Introducer sheath with embolic protection
The embolic protection device comprises an embolic filter attached to an inner sheath. The embolic filter includes at least a first catheter access port and a second catheter port. At least the first catheter port will typically be radially expandable to receive catheters of different diameters and will be located at an atypical end of an aero conical structure at a downstream end of the filter.
1. An embolic protection device, said device comprising:
a cylindrical porous mesh filter having an open distal end, a closed proximal end, an interior including a collection chamber, a radially collapsed delivery configuration, and a radially expanded configuration; and
a sheath having a distal end, a proximal end, and an inner lumen extending from the proximal end to the distal end, said distal end of the sheath being fixedly attached to a proximal end of the cylindrical porous mesh filter and said inner lumen being configured to allow passage of a catheter therethrough;
wherein the closed proximal end of the cylindrical porous mesh filter is fixedly attached to the distal end of the sheath and has a radially expandable port configured to receive catheters of different diameters therethrough; and
wherein a first catheter may be introduced into the interior of the cylindrical porous mesh filter through the inner lumen of the sheath and a second catheter may be introduced into the interior of the cylindrical porous mesh filter though the expandable port.
2. An embolic protection device as in claim 1 , wherein the radially expandable port is disposed at an apical end of a conical inner portion of the closed proximal end of the cylindrical porous mesh filter.
3. An embolic protection device as in claim 1 , wherein the distal end of the sheath is fixedly attached to a port on the proximal end of the cylindrical porous mesh filter.
4. An embolic protection device as in claim 2 , wherein the conical inner portion defines the collection chamber between an inner surface of a cylindrical outer wall and an outer surface of the conical inner portion, wherein the apical end of the conical inner portion is oriented toward the open upstream end of the embolic filter.
5. An embolic protection device 4 , wherein the conical inner portion is positioned inside the cylindrical outer wall and has a wider proximal end joined to a proximal of the cylindrical outer cylindrical outer wall to form the closed proximal end.
6. An embolic protection device as in claim 4 , wherein the open distal end of the cylindrical porous mesh filter is configured to allow blood to flow between the conical inner portion and the cylindrical outer portion, with a space between the conical inner portion and the cylindrical outer portion defining the collection chamber for captured emboli.
7. An embolic protection device as in claim 1 , wherein the cylindrical porous mesh filter self-expands into the expanded configuration when the filter is in the deployed configuration.
8. An embolic protection device as in claim 7 , wherein the cylindrical porous mesh filter comprises a fabric of knitted, woven, or nonwoven fibers, filaments, or wires having a pore size chosen to prevent emboli over a predetermined size from passing through.
9. An embolic protection device as in claim 7 , wherein the cylindrical porous mesh filter is made of a resilient metal, polymer material, a malleable material, a plastically deformable material, a shape-memory material, or combinations thereof.
10. An embolic protection device as in claim 1 , wherein the cylindrical porous mesh filter has an anti-thrombogenic coating on its surface.
11. An embolic protection device as in claim 1 , wherein the cylindrical porous mesh filter has a pore size in the range of about 1 mm to about 0.1 mm.
12. An embolic protection device as in claim 1 , further comprising a resilient seal positioned within the expandable port for forming a seal around a catheter passing through the expandable port.
13. An embolic protection system comprising:
an embolic protection device as in claim 1 ; and
a delivery sheath having a lumen there through configured to restrain the embolic filter in its radially collapsed delivery configuration when the embolic filter is there within, wherein the embolic filter deploys into its radially expanded configuration when the embolic filter is advanced out of the outer delivery sheath.
14. An embolic protection system comprising:
an embolic protection device as in claim 1 ; and
a stylet configured to be advanced through the sheath lumen and the embolic filter to elongate the embolic filter to assume its radially collapsed delivery configuration, wherein the embolic filter deploys into its radially expanded configuration when the stylet is removed from the embolic filter.
15. A method for advancing a catheter over a patient's aortic arch having aortic side vessels, said method comprising:
providing an embolic protection device as in claim 1 ;
advancing the sheath through the patient's aorta to position the cylindrical porous mesh filter over the aortic arch;
radially expanding the cylindrical porous mesh filter within the aortic arch to cover the aortic side vessels with the open distal end facing the patient's heart to direct blood flow through the upstream end and emboli into the collection chamber, wherein blood free from emboli flows through the porous mesh into the aortic side vessels;
advancing the first catheter through the inner lumen of the sheath, through the interior of the cylindrical porous mesh filter, and toward the heart; and
advancing the second catheter through the though the expandable port, through the interior of the cylindrical porous mesh filter, and toward the heart.
16. A method as in claim 15 , further comprising performing a first diagnostic or interventional procedure with the first catheter and performing a second diagnostic or interventional procedure with the second catheter.
17. A method as in claim 15 , wherein the sheath is used to advance the cylindrical porous mesh filter through a delivery sheath that constrains the embolic protection device in its radially collapsed configuration while it is being delivered.
18. A method as in claim 17 , wherein radially expanding the cylindrical porous mesh filter comprises proximally retracting the delivery sheath relative to the embolic protection device to release the embolic protection device from radial constraint.
19. A method as in claim 15 , further comprising performing an interventional procedure with the first catheter positioned through the first port and introducing contrast media through a second catheter positioned through the inner sheath and second port while the interventional procedure is being performed.
20. A method as in claim 19 , wherein the interventional procedure is delivery of a prosthetic aortic valve.