Patent US5454790A successfully refreshed from Google Patents.
US5454790A
Expired / Lapsed
US
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Method and apparatus for catheterization access
Assignee: Covidien LP
•
Filing: 1994-05-09
•
Granted: 1995-10-03
•
Expires: 2014-05-09
Abstract
Abstract An apparatus and method for percutaneous placement of access tubes, such as feeding and drainage tubes, vascular catheters, and the like, comprises an elastic access tube in an internal stylet. The stylet is received within a central lumen of the access tube and is used to axially elongate the tube, resulting in a reduced diameter. In a first embodiment, the diameter of the access tube is reduced sufficiently so that it can be placed through a relatively narrow penetration and so that it will radially expand by an amount sufficient to cause a tight anchor and seal against the penetration when the stylet is removed. In a second embodiment, the stylet has a sharpened distal tip which extends beyond the distal end of the access tube when in its axially extended configuration. The sharpened tip allows self-introduction of the assembly of access tube and stylet. In a third embodiment, a distal portion of the access tube is covered with a lubricous sheath. The lubricous sheath facilitates use of the assembly in combination with a dilation member which is radially expanded when the assembly of access tube and stylet is introduced therethrough.
Inventors
- 👤 William R. Dubrul
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 23:30
CPC Classifications
A; A61; A61M; A61M25/00; A61M25/01; A61M25/0102; A61M25/02; A61M25/04; A61M25/06; A61M25/0662; A61M25/0668; A61B; A61B17/00; A61B17/34; A61B17/3474
Claims Analysis
Total Claims: 75
Claim 1
Independent Claim
114 words
An access tube assembly comprising: an elastic access tube having a proximal end, a distal end, and a central lumen extending from the proximal end to the distal end, wherein the tube has an intrinsic length and intrinsic outer diameter when not restrained under axial tension or radial compression; a stylet receivable within the central lumen and coupled to the distal end of the elastic access tube; and a removable sheath covering at least a distal portion of the elastic tube and having an inner diameter which is less than the intrinsic outer diameter of the elastic tube; wherein the elastic access tube is releasably restrained so as to have a reduced outer diameter.
Claim 2
Dependent Claim
114 words
An access tube assembly comprising: an elastic access tube having a proximal end, a distal end, and a central lumen extending from the proximal end to the distal end, wherein the tube has an intrinsic length and intrinsic outer diameter when not restrained under axial tension or radial compression; a stylet receivable within the central lumen and coupled to the distal end of the elastic access tube; and a removable sheath covering at least a distal portion of the elastic tube and having an inner diameter which is less than the intrinsic outer diameter of the elastic tube; wherein the elastic access tube is releasably restrained so as to have a reduced outer diameter.
Claim 3
Dependent Claim
21 words
An access tube assembly as in claim 1, wherein the elastic access tube has an expandable anchor near its distal end.
Claim 4
Dependent Claim
33 words
An access tube assembly as in claim 2, wherein the expandable anchor is a malecot structure which is elongated and collapsed when the stylet engages the distal end of the elastic access tube.
Claim 5
Dependent Claim
16 words
An access tube assembly as in claim 2, wherein the expandable anchor is an inflatable balloon.
Claim 6
Dependent Claim
37 words
An access tube assembly as in claim 1, wherein the elastic access tube has a closed distal tip which is engaged by the stylet and at least one side port located proximally of the closed distal tip.
Claim 7
Dependent Claim
31 words
An access tube assembly as in claim 5, wherein the side port is formed by one or more axial slits which open when the access tube is not under axial tension.
Claim 8
Dependent Claim
57 words
An access tube assembly as in claim 1, further comprising a latch mechanism on the stylet for releasably securing the proximal end of the access tube, wherein the latch mechanism is located at a distance from a distal end of the stylet which is at least 20% longer than the intrinsic length of the elastic access tube.
Claim 9
Dependent Claim
40 words
An access tube assembly as in claim 7, wherein the elastic access tube has an intrinsic length in the range from 2 cm to 20 cm and an intrinsic outer diameter in the range from 2 mm to 8 mm.
Claim 10
Dependent Claim
54 words
An access tube assembly as in claim 8, further comprising a fixture on the proximal end of the elastic access tube, which fixture is secured by the latch mechanism and the latch mechanism is located at a distance from the distal end of the stylet in the range from 3 cm to 40 cm.
Claim 11
Dependent Claim
29 words
An access tube assembly as in claim 1, wherein the removable sheath is a polymeric tube having an inside diameter in the range from 2 mm to 8 mm.
Claim 12
Dependent Claim
30 words
An access tube assembly as in claim 10, wherein the polymeric tube is axially scored or split on at least one side to facilitate splitting and removing of the sheath.
Claim 13
Dependent Claim
126 words
An access tube assembly comprising: an elastic access tube having a proximal end, a distal end, and a central lumen extending from the proximal end to the distal end, wherein the tube has an intrinsic length and intrinsic outer diameter when not under axial tension or radial compression, and a reduced outer diameter when under an axial tension; and a stylet having a proximal end and a distal end and being receivable within the central lumen of the elastic access tube, wherein the distal end of the stylet is detachably securable to the distal end of the access tube and is capable of applying the axial tension to the elastic tube, and the stylet includes a penetration element at its distal end for facilitating percutaneous introduction.
Claim 14
Dependent Claim
126 words
An access tube assembly comprising: an elastic access tube having a proximal end, a distal end, and a central lumen extending from the proximal end to the distal end, wherein the tube has an intrinsic length and intrinsic outer diameter when not under axial tension or radial compression, and a reduced outer diameter when under an axial tension; and a stylet having a proximal end and a distal end and being receivable within the central lumen of the elastic access tube, wherein the distal end of the stylet is detachably securable to the distal end of the access tube and is capable of applying the axial tension to the elastic tube, and the stylet includes a penetration element at its distal end for facilitating percutaneous introduction.
Claim 15
Dependent Claim
21 words
An access tube assembly as in claim 12, wherein the elastic access tube has an expandable anchor near its distal end.
Claim 16
Dependent Claim
33 words
An access tube assembly as in claim 13, wherein the expandable anchor is a malecot structure which is elongated and collapsed when the stylet engages the distal end of the elastic access tube.
Claim 17
Dependent Claim
16 words
An access tube assembly as in claim 13, wherein the expandable anchor is an inflatable balloon.
Claim 18
Dependent Claim
57 words
An access tube assembly as in claim 12, further comprising a latch mechanism on the stylet for releasably securing the proximal end of the access tube, wherein the latch mechanism is located at a distance from a distal end of the stylet which is at least 20% longer than the intrinsic length of the elastic access tube.
Claim 19
Dependent Claim
40 words
An access tube assembly as in claim 16, wherein the elastic access tube has an intrinsic length in the range from 2 cm to 20 cm and an intrinsic outer diameter in the range from 2 mm to 8 mm.
Claim 20
Dependent Claim
54 words
An access tube assembly as in claim 17, further comprising a fixture on the proximal end of the elastic access tube, which fixture is secured by the latch mechanism and the latch mechanism is located at a distance from the distal end of the stylet in the range from 3 cm to 40 cm.
Claim 21
Dependent Claim
34 words
An access tube assembly as in claim 12, wherein the penetration element comprises a sharpened distal tip which extends distally beyond the access tube when the stylet is fully received within the access tube.
Claim 22
Dependent Claim
35 words
An access tube assembly as in claim 19, wherein the stylet includes a tapered cylinder at its distal end which tapered cylinder defines an annular recess for receiving the distal end of the access tube.
Claim 23
Dependent Claim
135 words
An access tube assembly comprising: an elongate dilation member including a radially expandable tubular body having a proximal end, a distal end, an axial lumen, and a penetration member at the distal end; an elastic access tube having a proximal end, distal end, and a central lumen extending from the proximal end to the distal end, wherein the tube has an intrinsic length and intrinsic outer diameter when not under axial tension or radial compression; and a stylet receivable within the central lumen and engagable against the distal end of the elastic access tube, wherein a tapered distal end is formed on the elastic access tube when under axial tension from the stylet, whereby the tapered distal end facilitates introduction of the access tube and stylet through the axial lumen of the elongate dilation member.
Claim 24
Dependent Claim
135 words
An access tube assembly comprising: an elongate dilation member including a radially expandable tubular body having a proximal end, a distal end, an axial lumen, and a penetration member at the distal end; an elastic access tube having a proximal end, distal end, and a central lumen extending from the proximal end to the distal end, wherein the tube has an intrinsic length and intrinsic outer diameter when not under axial tension or radial compression; and a stylet receivable within the central lumen and engagable against the distal end of the elastic access tube, wherein a tapered distal end is formed on the elastic access tube when under axial tension from the stylet, whereby the tapered distal end facilitates introduction of the access tube and stylet through the axial lumen of the elongate dilation member.
Claim 25
Dependent Claim
68 words
An access tube assembly as in claim 21, wherein the elongate dilation member further includes a removable sheath formed over the radially expandable tubular body, wherein the sheath covers the tubular body while the elongate dilation member is percutaneously advanced and can thereafter be removed to permit radial expansion of the tubular body as the tapered end of the elastic access tube is advanced through said tubular body.
Claim 26
Dependent Claim
22 words
An access tube assembly as in claim 21, wherein the radially expandable tubular body is an elastomeric tube or a tubular braid.
Claim 27
Dependent Claim
45 words
An access tube assembly as in claim 21, wherein the penetration member comprises an elongate penetrating element having a sharpened distal tip, which element is removedly received within the axial lumen of the radially expandable tubular body with the sharpened distal tip extending distally therefrom.
Claim 28
Dependent Claim
22 words
An access tube assembly as in claim 21, wherein the elongate dilator member further includes an expandable anchor near its distal end.
Claim 29
Dependent Claim
21 words
An access tube assembly as in claim 21, wherein the elastic access tube has an expandable anchor near its distal end.
Claim 30
Dependent Claim
33 words
An access tube assembly as in claim 26, wherein the expandable anchor is a malecot structure which is elongated and collapsed when the stylet engages the distal end of the elastic access tube.
Claim 31
Dependent Claim
16 words
An access tube assembly as in claim 26, wherein the expandable anchor is an inflatable balloon.
Claim 32
Dependent Claim
37 words
An access tube assembly as in claim 21, wherein the elastic access tube has a closed distal tip which is engaged by the stylet and at least one side port located proximally of the closed distal tip.
Claim 33
Dependent Claim
31 words
An access tube assembly as in claim 29, wherein the side port is formed by one or more axial slits which open when the access tube is not under axial tension.
Claim 34
Dependent Claim
57 words
An access tube assembly as in claim 21, further comprising a latch mechanism on the stylet for releasably securing the proximal end of the access tube, wherein the latch mechanism is located at a distance from the distal end of the stylet which is at least 20% longer than the intrinsic length of the elastic access tube.
Claim 35
Dependent Claim
40 words
An access tube assembly as in claim 31, wherein the elastic access tube has an intrinsic length in the range from 2 cm to 20 cm and an intrinsic outer diameter in the range from 2 mm to 8 mm.
Claim 36
Dependent Claim
54 words
An access tube assembly as in claim 32, further comprising a fixture on the proximal end of the elastic access tube, which fixture is secured by the latch mechanism and the latch mechanism is located at a distance from the distal end of the stylet in the range from 3 cm to 40 cm.
Claim 37
Dependent Claim
29 words
An access tube assembly as in claim 21, wherein the removable sheath is a polymeric tube having an inside diameter in the range from 2 mm to 8 mm.
Claim 38
Dependent Claim
30 words
An access tube assembly as in claim 34, wherein the polymeric tube is axially scored or slit on at least one side to facilitate splitting and removing of the sheath.
Claim 39
Independent Claim
83 words
A method for introducing and anchoring an access tube in a tissue penetration, said method comprising: introducing the access tube through the penetration to a target location while the access tube is under sufficient axial tension so that the outer diameter of the tube is at least 10% less than the intrinsic diameter when the tube is not under axial tension; and releasing the axial tension so that the diameter of the tube expands and seals radially against peripheral tissue along the penetration.
Claim 40
Independent Claim
83 words
A method for introducing and anchoring an access tube in a tissue penetration, said method comprising: introducing the access tube through the penetration to a target location while the access tube is under sufficient axial tension so that the outer diameter of the tube is at least 10% less than the intrinsic diameter when the tube is not under axial tension; and releasing the axial tension so that the diameter of the tube expands and seals radially against peripheral tissue along the penetration.
Claim 41
Dependent Claim
41 words
A method as in claim 36, wherein the target location is a hollow body organ selected from the group consisting of the stomach, the intestines, the kidney, the gall bladder, chest, lungs, peritoneum, blood vessel, and bladder, or is a cyst.
Claim 42
Dependent Claim
18 words
A method as in claim 36, wherein the access tube is introduced in a previously formed tissue penetration.
Claim 43
Dependent Claim
18 words
A method as in claim 36, wherein the access tube is introduced simultaneously with forming the tissue penetration.
Claim 44
Dependent Claim
35 words
A method as in claim 39, wherein the tissue penetration is formed by advancing a penetrating element secured to a distal end of the axially tensioned access tube through the tissue to the target location.
Claim 45
Dependent Claim
47 words
A method as in claim 36, wherein the tissue penetration has an effective diameter which is less than the intrinsic diameter of the access tube and wherein sufficient axial tension is placed on the access tube to reduce the outside diameter to less than said effective diameter.
Claim 46
Dependent Claim
64 words
A method as in claim 41, wherein the effective diameter of the tissue penetration is in the range from 1 mm to 6 mm, the intrinsic diameter of the access tube is in the range from 2 mm to 8 mm, and the outer diameter of the access tube when introduced under axial tension is in the range from 2 mm to 8 mm.
Claim 47
Dependent Claim
34 words
A method as in claim 36, wherein the access tube is covered with a sheath while being introduced through the penetration, further comprising removing the sheath to permit radial expansion of the access tube.
Claim 48
Dependent Claim
22 words
A method as in claim 43, wherein the sheath is axially scored or slit along at least one side to facilitate removal.
Claim 49
Dependent Claim
13 words
A method as in claim 36, further comprising dilating the tissue being penetrated.
Claim 50
Dependent Claim
18 words
A method as in claim 45, wherein the tissue penetration is dilated prior to introducing the access tube.
Claim 51
Dependent Claim
18 words
A method as in claim 46, wherein the tissue penetration is dilated as the access tube is introduced.
Claim 52
Dependent Claim
27 words
A method as in claim 36, further comprising expanding an anchor near a distal end of the access tube on a posterior side of the tissue penetration.
Claim 53
Dependent Claim
25 words
A method as in claim 48, wherein the anchor is a malecot structure which expands as the axial tension on the access tube is released.
Claim 54
Dependent Claim
22 words
A method as in claim 48, wherein the anchor is a balloon which is inflated after the access tube has been introduced.
Claim 55
Dependent Claim
23 words
A method as in claim 36, further comprising axially extending the access tube over an internal stylet to provide the sufficient axial tension.
Claim 56
Dependent Claim
32 words
A method as in claim 51, further comprising removedly securing a proximal end of the access tube to the stylet to maintain the axial tension while the access tube is being introduced.
Claim 57
Dependent Claim
31 words
A method as in claim 52, wherein releasing the axial tension comprises releasing the proximal and of the access tube from the stylet whereby the diameter of the access tube increases.
Claim 58
Independent Claim
112 words
A method for introducing and anchoring an access tube in a tissue penetration, said method comprising: penetrating an elongate dilation member through tissue to a target location; introducing the access tube through a lumen of the elongate dilation member while the access tube is under sufficient axial tension so that the outer diameter of the tube is at least 10% less than the intrinsic diameter when the tube is not under stress; removing the elongate dilation member to leave the access tube in the tissue penetration; and releasing the axial tension so that the diameter of the tube expands so as to dilate and seal radially against peripheral tissue along the penetration.
Claim 59
Independent Claim
112 words
A method for introducing and anchoring an access tube in a tissue penetration, said method comprising: penetrating an elongate dilation member through tissue to a target location; introducing the access tube through a lumen of the elongate dilation member while the access tube is under sufficient axial tension so that the outer diameter of the tube is at least 10% less than the intrinsic diameter when the tube is not under stress; removing the elongate dilation member to leave the access tube in the tissue penetration; and releasing the axial tension so that the diameter of the tube expands so as to dilate and seal radially against peripheral tissue along the penetration.
Claim 60
Dependent Claim
41 words
A method as in claim 54, wherein the target location is a hollow body organ selected from the group consisting of the stomach, the intestines, the kidney, the gall bladder, chest, lungs, peritoneum, blood vessel, and bladder, or is a cyst.
Claim 61
Dependent Claim
25 words
A method as in claim 54, wherein the access tube is introduced through the dilation member substantially immediately after the tissue penetration has been formed.
Claim 62
Dependent Claim
59 words
A method as in claim 54, wherein the outer diameter of the access tube when introduced under tension is larger than the lumen diameter of the elongate dilation member, whereby the diameter of the dilation member is radially expanded as the access tube is advanced from a proximal end of the member through a distal end of the member.
Claim 63
Dependent Claim
65 words
A method as in claim 57, wherein the lumen diameter of the dilation member is in the range from 1 mm to 6 mm and the outer diameter of the access tube when introduced under axial tension is in the range from 2 mm to 8 mm, and the intrinsic diameter of the access tube is in the range from 5 mm to 8 mm.
Claim 64
Dependent Claim
38 words
A method as in claim 54, wherein the access tube is covered with a sheath while being introduced through the lumen of the dilation member, further comprising removing the sheath to permit redial expansion of the access tube.
Claim 65
Dependent Claim
20 words
A method as in claim 59, wherein the sheath is axially scored along at least one side to facilitate removal.
Claim 66
Dependent Claim
27 words
A method as in claim 54, further comprising expanding on anchor near a distal end of the access tube on a posterior side of the tissue penetration.
Claim 67
Dependent Claim
25 words
A method as in claim 61, wherein the anchor is a malecot structure which expands as the axial tension on the access tube is released.
Claim 68
Dependent Claim
22 words
A method as in claim 61 wherein the anchor is a balloon which is inflated after the access tube has been introduced.
Claim 69
Dependent Claim
23 words
A method as in claim 54, further comprising axially extending the access tube over an internal stylet to provide the sufficient axial tension.
Claim 70
Dependent Claim
32 words
A method as in claim 64, further comprising removably securing a proximal end of the access tube to the stylet to maintain the axial tension while the access tube is being introduced.
Claim 71
Dependent Claim
23 words
A method as in claim 65, wherein releasing the axial tension comprises releasing the proximal end of the access tube from the stylet.
Claim 72
Dependent Claim
118 words
An access tube assembly comprising: an elastic access tube having a proximal end, a distal end, and a radially sealed central lumen extending from the proximal end to the distal end, wherein the tube has an intrinsic length and intrinsic outer diameter when not restrained under an axial tension or a radial compression; a stylet receivable within the central lumen and coupled to the distal end of the elastic access tube; and a removable sheath covering at least a distal portion of the elastic tube and having an inner diameter which is less than the intrinsic outer diameter of the elastic tube; wherein the elastic access tube is releasably restrained so as to have a reduced outer diameter.
Claim 73
Dependent Claim
118 words
An access tube assembly comprising: an elastic access tube having a proximal end, a distal end, and a radially sealed central lumen extending from the proximal end to the distal end, wherein the tube has an intrinsic length and intrinsic outer diameter when not restrained under an axial tension or a radial compression; a stylet receivable within the central lumen and coupled to the distal end of the elastic access tube; and a removable sheath covering at least a distal portion of the elastic tube and having an inner diameter which is less than the intrinsic outer diameter of the elastic tube; wherein the elastic access tube is releasably restrained so as to have a reduced outer diameter.
Claim 74
Dependent Claim
25 words
An access tube assembly as claimed in claim 67, wherein the elastic access tube is releasably restrained under the radial compression by the removable sheath.
Claim 75
Dependent Claim
24 words
An access tube assembly as claimed in claim 67, wherein the elastic access tube is releasably restrained under the axial tension by the stylet.
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