end  19  for receiving a working device such as a distal protection device  40  that has a distal region with a working area, as shown in FIG. 1. The distal protection device  40  is front-loaded into second lumen  14  such that the distal region of distal protection device  40  is adjacent second lumen distal end  18 . The distal protection device  40  reciprocates within second lumen  14  such that the distal region of distal protection device  40  may advance into distal lumen  16  and advance distal to distal tip  11 . Once advanced, distal protection device  40  may be deployed distal to distal tip  11 . The delivery catheter  10  and guidewire  50  may then be withdrawn over the length of the distal protection device  40  by sliding delivery catheter  10  over distal protection device  50  in the proximal direction. The first lumen distal end  17  may have a bevel  26  such that the portion of the first tubular member  60 , in contact with flared tubular member  63 , has a length less than that of the portion not in contact, thus forming bevel  26 . The distal lumen  16  is located distal to bevel  26 . The bevel  26  can be used to create a positive stop for distal protection device  40  wherein the distal protection device  40  cannot advance into distal lumen  16  without deforming bevel  26 . The bevel  26  could also be beneficial for initially back-loading a guidewire, since it would prevent the guidewire from entering the protection device lumen during initial back-loading. The bevel  26  is a flexible or resilient material that allows distal protection device  40  to advance into distal lumen  16  only upon deforming or bending of bevel  26 . The bevel  26  prevents the distal protection device  40  from advancing distal to bevel  26  until a deforming force is applied to the distal protection device  40  sufficient to deform bevel  26 .  
         [0037]    The delivery catheter  10  illustrated in FIG. 3 may be used in a lumen of a human body such as a blood vessel for use in treatment of a stenosis. The delivery catheter  10  has a pre-loaded guidewire  50  in first lumen  12  and a pre-loaded distal protection device  40  in second lumen  14  wherein the distal region of distal protection device  40  is adjacent to the distal region of guidewire  50  and adjacent distal end of first lumen  17  and second lumen  18 . The pre-loaded delivery catheter  10  is advanced into the blood vessel to a position proximal to the stenosis. The guidewire  50  distal region is advanced through distal lumen  16  and distal to distal tip  11 . The guidewire  50  crosses the stenosis to a position distal to the stenosis. The delivery catheter  10  is then advanced over the guidewire  50  such that distal tip  11  is distal to the stenosis. The guidewire  50  is then retracted into first lumen  12 . The distal protection device  40  is then advanced distal to distal tip  11  by advancing across bevel  26  by deforming bevel  26 . The distal protection device  40  is deployed in the blood vessel. The delivery catheter  10  is withdrawn proximally over length of distal protection device  40  thus removing delivery catheter  10  and guidewire  50  in a “rapid exchange” style from the blood vessel and leaving distal protection device  40  deployed in the blood vessel. The use of the delivery catheter  10  in the treatment of the stenosis merely illustrates a use of the delivery catheter  10  and does not limit such use to treatment of a stenosis.  
         [0038]    The first tubular member  60  is secured to the flared tubular member  63  using an adhesive type bond or a heat bond or any suitable method of securing the tubular members known to those of ordinary skill in the art. The delivery catheter components can be made of any of suitable materials known in the art. For example, materials having low surface friction are preferable such as those lined with PTFE. Additionally, braid reinforcement may be utilized over all or part of the length of the delivery catheter  10 .  
         [0039]    It will be understood that this disclosure, in many respects, is only illustrative. Changes may be made in details, particularly in matters of shape, size, material, and arrangement of parts without exceeding the scope of the invention. Accordingly, the scope of the invention is as defined in the language of the appended claims.