Patent US20010034547A1 successfully refreshed from Google Patents.
US20010034547A1
Expired / Lapsed
US
⏱️ 0.0 years remaining
Delivery methods for left ventricular conduit
Assignee: Horizon Technology Funding Co LLC
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Filing: 2001-03-02
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Granted: —
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Expires: 2021-03-02
Abstract
Abstract Described herein are various methods and apparatuses for delivering stents or conduits and other devices into the myocardium of a patient. One preferred stent delivery system provides access to the insertion site in the myocardium by advancing a delivery catheter through a blockage in a coronary artery, or around the blockage through a coronary vein or through a channel or tunnel formed around the blockage. In one embodiment, once the distal end of the delivery catheter is adjacent the myocardium, an angled bend is created in the catheter by actuating expandable steering guides mounted to the catheter which cooperate with the walls of the blood vessel to cause the catheter to turn. Then, a guidewire is advanced through the delivery catheter and into the myocardium. In another embodiment, a tip-deflecting pull wire extends from the distal end of the delivery catheter which may be actuated to turn towards and then inserted into the myocardium. In another embodiment, an exit port facing the insertion site is provided within the catheter or a balloon mounted on the catheter so that a guidewire may be directed through a lumen and out the exit port into the myocardium. Once the guidewire punctures into the myocardium, the guidewire is anchored using barbs, balloons or other actuatable members to secure the guidewire to the myocardium. Subsequently, using a push-pull mechanism, stents and other medical devices can be advanced over the guidewire into the myocardium.
Inventors
- 👤 Todd Hall
- 👤 Greg Furnish
- 👤 Simon Furnish
- 👤 Scott Wolf
- 👤 Peter Wilk
- 👤 David Phelps
- 👤 Vincent Pompili
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-22 23:04
CPC Classifications
A; A61; A61M; A61M25/00; A61M25/01; A61M25/0105; A61M25/0133; A61M25/0147; A61F; A61F2/00; A61F2/02; A61F2/24; A61F2/2493; A61F2/95; A61F2/958; A61M25/0152; A61M25/0155; A61M25/0194; A61M25/10; A61B; A61B17/00; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B2017/00247; A61B2017/00252; A61B17/22; A61B2017/22051; A61B2017/22054; A61B2017/22065; A61B2017/22071; A61B2017/22094; A61B2017/22095; A61B18/00; A61B2018/00315; A61B2018/00345; A61B2018/00351; A61B2018/00392; A61F2/82; A61F2/86; A61M25/0067; A61M25/0082; A61M2025/0096; A61M2025/0197; A61M2025/1043; A61M2025/1095; A61M2025/1097; A61M2210/00; A61M2210/12; A61M2210/125; A61M25/1006; A61M25/1011
Claims Analysis
Total Claims: 134
Claim 1
Independent Claim
83 words
1 . A method for delivering a medical device into the heart wall of a patient, comprising: delivering a guidewire into the patient, the guidewire once delivered having a proximal end extending out of the patient and a distal end positioned adjacent the heart wall; inserting the distal end of the guidewire into the heart wall; anchoring the guidewire to the heart wall; and advancing an introducer catheter carrying the medical device over the guidewire to deliver the device into the heart wall.
Claim 2
Dependent Claim
83 words
1 . A method for delivering a medical device into the heart wall of a patient, comprising: delivering a guidewire into the patient, the guidewire once delivered having a proximal end extending out of the patient and a distal end positioned adjacent the heart wall; inserting the distal end of the guidewire into the heart wall; anchoring the guidewire to the heart wall; and advancing an introducer catheter carrying the medical device over the guidewire to deliver the device into the heart wall.
Claim 3
Dependent Claim
17 words
2 . The method of claim 1 , wherein the guidewire is delivered percutaneously into the patient.
Claim 4
Dependent Claim
24 words
3 . The method of claim 2 , wherein the distal end of the guidewire is advanced through a blockage in a coronary artery.
Claim 5
Dependent Claim
21 words
4 . The method of claim 2 , wherein the distal end of the guidewire is advanced through a coronary vein.
Claim 6
Dependent Claim
21 words
5 . The method of claim 2 , wherein the distal end of the guidewire is advanced into the left ventricle.
Claim 7
Dependent Claim
59 words
6 . The method of claim 1 , further comprising advancing a delivery catheter into the patient prior to delivering the guidewire, the delivery catheter comprising a tubular body having a proximal end and a distal end and a lumen extending at least partially therethrough, until the distal end of the delivery catheter is positioned adjacent the heart wall.
Claim 8
Dependent Claim
109 words
7 . The method of claim 6 , further comprising turning the distal end of the guidewire toward the heart wall prior to inserting the distal end of the guidewire, by: actuating an anchoring member mounted on the distal end of the delivery catheter to secure the delivery catheter within the patient; and actuating a steering member mounted on the distal end of the tubular body at a position distal to that of the anchoring member to turn the distal end of the delivery catheter toward the heart wall; and advancing the guidewire through the lumen in the delivery catheter and out the distal end of the delivery catheter.
Claim 9
Dependent Claim
43 words
8 . The method of claim 1 , wherein the guidewire is a tip-deflecting wire, and further comprising turning the distal end of the guidewire toward the heart wall prior to inserting the distal end of the guidewire by actuating the tip-deflecting wire.
Claim 10
Dependent Claim
57 words
9 . The method of claim 1 , further comprising: providing a passageway adjacent the heart wall having a proximal opening for receiving the distal end of the guidewire and a side port exit facing the heart wall; wherein delivering the guidewire comprises advancing the distal end of the guidewire through the passageway toward the heart wall.
Claim 11
Dependent Claim
20 words
10 . The method of claim 9 , wherein the passageway is provided through a lumen in a delivery catheter.
Claim 12
Dependent Claim
26 words
11 . The method of claim 9 , wherein the passageway is provided through an anchoring member mounted to a distal end of a delivery catheter.
Claim 13
Dependent Claim
53 words
12 . The method of claim 1 , wherein anchoring the guidewire to the heart wall comprises providing at least one barb attached to the distal end of the guidewire, the barb having a shape that facilitates advancement of the guidewire distally through the heart wall but prevents retraction of the guidewire proximally.
Claim 14
Dependent Claim
38 words
13 . The method of claim 1 , wherein inserting the distal end of the guidewire into the heart wall comprises advancing the guidewire from a coronary blood vessel until the distal end extends into the left ventricle.
Claim 15
Dependent Claim
30 words
14 . The method of claim 1 , wherein anchoring the guidewire further comprises expanding an anchoring member mounted on the distal end of the guidewire within the left ventricle.
Claim 16
Dependent Claim
16 words
15 . The method of claim 14 , wherein the anchoring member is an inflatable balloon.
Claim 17
Dependent Claim
41 words
16 . The method of claim 1 , wherein advancing the introducer catheter carrying a medical device further comprises: pulling proximally on the guidewire anchored to the heart wall; and pushing the introducer catheter over the guidewire into the heart wall.
Claim 18
Dependent Claim
83 words
17 . A method for delivering a conduit into a heart wall to bypass a blockage formed in a coronary artery, comprising: creating a channel from a position proximal to the blockage in the coronary artery to a position distal to the blockage in the coronary artery; advancing a guidewire through the channel until a distal end of the guidewire is adjacent the heart wall; inserting the guidewire into the heart wall; and advancing a conduit over the guidewire into the heart wall.
Claim 19
Dependent Claim
83 words
17 . A method for delivering a conduit into a heart wall to bypass a blockage formed in a coronary artery, comprising: creating a channel from a position proximal to the blockage in the coronary artery to a position distal to the blockage in the coronary artery; advancing a guidewire through the channel until a distal end of the guidewire is adjacent the heart wall; inserting the guidewire into the heart wall; and advancing a conduit over the guidewire into the heart wall.
Claim 20
Dependent Claim
18 words
18 . The method of claim 17 , wherein the channel is a tunnel formed through the myocardium.
Claim 21
Dependent Claim
14 words
19 . The method of claim 17 , wherein the conduit is a stent.
Claim 22
Dependent Claim
55 words
20 . A method for creating a bypass around a blockage in a blood vessel, comprising: delivering a guidewire along a pathway from a location in the blood vessel proximal to the blockage to a location in the blood vessel distal to the blockage; and creating a channel along the pathway formed by the guidewire.
Claim 23
Dependent Claim
55 words
20 . A method for creating a bypass around a blockage in a blood vessel, comprising: delivering a guidewire along a pathway from a location in the blood vessel proximal to the blockage to a location in the blood vessel distal to the blockage; and creating a channel along the pathway formed by the guidewire.
Claim 24
Dependent Claim
16 words
21 . The method of claim 20 , wherein the blockage occurs in a coronary artery.
Claim 25
Dependent Claim
17 words
22 . The method of claim 21 , wherein the guidewire is delivered through the heart wall.
Claim 26
Dependent Claim
20 words
23 . The method of claim 22 , wherein creating the channel comprises dilating the pathway formed by the guidewire.
Claim 27
Dependent Claim
17 words
24 . The method of claim 23 , further comprising implanting a shunt in the dilated pathway.
Claim 28
Dependent Claim
26 words
25 . The method of claim 21 , wherein the guidewire is delivered through the pericardial space, and further comprising providing a shunt over the guidewire.
Claim 29
Dependent Claim
15 words
26 . The method of claim 20 , wherein the guidewire has eyes for navigation.
Claim 30
Dependent Claim
122 words
27 . A method for creating a bypass around a blockage in a coronary artery, adjacent a heart wall, comprising: inserting a needle into a patient into the heart wall, the needle having a lumen extending therethrough; advancing the needle through the heart wall and into the coronary artery distal to the blockage; advancing a guidewire through the lumen in the needle, the guidewire once advanced extending through the coronary artery proximal to the blockage, through the heart wall, and into the coronary artery distal to the blockage; removing the needle from the patient while leaving the guidewire in place; advancing a shunt over the guidewire, the shunt once advanced having a distal end in the coronary artery distal to the blockage.
Claim 31
Dependent Claim
122 words
27 . A method for creating a bypass around a blockage in a coronary artery, adjacent a heart wall, comprising: inserting a needle into a patient into the heart wall, the needle having a lumen extending therethrough; advancing the needle through the heart wall and into the coronary artery distal to the blockage; advancing a guidewire through the lumen in the needle, the guidewire once advanced extending through the coronary artery proximal to the blockage, through the heart wall, and into the coronary artery distal to the blockage; removing the needle from the patient while leaving the guidewire in place; advancing a shunt over the guidewire, the shunt once advanced having a distal end in the coronary artery distal to the blockage.
Claim 32
Dependent Claim
45 words
28 . The method of claim 27 , wherein prior to inserting the needle into the heart wall, the needle is inserted into the coronary artery from the pericardial space through the anterior wall of the coronary artery at a location proximal to the blockage.
Claim 33
Dependent Claim
25 words
29 . The method of claim 27 , wherein the shunt once delivered has a proximal end in the coronary artery proximal to the blockage.
Claim 34
Dependent Claim
27 words
30 . The method of claim 27 , wherein the needle is advanced through the heart wall into the left ventricle and back into the heart wall.
Claim 35
Dependent Claim
22 words
31 . The method of claim 30 , wherein the shunt once delivered has a proximal end opening toward the left ventricle.
Claim 36
Dependent Claim
17 words
32 . The method of claim 27 , wherein the needle is pre-shaped in a carved configuration.
Claim 37
Dependent Claim
131 words
33 . A method for creating a bypass through the heart wall of a patient to bypass a blockage formed in a coronary artery, comprising: creating a first tunnel through the heart wall having a proximal end and a distal end, the proximal end opening into the coronary artery proximal to the blockage, and the distal end positioned within the heart wall; creating a second tunnel through the heart wall, the second tunnel having a first branch extending from the distal end of the first tunnel and opening into the coronary artery at a position distal to the blockage, and a second branch extending from the distal end of the first channel and opening into a heart chamber; and disposing a conduit in the second tunnel to provide a passageway therethrough.
Claim 38
Dependent Claim
131 words
33 . A method for creating a bypass through the heart wall of a patient to bypass a blockage formed in a coronary artery, comprising: creating a first tunnel through the heart wall having a proximal end and a distal end, the proximal end opening into the coronary artery proximal to the blockage, and the distal end positioned within the heart wall; creating a second tunnel through the heart wall, the second tunnel having a first branch extending from the distal end of the first tunnel and opening into the coronary artery at a position distal to the blockage, and a second branch extending from the distal end of the first channel and opening into a heart chamber; and disposing a conduit in the second tunnel to provide a passageway therethrough.
Claim 39
Dependent Claim
14 words
34 . The method of claim 33 , wherein the conduit is a stent.
Claim 40
Dependent Claim
20 words
35 . The method of claim 33 , further comprising closing off the first tunnel at the distal end thereof.
Claim 41
Dependent Claim
20 words
36 . The method of claim 33 , further comprising closing off the first tunnel at the proximal end thereof.
Claim 42
Dependent Claim
60 words
37 . A delivery catheter, comprising: an elongate tubular body having a proximal end and a distal end and a lumen extending therethrough; a first steering member mounted on the distal end of the tubular body; and a second steering member mounted on the distal end of the tubular body at a position distal to that of the anchoring member.
Claim 43
Dependent Claim
60 words
37 . A delivery catheter, comprising: an elongate tubular body having a proximal end and a distal end and a lumen extending therethrough; a first steering member mounted on the distal end of the tubular body; and a second steering member mounted on the distal end of the tubular body at a position distal to that of the anchoring member.
Claim 44
Dependent Claim
39 words
38 . The catheter of claim 37 , wherein the first steering member is an expandable anchoring member which, when actuated, is sized to press against a wall of the body lumen to secure the catheter within the lumen.
Claim 45
Dependent Claim
36 words
39 . The catheter of claim 38 , wherein the second steering member is an expandable member which, when actuated, cooperates with a wall of the body lumen to turn the distal end of the catheter.
Claim 46
Dependent Claim
27 words
40 . The catheter of claim 39 , wherein the second steering member is capable of turning the distal end of the catheter greater than 90 degrees.
Claim 47
Dependent Claim
18 words
41 . The catheter of claim 37 , wherein the anchoring member and steering member are inflatable balloons.
Claim 48
Dependent Claim
35 words
42 . The catheter of claim 37 , wherein the anchoring member is mounted to one side of the tubular body and the steering member is mounted to an opposite side of the tubular body.
Claim 49
Dependent Claim
98 words
43 . A method for turning a distal end of a catheter within a body lumen, the catheter comprising an elongate tubular body having a proximal end and a distal end, the method comprising: actuating an anchoring member mounted on the distal end of the tubular body to secure the catheter against the body lumen; and actuating a steering member mounted on the distal end of the tubular body at a position distal to that of the anchoring member, wherein the steering member when actuated cooperates with the body lumen to turn the distal end of the catheter.
Claim 50
Dependent Claim
98 words
43 . A method for turning a distal end of a catheter within a body lumen, the catheter comprising an elongate tubular body having a proximal end and a distal end, the method comprising: actuating an anchoring member mounted on the distal end of the tubular body to secure the catheter against the body lumen; and actuating a steering member mounted on the distal end of the tubular body at a position distal to that of the anchoring member, wherein the steering member when actuated cooperates with the body lumen to turn the distal end of the catheter.
Claim 51
Dependent Claim
19 words
44 . The method of claim 43 , wherein the anchoring member and the steering member are inflatable balloons.
Claim 52
Dependent Claim
96 words
45 . A method for delivering a medical device to a delivery site within a patient comprising: providing a delivery catheter having a proximal end and a distal end and a lumen extending therethrough into a body lumen of the patient; securing the delivery catheter within the body lumen; turning the distal end of the catheter by actuating a steering member mounted on the distal end of the catheter which pushes off against a wall of the body lumen; and advancing the medical device through the lumen of the delivery catheter and out the distal end.
Claim 53
Dependent Claim
96 words
45 . A method for delivering a medical device to a delivery site within a patient comprising: providing a delivery catheter having a proximal end and a distal end and a lumen extending therethrough into a body lumen of the patient; securing the delivery catheter within the body lumen; turning the distal end of the catheter by actuating a steering member mounted on the distal end of the catheter which pushes off against a wall of the body lumen; and advancing the medical device through the lumen of the delivery catheter and out the distal end.
Claim 54
Dependent Claim
30 words
46 . The method of claim 45 , wherein the steering member when actuated pushes off a wall of the body lumen to turn the distal end of the catheter.
Claim 55
Dependent Claim
33 words
47 . The method of claim 45 , wherein securing the delivery catheter comprises actuating an anchoring member mounted on the distal end of the catheter against the wall of the body lumen.
Claim 56
Dependent Claim
24 words
48 . The method of claim 47 , wherein actuating the anchoring member comprises inflating a balloon against the wall of the body lumen.
Claim 57
Dependent Claim
24 words
49 . The method of claim 45 , wherein actuating the steering member comprises inflating a balloon against the wall of the body lumen.
Claim 58
Dependent Claim
44 words
50 . A catheter, comprising: an elongate tubular body having a proximal end and a distal end and a lumen extending at least partially therethrough; and means for turning the distal end of the catheter mounted on the distal end of the tubular body.
Claim 59
Dependent Claim
44 words
50 . A catheter, comprising: an elongate tubular body having a proximal end and a distal end and a lumen extending at least partially therethrough; and means for turning the distal end of the catheter mounted on the distal end of the tubular body.
Claim 60
Dependent Claim
29 words
51 . The catheter of claim 50 , wherein the means for turning the distal end of the catheter includes means for anchoring the catheter to a body lumen.
Claim 61
Dependent Claim
101 words
52 . A method for delivering a conduit into the heart wall of a patient, comprising: advancing a delivery catheter into the vasculature of the patient, the delivery catheter having a proximal end and a distal end and a lumen extending therethreough, until the distal end is adjacent the heart wall; actuating a pull wire extending from the distal end of the delivery catheter to turn the pull wire toward the heart wall; advancing the pull wire from the distal end of the delivery catheter into the heart wall; and delivering the conduit over the pull wire into the heart wall.
Claim 62
Dependent Claim
101 words
52 . A method for delivering a conduit into the heart wall of a patient, comprising: advancing a delivery catheter into the vasculature of the patient, the delivery catheter having a proximal end and a distal end and a lumen extending therethreough, until the distal end is adjacent the heart wall; actuating a pull wire extending from the distal end of the delivery catheter to turn the pull wire toward the heart wall; advancing the pull wire from the distal end of the delivery catheter into the heart wall; and delivering the conduit over the pull wire into the heart wall.
Claim 63
Dependent Claim
14 words
53 . The method of claim 52 , wherein the conduit is a stent.
Claim 64
Dependent Claim
107 words
54 . A method for delivering a conduit into the heart wall of a patient, comprising: advancing a delivery catheter into the vasculature of the patient, the catheter having a proximal end and a distal end and a lumen extending from the proximal end to a side port near the distal end, until the side port faces the heart wall; inserting a guidewire having a proximal end and a distal end into the lumen; advancing the distal end of the guidewire through the lumen and out the side port; advancing the guidewire into the heart wall; and delivering the conduit over the guidewire into the heart wall.
Claim 65
Dependent Claim
107 words
54 . A method for delivering a conduit into the heart wall of a patient, comprising: advancing a delivery catheter into the vasculature of the patient, the catheter having a proximal end and a distal end and a lumen extending from the proximal end to a side port near the distal end, until the side port faces the heart wall; inserting a guidewire having a proximal end and a distal end into the lumen; advancing the distal end of the guidewire through the lumen and out the side port; advancing the guidewire into the heart wall; and delivering the conduit over the guidewire into the heart wall.
Claim 66
Dependent Claim
17 words
55 . The method of claim 54 , further comprising anchoring the delivery catheter within the vasculature.
Claim 67
Dependent Claim
28 words
56 . The method of claim 54 , wherein anchoring of the delivery catheter comprises expanding an anchoring member mounted to the distal end of the delivery catheter.
Claim 68
Dependent Claim
16 words
57 . The method of claim 56 , wherein the anchoring member is an inflatable balloon.
Claim 69
Dependent Claim
21 words
58 . The method of claim 56 , further comprising perfusing blood through at least one channel in the anchoring member.
Claim 70
Dependent Claim
40 words
59 . The method of claim 54 , wherein the distal end of the guidewire is advanced out the side port at an angle greater than about 90 degrees relative to the direction the guidewire is advanced through the lumen.
Claim 71
Dependent Claim
134 words
60 . A method for delivering a conduit into the heart wall of a patient, comprising: advancing a delivery catheter into the vasculature of a patient, the catheter having a proximal end and a distal end, until the distal end is adjacent the heart wall; expanding an anchoring member mounted on the distal end of the catheter to secure the delivery catheter within the vasculature; inserting a guidewire having a proximal end and a distal end through a lumen in the expanded anchoring member, the lumen extending from a proximal end of the anchoring member to a side port facing the heart wall, so that the distal end of the guidewire exits through the side port; advancing the guidewire into the heart wall; and advancing the conduit over the guidewire into the heart wall.
Claim 72
Dependent Claim
134 words
60 . A method for delivering a conduit into the heart wall of a patient, comprising: advancing a delivery catheter into the vasculature of a patient, the catheter having a proximal end and a distal end, until the distal end is adjacent the heart wall; expanding an anchoring member mounted on the distal end of the catheter to secure the delivery catheter within the vasculature; inserting a guidewire having a proximal end and a distal end through a lumen in the expanded anchoring member, the lumen extending from a proximal end of the anchoring member to a side port facing the heart wall, so that the distal end of the guidewire exits through the side port; advancing the guidewire into the heart wall; and advancing the conduit over the guidewire into the heart wall.
Claim 73
Dependent Claim
17 words
61 . The method of claim 60 , wherein expanding the anchoring member comprises inflating a balloon.
Claim 74
Dependent Claim
22 words
62 . The method of claim 60 , further comprising perfusing blood through at least one channel in the expanded anchoring member.
Claim 75
Dependent Claim
75 words
63 . A delivery catheter, comprising: an elongate body having a proximal end and a distal end; an expandable member mounted on the distal end of the tubular body, the expandable member having a proximal end and a distal end and an exterior surface; and a guide lumen extending from the proximal end of the expandable member to a side port on the exterior surface of the expandable member for directing a medical device therethrough.
Claim 76
Dependent Claim
75 words
63 . A delivery catheter, comprising: an elongate body having a proximal end and a distal end; an expandable member mounted on the distal end of the tubular body, the expandable member having a proximal end and a distal end and an exterior surface; and a guide lumen extending from the proximal end of the expandable member to a side port on the exterior surface of the expandable member for directing a medical device therethrough.
Claim 77
Dependent Claim
30 words
64 . The delivery catheter of claim 63 , wherein the guide lumen extends through the elongate body from the side port to the proximal end of the elongate body.
Claim 78
Dependent Claim
19 words
65 . The delivery catheter of claim 63 , wherein the guide lumen is separate from the elongate body.
Claim 79
Dependent Claim
19 words
66 . The delivery catheter of claim 63 , wherein the guide lumen curves up to about 90 degrees.
Claim 80
Dependent Claim
17 words
67 . The delivery catheter of claim 63 , wherein the expandable member is an inflatable balloon.
Claim 81
Dependent Claim
20 words
68 . The delivery catheter of claim 63 , further comprising a perfusion channel to allow blood to flow therethrough.
Claim 82
Dependent Claim
18 words
69 . The delivery catheter of claim 68 , wherein the perfusion channel extends through the expandable member.
Claim 83
Dependent Claim
89 words
70 . A delivery catheter, comprising: an elongate body having a proximal end and a distal end defining a generally longitudinally axis therebetween; a guidewire lumen extending at least partially between the proximal end and the distal end of the elongate body and having a proximal end and a distal end; an exit port at the distal end of the guidewire lumen creating a curve of between about 0 and 180 degrees relative to the longitudinal axis of the elongate body for directing a guidewire out of the lumen.
Claim 84
Dependent Claim
89 words
70 . A delivery catheter, comprising: an elongate body having a proximal end and a distal end defining a generally longitudinally axis therebetween; a guidewire lumen extending at least partially between the proximal end and the distal end of the elongate body and having a proximal end and a distal end; an exit port at the distal end of the guidewire lumen creating a curve of between about 0 and 180 degrees relative to the longitudinal axis of the elongate body for directing a guidewire out of the lumen.
Claim 85
Dependent Claim
27 words
71 . The delivery catheter of claim 70 , wherein the exit port is a side port formed proximal to the distal end of the elongate body.
Claim 86
Dependent Claim
21 words
72 . The delivery catheter of claim 71 , further comprising an expandable member mounted proximal to the side exit port.
Claim 87
Dependent Claim
21 words
73 . The delivery catheter of claim 71 , further comprising an expandable member mounted distal to the side exit port.
Claim 88
Dependent Claim
40 words
74 . The delivery catheter of claim 70 , wherein the guidewire lumen extends between the proximal end and the distal end of the elongate body, and the exit port is located at the distal end of the elongate body.
Claim 89
Dependent Claim
22 words
75 . The delivery catheter of claim 74 , further comprising a narrowing passageway between the guidewire lumen and the exit port.
Claim 90
Dependent Claim
46 words
76 . A catheter, comprising: an elongate tubular body having a proximal end and a distal end and a lumen extending at least partially therethrough; means provided near the distal end of the tubular body for directing a guidewire at an angle into a body tissue.
Claim 91
Dependent Claim
46 words
76 . A catheter, comprising: an elongate tubular body having a proximal end and a distal end and a lumen extending at least partially therethrough; means provided near the distal end of the tubular body for directing a guidewire at an angle into a body tissue.
Claim 92
Dependent Claim
51 words
77 . A method for treating an aneurysm, comprising: advancing a catheter having a proximal end and a distal end to the site of the aneurysm; actuating an expandable member mounted on the distal end of the catheter to substantially enclose the aneurysm; and inserting an embolic element into the aneurysm.
Claim 93
Dependent Claim
51 words
77 . A method for treating an aneurysm, comprising: advancing a catheter having a proximal end and a distal end to the site of the aneurysm; actuating an expandable member mounted on the distal end of the catheter to substantially enclose the aneurysm; and inserting an embolic element into the aneurysm.
Claim 94
Dependent Claim
21 words
78 . The method of claim 77 , wherein the embolic element is inserted through a lumen in the expandable member.
Claim 95
Dependent Claim
17 words
79 . The method of claim 77 , wherein actuating the expandable member comprises inflating a balloon.
Claim 96
Dependent Claim
21 words
80 . The method of claim 77 , further comprising perfusing blood through at least one channel in the expandable member.
Claim 97
Dependent Claim
15 words
81 . The method of claim 77 , wherein the embolic element is a wire.
Claim 98
Dependent Claim
25 words
82 . A method for treating an aneurysm, comprising: enclosing the aneurysm; and inserting an embolic element into the aneurysm while the aneurysm is closed.
Claim 99
Dependent Claim
25 words
82 . A method for treating an aneurysm, comprising: enclosing the aneurysm; and inserting an embolic element into the aneurysm while the aneurysm is closed.
Claim 100
Dependent Claim
23 words
83 . The method of claim 82 , wherein the embolic element is inserted into the aneurysm by delivering wire through a catheter.
Claim 101
Dependent Claim
17 words
84 . The method of claim 82 , wherein the aneurysm is enclosed with an inflatable balloon.
Claim 102
Dependent Claim
23 words
85 . The method of claim 84 , wherein the embolic element is inserted into the aneurysm by delivering wire through the balloon.
Claim 103
Dependent Claim
139 words
86 . An assembly for delivering a medical device into a heart wall of a patient, comprising: an insertion tube having a proximal end and a distal end and a delivery channel extending therethrough; a tubular member having a proximal end and a distal end and a lumen extending therethrough, the tubular member having a distal portion provided with an internal spring bias tending to form said distal portion into an arcuate configuration in the absence of an external straightening force on said distal portion, the tubular member being longitudinally slidable in said delivery channel, and wherein said distal portion may be alternately maintained in a relatively straightened configuration in the distal end of said channel and moved outside of said channel to assume said arcuate configuration; and a guidewire longitudinally slidable within the lumen of the tubular member.
Claim 104
Dependent Claim
139 words
86 . An assembly for delivering a medical device into a heart wall of a patient, comprising: an insertion tube having a proximal end and a distal end and a delivery channel extending therethrough; a tubular member having a proximal end and a distal end and a lumen extending therethrough, the tubular member having a distal portion provided with an internal spring bias tending to form said distal portion into an arcuate configuration in the absence of an external straightening force on said distal portion, the tubular member being longitudinally slidable in said delivery channel, and wherein said distal portion may be alternately maintained in a relatively straightened configuration in the distal end of said channel and moved outside of said channel to assume said arcuate configuration; and a guidewire longitudinally slidable within the lumen of the tubular member.
Claim 105
Dependent Claim
158 words
87 . A method for delivering a guidewire at an angle into a desired insertion site in the body, the method comprising: delivering an insertion tube into the vasculature of a patient, the insertion tube having a delivery channel extending therethrough and once delivered having a proximal end located outside of the patient and a distal end located adjacent a desired insertion site; delivering a delivery catheter through the delivery channel, the delivery catheter having a guidewire lumen extending therethrough, the delivery catheter once delivered having a proximal end outside of the patient and a distal end within the delivery channel; ejecting the distal end of the delivery catheter out of the delivery channel at the distal end of the insertion tube, the ejection of the delivery catheter from the delivery channel causing the distal end of the delivery catheter to turn toward the insertion site; and advancing a guidewire through the guidewire lumen into the insertion site.
Claim 106
Dependent Claim
158 words
87 . A method for delivering a guidewire at an angle into a desired insertion site in the body, the method comprising: delivering an insertion tube into the vasculature of a patient, the insertion tube having a delivery channel extending therethrough and once delivered having a proximal end located outside of the patient and a distal end located adjacent a desired insertion site; delivering a delivery catheter through the delivery channel, the delivery catheter having a guidewire lumen extending therethrough, the delivery catheter once delivered having a proximal end outside of the patient and a distal end within the delivery channel; ejecting the distal end of the delivery catheter out of the delivery channel at the distal end of the insertion tube, the ejection of the delivery catheter from the delivery channel causing the distal end of the delivery catheter to turn toward the insertion site; and advancing a guidewire through the guidewire lumen into the insertion site.
Claim 107
Dependent Claim
48 words
88 . The method of claim 87 , wherein the delivery catheter comprises a tubular member having a distal portion provided with an internal spring bias tending to form said distal portion into an arcuate configuration in the absence of an external straightening force on said distal portion.
Claim 108
Dependent Claim
145 words
89 . A method for delivering a guidewire into the heart wall, comprising: inserting a guidewire into a lumen of a delivery catheter, the guidewire having a proximal section and a distal section, the distal section of the guidewire being folded back over the proximal section while inside the delivery catheter lumen; delivering the delivery catheter into a patient, the delivery catheter once delivered having a proximal end outside of the patient and a distal end adjacent a desired insertion site in the heart wall; ejecting the distal section of the guidewire out of the lumen of the delivery catheter at its distal end; and pulling proximally on the guidewire such that the distal section punctures into the heart wall at an obtuse angle relative to the direction that the guidewire is ejected out of the lumen of the delivery catheter at its distal end.
Claim 109
Dependent Claim
145 words
89 . A method for delivering a guidewire into the heart wall, comprising: inserting a guidewire into a lumen of a delivery catheter, the guidewire having a proximal section and a distal section, the distal section of the guidewire being folded back over the proximal section while inside the delivery catheter lumen; delivering the delivery catheter into a patient, the delivery catheter once delivered having a proximal end outside of the patient and a distal end adjacent a desired insertion site in the heart wall; ejecting the distal section of the guidewire out of the lumen of the delivery catheter at its distal end; and pulling proximally on the guidewire such that the distal section punctures into the heart wall at an obtuse angle relative to the direction that the guidewire is ejected out of the lumen of the delivery catheter at its distal end.
Claim 110
Dependent Claim
29 words
90 . The method of claim 89 , further comprising, prior to pulling proximally on the guidewire, turning the guidewire so that the distal section faces the heart wall.
Claim 111
Dependent Claim
103 words
91 . A method for delivering a guidewire into an insertion site in the body, comprising: advancing a delivery catheter having a proximal end and a distal end and a lumen extending therethrough into the body, the distal end of the delivery catheter once advanced being located adjacent the insertion site; turning the distal end of the delivery catheter toward the insertion site; and advancing a guidewire through the lumen in the delivery catheter from the proximal end toward the distal end; and guiding the guidewire out the distal end and into the insertion site through a narrowing passageway formed in the lumen.
Claim 112
Dependent Claim
103 words
91 . A method for delivering a guidewire into an insertion site in the body, comprising: advancing a delivery catheter having a proximal end and a distal end and a lumen extending therethrough into the body, the distal end of the delivery catheter once advanced being located adjacent the insertion site; turning the distal end of the delivery catheter toward the insertion site; and advancing a guidewire through the lumen in the delivery catheter from the proximal end toward the distal end; and guiding the guidewire out the distal end and into the insertion site through a narrowing passageway formed in the lumen.
Claim 113
Dependent Claim
28 words
92 . A medical guidewire, comprising: an elongate body having a proximal end and a distal end; and a tip on the distal end having a screw configuration.
Claim 114
Dependent Claim
28 words
92 . A medical guidewire, comprising: an elongate body having a proximal end and a distal end; and a tip on the distal end having a screw configuration.
Claim 115
Dependent Claim
73 words
93 . A method for delivering a medical device into a body tissue of a patient comprising: inserting a guidewire having a proximal end and a distal end into the heart wall from a coronary blood vessel; anchoring the guidewire to the body tissue; pushing the medical device over the guidewire into the body tissue; and pulling on the proximal end of the guidewire while advancing the medical device through the body tissue.
Claim 116
Dependent Claim
73 words
93 . A method for delivering a medical device into a body tissue of a patient comprising: inserting a guidewire having a proximal end and a distal end into the heart wall from a coronary blood vessel; anchoring the guidewire to the body tissue; pushing the medical device over the guidewire into the body tissue; and pulling on the proximal end of the guidewire while advancing the medical device through the body tissue.
Claim 117
Dependent Claim
17 words
94 . The method of claim 93 , wherein anchoring the guidewire comprises actuating an expandable member.
Claim 118
Dependent Claim
16 words
95 . The method of claim 94 , wherein the expandable member is an inflatable balloon.
Claim 119
Dependent Claim
30 words
96 . The method of claim 93 , further comprising providing at least one barb on the distal end of the guidewire to anchor the guidewire to the heart wall.
Claim 120
Dependent Claim
74 words
97 . A delivery system for directing a medical treatment at least partially into the heart wall, comprising: a guidewire having a proximal end and a distal end; means for turning the distal end of the guidewire toward the heart wall; means for anchoring the guidewire to the heart wall; and a catheter carrying the medical treatment having a lumen extending therethrough for receiving the guidewire and advancing the catheter into the heart wall.
Claim 121
Dependent Claim
74 words
97 . A delivery system for directing a medical treatment at least partially into the heart wall, comprising: a guidewire having a proximal end and a distal end; means for turning the distal end of the guidewire toward the heart wall; means for anchoring the guidewire to the heart wall; and a catheter carrying the medical treatment having a lumen extending therethrough for receiving the guidewire and advancing the catheter into the heart wall.
Claim 122
Dependent Claim
208 words
98 . A method for delivering a conduit into the heart wall of a patient to bypass a blockage formed in a coronary artery, comprising: advancing a catheter having a proximal end and a distal end and a lumen extending at least partially therethrough from the proximal end to a distal opening through the coronary artery of the patient until the distal opening is past the blockage; turning the catheter so that the distal opening faces the heart wall; extending a wire having a proximal end and a distal end through the distal opening such that the distal end punctures into the heart wall; anchoring the distal end of the wire to the heart wall; delivering a dilation catheter over the wire, the catheter carrying a dilation balloon on a distal end thereof, until the balloon is within the heart wall; inflating the dilation balloon to create an opening in the heart wall; deflating the dilation balloon and removing the dilation catheter from the wire; delivering a conduit introducer catheter over the wire, the conduit introducer catheter carrying a conduit on a distal end thereof, until the conduit is located within the opening in the heart wall, and deploying the conduit within the opening in the heart wall.
Claim 123
Dependent Claim
208 words
98 . A method for delivering a conduit into the heart wall of a patient to bypass a blockage formed in a coronary artery, comprising: advancing a catheter having a proximal end and a distal end and a lumen extending at least partially therethrough from the proximal end to a distal opening through the coronary artery of the patient until the distal opening is past the blockage; turning the catheter so that the distal opening faces the heart wall; extending a wire having a proximal end and a distal end through the distal opening such that the distal end punctures into the heart wall; anchoring the distal end of the wire to the heart wall; delivering a dilation catheter over the wire, the catheter carrying a dilation balloon on a distal end thereof, until the balloon is within the heart wall; inflating the dilation balloon to create an opening in the heart wall; deflating the dilation balloon and removing the dilation catheter from the wire; delivering a conduit introducer catheter over the wire, the conduit introducer catheter carrying a conduit on a distal end thereof, until the conduit is located within the opening in the heart wall, and deploying the conduit within the opening in the heart wall.
Claim 124
Dependent Claim
14 words
99 . The method of claim 98 , wherein the conduit is a stent.
Claim 125
Dependent Claim
91 words
100 . A method for delivering medical treatment into the heart wall of a patient, comprising: delivering a tubular wire having a lumen extending therethrough into the patient, the wire once delivered having a proximal end extending out of the patient and a distal end positioned adjacent the heart wall; providing a means for turning the distal end of the wire towards the heart wall; inserting the distal end of the wire into the heart wall; and delivering the medical treatment through the lumen in the wire into the heart wall.
Claim 126
Dependent Claim
91 words
100 . A method for delivering medical treatment into the heart wall of a patient, comprising: delivering a tubular wire having a lumen extending therethrough into the patient, the wire once delivered having a proximal end extending out of the patient and a distal end positioned adjacent the heart wall; providing a means for turning the distal end of the wire towards the heart wall; inserting the distal end of the wire into the heart wall; and delivering the medical treatment through the lumen in the wire into the heart wall.
Claim 127
Dependent Claim
26 words
101 . The method of claim 100 , wherein delivering medical treatment through the lumen comprises providing drug fluid into the lumen at the proximal end.
Claim 128
Dependent Claim
22 words
102 . The method of claim 100 , wherein the distal end of the wire further comprises at least one exit port.
Claim 129
Dependent Claim
24 words
103 . The method of claim 100 , wherein the means for turning the distal end comprises delivering the wire through a delivery catheter.
Claim 130
Dependent Claim
76 words
104 . The method of claim 103 , wherein the means for turning the distal end further comprises: actuating an anchoring member mounted on a distal end of the delivery catheter to secure the delivery catheter within the patient; and actuating a steering member mounted on the distal end of the tubular body at a position distal to that of the anchoring member to turn the distal end of the delivery catheter toward the heart wall.
Claim 131
Dependent Claim
29 words
105 . The method of claim 100 , wherein the tubular wire is a pull wire, and the means for turning the distal end comprises actuating the pull wire.
Claim 132
Dependent Claim
56 words
106 . The method of claim 100 , wherein the means for turning the distal end comprises: providing a curved passageway adjacent the heart wall having a proximal opening for receiving the distal end of the tubular wire and a side port exit facing the heart wall; and delivering the tubular wire through the curved passageway.
Claim 133
Dependent Claim
20 words
107 . The method of claim 106 , wherein the passageway is provided through a lumen in a delivery catheter.
Claim 134
Dependent Claim
26 words
108 . The method of claim 106 , wherein the passageway is provided through an anchoring member mounted to a distal end of a delivery catheter.
References Cited (Backward Citations)
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