Method and device for locating guidewire and treating chronic total occlusions
First Claim
1. A vascular obstruction removal catheter comprising:
- a flexible tubular body having a proximal end and a distal end;
an outer shearing member attached near the distal end, the outer member having a perforate inner surface;
an inner shearing member rotatably disposed within the outer member, the inner member having a proximal portion, a distal portion, and a circumferential series of struts extending therebetween, the struts sliding along the inner surface of the outer shearing member when the inner shearing member rotates.
6 Assignments
0 Petitions
Accused Products
Abstract
Devices, methods, kits, and methods remove obstructive material from the vasculature and other body lumens. Expansible baskets may be used as cooperating radially expansible shearing members. Helically oriented struts of each basket may wind in a uniform circumferential direction. The struts can be independently flexible, allowing the shearing members to flex axially together. The inner basket may be rotatably driven and may use an axial pump extending proximally from the shearing members and/or a distal penetrator for advancing into an occlusion which inhibits guidewire access. The struts may slide substantially continuously across each other, and may be sufficiently aggressive for highly effective thrombectomy. A rotationally static and axially flexible outer basket may provide a safe, limited atherectomy treatment.
456 Citations
53 Claims
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1. A vascular obstruction removal catheter comprising:
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a flexible tubular body having a proximal end and a distal end;
an outer shearing member attached near the distal end, the outer member having a perforate inner surface;
an inner shearing member rotatably disposed within the outer member, the inner member having a proximal portion, a distal portion, and a circumferential series of struts extending therebetween, the struts sliding along the inner surface of the outer shearing member when the inner shearing member rotates. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A vascular obstruction removal catheter comprising:
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a flexible tubular body having a proximal end and a distal end;
a flexible drive shaft rotatably disposed within the tubular body;
an outer shearing member attached near the distal end of the tubular body, the outer member having a circumferential series of independent outer struts, the outer struts having inner surfaces;
an inner shearing member rotationally driven by the drive shaft within the outer member, the inner member having a circumferential series of independent inner struts, the inner struts having outer surfaces which slide across the inner surfaces of the outer struts when the inner shearing member rotates, at least one member of the group comprising the inner struts and the outer struts being helically oriented. - View Dependent Claims (18, 19, 20, 21)
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22. A method for forming a vascular obstruction removal catheter, the method comprising:
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providing a first tube having a proximal end and a distal end with a central region therebetween, the tube comprising a tube material;
cutting axially along the central region of the first tube so as to define a circumferential series of independent struts, the struts comprising the tube material;
positioning the first cage coaxially with a second resiliently deformable cage; and
attaching a drive for rotating at least one of the cages within a blood vessel for shearing of obstructive material between the cages.
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23. A method for removing obstructive material from a blood vessel of a patient, the method comprising:
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introducing a distal portion of a catheter into the blood vessel;
positioning the distal portion of the catheter adjacent the obstructive material from outside the patient by manipulating a flexible body of the catheter;
radially expanding inner and outer shearing members of the catheter within the blood vessel; and
rotating the inner shearing member within the outer shearing member to shear the occlusive material therebetween.
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24. A component for use in a catheter device for removal of obstructive material from the lumen of a body conduit, said component comprising:
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first and second end portions having a longitudinal axis therebetween;
a middle portion having at least one second cross sectional diameter and further comprising one or more flexible struts around the circumference of said longitudinal axis and extending between, but not along, said first end portion and said second end portion; and
wherein said middle portion and said end portions are formed from a continuous tube. - View Dependent Claims (25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42)
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43. A component for use in a catheter device for removal of obstructive material from the lumen of a body conduit, said component comprising:
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first and second end portions having a longitudinal axis there between;
a middle portion having a plurality of struts forming a helix around the circumference of said longitudinal axis and extending between but not including, said first end portion and said second end portion, wherein said middle portion and said end portions are formed from a continuous tube. - View Dependent Claims (44, 45, 46)
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47. A device for treating a total occlusion in a vessel having a vessel wall, the device comprising:
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a catheter body having a proximal end, a distal end and a lumen;
a radially expansible positioning cage near the distal end of the catheter body;
a shaft disposed in the catheter body lumen, the shaft advanceable into the total occlusion without penetrating through the vessel wall when the positioning cage is radially expanded. - View Dependent Claims (48, 49, 50, 51)
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52. A method of removing a total occlusion from the vessel of a patient, the method comprising:
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providing a positioning cage catheter system having a proximal end, a distal end and a lumen therethrough;
introducing said catheter system into a vessel of a patient and advancing it to the site of the occlusion to be treated;
radially expanding a positioning cage of the catheter system within the vessel to position a lumen of the catheter system;
advancing an occlusion penetrator of the catheter system within the positioned lumen and into the occlusion along a luminal length of the occlusion;
manipulating the catheter system to advance a guidewire or guide catheter distally of the occlusion.
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53. A method of removing a total occlusion from the vessel of a patient comprising the following steps:
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providing a positioning cage catheter device having a proximal end, a distal end and a lumen therethrough;
introducing said positioning cage catheter device into a vessel of a patient and advancing it to the site of the occlusion to be treated;
further advancing said positioning cage catheter device to engage the occlusion to be treated such that a pilot hole is formed at a given point along the length of the occlusion to be treated;
advancing a guidewire device through the position cage catheter device lumen;
manipulating the positioning cage catheter device and said guidewire device such that the guidewire can be advanced through the pilot hole of the occlusion and positioned past the distal portion of the occlusion to be treated.
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Specification