Apparatus and method for stabilization of procedural catheter in tortuous vessels
For percutaneous minimally-invasive intervention in vessels originating from other tortuous vessels, such as the tortuous aortic arch, guide wires/catheters are used to enable procedural catheters to access the vessels where an interventional procedure is needed. Two new methods for fixing a stabilization wire/catheter and providing the needed tension and stabilization without a second percutaneous access are disclosed (1) using a micro-anchor and pin and (2) using a modified Fogarty Balloon. These methods are also usable for access to and treatment of peripheral embolisms in tortuous vessels as well as renal and other visceral interventions.
1. A percutaneous intervention system comprising:
a bifurcated sheath catheter having a proximal end and a distal end, wherein the bifurcated sheath catheter comprises a single common lumen at its proximal end and separating into two, separate lumens at the distal end, the two, separate lumens at the distal end comprising a procedural lumen and a stabilization lumen, wherein the procedural lumen is extendable into a vessel where a procedure is to be conducted and the stabilization lumen is extendable into the ostium of a secondary vessel;
a procedural catheter slideably insertable through the procedural lumen and configured to be delivered to a treatment site; and
a stabilizer slideably insertable through the stabilization lumen of the bifurcated sheath catheter into the secondary vessel, the stabilizer configured such that when tension is applied to the stabilizer, the procedural catheter is stabilized while being advanced to a treatment site and further stabilized during a subsequent procedure at the treatment site,
wherein the stabilizer is a guide wire comprising a micro-anchor at its distal end configured to be used as a stabilization wire, and
wherein insertion of a pin through the expanded micro-anchor from outside the secondary vessel enables fixing of the micro-anchor in place inside the secondary vessel enabling application of tension to the stabilization wire.
2. The percutaneous intervention system of claim 1 , wherein the stabilizer is configured to stabilize the bifurcated sheath and the procedural catheter slideably insertable through the procedural lumen and configured to be delivered to the treatment site during a carotid artery intervention by fixing the expanded micro-anchor within the secondary vessel through the expanded micro-anchor from outside the secondary vessel, wherein the secondary vessel is a right brachial artery.
3. The percutaneous intervention system of claim 1 , wherein the stabilizer is configured to provide stabilization of the bifurcated sheath and the procedural catheter during carotid artery interventions by configuring the micro-anchor to be pinned in place within the secondary vessel, wherein the secondary vessel is a right brachial artery, wherein the pinning is performed using the pin inserted from outside a body of a patient undergoing the procedure.
4. The percutaneous intervention system of claim 1 , wherein the application of tension to stabilize the stabilizer slideably inserted through the stabilization lumen of the bifurcated sheath catheter enable stabilization of the procedural catheter slideably inserted through the procedural lumen of the bifurcated sheath catheter, during access to the treatment site and during the procedure at the treatment site.
5. The percutaneous intervention system of claim 2 , wherein the bifurcated sheath catheter comprises an ovoid cross-sectional shape away from its distal end.
6. The percutaneous intervention system of claim 1 , wherein the stabilizer is configured to stabilize the bifurcated sheath catheter and the procedural catheter during access to the treatment site and the stabilizer is further configured to provide stabilization to the procedural catheter at the treatment site during a carotid artery intervention by fixing the stabilizer within the secondary vessel by engaging the pin with the expanded micro-anchor from outside the secondary vessel and by application of the tension to the stabilizer, wherein the secondary vessel is a right subclavian artery.
7. A percutaneous intervention system comprising:
a bifurcated sheath catheter comprising a first procedural lumen and a second
stabilization lumen, wherein the first procedural lumen is extendable into a vessel where a procedure to be conducted and the second stabilization lumen extendable into a secondary vessel;
a procedural catheter configured to be slideably inserted through the first procedural lumen and configured to be delivered to a treatment site;
a stabilizer, configured to be slideably inserted through the stabilization lumen and extended into the secondary vessel to be fixed therein, and the stabilizer is further configured for applied tension, wherein the stabilizer comprises an expandable micro-anchor at a distal end of a stabilization wire; and
a pin engageable with the expanded micro-anchor from outside the secondary vessel to fix the distal end of the stabilization wire within the secondary vessel and enable application of tension to the stabilizer.
8. The percutaneous intervention system of claim 7 , wherein the interventional system is for interventional procedures through a common carotid artery, wherein the secondary vessel is a right brachial artery.
9. The percutaneous intervention system of claim 7 , wherein the bifurcated sheath catheter comprises an ovoid cross section away from its distal end.
10. The percutaneous intervention system of claim 7 , wherein the interventional system is for interventional procedures within superficial femoral arteries, wherein the secondary vessel is the deep femoral artery.
11. The percutaneous intervention system of claim 7 , wherein the secondary vessel is a peripheral artery.
12. The percutaneous intervention system of claim 7 ,
wherein the stabilizer is configured to be advanced into the secondary vessel beyond a treatment site access region through the second stabilization lumen of the bifurcated sheath catheter using radiographic imaging,
wherein the distal end of the stabilizer is configured to be fixed within the secondary vessel enabled for application of a tension for enabling a stabilization of the bifurcated sheath catheter,
wherein the bifurcated sheath catheter is configured to be advanced over the stabilizer to the treatment site access region, and
wherein the procedural catheter is configured to be advanced through the first procedural lumen of the stabilized bifurcated sheath catheter to the treatment site.
13. A method comprising:
advancing a stabilizer to a secondary vessel beyond a treatment site access region using radiographic imaging, wherein advancing the stabilizer comprises delivering a stabilization guidewire comprising a micro-anchor to the secondary vessel past the access to the treatment site:
fixing the distal end of the stabilizer within the secondary vessel, wherein fixing the distal end of the stabilizer comprises inserting a pin into the patient from outside the patient's body, and engaging the pin with an expanded micro-anchor within the secondary vessel to fix the distal end of the stabilization guide wire within the secondary vessel;
advancing a bifurcated sheath catheter over the stabilizer to the treatment site access region, wherein the bifurcated sheath catheter comprises a stabilization lumen and an procedural lumen, and wherein advancing the bifurcated sheath catheter over the stabilizer comprises advancing the stabilization lumen over the stabilizer; and
advancing a procedural catheter through the procedural lumen of the bifurcated sheath catheter to the treatment site.
14. The method of claim 13 , further comprising inserting the stabilizer via percutaneous femoral artery access.