A new selective catheter with multidirectional controlled tip.

Abstract

The several guided catheters heretofore available all have the common feature of being controlled by means of a wire in the lumen of the catheter (1, 2, 4, 5). Flexion of the tip is produced in one direction, and the entire catheter must be rotated to obtain the desired position. We have been associated with the development and evaluation of a new type of catheter in which the controlling wires are incorporated in the wall of the catheter itself.2 This feature permits controlled flexion and rotation of the tip without rotating the rest of the catheter and without obstructing the lumen. The catheter tip is directed simply by manipulating a universal lever in the handle mechanism. Description of the Instrument The instrument consists of two parts, the catheter and the handle (Fig. 1). In the catheter itself, four evenly-spaced control wires are incorporated into the wall of the tubing and extend its entire length. These control the position and direction of the tip and give the catheter a squared cross-section. Distally, the wires attach to a minute stainless-steel rim molded into a polypropylene tip which is fused to a flexible and radiopaque distal portion of the catheter, 10 cm long. The main body of the catheter is made of a more rigid polyethylene tubing, ending with a Luer-Lok adapter. The four control wires are free to move in their channels. The proxima1 end of each wire emerges from the catheter in a protective spring sheath ending in a small plastic part to be attached to the handle. The handle, a square platform slotted at the corners to receive the four control wires of the catheter, is mounted on a ball joint and controlled by a lever free to swivel in all directions at varying radii. It can be maintained in any given position by friction. A Luer-Lok adapter distally attaches it to the catheter. Two proximal fittings are provided, a Luer-Lok adapter for injection of contrast material and a Touhy fitting for accommodation of the guide wire used during introduction of the catheter. The catheter is joined to the handle by the Luer fittings. The four control wires are clipped to the metal base-plate, and the cover is applied. A syringe containing saline is attached to the proximal Luer-Lok adapter. The total length of the catheter is 100 cm; that of the flexible tip is 10 cm. At the catheter tip the inner diameter is 0.035 inch and the outer diameter is 0.075 inch; at the proximal end the inner diameter is 0.060 inch and the outer diameter is 0.090 to 0.100 inch.