Guide extension catheter
Guide extension catheters and related methods are disclosed. A guide extension catheter can comprise an elongate tube member, a push member, and an external manipulation member. The push member can be eccentrically coupled relative to the tube member and extend proximally therefrom for slidably positioning the tube member within and partially beyond a distal end of a guide catheter. The manipulation member can be coupled to a proximal end of the push member, where the manipulation member can be configured to secure the guide extension catheter in place during use by attaching to an external object such that the tube member and push member remain stationary without user engagement.
1. A guide extension catheter for use with a predefined length guide catheter including a continuous lumen having a cross-sectional inner diameter, the guide extension catheter comprising:
an elongate tube member having a circular cross-section having a cross-sectional outer diameter sized to be insertable through the cross-sectional inner diameter of the guide catheter's continuous lumen and defining a coaxial lumen having a cross-sectional inner diameter through which an interventional cardiology device is insertable;
a push member that is rigid enough to allow the tube member to be advanced through the guide catheter, the push member being proximal of and operably connected to the elongate tube, the push member having a maximal cross-sectional dimension at a proximal portion that is smaller than the cross-sectional outer diameter of the tube member and having a length that, when combined with the length of the tube member, is longer than the guide catheter, such that when at least a distal portion of the tube member is extended distally of a distal end of the guide catheter, at least a portion of the proximal portion of the push member extends proximally through a hemostatic valve in common with the interventional cardiology device insertable through the coaxial lumen of the tube member; and
a manipulation member coupled to the push member, the manipulation member including means for securing its position during use in the absence of manual holding by a user.
2. The guide extension catheter of claim 1 , wherein the manipulation member is coupled to a proximal end of the push member.
3. The guide extension catheter of claim 1 , wherein the means for securing the manipulation member comprises at least one coupling member configured to attach to at least a portion of an external object.
4. The guide extension catheter of claim 3 , wherein the at least one coupling member comprises a flexible clip or a clamp configured to receive and grasp the external object.
5. The guide extension catheter of claim 3 , wherein the at least one coupling member comprises a tab that includes a first end and a second end, the first end fixed to a body of the manipulation member and the second end releasably engageable with the body of the manipulation member.
6. The guide extension catheter of claim 5 , wherein the tab further comprises a flexible portion between the first end and the second end.
7. The guide extension catheter of claim 5 , wherein the second end of the tab is configured to releasably engage the body of the manipulation member via a projection extending from a surface of the tab and is insertable within an aperture defined by the body of the manipulation member.
8. The guide extension catheter of claim 1 , wherein the means for securing the manipulation member comprising weighting the manipulation member at least as much as the tube member and the push member, combined.
9. The guide extension catheter of claim 8 , wherein the manipulation member weighs about 1 oz. to about 8 oz., inclusive.
10. The guide extension catheter of claim 1 , wherein the tube member includes a flexible cylindrical distal tip portion and a flexible cylindrical portion with a reinforcement member that is proximal to the flexible cylindrical distal tip portion, and wherein a distal portion of the tube member is more flexible than a proximal portion of the tube member.
11. The guide extension catheter of claim 1 , wherein the proximal portion of the tube member further comprises structure defining a proximal side opening extending for a distance along a longitudinal axis, and accessible from a longitudinal side defined transverse to the longitudinal axis, to receive the interventional cardiology device into the coaxial lumen while the proximal portion is located within the continuous lumen of the guide catheter.
12. The guide extension catheter of claim 11 , wherein the proximal side opening defines a concave track configured to guide the interventional cardiology device along a length of the concave track.
13. The guide extension catheter of claim 1 , wherein the interventional cardiology device insertable through the coaxial lumen is a stent, a stent catheter, or a balloon catheter.
14. A method comprising:
advancing a distal end of a guide catheter having a continuous lumen through a blood vessel to an ostium of a coronary artery;
advancing a distal end of a guide extension catheter through, and beyond the distal end of, the guide catheter, including advancing a push member of the guide extension catheter, that is proximal of and operably connected to a tube member of the guide extension catheter, into the continuous lumen of the guide catheter, the push member having a maximal cross-sectional dimension at a proximal portion that is smaller than a cross-sectional outer diameter of the tube member and having a length such that, when combined with the length of the tube member, a distal end portion of the tube member is extendable through the continuous lumen of the guide catheter and beyond the distal end of the guide catheter while a proximal end of the push member is extendable through a hemostatic valve positioned at a proximal end of the guide catheter,
the advancement of the push member causing advancement of the distal end portion of the tube member beyond the distal end of the guide catheter while a side opening of the guide extension catheter is positioned within the continuous lumen of the guide catheter, the side opening extending for a distance along a longitudinal axis of the guide extension catheter and accessible from a longitudinal side defined transverse to the longitudinal axis, the tube member defining a lumen coaxial with the continuous lumen of the guide catheter and having a cross-sectional inner diameter through which an interventional cardiology device is insertable;
securing a manipulation member at a position external to the hemostatic valve, the manipulation member coupled to the proximal portion of the push member; and
while maintaining the distal end portion of the tube member positioned beyond the distal end of the guide catheter, advancing a balloon catheter or stent through the hemostatic valve and into the continuous lumen of the guide catheter, into the side opening and through the coaxial lumen of the tube member, and into the coronary artery.
15. The method of claim 14 , wherein securing the manipulation member excludes manually holding the manipulation member.
16. The method of claim 14 , wherein securing the manipulation member involves receiving and grasping an external object via a coupling member of the manipulation member.
17. The method of claim 16 , wherein the coupling member comprises a flexible clip, a clamp, or a tab.
18. The method of claim 14 , wherein the manipulation member weighs at least as much as the push member and the tube member combined, and wherein securing the manipulation member comprises placing it on a surface.
19. The method of claim 18 , wherein the manipulation member weighs about 1 oz. to about 8 oz., inclusive.
20. The method of claim 14 , wherein the tube member includes a flexible cylindrical distal tip portion and a flexible cylindrical portion with a reinforcement member that is proximal to the flexible cylindrical distal tip portion, and wherein a distal portion of the tube member is more flexible than a proximal portion of the tube member.