Intravascular device for coronary heart treatment

An improved intravascular device for use in combination with a guide catheter having a distal end, a proximal end and an internal diameter defining a central lumen, the improvement comprising:

• a relatively flexible tube having an outer diameter sized for insertion through the central lumen of the guide catheter into a coronary vessel, the flexible tube being concentrically aligned with the guide catheter and the tube having an inner diameter defining an internal lumen therethrough, the tube having a proximal end and a distal end, the extent therebetween defining an extension length of the flexible tube, the length of the tube being sized so that the proximal end of the tube terminates adjacent the distal end of the the guide catheter and the distal end extends into the vessel to reach a treatment site;
• a proximal funnel formed near the proximal end of the flexible tube, the proximal funnel having a distally tapered frusto-conical portion, the distally tapered frusto-conical portion defining an opening between the central lumen of the guide catheter and the internal lumen of the tube for allowing fluid communication therebetween, the distally tapered frusto-conical portion including a first proximal outer diameter and a second smaller distal outer diameter, the first outer diameter coinciding with the internal diameter of the guide catheter to provide a tight interaction therebetween;
• and
• a push rod coupled to the proximal end of the tube for slidably positioning the tube for placement.

A guide wire placement system for placement of a guide wire into a coronary vessel of a patient, the guide wire placement system comprising:

• a guide catheter having a proximal end, a distal end, and a central lumen extending therethrough;
• a relatively flexible tube sized for insertion into a coronary vessel through the central lumen of the guide catheter into a coronary vessel, the flexible tube of the intravascular device being concentrically aligned with the guide catheter and having a proximal end and a distal end, the extent therebetween defining an extension length of the flexible tube, the length of the tube being sized so that the proximal end of the tube terminates adjacent the distal end of the guide catheter and the distal end extends into the vessel to reach a treatment site, the tube defining an internal lumen being sized to receive the guide wire therethrough for placement of the guide wire into the patient, the tube having sufficient rigidity to support a pre-formed guide wire for advancement and placement into the vessel;
• a push rod attached to the proximal end of the tube for slidably positioning the tube for placement with the guide wire, wherein the tube is slidable between a first retracted position and a second extended position;
• and
• means for coupling the proximal end of the flexible tube adjacent to the distal end of the guide catheter when the tube is positioned in the second extended position, the means having an opening between the central lumen of the guide catheter and the internal lumen of the tube allowing fluid communication therebetween to form a continuous lumen from the proximal end of the guide catheter into the treatment site.

For use in combination with a guide catheter having an inner diameter defining a central lumen, a proximal end and a distal end, an improvement comprising:

• a distal extension device including:
• a relatively flexible tube defining an inner lumen and being sized for insertion through the central lumen of the guide catheter into a coronary vessel requiring treatment, the flexible tube being concentrically aligned with he guide catheter, the tube having a proximal end and a distal end, the extent therebetween defining an extension length of the flexible tube, the length of the tube being sized so that the proximal end of the tube terminates adjacent the distal end of the guide catheter and the distal end of the flexible tube extends into a vessel to reach a treatment site;
• means extending between the proximal end of the tube and the inner diameter of the guide catheter for joining the central lumen and the inner lumen in fluid communication with one another to establish a continuous lumen beyond the distal end of the guide catheter into a coronary vessel;
• and
• a push rod coupled to the proximal end of the flexible tube for placement of the tube into the vessel requiring treatment.

A fluid delivery system for delivering fluid into and through a coronary vessel to a treatment site, the system comprising:

• a guide catheter having a proximal end and a distal end;
• a relatively flexible tube sized for insertion through the coronary vessel, the tube defining an inner lumen for fluid delivery, the length of the tube being sized so that the proximal end of the tube aligns with the distal end of the guide catheter and the distal end of the tube extends into the vessel to reach the treatment site;
• a push rod coupled to the flexible tube and extending proximally therefrom for placement of the tube into the vessel, wherein the flexible tube is movable between a first retracted position and a second extended position;
• and
• means adjacent a distal portion of the guide catheter for fluidly sealing between the tube and the guide catheter when the tube is extended into the second extended position.

An aspiration system for withdrawing blood clotting material from a treatment site within a coronary vessel, the aspiration system comprising:

• a guide catheter having a proximal end, a distal end, a central lumen, and an internal diameter;
• a relatively flexible tube sized for insertion through the central lumen of the guide catheter into a coronary vessel requiring treatment, the flexible tube being concentrically aligned with the guide catheter, the tube having a proximal end and a distal end, the extent therebetween defining an extension length of the flexible tube, wherein the flexible tube is movable between a first retracted position and a second extended position, the length of the tube being sized so that the proximal end of the tube aligns with the distal end of the guide catheter and the distal end of the tube extends into a vessel to reach the treatment site when the flexible robe is in the second extended position;
• a push rod coupled to the proximal end of the tube for slidably positioning the tube for placement, wherein the flexible tube is movable between a first retracted position and a second extended position;
• and
• a seal at the proximal end of the tube and coupled between the tube and the guide catheter for sealing between the tube and the guide catheter when the distal end of the tube is extended into the second extended position.

An intravascular system comprising:

• a guide catheter having a proximal end, a distal end, a central lumen, and an internal diameter;
• a relatively flexible tube having a proximal end, a distal end, an outer diameter and an internal lumen, wherein the outer diameter is sized for insertion through the central lumen of the guide catheter so that the distal end of the tube may be positioned beyond the distal end of the guide catheter to extend the flexible tube to the treatment site and wherein the proximal end of the tube terminates adjacent the distal end of the the guide catheter;
• means for coupling the proximal end of the flexible tube relative to the distal end of the guide catheter, the means having an opening between the central lumen of the guide catheter and the internal lumen of the tube allowing fluid communication therebetween to form a continuous lumen from the proximal end of the guide catheter into a coronary vessel to the treatment site;
• and
• a push rod eccentrically coupled to the proximal end of the tube for slidably positioning the tube.

An intravascular system comprising;

• a first main outer tube having a proximal end, a distal end, an inner diameter, an outer diameter, and a central lumen;
• a second inner tube having a proximal end and a distal end, wherein the second inner tube is adapted to be positioned within and through the first main outer tube, the second inner tube including an internal lumen having a distal opening, wherein the internal lumen is in fluid communication with the central lumen of the guide catheter and wherein the second inner tube is flexible so that the inner tube may be directed through a coronary ostium to position the distal opening at a treatment site;
• and
• a push rod coupled to the second inner tube for slidably positioning the second inner tube relative to the first main outer tube.