Methods and systems for treatment of acute ischemic stroke

• US 10,569,049 B2
• Filed: 06/16/2017
• Issued: 02/25/2020
• Est. Priority Date: 12/23/2013
• Status: Active Grant

• Current Assignee: Route 92 Medical, Inc.
• Original Assignee: Route 92 Medical, Inc.
• Inventors: Garrison, Michi E., Chou, Tony M.
• Primary Examiner(s): Stransky, Katrina M
• Application Number:
  US15/625,135
• Publication Number:
  US 20170281204A1
• Time in Patent Office: 984 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 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/00991 Telescopic means
• 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 2017/22039 eccentric
• CPC Class Codes: A61B 2017/22042 Details of the tip of the guide wire
• CPC Class Codes: A61B 2017/22054 with two balloons
• CPC Class Codes: A61B 2017/22062 to be filled with liquid
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2017/22072 with an instrument channel, e.g. for replacing one instrument by the other
• CPC Class Codes: A61B 2017/22074 the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
• CPC Class Codes: A61B 2017/22079 with suction of debris
• CPC Class Codes: A61B 2017/22082 after introduction of a substance
• CPC Class Codes: A61B 2017/22084 stone- or thrombus-dissolving
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/2215 having an open distal end
• CPC Class Codes: A61B 2017/2217 : single wire changing shape to a gripping configuration
• CPC Class Codes: A61B 2017/320775 : Morcellators, impeller or propeller like means
• CPC Class Codes: A61B 2017/3484 : Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61B 2017/3486 : Balloon
• CPC Class Codes: A61B 2090/062 : penetration depth
• CPC Class Codes: A61F 2/013 : Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
• CPC Class Codes: A61M 2025/0004 : having two or more concentrically arranged tubes for forming a concentric catheter system
• CPC Class Codes: A61M 2025/0037 : characterized by lumina being arranged side-by-side
• CPC Class Codes: A61M 2025/0042 : Microcatheters, cannula or the like having outside diameters around 1 mm or less
• CPC Class Codes: A61M 2025/0175 : having telescopic features, interengaging nestable members movable in relations to one another
• CPC Class Codes: A61M 2025/0681 : Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
• CPC Class Codes: A61M 2025/1052 : for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2210/12 : Blood circulatory system
• CPC Class Codes: A61M 25/0023 : by the form of the lumen, e.g. cross-section, variable diameter
• CPC Class Codes: A61M 25/0041 : pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61M 25/0043 : characterised by structural features
• CPC Class Codes: A61M 25/0054 : with regions for increasing flexibility
• CPC Class Codes: A61M 25/0068 : Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
• CPC Class Codes: A61M 25/007 : Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: A61M 25/01 : Introducing, guiding, advancing, emplacing or holding catheters A61M25/10 takes precedence
• CPC Class Codes: A61M 25/0662 : Guide tubes
• CPC Class Codes: A61M 29/00 : Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00

Abstract

A system of devices for treating an artery includes an arterial access sheath adapted tointroduce an interventional catheter into an artery and an elongated dilator positionable within the internal lumen of the sheath body. The system also includes a catheter formed of an elongated catheter body sized and shaped to be introduced via a carotid artery access site into a common carotid artery through the internal lumen of the arterial access sheath. The catheter has an overall length and a distal most section length such that the distal most section can be positioned in an intracranial artery and at least a portion of the proximal most section is positioned in the common carotid artery during use.

Claims

1. A suction catheter system comprising:

a guide catheter comprising a tubular shaft with a central lumen having an inner diameter, a proximal end and a distal opening, and a proximal section operably connected with the proximal end of the tubular shaft and having fittings that connect to a suction device; and

a suction extension comprising a proximal portion, a suction tip comprising a distal opening and extending from the proximal portion in a distal direction, and a control structure connecting the proximal portion with the proximal section of the guide catheter, the suction tip having a distal inner diameter that is between about 0.035″ and

about 0.095″ and

the central lumen inner diameter is between about 0.065″ and

about 0.120″

,

wherein the proximal portion is configured to slide within the central lumen of the tubular shaft to change the relative position of the proximal portion within the central lumen and provide for at least a portion of the suction extension to extend outward from the distal opening of the tubular shaft,

wherein an effective seal is formed in an overlap region by a tight fit between a cylindrical outer surface of the proximal portion of the suction extension and a cylindrical inner surface of the central lumen of the guide catheter,

wherein a suction lumen is formed extending from the fitting configured to connect to the suction device through a portion of the central lumen, the proximal portion and the suction tip to the distal opening, and

wherein the suction tip has a first outer diameter and the cylindrical outer surface of the proximal portion has a second outer diameter, wherein the second outer diameter is larger than the first outer diameter.

2. The suction catheter system of claim 1, wherein the guide catheter has an outer diameter ranging from about 6 Fr to about 8 Fr.

3. The suction catheter system of claim 1, wherein the suction tip has an inner diameter that is between about 0.058″

and about 0.072″ and

the central lumen inner diameter is between about 0.074″ and

about 0.088″

.

4. The suction catheter system of claim 1, wherein the shaft of the guide catheter has a length from about 90 cm to about 120 cm and the suction tip has a length from about 10 cm to about 25 cm.

5. The suction catheter system of claim 1, wherein the suction tip comprises a plurality of constant diameter segments with a distal segment having a smaller inner diameter than a more proximal segment.

6. The suction catheter system of claim 1, wherein a flow rate of at least about 321 mL/min is established when an aspiration gauge pressure is applied by a syringe having a volume of at least 30 cc.

7. A method for performing a thrombectomy procedure with the suction catheter system of claim 1, the method comprising:

applying suction through the suction lumen of the suction catheter system positioned with the guide catheter extending into a vessel of a patient in a percutaneous configuration, to draw fluid into the distal opening of the suction tip to remove thrombus from the vessel.

8. The method of claim 7, further comprising positioning the guide catheter to extend into a carotid artery with the suction tip extending into a cerebral artery.

9. The method of claim 7, further comprising deploying a fiber based filter in the vessel distal to a clot, and drawing the fiber based filter in the proximal direction while suction is applied.

10. The method of claim 9, further comprising deploying a further medical device at the location of thrombus to disrupt the thrombus while the fiber based filter is deployed.

11. The suction catheter system of claim 1, wherein the first outer diameter extends between 10 cm and 25 cm.

12. The suction catheter system of claim 11, wherein the second outer diameter extends between 10% and 20% of the working length of the suction extension.

13. The suction catheter system of claim 1, further comprising a tapered transition section between the first outer diameter and the second outer diameter.

14. The suction catheter system of claim 13, wherein the tapered transition section extends between 3 mm and 10 mm in length.

15. A method for performing a medical procedure in a bodily vessel using a suction catheter system comprising a guide catheter and a suction extension slidably engaged with the guide catheter, the suction extension comprising a proximal portion configured to remain in a central lumen of the guide catheter and a suction tip extending in a distal direction from the proximal portion, the method comprising:

advancing the guide catheter into an internal carotid artery via a transfemoral access site of a patient;

tracking the suction tip to a location within a cerebral blood vessel by sliding the suction extension relative to the guide catheter;

forming a seal by a tight fit in an overlap region between a cylindrical outer surface of a region of the suction catheter and a cylindrical inner surface of the central lumen of the guide catheter so as to define a suction lumen formed by the central lumen of the guide catheter and a lumen if the suction catheter; and

applying suction at the proximal portion of the guide catheter through the suction lumen that extends to the proximal end of the guide catheter, wherein the suction is at least partially enabled by the seal.

16. The method of claim 15, wherein the tracking is performed by directing the suction tip over a guidewire.

17. The method of claim 15, further comprising deploying a fiber based filter extending in a distal direction from the suction tip.