Steerable ultrasound catheter
Ultrasound catheter devices and methods provide enhanced disruption of blood vessel obstructions. Ultrasound catheter devices generally include an elongate flexible catheter body with one or more lumens, an ultrasound transmission member extending longitudinally through the catheter body lumen and a distal head coupled with the transmission member and positioned adjacent the distal end of the catheter body for disrupting occlusions. Improved features of ultrasound catheters include catheter bodies and ultrasound transmission members with increasing distal flexibility, guidewire tubes allowing contact between a guidewire and an ultrasound transmission member, distal heads with improved guidewire lumens, and torquable proximal housings for enhancing disruption of blood vessel occlusions.
1. A method for disrupting an occlusion in a blood vessel, the method comprising:
providing an ultrasound catheter comprising a catheter body, a distal head, an ultrasound transmission member coupled to the distal head, and a guidewire tube extending through at least a portion of the distal head, the guidewire tube receiving at least a portion of a guidewire and at least a portion of the ultrasound transmission member, the catheter body receiving at least a portion of the guidewire tube and at least a portion of the ultrasound transmission member;
advancing the ultrasound catheter through a blood vessel having at least one bend, the catheter conforming concomitantly to the at least one bend, wherein advancing includes contacting the ultrasound transmission member with the guidewire at one or more locations within the guidewire tube;
positioning the distal head of the ultrasound catheter adjacent an occlusion in the blood vessel; and
transmitting ultrasound energy to the ultrasound transmission member to disrupt the occlusion into multiple occlusion fragments, wherein transmitting includes transmitting ultrasound energy to the guidewire.
2. A method as in claim 1 , further including removing at least some of the occlusion fragments from the blood vessel via the ultrasound catheter.
3. A method as in claim 1 , wherein the ultrasound catheter is advanced along the guidewire.
4. A method as in claim 1 , wherein the guidewire is passed through the catheter.
5. A method as in claim 1 , wherein the catheter and the guidewire are advanced together through the blood vessel.
6. A method as in claim 1 , wherein the ultrasound catheter is advanced through at least one bend having a radius of about 1.0 cm or less.
7. A method as in claim 1 , wherein the ultrasound catheter and the guidewire are advanced along multiple bends in the blood vessel, wherein the catheter body of the catheter, the ultrasound transmission member and the guidewire are sufficiently flexible to conform concomitantly to the multiple bends.
8. A method as in claim 1 , further comprising applying radial force to a proximal housing of the ultrasound catheter to radially turn the distal head of the ultrasound catheter in the blood vessel.
9. A method for disrupting an occlusion in a blood vessel, the method comprising:
providing an ultrasound catheter comprising a catheter body, a distal head, an ultrasound transmission member coupled to the distal head, and a guidewire tube extending through at least a portion of the distal head, the guidewire tube receiving at least a portion of a guidewire and at least a portion of the ultrasound transmission member, the catheter body receiving at least a portion of the guidewire tube and at least a portion of the ultrasound transmission member;
advancing the ultrasound catheter through a blood vessel;
contacting the ultrasound transmission member with the guidewire at one or more locations within the guidewire tube; and
transmitting ultrasound energy from the ultrasound transmission member to the guidewire.
10. A method as in claim 9 further comprising advancing the ultrasound catheter along the guidewire.
11. A method as in claim 9 further comprising extending the guidewire through the catheter.
12. A method as in claim 9 further comprising positioning the distal head of the ultrasound catheter adjacent an occlusion in the blood vessel.
13. A method as in claim 12 further comprising applying radial force to a proximal housing of the ultrasound catheter to rotate the distal head of the ultrasound catheter in the blood vessel.
14. A method for treating a patient:
providing a catheter including an ultrasound transmission member, the catheter having at least a bent configuration and a straight configuration;
providing a guidewire;
advancing the catheter through a blood vessel of the patient; and
contacting the guidewire and the ultrasound transmission member at least when the catheter is in the straight configuration and directly transmitting ultrasound energy to the guidewire via the ultrasound transmission member.
15. A method as in claim 14 further comprising advancing the catheter along the guidewire.
16. A method as in claim 14 further comprising extending the guidewire through the catheter.
17. A method as in claim 14 further comprising positioning a distal end of the catheter adjacent an occlusion in the blood vessel.
18. A method for disrupting an occlusion in a blood vessel, the method comprising:
providing a catheter forming a lumen, an ultrasound transmission member and a guidewire being disposed within the lumen;
advancing the catheter through a blood vessel of the patient;
contacting the guidewire and the ultrasound transmission member in the lumen; and
penetrating an occlusion with the guidewire using ultrasound energy, the ultrasound energy used to penetrate the occlusion coming directly from the ultrasound transmission member.
19. A method as in claim 18 further comprising advancing the catheter along the guidewire.
20. A method as in claim 18 further comprising extending the guidewire through the catheter.