Rapid exchange catheters usable with embolic protection devices
Catheters, assemblies, and methods for delivering and recovering embolic protection devices. Catheters are provided that can be advanced over single length guide wires and which can be retracted over single length wire shafts of distal embolic protection devices. One catheter is a two-port catheter having two sidewall ports, a distal end port, and a proximal end port. The two-port catheter can be advanced over a guide wire threaded between the distal end port and the distal sidewall port. An embolic protection device wire shaft can be back loaded into the distal end port and out the proximal sidewall port. A three-port catheter includes a distal end port, and distal, intermediate, and proximal sidewall ports. The distal sidewall port can be dimensioned to accept passage of a filter body through the port. The distal end port can be dimensioned to accept only a guide wire to provide a smooth transition from the guide wire to the small profile distal end. The guide wire can extend between the distal end port and the intermediate port while the filter body shaft can extend through the proximal port, to be distally urged through the distal sidewall port. Another catheter embodiment is a slotted catheter, including a biased, normally open slot over most of its length. The slot can be sufficiently small to resist unwanted transverse movement of a wire through the slot. The slotted catheter can be retracted over a wire by forcing the wire through the resilient slot.
1. A method for positioning a distal embolic protection device at a target site within a blood vessel, the method comprising:
providing a guide wire having a distal region and a distal end;
providing a distal embolic protection device including an elongate shaft having a proximal region, a distal region, and a filter secured to the shaft distal region;
providing a catheter having a distal end, a distal region, a proximal region, and a lumen disposed within a tubular sidewall through the distal region, wherein the distal region includes a distal end port, a distal sidewall port extending from the lumen through the tubular sidewall, and a proximal sidewall port extending from the lumen through the tubular sidewall, the distal and proximal sidewall ports being proximal of the distal end port and distal of a proximal end of the lumen;
disposing the distal embolic protection device within the catheter such that the distal embolic protection device shaft extends outwardly through the proximal sidewall port;
advancing the guide wire through the vessel until the distal end of the guidewire crosses the target site;
inserting the guide wire through the lumen of the catheter between the distal end port and the distal sidewall port;
advancing the catheter through the vessel;
advancing the embolic protection device through the vessel to the target site;
proximally retracting the guide wire such that the guide wire distal region exits proximally from the lumen through the catheter distal sidewall port; and
radially expanding the filter within the vessel at the target site.
2. A method as in claim 1 , wherein the catheter and distal embolic protection device are advanced together through the vessel.
3. The method of claim 1 further comprising proximally retracting the catheter from the distal embolic protection shaft such that the distal embolic protection shaft proximal region is drawn into the catheter distal region and exits the catheter distal end port.
4. The method of claim 1 further comprising proximally retracting the catheter and the distal embolic protection device from the vessel.
5. A method of filtering material from blood flowing in a blood vessel at a target site within the blood vessel, the method comprising:
providing a guide wire having a distal end;
providing a distal embolic protection device including an elongate shaft having a proximal region, a distal region, and a filter secured to the shaft distal region;
providing a catheter having a distal end, a distal region, a proximal region, and a lumen disposed within a tubular sidewall through the distal region, wherein the distal region includes a distal end port, a distal sidewall port extending from the lumen through the tubular sidewall, and a proximal sidewall port extending from the lumen through the tubular sidewall, the distal and proximal sidewall ports being proximal of the distal end port and distal of a proximal end of the lumen;
disposing the distal embolic protection device within the catheter such that the distal embolic protection device shaft extends outwardly through the proximal sidewall port;
advancing the guide wire through the vessel until the distal end of the guidewire crosses the target site;
inserting the guide wire through the lumen of the catheter between the distal end port and the distal sidewall port;
advancing the catheter through the vessel;
advancing the distal embolic protection device through the vessel to the target site;
proximally retracting the guide wire such that the distal end of the guide wire exits proximally from the lumen through the catheter distal sidewall port;
radially expanding the distal embolic protection device filter within the vessel at the target site;
proximally retracting the catheter from the vessel; and
filtering material from blood flowing through the vessel at the target site with the distal embolic protection device filter.
6. The method of claim 5 further comprising advancing a second catheter through the vessel, over the shaft of the distal embolic protection device after the filter has been expanded within the vessel.
7. The method of claim 5 further comprising proximally retracting the distal embolic protection device and filtered material from the vessel.