JPH06507811A - Universal mode vascular catheter system - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed description of the invention] Universal mode vascular catheter system Optical plate Ω technology field The invention is particularly suited for rapid exchange of guidewires and catheters during use. Regarding vascular catheters (such as angioplasty catheters).

hole-shaped mushroom landscape Percutaneous transluminal coronary angioplasty (PTCA) aims to revascularize narrowed or occluded coronary arteries. It has become a major alternative to targeted bypass surgery. transluminal angioplasty hemp There is no need for anesthesia, chest wall incision, extracorporeal perfusion, or blood transfusion. For patients, percutaneous coronary angioplasty Not only does the technique not penetrate too deeply into the body and cause less damage, but it also eliminates blood loss. The hospitalization period and postoperative recovery period for patients undergoing canaloplasty are short, making it economically cheaper ( Intubate the balloon (with the balloon completely deflated by negative pressure). guide wire placement The pressure is applied to remove arteriosclerotic thrombi at the occluded site under observation using an X-ray fluoroscope. Once the balloon is fully deflated with negative pressure, the guiding catheter The catheter and guide wire are removed from the patient's artery and the procedure is successful.

The dimensions and diameter of the balloon used in percutaneous angioplasty are determined by the size and diameter of the artery being dilated. It should closely match the size and natural diameter of the area. Nature If the dimensions and diameter of the balloon are smaller than the artery under normal conditions, the balloon vessel shape The results were suboptimal even after the surgical procedure, and a second attempt was made using a larger balloon. The next expansion must be done. On the other hand, compared to the artery in its natural state, the balloon If the diameter is too large, complications may occur due to damage to the arterial wall.

When performing angioplasty, first introduce the guide wire to the desired position, then continue Insert the angioplasty catheter over the guide wire. Sometimes guided during the procedure Wires or balloon catheters may need to be replaced (i.e., replaced) be.

For example, if the balloon does not fit, a catheter may be used to dilate the diseased area appropriately. catheter must be removed and replaced with a catheter with a larger balloon. No. When using a conventional wire-based catheter, the catheter shaft The lumen (gap) extends along the entire length of the pipe (tube) from end to end. Before removing the catheter, first remove the guide wire extension (e.g., 145 cm long). ) to the specified guide wire (e.g. 175 cm long) used outside the patient's body. must be installed. This allows the distal end of the guidewire to Remove the catheter while holding it in place and replace it with a new catheter. I can do it. Typically, such catheter exchanges feature 2.3 operators. The catheter described in Patent No. 4,762,129 is substantially A short guidewire lumen that extends only at the end allows guidewires and Eliminates the need to extend the replacement guide wire (for example, 300 cm in length) It is. This type of catheter will be referred to herein as a rapid exchange catheter.

In this way, the guidewire can be attached most of the way along the length of the catheter. portion is outside the catheter shaft and is within the catheter only at the distal end portion.

Catheter can be exchanged without extending the 175cm standard guide wire. Yes, if there are 1 or 2 casters, you can exchange. However, this catheter A major drawback is that the guidewire is difficult to replace. Guidebooks are used in clinical settings. More often than not, the ears will need to be replaced.

If the tip of the guidewire is damaged or if the guidewire is of a different type or the patient has an angioplasty In some cases, it may be necessary to reshape it to make it perfect. This kind of knowledge The procedure for replacing the guidewire in a wire-based catheter is simple. death However, the rapid-exchange catheter of U.S. Pat. No. 4,762,129 To replace the wire, both the guidewire and angioplasty catheter must be completely removed. must be removed and reinserted. Therefore, rapid exchange catheters The original purpose of the superior advantage has become meaningless.

Another disadvantage of rapid exchange catheters is reflux. Select the target blood vessel or disease site When manipulating the guidewire to cross or Tuehy-Borst adapter must be loosened. Loosen the adapter This means that if you turn it inside out, backflow is more likely to occur.

Therefore, angioplasty catheters that allow rapid exchange of both catheter and guidewire There is a demand for tell. Users can also use quick exchanges between quick exchange and over-the-wire systems. A catheter with selectable modes is also needed.

a guidewire lumen having a proximal opening; Extends to the side port and guides the guidewire within the guidewire lumen can be moved laterally from the guide wire lumen through the outer wall of the wire lumen. Guide wire removal means provided on the outer wall of the guide wire lumen An angioplasty catheter having the following is obtained. In one embodiment, the side port adjacent to the balloon and on the proximal side of the balloon, preferably about 35 cm from the balloon. Located within. One embodiment of the guidewire removal means is a catheter system. This is a slit that passes through the outer wall of the shaft. This slit extends from the proximal opening to the It may be continuous from the proximal opening to the side port, or from the proximal opening to the side port. It may also be formed intermittently in the form of perforations. In other embodiments, the guide The Dwyer extraction means is a weakened area of the wall of the guidewire lumen. , through which the guidewire can be withdrawn. A change in the present invention The example model includes a second side port that communicates with the interior of the guidewire lumen. Ru.

In another example, the side port and balloon communicate with the interior of the guidewire lumen. and an irrigation opening located between. Still other embodiments include a shutter in the proximal opening. It includes a "Y-shaped" connector having a foot portion and a side portion. balloon inflation lumen extends through this shaft portion and includes the guidewire lumen of the guidewire. Insertion can also take place via the side parts. In this case, at least The other section should be removable from the catheter shaft and threaded through the connector. The guide wire that extends into the Dwyer lumen is used as a guide wire removal means. Therefore, make sure that it can be removed (this connector can be split in the longitudinal direction and At least a portion of the catheter should be removable from the catheter shaft.

Alternatively, the connector connects the first and second longitudinal sides to the catheter shaft. two longitudinally divisible portions on separate sides of the top. these parts are hinged on a first longitudinal side and separated on a second longitudinal side. are connected in a divisible manner.

According to another embodiment of the invention, the distal end of the catheter has a proximal end and a distal end. The portion containing the end is normally within the patient's body during use, and the proximal end is normally not removed from the patient's body. a catheter shaft that is external to the guide catheter and that extends through the shaft. , a guidewire lumen containing a steerable guidewire, the outer wall and a proximal opening at the proximal end of the shaft for inserting the guidewire into the lumen. When using the catheter through the proximal opening, the guidewire lumen has a The guidewire lumen extends distally to the point where it typically enters the patient's body. Insert the guidewire into the guidewire lumen through the outer wall of the guidewire lumen. formed in the outer wall of the guidewire lumen to allow for lateral movement from An intravascular catheter is provided comprising means.

Guidewire extraction means can be used to remove completely formed or unfinished slits. It may be This catheter penetrates the outer wall of the guidewire lumen, Provides passage into the guidewire lumen through the side of the catheter shaft Side port, usually when using a catheter distal to the proximal opening. It is preferred to have a side port located within the patient's body. Main catheter In one embodiment of the tell, the guidewire withdrawal means is a slit; The lit is continuous from the proximal opening to the side port. Also, the guide The ear removal means is a slit that connects the proximal opening to the side port. It is a discontinuous thing that forms a perforation up to. In yet other embodiments, the gas The guide wire removal means is a weakened area of the wall of the guide wire lumen. This allows the guide wire to be withdrawn through this area. −Example of change According to Prepare for tell.

The present invention relates to a catheter with a guide wire for use in the body of an animal, comprising: a catheter shaft having a proximal end and a distal end both having two lumens extending therethrough; , surrounding at least a portion of the proximal end of the catheter shaft and having at least two arches; ``Y-shaped'' connector with a lumen on one arm; An entry channel is formed in the other arm, and an entry channel into the other lumen is formed in the other arm. channels are formed, allowing the “Y” connector to be split along a longitudinal line. It has at least two split members connected together, and when splitting these split members, “ A "Y" connector is a connector that does not enclose the proximal end of the catheter shaft at all. Including Teter. In other embodiments, when the split member is split, one of the connectors is An elongated object extending from the arm into the lumen of the catheter shaft is connected to the connector. Remove the connector completely from the catheter shaft so that it remains in the lumen during removal. It can be removed.

The present invention also provides a method for passing a guidewire lumen from a proximal opening to a distal opening. Prepare a guide wire as described above and insert the proximal end of the guide wire into the proximal opening. positioning the catheter within the patient with the catheter extending out from the guide; Hold the proximal end of the wire so that the entire catheter is outside the patient's body, and the guidewire by the guidewire withdrawal means until a portion of the guidewire is exposed at the distal end of the catheter. By moving the guide wire laterally and out of the guide wire lumen. Maintaining guidewire position within the patient while removing the catheter from the patient from the proximal end of the guidewire by holding the step and the exposed portion of the guidewire. during procedures requiring angioplasty, including the step of removing the catheter; Also includes catheter removal methods. This method allows the distal portion of the catheter to The catheter section that goes into the patient's body is placed inside the guidewire lumen from end to end. or extend out through the side of the catheter and into the distal portion of the catheter. The guidewire in the guidewire lumen runs parallel to the proximal catheter. This also includes inserting other catheters at the same time.

The present invention has a proximal end and a distal end, and extends distally from the proximal end. a lumen having first and second proximal openings, the first lumen having a guide wall; Includes a longitudinally extending catheter shaft that is adaptable to accommodate ear guides. A first channel is formed in communication with the interior of the first lumen for insertion of a wire. a first connector extending longitudinally through the first channel and into the first lumen; transversely moving a guide wire extending in a direction to a connector including means for exiting the first channel through a portion commencing at the proximal end of the connector; Multi-lumen vascular catheter using a guide wire with a guide wire at the proximal end of the catheter. Also includes tell. In one embodiment, the first connector is separated into first and second parts. then move the guidewire laterally through the connector into the first channel. Allow it to come out from the flannel. The catheter communicates with the interior of the second lumen. A second connector defining a second channel can be provided at the proximal end of the catheter. good. The second connector may be distal or proximal to the first connector. good. In one embodiment, the first and second connectors are connected together in the form of an rYJ. will be combined. The catheter extends distally from the proximal opening and extends within the first lumen. Insert the guidewire laterally from the first lumen through the outer wall of the guidewire lumen. A guide wire removal means is provided on the outer wall of the first lumen to allow the guide wire to be moved in the direction of the guide wire. May include. Guidewire removal means include a slit and guidewire lumen. Reduced strength areas on the exterior walls of the tunnel, removable strips, etc. can be used. pickpocket The cut is continuous from its proximal opening to the point where it normally enters the patient's body when in use. or discontinuous (for example, perforations). guide wire - The extraction means is a weakened area of the wall of the first lumen, through which Alternatively, the guide wire may be removed. When using this catheter, is usually located inside the patient's body and has a first lumen for insertion of the guidewire. A side port may be provided extending through the outer wall. Also, the distal end of the catheter The angioplasty balloon is located in the lumen and communicates with the second lumen to allow fluid to flow therein. You may prepare for Tater.

The present invention also provides a catheter having a proximal end and a distal end, and a portion including the distal end of the catheter. The proximal end is usually located outside the patient's body, i.e. the guiding catheter. A catheter shaft located outside the catheter and a steerable guide extending through the shaft. A guide wire lumen that accommodates a guide wire, and has an outer wall and a shaft. a guide having a proximal opening at the proximal end for inserting the guidewire into the lumen; The Dwyer lumen and the proximal opening will normally be inside the patient's body when using the catheter. the guidewire within the guidewire lumen. Transfer laterally from the guidewire lumen through the outer wall of the guidewire lumen. means formed in the outer wall of the guidewire lumen to allow movement of the guidewire; Includes intravascular catheters. The catheter according to claim 14, wherein the guide wire The ear removal means is a slit. Place the catheter outside the guidewire lumen. Through the wall and into the guidewire lumen through the side of the catheter shaft Use of a catheter that is distal to the proximal opening and has a side port that provides a passageway for the Sometimes it may have a side port located at a location that would normally be within the patient's body.

As mentioned above, a slit can be used as the guide wire removal means. This pickpocket The cut may be continuous from the proximal opening to the side boat. Also, nearby It may be discontinuous, forming a perforation from the side opening to the side boat. .

Furthermore, as mentioned above, the guide wire removal means is located in the guide wire lumen. This is the area where the wall strength is reduced, through which the guidewire can be removed. That's how it is. A second side boat that communicates with the inside of the guide wire lumen. Prepare the catheter. The proximal opening is a point distal to the proximal end of the catheter. It may also be formed on the side of the catheter. This catheter is located at the proximal end of the catheter. The catheter is equipped with a sliding guide wire adapter that communicates with the guide wire lumen. through either the guidewire adapter or the proximal opening in the proximal portion of the A guidewire may be inserted into the guidewire lumen.

Other embodiments of the invention can be coupled to a catheter shaft and house a guidewire. The core has a channel that allows the guidewire to be inserted into the catheter shaft. Connector body and guides in place within the connector and catheter shaft means for allowing the wire to be moved laterally out of the connector; This is a guide wire connector for a catheter.

The enabling means may include a longitudinally extending groove formed in the connector. . In addition, the means for making it possible can be separated in the longitudinal direction of the connector and removed from the connector. A removable split member may be provided. Preferably, the strip formed on the side wall of the catheter The lead or guidewire removal means is located close to the guidewire connector. and preferably begins at the very proximal end of the catheter.

Yet another embodiment of the invention is a cover for use with a guidewire in a medical dish procedure. a catheter having a catheter shaft with a guidewire lumen; , the catheter has a proximal end and a distal end and includes an outer wall of the guidewire lumen. , which forms part of the outer wall of the guidewire lumen and extends distally from the proximal end of the catheter. a laterally extending longitudinally removable strip that is removable from the catheter; the guidewire lumen while maintaining the longitudinal position of the guidewire. a guidewire comprising a member that allows the guidewire to be removed laterally from the guidewire; Both catheters are used for medical treatment. With this catheter, the strip are two areas with reduced strength extending in the longitudinal direction of the outer wall. Also, strips may be formed of a different material than the rest of the catheter shaft. catheter may have a strip including a longitudinally extending reinforcing member.

According to yet another aspect of the invention, a catheter shaft has a proximal portion and a distal end. an angioplasty balloon attached to the shaft at the distal end, and an angioplasty balloon attached to the shaft at the distal end; a balloon inflation lumen that extends through the balloon and communicates with the interior of the balloon; a guidewire that extends through the balloon and the guidewire and accommodates a steerable guidewire. – A lumen with an outer wall that is normally accessible outside the patient's body when using a catheter. a proximal opening for inserting the guidewire into the lumen at the point where the guidewire - a passageway for inserting the guide wire into the lumen through the side wall of the lumen; When used distally from the proximal opening, the side boat is normally placed inside the patient's body. a guidewire lumen having a side port located at the proximal side; The guidewire extends from the opening to the side port and is within the guidewire lumen. from the guidewire lumen laterally through the outer wall of the guidewire lumen. Guidewire mounted on the outer wall of the guidewire lumen to allow movement An angioplasty catheter is obtained having removal means. In one embodiment, the support The id boat is located adjacent to the balloon on the proximal side of the balloon, preferably approximately from the balloon. Located within 35cm. One embodiment of the guidewire removal means includes a catheter. This is a slit that penetrates the outer wall of the tell shaft. This slit has a proximal opening. It may be continuous from the proximal opening to the side port, or from the proximal opening to the side port. It may be formed intermittently in the form of perforations up to the port. In other embodiments Therefore, the guide wire removal means is a region where the wall strength of the guide wire lumen is reduced. area through which the guidewire can be withdrawn. Main departure In one variation, a second side port communicates with the interior of the guidewire lumen. Equipped with In another example, the side port may communicate with the interior of the guidewire lumen. and a perfusion opening located between the balloon and the balloon. Yet other embodiments provide proximal It includes a "Y-shaped" connector having a shaft portion and a side portion in the side opening. balloon The inflation lumen extends through this shaft portion and guides the guide wire. Insertion into the ear lumen can also take place via the side parts. In this case, connect At least a portion of the catheter is removable from the catheter shaft and the connector The guidewire extends through the guidewire lumen and into the guidewire lumen. - Make sure that it can be removed using the removal means. This connector is separated longitudinally. the catheter shaft so that at least a portion thereof can be removed from the catheter shaft; It's a good idea to leave it there. As a variant, the connector can cover the first and second longitudinal sides. has two longitudinally divisible sections on separate sides of the shaft.

These parts are hinged on a first longitudinal side and on a second longitudinal side. The sides are divisibly combined.

According to another embodiment of the invention, the distal end of the catheter has a proximal end and a distal end. The portion containing the end is normally within the patient's body during use, and the proximal end is normally not removed from the patient's body. a catheter shaft that is external to the guide catheter and that extends through the shaft. , a guidewire lumen containing a steerable guidewire, the outer wall and a proximal opening at the proximal end of the shaft for inserting the guidewire into the lumen. When using the catheter through the proximal opening, the guidewire lumen has a The guidewire lumen extends distally to the point where it typically enters the patient's body. Insert the guidewire into the guidewire lumen through the outer wall of the guidewire lumen. formed in the outer wall of the guidewire lumen to allow for lateral movement from An intravascular catheter is provided comprising means.

Guidewire extraction means can be used to remove completely formed or unfinished slits. It may be This catheter penetrates the outer wall of the guidewire lumen, Provides passage into the guidewire lumen through the side of the catheter shaft When using a catheter that is a side boat and is distal to the proximal opening, it is usually It is preferred to have a side boat positioned within the patient's body. Main catheter In one embodiment of the tell, the guidewire withdrawal means is a slit; The lit is continuous from the proximal opening to the side boat. Also, the guide The ear removal means is a slit, which is inserted into the side boat from the proximal opening. It is a discontinuous thing that forms a perforation up to. In yet other embodiments, the gas The guide wire removal means is a weakened area of the wall of the guide wire lumen. This allows the guidewire to be removed through this area. −Example of change According to (e.g.) in the catheter.

The present invention relates to a catheter with a guide wire for use in the body of an animal, comprising: a catheter shaft having a proximal end and a distal end both having two lumens extending therethrough; , surrounding at least a portion of the proximal end of the catheter shaft and having at least two arches; ``Y-shaped'' connector with a lumen on one arm; An entry channel is formed in the other arm, and an entry channel into the other lumen is formed in the other arm. channels are formed, allowing the “Y” connector to be split along a longitudinal line. A connected small (both have two split members, and when splitting these split members, " A "Y" connector is a connector that does not enclose the proximal end of the catheter shaft at all. Including Teter. In other embodiments, when the split member is split, one of the connectors is An elongated object extending from the arm into the lumen of the catheter shaft is connected to the connector. Remove the connector completely from the catheter shaft so that it remains in the lumen during removal. It can be removed.

The present invention also provides a method for passing a guidewire lumen from a proximal opening to a distal opening. Prepare the catheter as described above and insert the proximal end of the guidewire through the proximal opening. positioning the catheter within the patient while it extends outward; and Hold the proximal end of the guide wire until the entire catheter is outside the patient's body and The guidewire is guided by the guidewire withdrawal means until a portion is exposed at the distal end of the catheter. patient by moving the guidewire laterally out of the guidewire lumen. A station that maintains the guidewire position within the patient while removing the catheter from the hold the exposed portion of the guidewire and insert the catheter from the proximal end of the guidewire. procedures requiring angioplasty, including the step of removing the catheter and It also includes the procedure for removing the catheter. The method uses the distal portion of the catheter to Is the catheter section inside the patient's body within the guide wire lumen from end to end? , or extending out through the side of the catheter and closer to the distal portion of the catheter. with the guidewire in the guidewire lumen running parallel to the distal catheter. This includes inserting other catheters into the

Other embodiments of the invention have proximal and distal ends, and first and second lumens. a first lumen having an outer wall and a guide extending through the first lumen; A catheter shaft that can accommodate a wire and that is attached to the proximal end of the catheter. a guidewire that communicates with the first lumen and allows the guide wire to be inserted into the first lumen. The guidewire connector and the longitudinal position of the guidewire were maintained within the patient. The guidewire can be removed laterally through the outer wall of the first lumen. and a vascular catheter. In one embodiment, the guide wire The ear connector is at least partially removable from the catheter shaft. Also, A portion of the guidewire connector connects to the proximal end of the catheter shaft and the guidewire. can be removed longitudinally from the proximal end of the Optionally, guide wire connector Leave the other part of the catheter on the catheter shaft and insert the guidewire connector. Remove the guidewire laterally through the outer wall of the guidewire lumen. Good too.

Explanation of exchange between countries FIG. 1 is a partially omitted plan view of a catheter according to the present invention.

FIG. IA is a cross-sectional view of the catheter shown in FIG. 1 taken along line A-A.

FIG. IB is a cross-sectional view of the catheter shown in FIG. 1 taken along line B-B.

Figure IC is the catheter shown in Figure 1, except that it is the opening of the guide wire removal means. Figure IB is a diagram similar to Figure IB showing a cross section of the cell;

FIG. 2 shows the portion of the catheter of FIG. 1 surrounding the proximal opening of the catheter shaft; is a partial view showing a modification of the guide wire removal means. This is a diagram.

FIG. 3 is a longitudinal cross-sectional view taken along line 3--3 of the catheter shown in FIG. Describe the function of the placed guide wire and the guide wire removal means. This is a diagram for

FIG. 4 is a partial perspective view of the catheter shown in FIG. 1 taken along line B-B; It is a figure for explaining another modification of a wire extraction means.

Figure 5 is a longitudinal cross-sectional view similar to Figure 3, with the guide wire removed. FIG. 6 is a diagram for explaining the lateral movement out of the removal means.

FIG. 6 is a partially omitted longitudinal cross-sectional view of the proximal end of an embodiment of the catheter of the present invention. It is.

Figure 7 shows the removable "Y-shaped" connector at the proximal end of the catheter shaft. FIG.

FIG. 8 is a perspective view showing in detail the locking mechanism of the "Y-type" connector shown in FIG. 7.

FIG. 9 is a cross-sectional view taken along line 9-9 of FIG.

FIG. 10 is a perspective view showing in detail the locking mechanism of the "Y-type" connector shown in FIG. 7. FIG.

Figure 11 is an enlarged cross-sectional view similar to Figure 9, with a "Y-shaped" view from the catheter shaft. FIG. 6 is a diagram for explaining removal of the connector.

Figure 12 shows the distal end of the catheter shaft after removing the "Y" connector. FIG. 2 is a perspective view for explaining a sealing member.

Figure 13 is a longitudinal view taken along line 13-13 of the removable "Y-shaped" connector shown in Figure 7. FIG.

FIG. 14 is a longitudinal cross-sectional view taken along line 13-13 of the entire catheter shown in FIG. be.

Figure 15 shows the guidewire in place within the guidewire lumen. This is a diagram similar to FIG. 14 except as shown.

FIG. 16 is a partially omitted side view showing another embodiment of the catheter of the present invention.

FIG. 17 is a longitudinal cross-sectional view taken along line 17-17 of the catheter shown in FIG. Ru.

FIG. 18 is a view similar to FIG. 17 except that the removable breakaway portion is shown in dotted lines. It is.

Figure 19 is a view similar to Figure 18, with the lateral The figure shows how the guide wire is removed.

FIG. 20 is a view similar to FIG. 19 in which the guide wire is inserted through the side wall of the guide wire lumen. This shows Dwyer being removed.

FIG. 21 is an enlarged view of a breakaway "Y" connector according to the present invention.

22 is a cross-sectional view taken along line 22-22 in FIG.

FIG. 23 is a cross-sectional view taken along line 23--23 in FIG.

24 is a cross-sectional view taken along line 24-24 of FIG.

FIG. 25 is a cross-sectional view taken along line 25-25 in FIG.

Figure 26 shows the separated portion of the “Y” connector with the remaining portion of the “Y” connector. 22 is a view similar to FIG. 21 except shown assembled together; FIG.

27 is a cross-sectional view taken along line 27-27 of FIG. 26.

Figure 28 shows the "Y" connector with the cutaway section removed, except as indicated by the dotted line. is a diagram similar to FIG. 27.

FIG. 29 is a partial cross-sectional view of one embodiment of a catheter with a removable length. It is a figure for demonstrating a hand direction strip.

FIG. 30 is a view similar to FIG. 29, illustrating another removable strip. This is a diagram for

FIG. 31 is a view similar to FIG. 29, but also for other forms of removable strips This is a diagram that cannot be explained in detail.

FIG. 32 is an enlarged view showing one embodiment of the side port.

FIG. 33 is an enlarged view showing another embodiment of the side port.

Detailed explanation of base A basic embodiment of a catheter according to the invention is shown in FIG. The catheter 10 is A catheter shaft 12 is provided that extends from a proximal end 14 to a distal end 16. Figure IB As can be clearly seen, the catheter shaft 12 is connected to the catheter shaft 1. a guidewire lumen 20 extending through 2 and a balloon inflation lumen 2 It has 2.

Catheter 10 has an angioplasty balloon 24 at its distal end 16. catheter The proximal end of the shaft 12 is capable of transferring fluid to and from the balloon lumen 22. The balloon inflation connector 26 is provided in such a state. balloon inflation connector Fluid entering the proximal end of the tank 26 passes through the balloon lumen 22 to the balloon 24. The balloon 24 is inflated and deflated during the angioplasty procedure. do. Balloon inflation lumen 22 is interrupted to the interior of balloon 24.

The opposite end of balloon inflation lumen 22 terminates inside balloon inflation connector 26. I'm awake.

Guidewire lumen 20 can accommodate a steerable guidewire, and outer wall 30 (shown in Figure IB).

A proximal opening 32 is formed through the outer wall 30 of the guidewire lumen 20. There is. This proximal opening 32 is located at the proximal end 1 of the proximal portion of the catheter shaft 12. 4, and when an angioplasty (or other vascular procedure) is performed, the patient is usually It is located outside the person's body. Typically, the proximal opening 32 is connected to the catheter 1. within 60 cm, preferably within 40 cm, more preferably within 40 cm from the proximal end 14 of 0. Within 30cm.

Balloon 24 was manufactured according to well-known angioplasty balloon manufacturing techniques. . Preferably, the balloon is insufflated from the distal end 16 of the catheter shaft 12; or by insufflating with another piece of material glued to the distal end 16 of the catheter shaft 12. Form it. Balloon 24 is made of polyethylene, polypropylene, polysalt Molding with relatively inelastic materials such as vinyl chloride or polyethylene terephthalate is effective. stomach.

Catheter shaft 12 includes a tube extending through outer wall 30 of guidewire lumen 20. A side port 34 is also provided that extends from the side. Side port 34 is a proximal opening It is located distal to the point 32, and is used to insert the catheter in place for angioplasty. It is usually located inside the patient's body when it enters the body. Preferably side port 34 is on the proximal side of the balloon 24 and within 80 cm from the balloon 24, preferably It is located within 60 cm, more preferably within 40 cm.

Catheter 10 according to the present invention includes a guidewire within a guidewire lumen. from the guide wire lumen 20 through the outer wall 30 of the guide wire lumen. Means are provided for removal. catheter shaft 12 or guidewa If the ears extend longitudinally or axially, the guidewire -When removing the guide wire from lumen 20, the movement is in the horizontal direction of the guide wire. can be considered as radial, or lateral, movement. Guide wire removed The removing means 40 is in the form of a slit passing through the outer wall 30 of the guide wire lumen 20. The guide wire is inserted from inside the guide wire lumen 20 through this slit. Dwyer may be removed. The guide wire removal means 40 Actual slit formed completely through the outer wall 30 of the Dwyer lumen 20 or unfinished areas such as the areas of reduced intensity shown in Figure IB. It may also be a slit of any size. The guide wire removal means 40 It is only possible to cut completely through the outer wall of the guide wire lumen 20. It is possible. Other parts remain at least partially unchanged. Make it look like a perforation. This part is another part of the catheter shaft 12. It may be made of a different material. Furthermore, the outer wall 3 of the guide wire lumen 20 The adjacent portion of 0 may also be formed of a different material. Usually the patient when using a catheter The part that comes outside the body is left unfinished (to prevent backflow through the slit), A complete slit is usually formed in the part of the catheter that would enter the patient's body when used. A fully formed slit and an area with reduced strength, i.e. an unfinished slit. It may also be used in combination with lit.

One of the advantages of forming only an unfinished slit is that during the procedure Backflow from the guide wire removal means 40 can be prevented. deer While using the guide wire removal means 40, the part that comes outside the guide catheter An unfinished slit may be applied only to the minute. Guide catheter outside the patient's body Other parts of the guidewire withdrawal means 40 outside the It is possible to form slits or perforation-like slits.

As shown in FIG. removable as defined by a pair of score lines 44, 46 extending distally from A tear strip 42 that can be used may also be provided.

The guidewire removal means 40 extends from the proximal opening 32 of the catheter shaft 12. When the catheter 10 is inserted into the proper position during angioplasty along the length direction, It usually extends into the patient's body. In this way, the guide wire can be removed. The evacuation means 40 is typically located outside the patient's body when the catheter 10 is placed in place. It starts at a point outside the catheter and ends at a point inside the patient's body, which is usually the case with this placement. Extending. Another way of looking at it is that the guide wire removal means should be distally distal. 40 cm, preferably at least 60 to 70 cm, more preferably at least It can also be said that it extends 80,90 to 100 cm.

Preferably, the guidewire removal means 40 extends distally toward the side port 34. Indeed, in this embodiment, it extends further to the distal side than the side port 34.

The guide wire removal means 40 preferably terminates proximal to the balloon 24. 24, or 5 cm proximal to the balloon 24, Locm or A little more proximally.

When the guide wire removal means 40 is left unslit before use, After use, it becomes a slit or opening as shown in Figure IC.

The use of catheter 10 according to the invention will be described with reference to FIG. This long side In a directional cross-sectional view, catheter 10 is guided within guidewire lumen 20. The dwyer 50 is shown in an appropriately arranged state. Proximal to guide wire 50 The side portions extend outside the catheter 10. The guide wire 50 is inserted into the proximal opening 32. into the guidewire lumen 20 and distally through the proximal opening 32. located within guidewire lumen 20 along extending catheter shaft 12 do. The distal end of guidewire 50 extends from distal end 16 of catheter shaft 12. Extending outside.

Guidewire lumen 2 by moving the guidewire radially or laterally. When attempting to remove the guide wire from 0, the guide wire removing means 40 A slit or opening is formed in the outer wall 30 of the men 20 and the guide is inserted through the opening. Wire 50 can be withdrawn from guidewire lumen 20. This space Lits or openings do not need to be completely formed to reduce the strength of the exterior wall 30. tear or tear the area that has been removed or remove it (as shown in Figure 2). Completely cut through the outer wall 30 of the guidewire lumen 20 by tearing the strip. It becomes a complete shape. In a preferred embodiment, the guidewire removal means 40 is , only when the guide wire 50 is removed via the guide wire removal means 40. This is the area where the strength is reduced to fully open. In one embodiment, guidewire 50 can be easily pulled through the outer wall 30 of the guidewire lumen 20. . In addition, as shown in FIG. 4, the filament 5 accommodated in the guide wire removal means 2 may be provided on the catheter shaft 12. The filament 52 is a guide wire. Continuous fibers or strands extending along the length of the yarn removal means, with a small It is buried in at least a part of the outer wall 30 of the guide wire lumen 20. . When filament 52 is pulled outward, outer wall 3 of guidewire lumen 20 0 is torn to form a slit.

In FIG. 3, the guidewire 50 is first removed by the guidewire removal means 40. The dotted line indicates the initial state in which the material is removed. In the same figure, the guide wire indicated by the dotted line The wire 50 connects to the outer wall 30 of the guidewire 20 at a point distal to the proximal opening 32. It is shown extending through the.

As shown in FIG. 5, the guide passes through the outer wall 30 to the side port 32. through the outer wall 30 of the guide wire lumen 20 until the guide wire 50 is removed. Pull the guide wire 50 shown by the dotted line. Of course, according to the invention, the guide The ear 50 extends through the outer wall 30 to a point proximal or distal to the side port 34. I understand that it can be removed. However, in a preferred embodiment, the Lateral removal outside the side wire lumen 20 is limited to the side port 34. do.

To remove the guide wire 50 through the outer wall 30, remove the guide wire 50 longitudinally. Note that this is done without any movement in the direction or shaft direction. others 3, the distal tip of the guidewire 50 is exactly the same as that shown in FIG. in the same position. However, in Figure 5, the guide wire is The catheter shaft 12 can be laterally removed along the length of the catheter shaft 12 by the removal means. Ru. In the simplest embodiment of the invention, a proximal opening 32 and a side port 34; Extending from the distal side of the proximal opening 32 to at least the side port 34 or further. It would be better if the existing guide wire removal means 40 is provided in the guide wire lumen 20. stomach.

However, the invention may be implemented in even more sophisticated forms. In such embodiments, A distal side opening 54 is provided through the outer wall of the guidewire lumen 20 to provide support. Entry into guidewire lumen 20 at a point distal to guide port 34 road. The distal side 054 can be left open during normal use. , the distal side opening 54 is preferably removable as shown in FIGS. Cover with a covering member 56. The removable abutment member 56 is preferably made of metal. such as foil, Mylar, aluminized or metallized Mylar, or other suitable materials. Make it and hold it in place with glue. Place the removable abutment member 56 on the catheter system. The distal side opening is opened by removing the shaft 12 from the shaft 12 and opening the distal side opening. The distal side opening 54 may be used as an irrigation opening to allow extension of the guidewire 50 or and make it available for use. In one embodiment of the invention, the guidewire removal means 40 extends distally to the distal side of opening 54.

The portion of the guide wire lumen 20 located more proximally than the proximal opening 32 is preferred. Preferably, it should be kept closed and a polymeric material formed as appropriate as shown in FIGS. 3 and 5. Which filler 60 should be filled or whether the guide wire lumen 20 should be waterproof? Insert the probe in this position.

In another embodiment of the invention, the catheter shown in FIG. Change it partially. Specifically, this catheter is It includes a well-known "Y-shaped" connector 62 with a balloon inflation connector 26 at the distal end 14. Eh, the guide wire connectors 64 are provided at the two "branch parts" of the "Y-shape". Ru. Guidewire lumen 20 extends from proximal end 14 of catheter shaft 10. Extending through a guidewire connector 64 and a "Y" connector 62, the catheter The terminal shaft 12 also extends distally.

Proximal opening 32 is located more distally than the "Y" connector. Catheter 1 0 includes a slide that can be moved in the shaft direction to close or open the proximal opening 32. A type cover 66 is provided. Sliding cover 66 preferably covers the catheter shaft. An annular sleeve surrounding the foot 12 and extending the shaft relative to the catheter shaft 12. It is movable in the direction. The sliding cover 66 preferably includes a soft sealing material 70 ( For example, flexible closed cell polymer foams, silicone elastomers, and other suitable (such as a suitable material) on the inner surface so that it can be sealed against the catheter shaft 12. Make it. Typically, the sliding cover 66 covers the proximal opening 32 and 2 is closed and sealed.

In other embodiments, the proximal opening 32 may be used instead of the sliding cover 66. A removable cover such as a removable stopper 56 that keeps it closed ( (not shown) may also be used.

During normal use, the guidewire 50 connects to the guidewire connector 64, a "Y-shaped" ” distally through one side of the connector 62 and the inside of the guidewire lumen 20. It extends through proximal opening 32 and out of distal end 16 of catheter 10 .

If necessary (described in more detail below), a sliding cover 66 or other proximal opening may be provided. Remove the cover sealing the port 32 and maintain the catheter 10 in place within the patient's body. Remove the guide wire 50 from the guide wire connector 64 in the proximal direction while keeping it in place. Then, insert the guide wire 50 through the proximal opening 32 to the desired position. Can also be done. Thereafter, the outer wall 30 of the guide wire lumen 20 is The guide wire 50 is removed through the guide wire 50. via the outer wall 30 of the catheter shaft 12. By removing the guide wire 50, the catheter can be connected to a catheter using a wire. A quick exchange catheter that can be removed from the patient without extending the guide wire 50 from the catheter. It can be changed to tell.

In the embodiment shown in FIG. 6, a commonly known guidewire connector 64 is used. Tuehy-Bors By tightening the T adapter (not shown), backflow can be prevented during use. This is Figure 1 This is in contrast to the embodiment shown in Figure 3, in which some degree of backflow is expected.

In yet another embodiment of the invention, a removable "Y-shaped" connector is shown in FIGS. 7-13. By providing the connector 80, the guide wire can be removed and removed as described with reference to FIG. Eliminates reinsertion.

The embodiment of the removable "Y" connector shown in Figure 7 includes A "Y" connector 80 is provided. "Y-shaped" connector 80 is preferably The catheter shaft is molded from a relatively stiff thermoplastic material and is concentric with the catheter shaft. Make sure that it fits around the top. The "Y-shaped" connector 80 is connected to the catheter shaft. 2 (or (no more) pieces. In the illustrated embodiment, a removable "Y-shaped" connector has a shaft portion 82 through which the balloon lumen 22 (and preferably a cover) is inserted. The taetel shaft 12) passes through it. The removable "Y-type" connector 80 is Proximally at an outward angle from the shaft portion 82 of the removable "Y" connector 80. It has an extending guide wire connector 64.

The guide wire connector 64 of the removable "Y-shaped" connector 80 has a cylindrical shape. It has a guide wire hole 84 passing therethrough. Guide wire hole 84 The guide wire is inserted through the proximal opening 32 as best shown in FIG. It is connected to Yarumen 20.

The removable "Y" connector 80 preferably has a first split member 86 and a second split member 86. and a member 90. Each of the first split member 86 and the second split member 90 is , in the shaft direction from end to end of each split member 86,90 of the "Y-shaped" connector 80. It has an extending semi-circular recess 92,94. The semicircular recesses 92 and 94 are shown in FIG. best shown. When the first and second split members 86.90 are combined, the half The circular recesses 92 and 94 together form a cylindrical recess through which the catheter is inserted. The shaft 12 is in an extended shape.

When the first and second split members 86.90 are brought together on the catheter shaft 12, When connected, these split members are attached to the first end 9 on opposite sides of the catheter shaft 12. 6 and the second end 100. The first and second parts of each split member 86.90 The end 96.100 of the catheter shaft 12 is parallel to the shaft of the catheter shaft 12. extending in the direction.

In a preferred embodiment of the invention, the first of the first and second split members 86,90 The ends 96 of are joined by a hinge 102. Preferably, the hinge 10 2 is a polygon which forms a "live" hinge or removable "Y" connector 80. The hinge consists of a thin section of mer material. In a preferred embodiment, hinge 1 02 extends along the shaft direction from one end of the first end 96 to the other.

The second ends 100 of the first and second split members 86.9o are connected to a suitable connection mechanism. Therefore, they are combined in a divisible manner. The mechanism shown is only one possible mechanism. stomach. In the illustrated arrangement, the second ends 10 of the first and second split members 86,90 0 each have radially extending tabs 104 running from one end of the second end 100 to the other. have Since an edge 106 is formed on the outside of the radial end of the tab 104, When the first and second split members 86.90 are mated at the second end 100, the edge 10 6 extend in opposite directions on the first and second split members 86 and 90, respectively, and are shown in FIG. It forms a T-shape in the radial cross section.

a second end of the first and second split members 86,90 with an end connector 110; Hold 100 together. End connector 110 preferably connects second end 100 to The first and second the tab 104 and lip 106 of the second end 100 of the split member 86.90. Ru. In this way, the first and second ends 100 of the first and second split members 86.90 The rTJs of the second ends coupled to each other connect to the rTJ channels of the end connector 110. It is designed to be able to slide inside the cage. Connector 110 to the rTJ portion of the second end. Once in place, use a suitable mechanism to lock the connector in place. As an example The first end 112 of the connector is permanently closed and one end of the end connector 110 is closed. Prevent movement in the direction. The second end 114 of the end connector 110 is shown in FIGS. A cut-off end 116 as shown in FIG. 8 may be used. The cutoff end 116 is an end Other portions of the connector 110 are configured to be radially separable from the connector 110. Glue or connect in minutes. This is cut as shown by arrow 120 in FIG. This can be achieved by shaking the separating end 116. As shown in FIG. Once removed, the end connector 110 is attached to the removable “Y” connector 80. Connector 110 in the shaft direction as shown by arrow 122 until disconnected from other parts. move it to

Another way to lock the end connector 110 to the removable "Y-shaped" connector 80 As a method, a locking pin as shown in FIG. 10 may be used. The locking pin is the first and second end 100 and end connector 110 of second split member 86.90. extending through the end connector 100 to hold the end connector 100 in place. When pin 124 is removed , the end connector 110 can also be removed.

Although the pin shown in Figure 10 is annular, other pins and locking devices of appropriate shapes may be used. You may.

After removing the end connector 110, the second ends 100 are connected together as shown in FIG. The first and second split members 86,90 are connected to the catheter shaft 1 in a pivotally spaced manner. 2 and connect the removable “Y-shaped” connector 80 proximal to the guide wire 50. Slide proximally from the end.

In a preferred embodiment of the invention, the circumference of catheter shaft 12 as shown in FIG. A seal 126 is provided around the enclosure. The seal 126 is a removable “Y” connector 80 and the catheter shaft 12, preferably the catheter shaft 12. It is made of a polymeric material such as a lastomer material or closed cell foam formed into an annular shape.

The seal 126 preferably includes an indexing mechanism 130 and is attached to the catheter shaft 12. This prevents rotational or longitudinal movement of the "Y-shaped" connector 80 relative to the connector. figure In the illustrated embodiment, indicator feature 130 is an outwardly extending tab. however, The indicator mechanism 130 may be a groove, a recess, an edge, or the like. Outside shown in Figures 11 and 12 The index mechanism 130 extending to the side is connected to the shaft portion of the detachable "Y-shaped" connector 80. can cooperate with index socket 132 on portion 82.

See Figures 14 and 15 for using removable “Y” connectors. Further explanation will be given below. Diagram of catheter 10 without “Y-shaped” connector 80 14. As shown in FIG. A guide wire 50 is inserted into the proximal opening 32. The guide wire 50 is a catheter. extending from end to end of shaft 12 and exiting distal end 16 of catheter 10. Ru.

When the removable "Y-shaped" connector 80 is removed from the catheter shaft 12, the catheter The terminal 10 is in the state shown in FIG. 3, and the guide wire 50 is inserted in FIGS. and laterally through the outer wall 30 of the guidewire lumen 20 as shown in FIG. It is removed in the opposite direction.

Having described a preferred embodiment of a removable "Y" connector 80, " Remove only a portion of the “Y-type” connector (such as the strip) from the catheter shaft 12. It should be understood that similar removable "Y-shaped" connectors may be used. . Additionally, a "Y-shaped" connector may be formed from two or more pieces, or may be formed from separate lugs. "Y-shaped" connector that can be attached and detached using a locking mechanism or locking mechanism until removal is necessary. may be held together. In addition, other mechanical mechanisms with equivalent functionality are mentioned above. May be used in place of the element.

A catheter according to the invention having another "Y" connector is shown in FIGS. 16 and 17. show. This embodiment of the invention is referred to as a "universal mode" vascular catheter.

In this embodiment of the invention, catheter 210 has a proximal end 214 and a distal end 216. A catheter shaft 212 is provided. The catheter shaft 212 is A guidewire lumen 22 extends across the catheter shaft 212. 0 and a balloon lumen 222. The well-known angioplasty balloon 224 is A distal end 216 of the tater shaft 212 is provided. The balloon 224 is connected to the catheter. through a balloon inflation connector 226 located at the proximal end 214 of the shaft 212. It is inflated by injecting pressurized fluid. Such pressurized fluid is connected to the balloon inflation connector. from the balloon inflation lumen 222 communicating with the interior of the balloon 224. and flows distally.

Guidewire lumen 220 has an outer wall 230 and a proximal opening 232.

The catheter 210 also includes a wire that passes through the outer wall 230 of the guidewire lumen 220 A side boat 234 is also formed as an opening.

The side boat 234 corresponds to the side boat 34 described above, and has a guide. It is used to insert and remove wires. Preferably, the side boat 23 4 connects the guide wire passing through this side boat 234 to guide wire lumen 2. The guidewire lumen 22 can be easily extended distally through the guidewire lumen 22. Extending the guide wire proximally from the side boat 234 through the Form into a shape that doesn't exist. The position of the side boat 234 is determined relative to the side boat 34. and position it as described above.

Guidewire lumen 220 passes through balloon 234 through proximal opening 232. substantially extending the catheter to a distal opening 236 distal to the balloon 224. It extends from one end of the terminal shaft 212 to the other.

Proximal end 214 of catheter 210 includes a guidewire lumen. This is a guide wire connector 240 that serves as an entrance to the main body 220. guide wire - Proximal opening 232 of lumen 220 extends through guidewire connector 240. It is an extended channel. Guidewire connector 240 is a balloon inflation connector. The guide wire connector 24 is preferably located on the proximal side of the connector 226. 0 distal to the balloon inflation connector 226.

In a preferred embodiment of the invention, guidewire connector 240 and balloon The expansion connectors 226 together form a "Y-shaped" connector 24 as shown in FIG. It becomes 2. In a preferred embodiment of the "Y" connector 242, the guidewire Connector 240 and balloon inflation connector 226 are made of molded polyester bonded together. It is made of a suitable material such as a mer material. For example, the guidewire connector The connector 240 is coaxial with the guidewire lumen 220 and the balloon inflation connector 240 is coaxial with the guidewire lumen 220. 26 extends at an angle from balloon inflation lumen 220. In this way , connectors 226 and 240 together form a "Y-shape".

As shown in FIG. 18, one preferred embodiment of a universal mode catheter 210 It includes a "Y-shaped" connector 242 with a release piece 246. The separation piece 246 is shown in FIG. 8 is indicated by a dotted line. As shown, the breakaway piece of the "Y" connector 242 is The outer wall 230 of the guidewire lumen 220 is removed throughout its length. exposed. The breakaway piece 246 is completely removed from the rest of the "Y" connector. It can be removed or simply pivoted away from the rest of the connector. It may be hinged.

The outer wall 230 of the guidewire lumen 220 in embodiments according to the invention Ear removal means 250 is provided. The guide wire removal means 250 is the guide wire removal means described above. This corresponds to the Dwyer removal means 40. As shown in FIG. 19, the guide wire 25 2 is in place within the guidewire lumen 220, the breakaway piece 246 The guide wire 252 can be removed from the guide wire connector 240 so that the guide wire 252 is The guide wire removal means 2 penetrates the outer wall 230 of the guide wire lumen 220. 50 and can be moved laterally. (Proximal end 214 to guidewire lumen) Guide wire 250 extending through 220 is shown in dotted lines: solid guide wire The wire 252 is removed laterally from the guide wire lumen 220 to remove the guide wire 252 from the guide wire lumen 220. after exiting from wire connector 240 and “Y” connector 242. be. ) FIG. 20 shows that the guidewire lumen 22 is removed by the guidewire removal means 250. Regarding laterally withdrawing the guide wire 252 through the outer wall 230 of the It is a figure for further explanation. In FIG. 20, the guide wire 252 is shown in FIG. The starting position corresponding to the guide wire shown in 9 is indicated by a dotted line and the guide wire Guide wire removal hand until ear 252 extends through side boat 234. The state in which the step 250 is laterally removed is shown by a solid line. Guide wire removal means The guide wire 252 can be removed using the same method as described above. I can do it.

A disconnect connector 242 in this embodiment of the invention is shown in FIGS. 20-25. Show more details.

1m21 connects the "Y-shaped" connector 242 to the balloon inflation connector 226 (see Figure 21). (hidden) is a perspective view seen from the opposite side. At 1g21, the guidewa Ear connector 240 is the balloon inflation connector of guidewire connector 240. A removable cutoff piece 246 is provided on the side facing the tab 226. Guide Y Year connector 240 is preferably formed from an injection molded thermoplastic material. favorable fruit In some embodiments, the guide wire connector may be connected to other portions of the "Y" connector 242. Form into one piece. of the “Y-shaped” connector 242 (which meets the catheter shaft 212). ) A stress relief sleeve 254 may be provided at the distal end. Stress relief sleeve 25 4 is formed of a flexible polymeric material or the like, and is slightly connected to the "Y" connector 242 (e.g. e.g. 1-2 cm) from a point within the distal end of the distally extending "Y-shaped" connector 242. It is preferable to surround the catheter shaft and prevent the catheter shaft 212 from curving. .

A removable breakaway piece 246 is attached to the outer wall 23 of the guidewire lumen 220. It is preferable that it overlaps with a part of 0. For example, when viewed in radial cross section, the separation piece 24 6 is about 5° to about 180° of arc. In the embodiment shown in FIG. 46 surrounds catheter shaft 212 at approximately 90° to 120° of arc.

A longitudinally extending breakaway piece 246 extends from one end of the "Y" connector 242 to the other. Although shown in extended form, the guidewire and longitudinally extending radial A proximal side that is removable in the direction of the shaft that completely encloses the removable part in the direction of the shaft. Using a "Y-type" connector with a section (indicated by the dashed line rAJ in Figure 27) I can understand that this is a good thing. For such an embodiment, the proximal side of the surrounding The molecule AJ is removed in the shaft direction, and the rBJ portion extending in the longitudinal direction is removed in the radial direction. Remove it. As an alternative to this embodiment, the partial molecule BJ can be easily removed, leaving a groove. , lateral or radial withdrawal of the guide wire 252 from the "Y" connector. Loosen the segment AJ from the rest of the CrY-type connector 242 and attach the guide wire. -252 at the proximal end).

The breakaway piece 246 is the same as that forming the rest of the "Y" connector 242. It is recommended to form it using the following material. This is made separately from the rest of the “Y” connector 242. or the "Y-shaped" connector may be molded as one piece. Also, Even if the breakaway piece 246 is formed by cutting out the "Y-shaped" connector 242, good. The catheter may be left without the detachment piece 246 completely. stomach. In this example, a narrow longitudinal groove is formed along the side of the “Y” connector. to be accomplished. In this way, the proximal end of the guide wire connector 240 can be attached and detached. This allows it to completely surround the entire guide wire.

In either case, hold the tearaway piece 246 in place until removal is required. A means (not shown) is provided for this purpose. This means includes a "Y" connector 242 By relatively weakly adhering the corresponding end of the tear-off piece 246 to the end of the other portion of the or welding methods. In addition, the disconnection piece 246 is an FY type connector 242. It is also possible to separate it halfway from the other parts. In other embodiments, the cut Release piece 246 and guidewire connector 240 and/or "Y" connector Tear-off piece 246 is held in place by tape surrounding all or a portion of cutter 242. to hold.

Guidewire connector 240 preferably has an annular lip surrounding its proximal end. , to make it easier to connect adapters, etc.

Connect the breakaway piece 246 to the guidewire connector 240 and/or "Y" connector. When removed from the handler 242, the guidewire removal means 250 is exposed. mentioned above As described above, the guide wire removal means is attached to the outer wall of the guide wire lumen 220. A slit and strength for laterally removing the guide wire 252 through the wire 230. This may be a dropped line, tear strip, or equivalent means.

In addition to removing breakaway piece 246, at least a portion of stress relief sleeve 254 is removed. It must also be removable as shown in Figure 21. Stress relief sleeve 254 is a slit or notch, and the removable part is connected to the detachable piece 246 has been done. As another example, the stress relief sleeve 254 may be attached to the guidewire lumen. It may be a simple slit that does not come off the outer wall 230 of 220.

Please refer to the cross-sectional views shown in Figures 22 to 24 for the configuration of the detachable "Y-type" connector. I will explain further.

In FIG. 22, the proximal end of guidewire connector 240 or its single polygon mer structure is shown. In FIG. 23, the guidewire loop of catheter shaft 212 is shown. A single guide wire connector 240 is shown surrounding only the men 220.

In FIG. 24, balloon inflation connector 226 is distal to "Y" connector 242. Shown extending from the side. “Y-type” connector 242 guide wire connector The guide wire lumen 220 and balloon inflation lumen 222 It is shown surrounding both. Stress relief sleeve 254 Shown between connector 240 and catheter shaft 212.

Finally, in FIG. 25, the catheter shaft distal to the "Y" connector 242 This shows the shaft part. In the figure, a guide wire 220, a balloon Inflation lumen 222 and outer wall 230 of catheter shaft 212 are shown. .

FIG. 26 shows "Y-shaped" connector 242 assembled with breakaway piece 246. FIG. Stress relief sleeve 254 is shown partially cut away.

The partially cut-out portion of this stress relief sleeve 254 is the actual finished product. corresponds to In other words, in the finished product, the guide wire removal means 250 is removed. A portion of the stress relief sleeve 254 may be superposed thereon. As other shapes, cut This section of the stress relief sleeve 254 can be removed when removing the release piece 246. You may do so.

FIG. 27 is a longitudinal cross-sectional view of "Y" connector 242. FIG. The figure shows stress relaxation This shows the rib 254 partially placed within the “Y” connector 242. be. Connector lip 256 to guide wire connector 240 and balloon inflation connector. 226. Insertion of guidewire 252 and appropriate connector or Proximal opening 23 of the guide wire lumen to facilitate connection of the adapter. 2 so that the channel passing through the guidewire connector is widened at the proximal end 214. It is preferable to keep the

FIG. 28 is a view similar to FIG. 27 except that the cutoff piece 246 has been removed and is shown in dotted lines. It is.

FIG. 29 is a diagram showing still another embodiment of the guide wire removal means 250.

In the embodiment shown in FIG. 2 extending longitudinally and parallel to the outer wall 230 of the wire lumen 220 Regions 260 and 262 with reduced strength are formed. In a preferred embodiment , each of the reduced strength regions 260 and 262 is formed parallel to the outer wall 230. Having a pair of continuous or intermittent grooves. One of them is inside the wall, the other is the wall 23 Formed outside of 0. Between the weakened areas 260 and 262 of the outer wall 230 Optionally, reinforcing filaments 264 may be included within the located portion. Reinforced filament 264 is made of materials such as nylon or polyaramid (for example, manufactured by DuPont under the trade name K). High tensile strength yarns or filaments (such as materials sold as EVLAR) It is recommended to include information such as As another example, it may be made of metal.

The portions bordering the weakened areas 260 and 262 of the outer wall 230 are tear-resistant. A strip 266 is provided. This strip 266 is similar to other portions of the catheter shaft wall. The same thickness or thicker. Tear strip at proximal end when in use Grasp the fragment and tear it distally to remove it. As another example, simply guide wire Pull the guide wire laterally through the outer wall 230 of the The tear strip may be pulled.

Another form of tear strip 266 is shown in FIG. In this example, tear strip 2 66 is made of a different material from the other parts of the outer wall 230 of the guide wire lumen 220. It is being This special tear strip 266 can be used, for example, on the catheter shaft 21. It may also be formed by extrusion together with a second material. Guide wire in outer wall 230 - the part adjacent to the removal means 250 is spaced apart by the width of the tear strip 266; The tear strip 266 overlaps the exterior wall 230 on both the inside and outside of the exterior wall 230. ing. Until it is removed, the locking mechanism that overlaps against the outer wall 230 prevents tearing. It is preferable to keep the strip 266 in place.

Yet another embodiment of tear strip 266 is shown in FIG. In this example, the tear A strip 266 (preferably made of a different material than the exterior wall 230) is attached to the exterior wall 230. Let's go. In this case as well, a method similar to that described with reference to FIGS. 28 and 29 is used. The strip can be removed using a method.

The guide wire removal means of the catheter according to the present invention may be a slit or a tear. Even if it is a strip, it is difficult to use this catheter as a wire-based catheter. It should be understood that a side boat can be provided optionally if the vehicle is used.

However, it is difficult to insert the guidewire into the outer wall of the guidewire lumen. Place the catheter in rapid-exchange mode, where it would normally be inside the patient's body when using the catheter. This side boat is extremely useful when inserting into the guidewire lumen at It is for use.

There are many other shapes that can be used as a side boat. It can be applied to any of the above-mentioned catheters regardless of the shape. For example, in Figure 32 For reference, the side boat 234 looks like a slit rather than an actual opening. be. One of the slit shapes allows for easy insertion and removal of the guide wire. An example is the rYJ type. In this case, the handle of rYJ is the guidewire removal means. Corresponding to the slit or strip 250, the two arms of rYJ are at different angles from the handle. extend. The slit may be completely formed, as shown in FIG. 23.

Alternatively, it may be a discontinuous slit or a region with reduced strength. guidewa There are no openings or holes in the outer wall of the ear lumen, and it is a "side boat" 34.234 It is clear that the end of the slit is also closed until the guide wire passes through the .

Another embodiment of the side boat 34.234 is shown in FIG. Here, the sideboard Port 234 is initially closed, and one portion of outer wall 230 of guidewire lumen 220 is closed. It has become a department. At this point, the side boat 234 is unfinished. side bow When it becomes necessary to use the side boat 234, remove the material that closes the side boat 234. to open the side boat. In this way, the side boat 234 has a perforation It can be defined by (intermittent slits) or areas with reduced strength. Also, simple One-groove guide wire removal means 250 and other guide wire removal means mentioned above. May be connected. When using tear strips as a guidewire removal method The side boat 234 can be part of the strip that connects to this strip. , can be the same size as the strip or larger.

of the catheter The catheter according to the invention extends through the side boat 34.234 and the guide Guidewire exiting proximal end 16.216 of wire lumen 20.220 -50.252 as a rapid exchange catheter. Also, substantially proximal end CrY type" connector 62.80 or 242 or through the distal opening 32.232) along the length of the catheter shaft. extending distally from one end of the catheter shaft 12.212 to the distal end thereof. A well-known wire catheter with a guide wire 50.252 exiting from the May be used as a tell.

A revolutionary aspect of the catheter according to the invention is that it can be used from one mode of use to another. The point is that it can be changed quickly and easily. Therefore, initially 34.Insert the guidewire only from 234 to the distal end of the catheter. - Can be used as a rapid exchange catheter without passing through the lumen 20.220 can. Remove the guidewire and place the catheter 10.210 in place within the patient's body. Connect the new guide wire 50, 252 to the CrY type connector or (through the proximal opening 32.232) near the guidewire lumen 20.220. and extend the guidewire 50.252 out from the distal end of the catheter. Easily change from quick exchange mode to well-known wire usage mode by can be done.

When using the catheter shown in Figure 4 as a catheter using a well-known wire , remove the removable “Y” connector 80 (if used) and connect the guide wire. exit the proximal opening 32 and extend proximally, and the guidewire 50 is inserted into the patient's body. The guide wire is removed by the guide wire removal means 40 while being maintained in place within the guide wire. While moving the guidewire laterally through the outer wall 30 of the lumen 20 Pull catheter 10 until distal end 16 of catheter 10 is outside the patient's body. It can be a rapid exchange catheter. Use a guide watch while performing this procedure. Grasp and hold the ear 50 at its proximal end. Next, the surgeon attaches the guide wire 50. Hold the guidewire 50 by grasping the exposed portion of the distal end 16 of the tether 10. holding the catheter 10 from the proximal end of the guide wire 50, and removing the catheter 10 from the proximal end of the guide wire 50. - Insert the new catheter 10 into the guide wire while maintaining the position 50 inside the patient's body. - Insert along line 50. The new catheter 10 is inserted through the distal end of the catheter. Insert the proximal end of the guide wire 50 in the opposite direction and take it out from the side port 34. Can be inserted in exchange mode. Then, while holding the proximal end of the guidewire, Place the catheter back in place within the patient's body. In this way, the catheter can be removed quickly. Can be used as an exchange catheter. Alternatively, if necessary, While holding the tether in place, remove the guidewire 50 and insert it into the catheter shaft. Another guidewire may be inserted through the proximal opening 32 or proximal end 14 of the port 12. You can also change the mode to one using a well-known wire.

Thus, the catheter according to the invention can also be used in rapid exchange mode using wire-based models. The two modes of use can be easily switched and the guide wire is easy to use. The catheter can be changed in either mode, and the catheter can be changed in either mode. exchange can be performed without the use of an extension guidewire, and all of the above The conversion and mode of use is to convert either the guidewire or catheter into the patient's body. You can do it while holding it.

Accordingly, one method according to the invention includes passing the guidewire 50 through the proximal opening; extending distally from that portion across the remaining portion of catheter shaft 12. 1, and insert the catheter shown in FIG. 1 into the patient with the catheter shown in FIG. including doing. The guidewire 50 is removed through the proximal opening 32 and replaced with a new one. You can replace it by inserting something. Hold the guidewire as described above. If the catheter is moved laterally while the catheter is The guidewire is pulled so that the distal end of the catheter exits the patient's body. You can replace the catheter by pulling it until it comes to a stop. Then the catheter Hold the guidewire distally and insert a new catheter. At this time will be in quick exchange mode. After inserting the catheter into position, remove the guide wire (if necessary). Promptly replace the wire and replace the catheter with wire-based use as described above. You may return to the mode.

Another method of use uses the catheter shown in FIG. This catheter is For use with a guide wire in a side port or proximal opening as described above catheter and guidewire can be replaced in the same way. In addition, from one end of the guide wire lumen 20 through the guide wire adapter 64 to the other end of the guide wire lumen 20. It can also be used with an extending guidewire. guide wire adapter The guide wire can be exchanged from the port 64 to the proximal opening 32 or vice versa.

Guide wire adapter 64.240 and nearby “Y” connector 80.242 The catheter shown in Figure 1 is The same mode of use as described for the telephone is shown in Figures 7-28. In other words, it can also be applied to catheters with splittable "Y-shaped" connectors. . In addition, this mode of use allows you to switch from wired mode to quick exchange mode. In addition to this, the guidewire removal means 40.250 must be attached and detached before use when converting. Removal of swivel "Y" connector 80 or detachable "Y" connector 240 (or other "Y" connector) ) will need to be removed.

Thus, for example, guidewire 252 may be inserted through proximal opening 232. connector 240, extending distally through guidewire lumen 220, and further extending distally through guidewire lumen 220. FIG. It is also possible to first insert the catheters shown in 6 to 28 in wire mode. Wear. In this form, the catheter is inserted into the patient and positioned within the patient in a well-known manner. can be done. Guide wire 252 guides the position of catheter 210 within the patient. while maintaining the guidewire from the proximal end 214 of the guidewire connector 240. After pulling it out, it can be easily replaced by inserting another guide wire 252. catheter If it is necessary to replace the terminal 210, remove the breakaway piece 24 of the "Y" connector 242. 6 and move the guide wire laterally from the proximal end portion of connector 242. then remove it from the "Y-shaped" connector 242, and firmly secure the guide wire 252. While holding the catheter, pull it out from the patient and simultaneously pull out the guide wire 252. The guide wire is removed by the guide wire removing means 250 by moving it in the lateral direction. Take it out from Men 220. A guide wire removal means 25 is attached to the tear strip 266. 0, remove the strip 266 while withdrawing the catheter from the patient. pull. The distal end 216 of catheter 210 is removed from the patient and the guidewire 252 at the proximal end 216, the guidewire is then inserted into the catheter 210. and remove catheter 210 from the proximal end of guidewire 252. Ru. A guidewire is then inserted into the distal end of guidewire lumen 220; The guidewire lumen 220 extends proximally to the side port 234. Guide the new catheter 210 by pulling it out from the side port 234. Send it on the wire. This catheter is inserted while the guidewire 252 is held in place. 210 is inserted into the patient along guidewire 252. If necessary, remove the catheter. While holding the catheter 210 in place, remove the guide wire 252 and remove the catheter 2. 10 through the proximal end 214 of the guidewire lumen 220. You can also switch back to wire mode.

Although the preferred embodiments of the present invention have been described above, the gist of the present invention is as follows. It is intended to include the following claims and their equivalents.

h-@ Continuation of front page (81) Designated countries EP (AT, BE, CH, DE.

DK, ES, FR, GB, GR, IT, LU, MC, NL, SE), AU, CA , J.P.

Claims (64)

[Claims] 1. at least a first component having a proximal end and a distal end, and extending distally from the proximal end. and a second lumen, each of said lumens having a proximal opening, and said second lumen having a proximal opening; The first lumen is a longitudinally extending catheter adapted to accommodate a guide wire. Equipped with a le shaft, a first channel communicating with the interior of the first lumen for insertion of a guidewire; a first connector formed with a connector configured to connect the first connector through the first channel; A longitudinally extending guidewire within the lumen is moved laterally to at least also from the first channel through a portion starting from the proximal end of the first connector. a guide wire comprising said connector at the proximal end of said catheter, including means for ejecting said connector; A multi-lumen vascular catheter using a tube. 2. dividing the first connector into first and second parts; from the first channel through the first connector by moving the The catheter according to claim 1, wherein the catheter is removed. 3. a second connector forming a second channel communicating with the interior of the second lumen; The catheter of claim 1 further comprising: at a proximal end of the catheter. 4. Claim 1: The second connector is located distally from the first connector. Catheter described. 5. 5. The first and second connectors are coupled together in a "Y" shape. catheter. 6. The catheter extends distally from the proximal opening and includes a gas in the first lumen. Insert the guidewire laterally from the first lumen through the outer wall of the guidewire lumen. A guide wire removal means is provided on the outer wall of the first lumen to allow the guide wire to be moved in the direction. The catheter according to claim 1, which comprises: 7. 7. The catheter according to claim 6, wherein said guide wire removal means is a slit. 8. The slit extends from the proximal opening to the point where it would normally be within the patient's body in use. 8. The catheter of claim 7, which is continuous. 9. The slit extends from the proximal opening to the point where it would normally be within the patient's body in use. 8. The catheter of claim 7, wherein the catheter is discontinuous to form perforations. 10. The guide wire removal means reduces the strength of the outer wall of the first lumen. 7. The catheter according to claim 6, wherein the catheter is a region through which the guide wire can be extracted. -tel. 11. The region with reduced strength includes a pair of parallel grooves, of which One groove is formed on the inside of the wall of the first lumen and the other groove is formed on the outside of the wall of the first lumen. The catheter according to item 10. 12. The guide wire removal means is an elongated guide wire removable from the catheter shaft. 7. The catheter of claim 6, wherein the catheter is part of the outer wall of the first lumen in the form of a hollow member. . 13. In use, the first 7. The catheter of claim 6, further comprising a side port extending through the outer wall of the lumen. Tell. 14. The side port is distal to the side port of the first lumen. The guide wire can be passed through the side port through the first part. In the proximal portion of the lumen, the guide wire is inserted into the side port. 14. The catheter according to claim 13, wherein the catheter is configured so that it does not go out through the port. Tell. 15. located at the distal end of the catheter and in communication with the second lumen for fluid flow therein. 7. The catheter of claim 6, further comprising an angioplasty balloon. 16. In intravascular catheters, having a proximal end and a distal end, the portion of the catheter including the distal end being in use. a catheter system typically located within the patient's body, and the proximal end is typically external to the patient's body; With shaft; a guidewire extending through the shaft and housing a steerable guidewire; a lumen, the outer wall and the proximal end of the shaft having a guidewire attached thereto; a proximal opening for insertion into the lumen; ; from the proximal opening distally to the point where the catheter would normally be inside the patient's body. Extend the guidewire into the guidewire lumen guide to allow lateral movement from the guidewire lumen through the outer wall of the An intravascular catheter comprising: means formed in the outer wall of the Dwyer lumen. 17. The catheter according to claim 16, wherein the guide wire removal means is a slit. Le. 18. The guidewire passes through the outer wall of the lumen and the side of the catheter shaft. a side port for passage of the guidewire into the lumen through the lumen; , when the catheter is used distal to the proximal opening, typically within the patient's body. 17. The catheter of claim 16, wherein the side port is located at the side of the catheter. 19. The guide wire removal means is a slit, and the slit has a proximal opening. 19. The catheter according to claim 18, wherein the catheter is continuous from the side port to the side port. 20. The guide wire removal means is a slit, and the slit has a proximal opening. 19. The perforation line according to claim 18, which is discontinuous and forms a perforation line from the side port to the side port. catheter. 21. The guide wire removal means reduces the strength of the wall of the guide wire lumen. 17. The guide wire can be removed through this region. catheter. 22. A second side port that communicates with the interior of the guidewire lumen. The catheter according to claim 18. 23. The proximal opening is located on the side of the catheter at a point distal to the proximal end of the catheter. and the catheter has a guide wire lumen at the proximal end of the catheter. a guidewire adapter that communicates with the guidewire at the proximal portion of the catheter. into the guidewire lumen through either the ear adapter or the proximal opening. 17. The catheter according to claim 16, into which a guide wire can be inserted. 24. Can be connected to the catheter shaft and accommodates the guidewire. a connector body with a channel formed therein that can be inserted into the catheter shaft; a connector and a guidewire in place within the catheter shaft; means for allowing the connector to move laterally and out of the connector; Guide wire connector for catheters that extend. 25. The enabling means may include a longitudinally extending groove formed in the connector. 25. The connector of claim 24, comprising: 26. The enabling means is separable in the longitudinal direction of the connector and 25. The connector of claim 24, further comprising a split member that is removable from the connector. 27. A catheter used in open medical procedures along with a guide wire, the guide wire being a catheter shaft with a Dwyer lumen, the catheter having a proximal an outer wall of the guidewire lumen; forming part of the outer wall of the ear lumen and extending distally from the proximal end of the catheter; a longitudinally removable strip that is attached to the catheter and is removed from the catheter; the guide wire lumen while maintaining the longitudinal position of the guide wire. a guide wire comprising said strip allowing said guide wire to be laterally removed from said guide wire; A catheter used in open medical procedures along with a catheter wire. 28. The strips are two areas with reduced strength extending in the longitudinal direction of the outer wall. 28. The catheter according to claim 27. 29. Each of the weakened regions is shaped parallel to the inner and outer sides of the outer wall. 29. The catheter of claim 28, including a groove formed in the catheter. 30. the strip is formed of a different material than the rest of the catheter shaft; 28. The catheter according to claim 27. 31. 28. The catheter of claim 27, wherein the strip includes a longitudinally extending reinforcing member. -tel. 32. 32. The catheter of claim 31, wherein the reinforcing member is inside the strip. 33. having a proximal end and a distal end, first and second lumens; a lumen having an outer wall and a guidewire extending through the first lumen. a catheter shaft capable of accommodating; attached to the proximal end of said catheter; communicates with the first lumen and allows a guide wire to be inserted into the first lumen. a guidewire connector; and a guidewire connector for adjusting the longitudinal position of the guidewire into the patient. The guide wire is moved laterally through the outer wall of the first lumen while maintaining and means for enabling removal. 34. The guidewire connector is at least partially connected to the catheter shaft. 34. The catheter of claim 33, wherein the catheter is removable from the catheter. 35. At least a portion of the guidewire connector is laterally disposed from the first lumen. 34. The catheter of claim 33, wherein the catheter is removable. 36. At least a portion of the guidewire connector is located near the catheter shaft. 36. The guidewire according to claim 35, wherein the catheter. 37. The other part of the guidewire connector was left on the catheter shaft. Leave the guidewire connector laterally through the outer wall of the guidewire lumen. 37. The catheter of claim 36, wherein the guide wire is removed in the direction of the guide wire. 38. a catheter shaft having a proximal portion and a distal end; an angioplasty balloon attached to a shaft; extending through said shaft and extending anteriorly; a balloon inflation lumen communicating with the interior of the balloon; a steerable guidewire extending through the shaft and the balloon; A guidewire lumen that accommodates a catheter, has an outer wall, and has a Proximally for inserting the guidewire into the lumen at a point that would normally be outside the patient's body the guidewire through the opening and the sidewall of the guidewire lumen. A side port that serves as a passage for insertion into the menstrual membrane, and is located far from the proximal opening. said side port located at a point that would normally be inside the patient's body during side use; the guidewire lumen extending from the proximal opening to the side port; Insert the guidewire inside the guidewire lumen onto the outer wall of the guidewire lumen. Allowing the guidewire to move laterally from the guidewire lumen through the - a guide wire removal means provided on the outer wall of the lumen; Angioplasty catheter with. 39. The side port is located proximal to the balloon adjacent to the balloon. 39. The catheter of claim 38. 40. The side port is located within about 35 cm proximal to the balloon. 39. The catheter of claim 38. 41. The catheter according to claim 38, wherein the guide wire removal means is a slit. Le. 42. The slit is continuous from the proximal opening to the side port. 42. A catheter according to claim 41. 43. The slit is a section forming a perforation from the proximal opening to the side port. 42. The catheter of claim 41, which is continuous. 44. The guide wire removal means reduces the strength of the wall of the guide wire lumen. 39. The guide wire can be removed through this region. catheter. 45. A second side port that communicates with the interior of the guidewire lumen. The catheter according to claim 38. 46. an irrigation opening communicating with the interior of the guidewire lumen, the side 39. The perfusion opening of claim 38, wherein the perfusion opening is located between a port and the balloon. catheter. 47. The proximal opening has a “Y-shaped” connector with a shaft portion and a side portion. , a balloon inflation lumen extends through this shaft section and Insertion into the guidewire lumen is through the side section, with at least one The second section can be removed from the catheter shaft and the guide threaded through the connector. The guide wire that extends into the Dwyer lumen is used as a guide wire removal means. 39. The catheter of claim 38, which is thus removable. 48. The connector can be divided longitudinally, and at least a portion thereof can be connected to a catheter. 48. The catheter of claim 47, wherein the catheter is removable from the shaft. 49. The connector connects first and second longitudinal sides of the catheter shaft. two longitudinally divisible portions having on separate sides, said portions having said first are hinged on the longitudinal side of the second longitudinal side, and are split on the second longitudinal side. 48. The catheter of claim 47, wherein the catheter is operably coupled. 50. In intravascular catheters, having a proximal end and a distal end, the portion of the catheter including the distal end being in use. a catheter system typically located within the patient's body, and the proximal end is typically external to the patient's body; With shaft; a guidewire extending through the shaft and housing a steerable guidewire; a lumen, the outer wall and the proximal end of the shaft having a guidewire attached thereto; a proximal opening for insertion into the lumen; ; from the proximal opening distally to the point where the catheter would normally be inside the patient's body. Extend the guidewire into the guidewire lumen guide to allow lateral movement from the guidewire lumen through the outer wall of the An intravascular catheter comprising: means formed in the outer wall of the Dwyer lumen. 51. The catheter according to claim 50, wherein the guide wire removal means is a slit. Le. 52. The guidewire passes through the outer wall of the lumen and the side of the catheter shaft. a side port for passage of the guidewire into the lumen through the lumen; , when the catheter is used distal to the proximal opening, typically within the patient's body. 51. The catheter of claim 50, wherein the side port is located in the opposite direction. 53. The guide wire removal means is a slit, and the slit has a proximal opening. 53. The catheter of claim 52, wherein the catheter is continuous from the side port to the side port. 54. The guide wire removal means is a slit, and the slit has a proximal opening. 53. The perforation line of claim 52 is discontinuous, forming a perforation line from the side port to the side port. catheter. 55. The guide wire removal means reduces the strength of the wall of the guide wire lumen. 51. The guide wire can be removed through this region. catheter. 56. A second side port that communicates with the interior of the guidewire lumen. 53. The catheter according to claim 52. 57. The proximal opening is located on the side of the catheter at a point distal to the proximal end of the catheter. and the catheter has a guide wire lumen at the proximal end of the catheter. a guidewire adapter that communicates with the guidewire at the proximal portion of the catheter. into the guidewire lumen through either the ear adapter or the proximal opening. 51. The catheter of claim 50, into which a guide wire can be inserted. 58. A catheter with a guide wire for use in the body of an animal, comprising at least a catheter shaft having a proximal end and a distal end from which two lumens extend; at least two arms surrounding at least a portion of the proximal end of the catheter shaft; a "Y-shaped" connector having a A channel is formed for the entry of the lumen into the other arm, and the other arm has a channel for the entry of the An entry channel is formed, and the "Y" connector is aligned along a longitudinal line. at least two split members separably coupled together; Upon separation, the "Y" connector connects the proximal end portion of the catheter shaft. A catheter with a guide wire that is not surrounded at all. 59. When the splitting members are separated, one of the splitting members is separated from the catheter shaft. 59. The catheter of claim 58, wherein the catheter is completely removable. 60. When the splitting member is separated, the catheter is removed from one arm of the connector. An elongated object extending into the lumen of the shaft may be removed during removal of the connector. completely removing the connector from the catheter shaft, leaving it within the lumen; 59. The catheter according to claim 58. 61. A catheter removal method during a procedure requiring angioplasty, which A guide wire passing through the guide wire lumen from the distal opening to the distal opening. 14. A catheter according to claim 1 or 13 having positioning the proximal end within the patient with the proximal end extending out of the proximal opening; Hold the proximal end of the guidewire until the entire catheter exits the patient and guide into the guidewire removal means until a portion of the wire is exposed at the distal end of the catheter. Therefore, move the guide wire laterally and out of the guide wire lumen. This allows the guidewire to be inserted into the patient while the catheter is removed from the patient. maintaining the position; Hold the exposed portion of the guidewire and insert the catheter from the proximal end of the guidewire. A method for removing a catheter, the method comprising: removing the catheter. 62. A catheter removal method during a procedure requiring angioplasty, which said guide from one of the distal opening and the guidewire adapter to its distal opening. 58. The catheter of claim 57, having a guide wire passing through the Dwyer lumen. and positioning the catheter within a patient; Remove the guide wire while maintaining the guide wire position, and - back into the lumen and through the proximal opening and the other side of the guidewire adapter. A method for removing a catheter, comprising: ejecting the distal end of the catheter. 63. a catheter shaft having a proximal portion and a distal end; an angioplasty balloon on the distal end; an angioplasty balloon extending along the shaft and within the balloon; a balloon inflation lumen communicating with the section; a steerable guidewire extending through the shaft and the balloon; a guidewire lumen containing an outer wall, the guidewire lumen having an outer wall and extending through the outer wall; When using the catheter, the proximal side port is normally located outside the patient's body. in place and the distal port is normally inside the patient when using the catheter. said proximal and distal guidewire lumens in place; Each of the side side ports connects the guide wire through the outer wall of the guide wire lumen. An angioplasty catheter that provides passage for the guidewire into the wire lumen. 64. formed in the outer wall of the guidewire lumen and from the proximal side port. a guide wire extending to the distal side ports and between the side ports; Insert the guide wire inside the guide wire lumen through the outer wall of the guide wire lumen. further includes a guidewire removal means that allows for lateral movement from the ear lumen. 64. The catheter of claim 63, comprising: