# US 10,864,041 B2 · Side-port catheter

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- Number: US 10,864,041 B2
- Document ID: US10864041B2
- Status: Granted
- Kind: B2
- Application number: 15/115,514
- Filed: 2015-01-29
- Published: 2017-06-22
- Granted: 2020-12-15
- Earliest claimed: 2014-01-29
- Assignees: Baylis Medical Company Inc.
- Applicants: Baylis Medical Company Inc.
- Inventors: John Paul Urbanski; Hans Fischer; Yun Uhm
- Web page: https://patentgrep.com/patent/US10864041B2

## CPC

- A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)}
- A61B 17/3207: Atherectomy devices {working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions (A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016)}
- A61B 17/34: Trocars; Puncturing needles
- A61B 18/1815: {using microwaves}
- A61M 25/007: {Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked}
- A61B 18/1477: {Needle-like probes}
- A61B 2017/22044: {with a pointed tip}
- A61B 2017/22095: {accessing a blood vessel true lumen from the sub-intimal space}
- A61B 2018/00601: {Cutting}
- A61B 2090/3966: {Radiopaque markers visible in an X-ray image}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}

## Abstract

Methods and apparatus are disclosed for a catheter having a side-port, through which a device, for example, a wire, may be advanced, and a vestibule in the outer surface of the catheter at the distal edge of the side-port. The vestibule is operable for providing a gap between the catheter body and a distal tip of the device positioned through the side-port whereby the vestibule facilitates advancement of the device 5 through the side-port and through tissue towards a desired trajectory. In examples wherein the device is a wire having a distal tip electrode, energy may be delivered to a tissue adjacent the side-port, while avoiding damage to a wall of the catheter body.

## Claims

### Claim 1

A catheter for delivering a medical device having a distal tip including an electrode when a layer of tissue is pressed against the catheter, the catheter comprising: a catheter body, the catheter body comprising a catheter body wall defining a lumen, and a side-port defined by a side of the catheter body wall in fluid communication with the lumen, the side-port being configured for delivering the medical device through the side-port when the layer of tissue is pressed against the side-port, the catheter having an outer surface and a longitudinal axis, the catheter body wall defining a vestibule and a side-port wall which is perpendicular to the longitudinal axis of the catheter, the side-port having a proximal end and a distal end, the side-port wall at the proximal end extending from the lumen to the outer surface of the catheter, the side-port wall at the distal end of the side-port extending perpendicularly from the lumen to the vestibule, the catheter body wall defining the vestibule as extending distally from the distal end of the side-port to the outer surface of the catheter wherein the side-port wall at the distal end of the side-port is configured to support a side of the medical device when the medical device is positioned through the side-port, wherein the vestibule defines a gap, whereby the distal tip of the medical device is positioned in the gap when the distal tip protrudes distally of the distal end of the side-port such that the distal tip of the medical device can contact the layer of tissue pressing against the side-port without contacting the catheter body wall.

### Claim 2 (depends on 1)

The catheter of claim 1, wherein the vestibule is C-shaped and has a proximal end which is closer to the lumen than a distal end of the vestibule.

### Claim 3 (depends on 1)

The catheter of claim 1, wherein when the catheter is in use, the distal tip of the medical device positioned through the side-port and located within the vestibule is spaced apart from the catheter body wall to avoid damaging the catheter body wall when energy is delivered through the electrode.

### Claim 4 (depends on 1)

The catheter of claim 1 for use with the medical device wherein the medical device is an angled wire, wherein the catheter body wall defining the lumen comprises a single lumen, the single lumen is in fluid communication with a distal end opening of the catheter, the single lumen is off-center within the catheter body, and a wall thickness of the catheter body wall is greater on the side of the catheter body wall defining the side-port relative to an opposite side of the catheter body wherein the side-port has an elongate shape configured to allow the angled wire to have enough space to assume its relaxed position without hitting the distal end of the side-port.

### Claim 5 (depends on 1)

The catheter of claim 1, wherein the side-port is substantially elongate.

### Claim 6 (depends on 5)

The catheter of claim 5, wherein the side-port has a relatively wider portion and a relatively narrower portion and is keyhole-shaped.

### Claim 7 (depends on 6)

The catheter of claim 6, wherein the relatively wider portion is proximal of the relatively narrower portion.

### Claim 8 (depends on 1)

The catheter of claim 1, wherein the catheter body wall defining the lumen defines a single lumen of constant diameter and a forward facing distal end opening.

### Claim 9 (depends on 1)

A kit comprising the catheter of claim 1 and at least one angled wire.

### Claim 10

A method of using a catheter and an angled wire for re-entry a true lumen of a vessel wherein the catheter comprises a catheter body, the catheter body having, a catheter body wall defining a lumen, and a side-port defined by a side of the catheter body wall in fluid communication with the lumen, the catheter having an outer surface and a longitudinal axis, the catheter body wall defining a vestibule and a side-port wall winch is perpendicular to the longitudinal axis of the catheter, the side-port having a proximal end and a distal end, the side-port wail at the proximal end extending from the lumen to the outer surface of the catheter, the side-port wall at the distal end of the side-port extending perpendicularly from the lumen to the vestibule, the catheter body wall defining the vestibule as extending distally from the distal end of the side-port to the outer surface of the catheter, the method comprising the steps of:
(a) advancing the angled wire through the lumen of the catheter which has a distal end opening and which is positioned sub-intimally within a wall 3 f the vessel such that a layer of tissue of the vessel contacts the outer surface of the catheter adjacent and surrounding the side-port whereby the layer of tissue covers the side-port and wherein the lumen is in fluid communication with the side-port and the distal end opening:
(b) positioning a distal tip of the angled wire through the side-port which has a longitudinally elongate opening such that the distal tip contacts the layer of tissue which covers the longitudinally elongate opening of the side-port without contacting a side of the distal end of the side-port, and
(c) wherein the side of the distal end of the side-port has the vestibule cut into an outer portion of it which is adjacent the outer surface of the body of the catheter to provide for advancing the angled wire through the side-port such that the distal tip of the angled wire slides along the layer of tissue without puncturing the layer of tissue until a side of the angled device is supported by an inner portion of the distal end of the side-port.

### Claim 11 (depends on 10)

The method of claim 10, wherein the angled wire comprises an electrode at the distal tip thereof and wherein the method further comprises a step (d) of delivering energy to the layer of tissue through the electrode to cut the layer of tissue.

### Claim 12 (depends on 11)

The method of claim 11, wherein the energy is selected from the group consisting of radiofrequency electrical energy and microwave electrical energy.

### Claim 13

A method of using a catheter and an angled wire for re-entry into a true lumen of a vessel wherein the catheter comprises a catheter body, the catheter body having a catheter body wall defining a lumen, and a side-port defined by a side of the catheter body wall in fluid communication with the lumen, the catheter having an outer surface and a longitudinal axis. the catheter body wall defining a vestibule and a side-port wall which is perpendicular to the longitudinal axis of the catheter, the side-port having a proximal end and a distal end, the side-port w all at the proximal end extending from the lumen to the outer surface of the catheter, the side-port wall at the distal end of the side-port extending perpendicularly from the lumen to the vestibule, the catheter body wall defining the vestibule as extending distally from the distal end of the side-port to the outer surface of the catheter, the method comprising the steps of:
(a) advancing the angled wire through the lumen of the catheter which has a distal end opening and which is positioned sub-intimally within a wall of the vessel such that a layer of tissue of the vessel contacts the outer surface of the catheter body adjacent the side-port whereby the layer of tissue covers the side-port and wherein the lumen is in fluid communication with the side-port and the distal end opening;
(b) positioning the angled wire through the side-port which has a longitudinally elongate opening such that a distal tip of the angled wire is spaced apart from both a side of the distal end of the side-port as well as the layer of tissue which is covering the longitudinally elongate opening of the side-port, and
(c) wherein the side of the distal end of the side-port has the vestibule cut into an outer portion of it which is adjacent the outer surface of the body of the catheter, such that further advancing the angled wire causes a side of the angled wire to abut and be supported by an inner portion of the distal end of the side-port which is adjacent the lumen while avoiding contact with the layer of tissue.

### Claim 14 (depends on 13)

The method of claim 13, further comprising a step (d) of further advancing the angled wire until the distal tip of the angled wire contacts the layer of tissue while avoiding contact with the distal end of the side-port.

### Claim 15 (depends on 14)

The method of claim 14, wherein the angled wire comprises an electrode located at the distal tip thereof and wherein the method further comprises a step (e) of delivering an energy to the layer of tissue through the electrode to cut the layer of tissue.

### Claim 16 (depends on 15)

The method of claim 15, wherein the energy is selected from the group consisting of radiofrequency electrical energy and microwave electrical energy.

### Claim 17 (depends on 13)

The method of claim 13, wherein the catheter comprises a radiopaque marker for positioning the angle wire relative to the side-port.