Guide extension catheter
Guide extension catheters and related methods are disclosed. A guide extension catheter can comprise an elongate tube member and a lumenless push member. The push member can be eccentrically coupled to the tube member for slidably positioning the tube member within and partially beyond a distal end of a guide catheter. At least a proximal end portion of the push member can include a cross-section defined by an arcuate first surface and an opposing second surface. The first surface can engage an inner wall surface of the guide catheter along an arc length, and the second surface can be spaced furthest from the first surface at its center point. The first surface can have the same or substantially the same radius of curvature as the guide catheter's inner wall surface, and the second surface can be flat or substantially flat. This configuration of the push member can provide an advantageous blend of stiffness and flexibility, as well as space conservation through the guide catheter.
1. A guide extension catheter for use with a guide catheter, the guide extension catheter comprising:
an elongate tube member defining a lumen and having an outer diameter smaller than a lumen of the guide catheter; and
a push member eccentrically coupled relative to an axis of the elongate tube member and extending proximal of the elongate tube member for slidably positioning the elongate tube member within the lumen, and partially beyond a distal end, of the guide catheter, the push member comprising a proximal end portion,
the proximal end portion having a length forming between 50% and 90%, inclusive, of an entire length of the guide extension catheter, and the proximal end portion having a cross-section defined by an arcuate first surface configured to engage an inner wall surface of the guide catheter along an arc length, a non-arcuate second surface located opposite the arcuate first surface and including a center point that is spaced further away from the arcuate first surface than any other point along the non-arcuate second surface, and an arcuate third surface and an arcuate fourth surface, each of which connect the arcuate first surface and the non-arcuate second surface and have a radius of curvature less than a radius of curvature of the arcuate first surface.
2. The guide extension catheter of claim 1 , wherein the push member comprises one or more additional portions distal to the proximal end portion and having a flexibility that is greater than a flexibility of the proximal end portion of the push member.
3. The guide extension catheter of claim 1 , wherein the push member comprises one or more additional portions distal to the proximal end portion and having a cross-section defined by an arcuate first surface configured to engage the inner wall surface of the guide catheter along an arc length and a non-arcuate second surface located opposite the arcuate first surface and including a center point that is spaced further away from the arcuate first surface than any other point along the non-arcuate second surface.
4. The guide extension catheter of claim 1 , wherein the push member comprises one or more additional portions distal to the proximal end portion and including an intermediate portion and a distal end portion, the intermediate portion coupling the proximal end portion and the distal end portion of the push member.
5. The guide extension catheter of claim 4 , wherein the distal end portion of the push member has a flexibility that is greater than a flexibility of the intermediate portion of the push member.
6. The guide extension catheter of claim 1 , further comprising a coupling member securing the push member to the elongate tube member.
7. The guide extension catheter of claim 6 , wherein the coupling member comprises a metallic or polymeric structure having a flexibility less than a flexibility of a distal end portion of the elongate tube member.
8. The guide extension catheter of claim 6 , wherein the coupling member comprises a concave track defining a partially cylindrical opening for receiving a treatment device into the elongate tube member.
9. The guide extension catheter of claim 6 , wherein the coupling member comprises a collar having a slanted opening.
10. The guide extension catheter of claim 6 , wherein the coupling member provides a flexibility transition between the push member and the elongate tube member.
11. The guide extension catheter of claim 1 , wherein a proximal end of the elongate tube member includes an opening formed in its peripheral wall, and wherein a distal end portion of the push member is inserted into the opening resulting in a mechanical coupling between the push member and the elongate tube member.
12. The guide extension catheter of claim 1 , wherein the proximal end portion of the push member comprises a polymeric material.
13. The guide extension catheter of claim 1 , wherein the proximal end portion of the push member comprises stainless steel.
14. The guide extension catheter of claim 1 , wherein the arc length is defined by a guide catheter central angle of at least 20 degrees.
15. The guide extension catheter of claim 1 , wherein the radius of curvature of the arcuate first surface of the proximal end portion of the push member is substantially the same as the inner wall surface of the guide catheter.
16. The guide extension catheter of claim 1 , wherein the radius of curvature of the arcuate first surface is at least three times greater than the radius of curvature of the arcuate third and fourth surfaces.
17. The guide extension catheter of claim 1 , wherein the push member is lumenless.
18. The guide extension catheter of claim 1 , wherein the arc length of the arcuate first surface is greater than a length of the non-arcuate second surface.
19. The guide extension catheter of claim 1 , wherein a diameter of the lumen of the elongate tube member is not more than one French size smaller than a diameter of the lumen of the guide catheter.
20. The guide extension catheter of claim 1 , wherein a proximal end of the elongate tube member is at least partially radially flared.
21. A method of performing a cardiac intervention on a patient, the method comprising:
advancing a guidewire through an aorta of the patient to an ostium; advancing a guide catheter having an inner lumen over the guidewire so that a distal end of the guide catheter is positioned near the ostium; and
advancing an elongate tube member of a guide extension catheter over the guidewire and through the inner lumen of the guide catheter to position a distal end of the elongate tube member beyond the distal end of the guide catheter and into the ostium by applying a force to a push member that is coupled to, and extends proximally from, the elongate tube member,
wherein applying the force to the push member includes engaging an arcuate first surface of the push member against an inner lumen wall of the guide catheter, and
wherein the push member includes a non-arcuate second surface, which is located opposite the arcuate first surface and has a midpoint that is spaced further away from the arcuate first surface than any other point along the non-arcuate second surface, and an arcuate third surface and an arcuate fourth surface, each of which connect the arcuate first surface and the non-arcuate second surface and have a radius of curvature less than a radius of curvature of the arcuate first surface.
22. The method of claim 21 , further comprising delivering a treatment catheter over the guidewire, through the guide catheter and alongside the push member of the guide extension catheter, and into the elongate tube member of the guide extension catheter so that a working portion of the treatment catheter is extended beyond the distal end of the elongate tube member,
wherein a smallest effective lumen diameter through the guide catheter and alongside the push member of the guide extension catheter and into the elongate tube member of the guide extension catheter for the treatment catheter to pass is not more than one French size smaller than a diameter of the inner lumen of the guide catheter.