Patent Publication Number: US-2022233810-A1

Title: Coronary guide catheter

Description:
CLAIM OF PRIORITY 
     This application is a continuation of U.S. patent application Ser. No. 15/224,323, filed Jul. 29, 2016, which application claims the benefit of priority to U.S. Provisional Patent Application Ser. No. 62/199,050, filed Jul. 30, 2015, the contents of which are hereby incorporated by reference in their entireties. 
    
    
     FIELD OF THE TECHNOLOGY 
     The present application relates to coronary guide catheters. More specifically, the present application relates to guide catheters that are used to introduce therapeutic catheters, such as stent delivery systems. 
     BACKGROUND 
     Interventional guide catheters are used by physicians to place catheters, electrode leads and other therapeutic interventional devices to desired locations in the patient&#39;s body. The guide catheter provides support for device advancement (stents, balloons, etc.) for instance, to the coronary arteries. It is the main conduit for therapeutic device and guide wire transport and provides a means for injecting contract media. Guide catheters typically have a pre-shaped distal end that is configured to allow access and direction into the arterial branches. In coronary guide catheters, the distal end shapes also provide back-up support for device placement by using shapes made to “back-up” against aortic anatomy. 
     Guide catheters are made so that the distal shapes as much as possible, retain their shape during the procedure and don&#39;t soften in body temperature to any significant or detrimental degree. Guide catheters with distal end shapes also are typically made to provide end-to-end torque to allow “steering” the distal end into the artery. In addition, guide catheter are typically made to be relatively stiff so that there is no stretching and biasing during device passage. To achieve these performance criteria, current guide catheter construction means are usually polymer based with metallic wire braid reinforcement. 
     The problems associated with current interventional guide catheters include softening at body temperature thereby losing critical performance features like back-up support or torsion. In addition, guide catheters have been prone to kinking, buckling, ovaling and stretching, especially in long procedures or difficult, more tortuous anatomy. 
     SUMMARY 
     Embodiments disclosed herein include an interventional guide catheter for introducing interventional catheters into the vasculature, comprising: a main tubular shaft with a distal tip and proximal end; the main tubular shaft comprising: a main inner structural layer comprising a metallic helically wound multi-filar wire (wall thickness (0.0015-0.010″) extending from a proximal tube termination to the distal end, a braided wire layer (0.0005-0.010″ thick) covering the metallic helically wound multi-filar layer that extends from the proximal tube termination to the distal end, an outer layer of polymer jacketing covering and fixedly attached to the main metal structure and braid layer with wall thickness of 0.001-0.005″, an inner layer of polymer jacketing covering and fixedly attached to the inner metal structure with wall thickness of 0.001-0.0005″, a distal tip made of layers of polymer, the distal tip being 0.05-0.20″ in length, an optional distal end curve shape for anatomical conformance that is heat processed in the main metal portion (e.g., one or more of the multi-filar layer, braid or the like) of the structure; and a lamination of the inner layer, metallic helically wound multi-filar layer, braid and outer layer that optionally does not comprise fusion of the outer and inner layers. The main metal portion is separately heat processed (e.g., to provide the distal end curve shape) prior to lamination in one example. In another example, the main metal portion is heat processed while incorporated with the other components of the catheter (e.g., the inner and outer layers, or the like). 
     In an embodiment, the main helically wound multi-filar layer terminates distally before the primary curve of the distal end. In another embodiment, the main helically wound layer terminates proximal to the distal end curve shape including the primary curve. 
     In an embodiment, the outer and inner layers are fused together through the main coil structure and braid. 
     In an embodiment, the metal helically wound multi-filar layer comprises stainless steel. 
     In an embodiment, the braid layer comprises stainless steel wire. 
     In an embodiment, the multi-filar structure comprises at least 6 filars and not more than 20 filars. 
     In an embodiment, the multi-filar structure wire has been swaged. 
     In an embodiment, the outer diameter of the main tubular shaft is at least 0.060 inches and not more than 0.115 inches. 
     In an embodiment, the outer layer comprises Pebax. 
     In an embodiment, the outer layer comprises nylon. 
     In an embodiment, the outer layer is coated with a hydrophilic polymer. 
     In an embodiment, the inner layer comprises PTFE. 
     In an embodiment, the inner layer comprises nylon. 
     In an embodiment, the inner layer is coated with a hydrophilic polymer. 
     In an embodiment, the distal tip comprises a PTFE inner layer and a Pebax outer layer. 
     In an embodiment, the metallic helically wound layer comprises welded terminations. 
     In an embodiment, the metallic helically wound layer comprises a distal end that comprises a gold coating. 
     In an embodiment, the gold coating is at least 0.5 mm and not more than 2 mm in length. 
     In an embodiment, the outer layer comprises at least two layers of Pebax. 
     In an embodiment, the outer layer is heat shrinkable to allow it to be formed tightly onto the metallic helically wound layer. 
     In an embodiment, the metallic helically wound wire has a rectangular cross-section. 
     In an embodiment, the metallic helically wound wire has a circular cross-section. 
     In an embodiment, the metallic helically wound layer wire has an oval or elliptical cross-section. 
     In an embodiment, the metallic helically wound layer wire has been coated with PTFE coating prior to forming into the multi-filar configuration. 
     In an embodiment, the main tubular shaft length is at least 60 cm and not more than 200 cm long. 
     This summary is an overview of some of the teachings of the present application and is not intended to be an exclusive or exhaustive treatment of the present subject matter. Further details are found in the detailed description and appended claims. Other aspects will be apparent to persons skilled in the art upon reading and understanding the following detailed description and viewing the drawings that form a part thereof, each of which is not to be taken in a limiting sense. The scope of the present application is defined by the appended claims and their legal equivalents. 
    
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
       The technology may be more completely understood in connection with the following drawings, in which: 
         FIG. 1  is a front view of a guide catheter, according to an embodiment. 
         FIG. 2  is a back view of a guide catheter, according to an embodiment. 
         FIG. 3  is a cross-section view of a guide catheter, according to an embodiment. 
         FIG. 4  is a cross-section view of a portion of a guide catheter, according to an embodiment. 
         FIG. 5  is a cross-section view of a portion of a guide catheter, according to an embodiment. 
         FIG. 6  is a cross-section view of a portion of a guide catheter, according to an embodiment. 
         FIG. 7  is a cross-section view of a portion of a guide catheter, according to an embodiment. 
         FIG. 8  is a cross-section view of a portion of a guide catheter, according to an embodiment. 
         FIG. 9  is a cross-section view of a portion of a guide catheter, according to an embodiment. 
         FIG. 10  is a front view of a guide catheter, according to an embodiment. 
     
    
    
     While the technology is susceptible to various modifications and alternative forms, specifics thereof have been shown by way of example and drawings, and will be described in detail. It should be understood, however, that the application is not limited to the particular embodiments described. On the contrary, the application is to cover modifications, equivalents, and alternatives falling within the spirit and scope of the technology. 
     DETAILED DESCRIPTION 
     The embodiments of the present technology described herein are not intended to be exhaustive or to limit the technology to the precise forms disclosed in the following detailed description. Rather, the embodiments are chosen and described so that others skilled in the art can appreciate and understand the principles and practices of the present technology. 
     All publications and patents mentioned herein are hereby incorporated by reference. The publications and patents disclosed herein are provided solely for their disclosure. Nothing herein is to be construed as an admission that the inventors are not entitled to antedate any publication and/or patent, including any publication and/or patent cited herein. 
     The guide catheter as described herein can solve the problems associated with current guide catheter technology by providing a novel design, construction and materials. 
     The guide catheter, described herein, can be used in interventional cases where significant arterial tortuosity is encountered such as using a radial artery access or using a femoral approach on an obese patient. 
     In various embodiments, the guide catheter can include a composite built tube that can be fabricated using a specially wound metal inner layer and jacketed with very thin layers of polymer inside and out. The metallic inner layer can be made using a multi-filar (6-20 filars) helically wound wire structure. In some embodiments, the helical structure can be swaged, such that each individual wire strand is partially rectangular in cross-section and therefore can result in a very tight/close fitting wire matrix. The helical structure can also be made using a non-swaged, round, square or rectangular wire. 
     In various embodiments, the wall thickness of the inner metal structure can range from 1.5 to 10 thousandths of an inch thick. 
     The helically wound metal structure can improve the mechanical integrity of the catheter tube, such as compared to current guide catheters with respect to kinking, buckling, flexibility, radial strength, and maintaining circularity of the catheter lumen cross-section. 
     This marked improvement can be achieved by the significant increase in the amount of metal in the catheter. For instance, current guide catheters that are composite built or wire braid reinforced have total cross-sectional metallic component in the range of 5-10%. The guide catheter as described herein can have a total cross-sectional metallic component of 40-60%. The transmission of mechanical energy through this significantly higher modulus composite can result in significantly higher performance. 
     The guide catheter of this invention also comprises an outer polymer layer and an inner polymer layer. In an embodiment, the outer polymer layer and the inner polymer layer can include one or more polymers, such as PTFE, Pebax, or Polyurethane. The polymer layers can be attached to the metal structure by thermal polymer heat-shrinking or reflow. The resultant wall thickness of the polymer layers can range from 0.5 to 3.0 thousandths of an inch for each layer. 
     In various embodiments, the guide catheter can include a pre-shaped curve, such as a curved distal end region. The guide catheter can attain the pre-shaped curve configuration by heat-setting the metal in this portion of the catheter. The result can include a curve that retains its shape in body temperature and over time does not substantially soften, such as soften enough to unintentionally change shape. 
     The guide catheter can further include a soft (low durometer) polymer distal tip, various distal curve shapes, a radiopaque distal marker band, and a proximal luer adapter. The guide catheter range in sizes from 4F to 8F and in lengths from 80 to 125 cm. 
     In reference now to the figures,  FIG. 1  shows a front view of a guide catheter  100 , according to an embodiment.  FIG. 2  shows a back view of the guide catheter  100 .  FIG. 3  shows a cross-sectional view of the guide catheter  100 . In an embodiment, the guide catheter  100  can be configured for introducing interventional catheters into the vasculature of a patient. 
     In an embodiment, the catheter  100  can include a main tubular shaft  102  with a distal tip  104  and proximal end  106 . The distal tip  104  can be on the opposite end of the tubular shaft  102  from the proximal end  106 . The distal tip  104  can include at least one layer of polymer. In an embodiment, the distal tip  104  includes at least two layers of polymer. In an embodiment, the distal tip  104  can include an inner layer and an outer layer. In an embodiment, the inner layer of the distal tip  104  can include PTFE. In an embodiment, the outer layer of the distal tip  104  can include Pebax. 
     In an embodiment, the distal tip  104  can be at least 0.05 inches long. In an embodiment, the distal tip  104  can be at least 0.02 inches long. In an embodiment, the distal tip  104  can be 0.2 inches long or shorter. In an embodiment, the distal tip  104  can be 0.5 inches long or shorter. In various embodiments, the tubular shaft  102  can include a main inner structural layer. 
     The main inner structural layer can include a metallic helically wound multi-filar wire extending from a proximal tube termination (e.g., the proximal shaft end  106  or proximal shaft portion  108 ) to a distal end  112  including at least the bracketed  112  shown in  FIGS. 1-3  (e.g., at the distal location). The main inner structural layer can further include a braided wire layer. In various embodiments, the braided wire layer can cover at least a portion of the outer portion (opposite from the inner lumen) of the metallic helically wound multi-filar layer that extends from the proximal tube termination to the distal end. In other embodiments, the braided wire layer is within the metallic helically wound multi-filar layer. 
     In various embodiments, the main tubular shaft  102  can include an outer layer. The outer layer can include a polymer. The outer layer can jacket, coat, or cover the outer surface of the main inner structural layer. The outer layer can be fixedly attached to the main inner structural layer. 
     In various embodiments, the main tubular shaft  102  can include an inner layer. The inner layer can include a polymer. The inner layer can jacket, coat, or cover the inner surface of the main inner structural layer. The inner layer can be fixedly attached to the main inner structural layer. 
     The main tubular shaft  102  can include a curve, such as on the distal end (shown in  FIG. 10 ). The curve shape can be configured for anatomical conformance. The shape can be heat processed in the main tubular shaft  102 , such as in the main inner structural layer or another metal portion. In an embodiment, the helically wound multi-filar layer terminates distally prior to the curve of the distal end. In another embodiment the helically wound multi-filar layer terminates proximal a primary curve of the curve (e.g., of the distal end curve shape) and distal to other portions of the curve including, but not limited to secondary and tertiary curves. 
     In various embodiments, the metallic helically wound multi-filar layer, and the braid can be laminated by the inner layer and the outer layer, such that the lamination does not fuse the outer layer and the inner layer together. 
     In an embodiment, the main tubular shaft  102  can be at least 60 cm long and not longer than 200 cm. In an embodiment, the main tubular shaft  102  can be at least 10 cm long and not longer than 300 cm. In an embodiment, the main tubular shaft  102  can be at least 30 cm long and not longer than 250 cm. In an embodiment, the main tubular shaft  102  can be at least 50 cm long and not longer than 225 cm. 
     In an embodiment, the main tubular shaft  102  can have an outer diameter of at least 0.060 inches and not more than 0.115 inches. In an embodiment, the main tubular shaft  102  can have an outer diameter of at least 0.060 inches. In an embodiment, the main tubular shaft  102  can have an outer diameter of at least 0.040 inches. In an embodiment, the main tubular shaft  102  can have an outer diameter of at least 0.050 inches. In an embodiment, the main tubular shaft  102  can have an outer diameter of at least 0.070 inches. In an embodiment, the main tubular shaft  102  can have an outer diameter of at least 0.080 inches. 
     In an embodiment, the main tubular shaft  102  can have an outer diameter of no greater than 0.115 inches. In an embodiment, the main tubular shaft  102  can have an outer diameter of no greater than 0.095 inches. In an embodiment, the main tubular shaft  102  can have an outer diameter of no greater than 0.105 inches. In an embodiment, the main tubular shaft  102  can have an outer diameter of no greater than 0.125 inches. In an embodiment, the main tubular shaft  102  can have an outer diameter of no greater than 0.135 inches. 
       FIG. 4  and  FIG. 5  show cross-section views of portions of a guide catheter  100 , according to various embodiments.  FIG. 5  shows a cross-section of a portion of the distal tip  104 . As seen in  FIG. 5 , the guide catheter  100  can define one or more apertures  506 . In various embodiments, the main tubular shaft  102  can define an aperture  506 . In an embodiment, the distal tip  104  can define an aperture  506 . 
       FIG. 6  shows a cross-section view of a portion of the main tubular shaft  102 , according to an embodiment.  FIG. 7  shows a cross-section view from the end of the main tubular shaft  102 . In an embodiment, the main tubular shaft  102 , can include a main inner structural layer  608 . The main inner structural layer  608  can include a metallic helically wound multi-filar wire. In various embodiments, the metallic helically wound multi-filar wire can include stainless steel. In various embodiments, the metallic helically wound multi-filar wire can be swaged. 
     In various embodiments, the metallic helically wound multi-filar wire can include at least 6 filars and not more than 20 filars. In various embodiments, the metallic helically wound multi-filar wire can include at least 4 filars and not more than 24 filars. In various embodiments, the metallic helically wound multi-filar wire can include at least 8 filars and not more than 18 filars. In various embodiments, the metallic helically wound wire can have a rectangular cross-section, a circular cross-section, an oval cross-section or an elliptical cross-section. In various embodiments, the metallic helically wound wire can have been substantially coated with PTFE coating prior to forming into the multi-filar configuration. 
     In an embodiment, the main inner structural layer  608  can include welded terminations. In an embodiment, the main inner structural layer  608  can include a distal end that includes a gold coating. In various embodiments, the gold coating can range from 0.5 mm thick to 2 mm in length. In various embodiments, the gold coating can range from 0.4 mm thick to 2.5 mm in length. In various embodiments, the gold coating can range from 0.25 mm thick to 3 mm in length. 
     In an embodiment, the main inner structural layer  608  can have a thickness that can range from 0.0015 inches to 0.010 inches (e.g., one or more of a consistent thickness or variable thicknesses). In an embodiment, the main inner structural layer  608  can have a thickness of at least 0.0010 inches. In an embodiment, the main inner structural layer  608  can have a thickness of at least 0.0005 inches. In an embodiment, the main inner structural layer  608  can have a thickness of no greater than 0.015 inches. In an embodiment, the main inner structural layer  608  can have a thickness of no greater than 0.020 inches. Optionally, the main inner structural layer  608  includes a varying wall thickness. For instance, the metallic helically wound multi-filar wire is ground so that portions of the layer have varying thickness. The catheter, in some examples includes corresponding reduced diameter based on the grinding of the metallic helically wound multi-filar wire. In still another example, the metallic helically wound multi-filar wire is formed with a varied diameter (e.g., is necked) to accordingly decrease the thickness of the main inner structural layer  608 . In one example, a proximal portion of the main inner structural layer  608  includes a greater thickness relative to a distal portion to enhance pushability of the catheter. In another example, the distal portion of the main inner structural layer  608  has a lesser thickness than the proximal portion to facilitate bending and corresponding navigation through tortuous vasculature. In an embodiment, the main tubular shaft  102  can include an outer layer  610 . The outer layer  610  can include a polymer. The outer layer  610  can jacket or cover at least a portion of the outer portion of the main inner structural layer  608 . In an embodiment, the outer layer  610  can be at least 0.001 inches thick and not more than 0.005 inches thick. In an embodiment, the outer layer  610  can be at least 0.0007 inches thick. In an embodiment, the outer layer  610  can be at least 0.0005 inches thick. In an embodiment, the outer layer  610  can be no more than 0.007 inches thick. In an embodiment, the outer layer can be no more than 0.01 inches thick. 
     In an embodiment, the outer layer  610  can include Pebax. In an embodiment, the outer layer  610  can include nylon. In an embodiment, the outer layer  610  can be coated with a hydrophilic polymer. In an embodiment, the outer layer  610  can include at least two layers. In an embodiment, each of the two layers included in the outer layer  610  can include Pebax. In various embodiments, the outer layer  610  can be heat shrinkable, such as to allow the outer layer  610  to be formed tightly onto the main inner structural layer  608 . 
     In an embodiment, the main tubular shaft  102  can include an inner layer  612 . The inner layer  612  can include a polymer. The inner layer  612  can jacket or cover at least a portion of the inner portion of the main inner structural layer  608 . In an embodiment, the inner layer  612  can be at least 0.001 inches thick and not more than 0.005 inches thick. In an embodiment, the inner layer  612  can be at least 0.0007 inches thick. In an embodiment, the inner layer  612  can be at least 0.0005 inches thick. In an embodiment, the inner layer  612  can be no more than 0.007 inches thick. In an embodiment, the inner layer can be no more than 0.01 inches thick. 
     In an embodiment, the inner layer  612  can include PTFE. In an embodiment, the inner layer  612  can include nylon. In an embodiment, the inner layer  612  can be coated with a hydrophilic polymer. 
     In an embodiment, the outer layer  610  and the inner layer  612  can be fused together, such as through the main inner structural layer  608  and/or the braid  814  (shown in  FIG. 8 ). 
       FIG. 8  shows a cross-section view of a portion of the main tubular shaft  802 , according to an embodiment.  FIG. 9  shows a cross-section view from the end of the main tubular shaft  802 . 
     In various embodiments, the main tubular shaft  802  can include a braided wire layer  814 . In an embodiment, the braided wire layer  814  can be disposed between the main inner structural layer  808  and the outer layer  810 . In an embodiment, the braided wire layer  814  can be disposed within a portion of the outer layer  810 . In another embodiment, the braided wire layer  814  is provided within the main inner structural layer  808  (e.g., along the interior of the layer  808 ). Optionally, the braided wire layer  814  is between the inner layer  812  and the main inner structural layer  808 . 
     The braided wire layer  814  can cover at least a portion of the main inner structural layer  808 , such as the helically wound multi-filar layer. In an embodiment, the braided wire can include stainless steel. 
     In an embodiment, the braided wire layer  814  can be at least 0.0005 inches thick and not more than 0.010 inches thick. In an embodiment, the braided wire layer  814  can be at least 0.005 inches thick and not more than 0.010 inches thick. 
     In an embodiment, the braided wire layer  814  can be at least 0.0004 inches thick. In an embodiment, the braided wire layer  814  can be at least 0.0003 inches thick. In an embodiment, the braided wire layer  814  can be no more than 0.015 inches thick. In an embodiment, the braided wire layer  814  can be no more than 0.020 inches thick. 
       FIG. 10  shows a front view of a guide catheter  1000 , according to an embodiment. In an embodiment, the guide catheter  1000  can include a distal end curve  1016 . The distal end curve  1016  can be configured for anatomical conformance. The distal end curve  1016  can be heat processed in the metal portion of the catheter  1000 . In an embodiment, the main helically wound layer can terminate distally before a primary curve (e.g., one or more of curves  1018 ,  1020 ,  1022  or the like) of the distal end  112 . 
     In various embodiments, the guide catheter can include a pre-shaped curve, such as a curved distal end region. The guide catheter can attain the pre-shaped curve configuration by heat-setting the metal in this portion of the catheter. The result can include a curve that retains its shape in body temperature and over time does not substantially soften, such as soften enough to unintentionally change shape. 
     It should be noted that, as used in this specification and the appended claims, the singular forms “a,” “an,” and “the” include plural referents unless the content clearly dictates otherwise. Thus, for example, reference to a composition containing “a compound” includes a mixture of two or more compounds. It should also be noted that the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise. 
     It should also be noted that, as used in this specification and the appended claims, the phrase “configured” describes a system, apparatus, or other structure that is constructed or configured to perform a particular task or adopt a particular configuration to. The phrase “configured” can be used interchangeably with other similar phrases such as arranged and configured, constructed and arranged, constructed, manufactured and arranged, and the like. 
     All publications and patent applications in this specification are indicative of the level of ordinary skill in the art to which this technology pertains. All publications and patent applications are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated by reference. 
     The technology has been described with reference to various specific and preferred embodiments and techniques. However, it should be understood that many variations and modifications may be made while remaining within the spirit and scope of the technology.