Apparatus for facilitating balloon catheter exchange in a vascular dilatation procedure using a balloon guidewire emplaced within the vascular system of a patient, and a balloon catheter defining an inflation lumen and a guidewire lumen and being attached at its proximal end to a hub. The apparatus includes a relatively short guidewire extension attached at its proximal end to a handle portion. The handle portion defines structure cooperative with the hub for facilitating sliding movement of the handle portion along the hub while the guidewire extension is at least partially inserted into the guidewire lumen. The handle portion is free to slide over the entire length of the hub and to slide off the hub in both proximal and distal directions. A guide element maintains the handle portion engaged for sliding movement along the balloon catheter. The guidewire lumen is slitted and the handle portion carries a separator for opening the slit in the region of the location of the handle portion. The guide element is separable from the handle portion and separates from the handle portion and docks at the distal end of the hub when the handle portion is slid past the hub's distal end in a proximal direction.
A method and apparatus for installing, removing or exchanging catheters into and out of a medical patient's body, including the vascular system, incorporates a slotted guide track for guiding and controlling sliding movement of a catheter while maintaining the relative position of a guidewire. The guide track includes an elongated base having a resilient, cushion-like body, adapted to physically conform to the outer shape of a guidewire and catheter to accommodate the passing through of a catheter and related structures. The guide track includes a clamp at one end for securing a guidewire end, and another clamp at the other end for securing the track to a guide catheter.
An exchange accessory useful with monorail and other types of catheters has a hollow, elongated sleeve for insertion into a Tuohy-Borst connector or the like, and an enlarged head at its proximal end to restrain the sleeve from advancing with the catheter into the connector. The sleeve is slidably mounted on the catheter shaft so that it may be interposed between a sealing member within the connector and the catheter. The internal diameter of the sleeve is greater than and complementary with the external diameter of the catheter shaft to define a space about the catheter shaft sufficient to allow backbleed of blood therethrough in a controlled manner. In one embodiment, the sleeve has a slotted head to accommodate a guidewire which may extend in parallel to the catheter shaft, for example, when used with a monorail type catheter. The slot permits the guidewire to extend proximal to the connector without bending or kinking. In another embodiment, the exchange accessory may be assembled onto a conventional catheter shaft. As a modification to these embodiments, an aperture may be provided for selectively engaging the catheter by closing the connector on the sleeve with the aperture aligned with a sealing member of the connector.
An exchange accessory useful with monorail and other types of catheters has a hollow, elongated sleeve for insertion into a Tuohy-Borst connector or the like, and an enlarged head at its proximal end to restrain the sleeve from advancing with the catheter into the connector. The sleeve is slidably mounted on the catheter shaft so that it may be interposed between a sealing member within the connector and the catheter. The internal diameter of the sleeve is greater than and complementary with the external diameter of the catheter shaft to define a space about the catheter shaft sufficient to allow backbleed of blood therethrough in a controlled manner. In one embodiment, the sleeve has a slotted head to accommodate a guidewire which may extend in parallel to the catheter shaft, for example, when used with a monorail type catheter. The slot permits the guidewire to extend proximal to the connector without bending or kinking. In another embodiment, the exchange accessory may be assembled onto a conventional catheter shaft. As a modification to these embodiments, an aperture may be provided for selectively engaging the catheter by closing the connector on the sleeve with the aperture aligned with a sealing member of the connector.
A catheter and guide wire exchange system including a catheter having a guide wire lumen with a guide way extending along the length of a stiffened proximal shaft portion, and a guide member slidably disposed about the proximal shaft for directing a guide wire into or out of the guide way and the guide wire lumen. The guide member may be slid along the proximal shaft portion and the guide wire in zipper-like fashion so that the guide wire is contained within the guide wire lumen distal to the guide member and with the guide wire and catheter being separated proximal of the guide member.
