Method and apparatus for placing a catheter within a vasculature
A catheter for insertion into vasculature of a patient to a target area in the vasculature includes a hollow inner shaft, a non-occluding self-expandable scaffold coupled to the distal end of the inner shaft and disposed at the distal end of the inner shaft, and a hollow outer shaft. The outer shaft is slidable over the inner shaft and scaffold such that the scaffold is in a non-expanded state when the outer shaft is around the scaffold. The outer shaft has a state where the distal end of the outer shaft remains near the target area without the inner shaft and the scaffold being within the outer shaft. The inner shaft and the scaffold are removable through the proximal end of the outer shaft while the distal end of the outer shaft remains near the target area.
1. A method for positioning a catheter close to an occlusion in a vasculature, the method comprising:
inserting a catheter apparatus into the vasculature, the catheter apparatus having a microcatheter, an outer shaft and a non-occluding self-expandable scaffold;
tracking the catheter apparatus along a guidewire located in proximity to the occlusion;
contacting a leading edge of the occlusion with a distal tip of the outer shaft;
centering the microcatheter and the non-occluding self-expandable scaffold within the vasculature by expanding the non-occluding self-expandable scaffold within the vasculature;
advancing the guidewire and the microcatheter out of the distal tip through the occlusion;
withdrawing the microcatheter and the non-occluding self-expandable scaffold through a proximal opening in the outer shaft, wherein, after withdrawing the microcatheter and non-occluding self-expandable scaffold, the outer shaft remains near the occlusion in the vasculature; and
advancing an instrument through the proximal opening of the outer shaft and through the occlusion.
2. The method of claim 1 , wherein centering the microcatheter and the non-occluding self-expandable scaffold within the vasculature by expanding the non-occluding self-expandable scaffold within the vasculature includes withdrawing or retracting the outer shaft.
3. The method of claim 1 , wherein withdrawing the non-occluding self-expandable scaffold through the proximal opening in the outer shaft comprises returning the non-occluding self-expandable scaffold to a non-expanded state.
4. The method of claim 3 , wherein returning the non-occluding self-expandable scaffold to the non-expanded state comprises advancing the outer shaft in a distal direction until the non-occluding self-expandable scaffold is contained within the outer shaft.
5. The method of claim 4 , the catheter apparatus further comprising an inner shaft, and wherein returning the non-occluding self-expandable scaffold to the non-expanded state comprises moving the inner shaft proximally so that the non-occluding self-expandable scaffold is received within the outer shaft.
6. The method of claim 1 , the catheter apparatus further comprising an inner shaft located between the microcatheter and the outer shaft, and further comprising centering the inner shaft with the microcatheter and the non-occluding self-expandable scaffold by expanding the non-occluding self-expandable scaffold.
7. The method of claim 6 , further comprising positioning the inner shaft through loops on the non-occluding self-expandable scaffold and positioning the microcatheter through the inner shaft.
8. The method of claim 6 , wherein the inner shaft, the outer shaft, the microcatheter and the guidewire are independently moveable.
9. The method of claim 1 , wherein the microcatheter supports the guidewire as the guidewire passes through the occlusion.
10. The method of claim 1 , wherein the guidewire and the microcatheter are advanced alternatively back and forth to penetrate the occlusion.
11. The method of claim 1 , wherein advancing the guidewire through the occlusion comprises penetrating through a portion of the occlusion or through the entirety of the occlusion.
12. The method of claim 1 , wherein the microcatheter moves independently of the outer shaft and wherein the microcatheter is withdrawn from the occlusion and the guidewire remains disposed in the occlusion.
13. The method of claim 1 , wherein the instrument is one of an angioplasty balloon, a stent, a catheter, a scope, an imaging or treatment device, or medical device.
14. The method of claim 1 , wherein the microcatheter and the non-occluding self-expandable scaffold are completely removed from the outer shaft.
15. The method of claim 1 , wherein the guidewire assists in guiding the instrument into the occlusion.