Delivery of thrombolytic agent through actuation member of thrombus retrieval device

• US 10,182,834 B2
• Filed: 01/08/2016
• Issued: 01/22/2019
• Est. Priority Date: 01/08/2015
• Status: Active Grant

• Current Assignee: Cook Incorporated (Cook Group Incorporated), Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Inventors: Merk, James C, Puckett, Dean R, Voorhies, Darin J, Mayle, Brent A, Milner, Keith R
• Primary Examiner(s): Nguyen, Victor
• Application Number:
  US14/991,362
• Publication Number:
  US 20160199080A1
• Time in Patent Office: 1,110 Days
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22039 eccentric
• CPC Class Codes: A61B 2017/22079 with suction of debris
• CPC Class Codes: A61B 2017/22084 stone- or thrombus-dissolving
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop

Abstract

A method of treating a thrombus is provided wherein a device is advanced to the vicinity of the thrombus, a thrombolytic agent is applied to the thrombus, and an expandable basket of the device is expanded to capture at least a portion of the thrombus within the expandable basket. The device includes a catheter having a distal portion, a lumen and a plurality of openings on the outer surface of the catheter, through which the thrombolytic agent is supplied. The device further includes a sheath and may include a collar which assists in expanding the expandable basket as the sheath is moved relative to the catheter.

Claims

1. A method of treating a thrombus, comprising:

advancing a device to the vicinity of the thrombus, wherein the device comprises a sheath having a lumen, a catheter disposed within the lumen, the catheter having an agent lumen, a distal portion, and a plurality of openings in fluid communication with the agent lumen, the openings being arranged on an outer surface of the catheter, and an expandable basket arranged on the outer surface of the catheter;

supplying a thrombolytic agent to the agent lumen and applying the thrombolytic agent to the thrombus through the plurality of openings on the outer surface of the catheter;

positioning the basket alongside the thrombus; and

moving the catheter relative to the sheath to expand the expandable basket from the collapsed position after positioning the basket alongside the thrombus and capture at least a portion of the thrombus within the expandable basket.

2. The method of claim 1, wherein the expandable basket further comprises a covering coupled to a distal portion of the expandable basket.

3. The method of claim 1, further comprising retracting the device with the portion of the thrombus captured in the expandable basket while maintaining a relative position of the device with respect to the catheter, such that the expandable basket remains in an expanded configuration.

4. The method of claim 3, further comprising,

retracting the device such that the portion of the thrombus is in the vicinity of an aspiration catheter, and

moving the device relative to the catheter to radially contract the expandable basket and release the portion of the thrombus.

5. The method of claim 1, wherein the device is advanced through a portion of the thrombus so that at least one of the plurality of openings is positioned inside the thrombus.

6. The method of claim 5, wherein the plurality of openings are arranged circumferentially about the outer surface of the catheter so that the thrombolytic agent is dispersed substantially around an entire circumference of the catheter.

7. The method of claim 1, wherein the device is advanced distally beyond the portion of the thrombus such that at least one of the openings is aligned with the thrombus.

8. The method of claim 7, wherein the plurality of openings are arranged linearly on the catheter such that the thrombolytic agent is dispersed around only a portion of the circumference of the catheter.

9. The method of claim 1, wherein the expandable basket further comprises a covering coupled to a proximal portion of the expandable basket.

10. The method of claim 1, wherein the catheter further comprises a wire guide which passes through the agent lumen.

11. The method of claim 10, wherein the catheter further comprises a ring projecting inwardly from a wall of the agent lumen at or near the distal portion of the catheter, configured to receive the wire guide.

12. The method of claim 1, wherein the catheter further comprises a wire guide within a wire guide lumen, wherein the wire guide lumen is outside of the agent lumen.

13. The method of claim 1, wherein a proximal end of the expandable basket is coupled to the sheath and a distal end of the expandable basket is coupled to the distal portion of the catheter.

14. The method of claim 1, further comprising a collar encircling a portion of the catheter and having a proximal surface, wherein a proximal end of the expandable basket is coupled to the collar, and a distal end of the expandable basket is coupled to the distal portion of the catheter.

15. The method of claim 14, further comprising advancing the sheath over the catheter after the catheter, collar, and expandable basket have been advanced, wherein the sheath is advanced to engage with the proximal surface of the collar.

16. The method of claim 14, wherein the thrombolytic agent is applied while the expandable basket is being expanded.

17. The method of claim 1, further comprising a collar encircling a portion of the catheter and having a distal surface, wherein a proximal end of the expandable basket is coupled to the sheath, and a distal end of the expandable basket is coupled to the collar.

18. The method of claim 17, further comprising advancing the catheter in the vicinity of the thrombus before the sheath, collar, and expandable basket have been advanced, wherein the distal surface of the collar is configured to engage with a proximal surface of the distal portion of the catheter.

19. The method of claim 17, wherein the expandable basket is heatset in an elongated configuration so that the expandable basket will expand only when compressed by relative movement between the sheath and the collar.

20. The method of claim 1, wherein expansion of the expandable basket and capture of the portion of the thrombus occur simultaneously.

21. A method of treating a thrombus, comprising:

advancing a device to the vicinity of the thrombus, wherein the device comprises a sheath having a lumen, a catheter disposed within the lumen, the catheter having an agent lumen, a distal portion, and a plurality of openings in fluid communication with the agent lumen, the openings being arranged on an outer surface of the catheter, and an expandable basket arranged on the outer surface of the catheter, the expandable basket comprising a plurality of wires;

supplying a thrombolytic agent to the agent lumen and applying the thrombolytic agent to the thrombus through the plurality of openings on the outer surface of the catheter;

positioning the basket alongside the thrombus; and

expanding the expandable basket from the collapsed position after positioning the basket alongside the thrombus, such that at least a portion of the plurality of wires pass through the thrombus.

22. The method of claim 21, wherein the device is advanced around the thrombus.

23. The method of claim 21, wherein the device is advanced through the thrombus.

24. The method of claim 21, further comprising applying additional thrombolytic agent to the thrombus wherein the wires of the expandable basket cannot pass through the thrombus.

25. The method of claim 21, further comprising dispersing the thrombolytic agent around the entire circumference of the catheter.

26. The method of claim 21, further comprising focusing the dispersion of the thrombolytic agent to a portion of the circumference of the catheter which faces the thrombus.