Catheter systems and methods for medical procedures using catheters
An intracranial intervention system comprises a seeker wire and delivery catheter used to navigate and access a target location within the intracranial subarachnoid spaces (ISAS) of a patient. A microcatheter is then advanced through the delivery catheter to perform a therapeutic procedure, such as installing a shunt within the ISAS to drain cerebral-spinal fluid (CSF). The shunt may be configured to drain CSF from a first and second ISAS, and includes a distal portion which extends into the first ISAS via the second ISAS and a dural venus sinus (DVS) of the patient. The shunt has a main body portion positioned and secured within the second ISAS, a distal portion extending into the first ISAS and the main body portion in the second ISAS have CSF intake opening which allow CSF to flow into a shunt lumen and out through an outflow opening positioned in the DVS.
1 . A method for performing an endovascular third ventriculostomy, comprising:
navigating a delivery catheter through a vasculature of a patient until a distal end portion of the delivery catheter is disposed in a dural venous sinus (DVS) of the patient;
penetrating a wall between the DVS and a cerebrospinal fluid-filled intracranial subarachnoid space (ISAS) of the patient with the distal end portion of the delivery catheter, so that the distal end portion of the delivery catheter is disposed within the ISAS;
navigating a tool through a lumen of the delivery catheter until a distal end portion of the tool extends out an opening in the distal end portion of the delivery catheter within the ISAS, and toward a cerebrospinal fluid-filled third ventricle:
navigating the distal end portion of the tool through the ISAS toward a floor of a cerebrospinal fluid-filled third ventricle that separates the ISAS from the third ventricle; and
penetrating the floor of the third ventricle with the distal end portion of the tool to thereby create an opening in the floor that allows cerebrospinal fluid to flow from the third ventricle into the ISAS.
2 . The method of claim 1 wherein the tool comprises a guidewire with an expandable dissector tip on a distal end of the guidewire, and wherein penetrating the floor of the third ventricle with the distal end portion of the tool comprises dissecting a hole through an arachnoid layer separating the third ventricle from the ISAS.
3 . The method of claim 2 , further comprising expanding a circumference of the hole through the arachnoid layer.
4 . The method of claim 1 , wherein penetrating the floor of the third ventricle with the distal end portion of the tool comprises making a hole through an arachnoid layer separating the third ventricle from the ISAS.