Method and apparatus for increasing blood flow through an obstructed blood vessel

• US 10,201,359 B2
• Filed: 11/08/2012
• Issued: 02/12/2019
• Est. Priority Date: 02/01/2006
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Fiorella, David, Woo, Henry
• Primary Examiner(s): Osinski, Bradley J
• Application Number:
  US13/672,496
• Publication Number:
  US 20130066348A1
• Time in Patent Office: 2,287 Days
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• 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 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22061 for spreading elements apart
• 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
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/320008 Scrapers
• CPC Class Codes: A61B 2017/320733 with a flexible cutting or scraping element, e.g. with a whip-like distal filament member
• CPC Class Codes: A61B 2017/320741 for stripping the intima or the internal plaque from a blood vessel, e.g. for endarterectomy
• CPC Class Codes: A61M 2025/1088 having special surface characteristics depending on material properties or added substances, e.g. for reducing friction
• CPC Class Codes: A61M 2025/1095 with perfusion means for enabling blood circulation while the balloon is in an inflated state or in a deflated state, e.g. permanent by-pass within catheter shaft
• CPC Class Codes: A61M 25/10 Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 25/1027 Making of balloon catheters
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

A method of increasing blood flow through an obstructed blood vessel includes providing an expandable member substantially made of a mesh having a plurality of interstices. The expandable member is inserted into the blood vessel, positioned within the blood vessel with the proximal member end upstream of the distal member end and the member body located radially adjacent at least a portion of an obstruction, and expanded to bring at least a portion of the member body into contact with the obstruction. An outward radial force is exerted on the obstruction to dislodge at least one fragment from the obstruction and to enhance blood flow through the blood vessel past the obstruction. The at least one fragment is passed through at least one interstice of the member body in the radial direction, and is selectively retained within the expandable member.

Claims

1. A method of removing an obstruction from a blood vessel with an expandable member that is attached to a delivery system, the expandable member having a proximal end, a distal end and a tubular body between the proximal end and the distal end, the tubular body being made of a mesh having a plurality of interstices, the method comprising the steps of:

positioning the tubular body of the expandable member radially adjacent to an obstruction within a blood vessel;

expanding the expandable member such that a portion of the tubular body comes into contact with a portion of the obstruction;

dislodging a portion of the obstruction to enhance blood flow through the blood vessel past the obstruction; and

removing the expandable member from the blood vessel while the expandable member retains at least a portion of the obstruction from the blood vessel;

wherein the step of removing the expandable member is performed with the expandable member in a fully expanded position.

2. The method of claim 1, wherein the expandable member is permanently attached to the delivery system.

3. The method of claim 1, wherein the expandable member is releasably attached to the delivery system.

4. The method of claim 1, wherein the dislodging step includes fracturing a portion of the obstruction.

5. The method of claim 4, wherein the removing step includes removing the fractured portion of the obstruction.

6. The method of claim 1, wherein the dislodging step includes extruding a portion of the obstruction.

7. The method of claim 6, wherein the removing step includes removing the extruded portion of the obstruction.

8. The method of claim 1, further comprising the step of increasing the blood flow rate in the blood vessel.

9. The method of claim 1, further comprising the step of chemically lysing the obstruction.

10. The method of claim 9, wherein the step of chemically lysing includes providing a pharmaceutical agent.

11. The method of claim 10, wherein the step of chemically lysing includes eluting the pharmaceutical agent from the expandable member.

12. The method of claim 10, wherein the step of chemically lysing includes providing the pharmaceutical agent via the delivery system.

13. The method of claim 1, wherein the expandable member is expanded radially.

14. The method of claim 1, wherein the expandable member is self-expanding.

15. The method of claim 1, wherein the expandable member is manually expanded.

16. The method of claim 1, further comprising the step of connecting at least a portion of the obstruction to the expandable member.

17. The method of claim 1, wherein the blood vessel is a cerebral blood vessel.

18. The method of claim 1, wherein the blood vessel is a blood vessel other than a cerebral blood vessel.

19. The method of claim 1, wherein the dislodging step occurs before the removing step.

20. The method of claim 1, wherein the dislodging step comprises separating a portion of the obstruction from the remainder of the obstruction.

21. The method of claim 1, wherein the dislodging a portion of the obstruction step includes at least a portion of the obstruction passing through at least one of the plurality of interstices.