Systems, method and devices for removing obstructions from a blood vessel

• US 20020072764A1
• Filed: 06/25/2001
• Published: 06/13/2002
• Est. Priority Date: 06/29/2000
• Status: Active Grant

• Current Assignee: Stryker Corporation
• Original Assignee: Concentric Medical, Inc. (Stryker Corporation)
• Inventors: Sepetka, Ivan, Miller, John, Pierce, Ryan, Gia, Son, Ngo, Tiffany Tran, Dieck, Martin
• Granted Patent: US 6,824,545 B2
• Time in Patent Office: Days
• US Class Current: 606/200
• CPC Class Codes: A61B 17/22031 Gripping instruments, e.g. forceps, for removing or smashing calculi A61B17/221 takes precedence
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• 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 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61F 2002/016 made from wire-like elements
• CPC Class Codes: A61F 2002/018 made from tubes or sheets of material, e.g. by etching or laser-cutting
• CPC Class Codes: A61F 2230/0091 helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
• 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 25/0074 Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
• CPC Class Codes: A61M 25/008 Strength or flexibility characteristics of the catheter tip
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool

Abstract

A system for removing an obstruction from a blood vessel includes an obstruction engaging element and an expandable capture element. The capture element preferably has a flexible cover and an expandable support structure. The engaging element engages the obstruction and moves the obstruction into the capture element. The capture element protects the obstruction when the obstruction is moved into the catheter.

Claims

1. A method of removing an obstruction from a blood vessel, comprising the steps of:

providing a obstruction engaging element having a collapsed position and an expanded position, the obstruction engaging element having at least one filament, the filament being in a substantially straight configuration when collapsed;

advancing the obstruction engaging element through a patient'"'"'s vascular system to an obstruction with the obstruction engaging element in the collapsed position; and

engaging the obstruction with the obstruction engaging element, the filament engaging the obstruction with a shape which extends from a proximal end toward a distal end, turns back toward the proximal end and again turns back and extends toward the distal end.

2. The method of claim 1, wherein:

the engaging step is carried out with the filament being naturally biased into the shape.

3. The method of claim 1, wherein:

the providing step is carried out with the distal end being a free end and the obstruction engaging element consisting essentially of one filament.

4. The method of claim 1, wherein:

the engaging step is carried out by manipulating the obstruction engaging element to form the shape.

5. The method of claim 4, wherein:

the manipulating step is carried out with the obstruction engaging element being rotated in at least one direction to form the shape, wherein at least part of the element prolapses.

6. The method of claim 4, wherein:

the manipulating step is carried out with the element having coils which prolapse over other coils.

7. A device for removing an obstruction from a blood vessel, comprising:

a delivery element having a lumen; and

an obstruction engaging element positioned in the lumen, the obstruction engaging element having a filament which has a collapsed position and an expanded position, the filament being in a substantially straight configuration when collapsed within the lumen of the delivery element, the filament being movable to a shape which extends from a proximal end toward a distal end, turns back toward the proximal end and again turns back and extends toward the distal end.

8. The device of claim 7, wherein:

the filament is naturally biased into the shape.

9. The device of claim 7, wherein:

the distal end of the filament is a free end and the obstruction engaging element has only one filament.

10. The device of claim 7, wherein:

the obstruction engaging element forms the shape by manipulating the obstruction engaging element.

11. The device of claim 10, wherein:

the obstruction engaging element is rotated to form the shape.

12. The device of claim 11, wherein:

the obstruction engaging element is rotated so that coils prolapse over other coils.

15. The device of claim 14,

the obstruction engaging element is in a substantially straightened configuration when collapsed.

16. The device of claim 14, wherein:

the obstruction engaging element has a filament.

17. The device of claim 14, wherein:

the obstruction engaging element has only one filament which extends to a free end.

19. The method of claim 18, wherein:

the providing step is carried out with the obstruction engaging element having a filament; and

the moving step is carried out with the filament ensnaring the obstruction.

20. The method of claim 18, wherein:

the providing step is carried out with the filament extending through the capture element.

21. The method of claim 18, wherein:

the moving step is carried out by moving the obstruction engaging element relative to the capture element.

22. The method of claim 21, wherein:

the providing step is carried out with the obstruction engaging element being coupled to the capture element.

23. The method of claim 22, wherein:

the providing step is carried out with the obstruction engaging element being wound around a central wire with the distal end of the obstruction engaging element being attached to the central wire.

24. The method of claim 22, wherein:

the providing step is carried out with the obstruction engaging element connected to the capture element.

25. The method of claim 18, wherein:

the moving step is carried out with the obstruction contacting the capture element to invert the capture element.

26. The method of claim 18, wherein:

the moving step is carried out with the obstruction contained entirely within the inverting portion of the capture element.

27. The method of claim 18, wherein:

providing step is carried out with the inverting portion being a braided structure.

29. The device of claim 28, further comprising:

an obstruction engaging element extending through the capture element.

30. The device of claim 28, wherein:

the obstruction engaging element has a filament which is manipulated to ensnare the obstruction.

31. The device of claim 28, wherein:

the filament extends through the capture element.

32. The device of claim 28, wherein:

the obstruction engaging element is movable relative to the capture element.

33. The device of claim 32, wherein:

the obstruction engaging element is movable relative to the capture element to invert the capture element.

34. The device of claim 32, wherein:

the obstruction engaging element is coupled to the capture element.

35. The device of claim 34, wherein:

the obstruction engaging element is wound around a central wire with a distal end of the obstruction engaging element attached to the central wire.

36. The device of claim 34, wherein:

the obstruction engaging element is connected to the capture element.

37. The device of claim 34, wherein:

the obstruction engaging element contacts the capture element to invert the capture element.

38. The device of claim 28, wherein:

the inverting portion is a braided structure.

40. The medical device of claim 39, further comprising:

an inner member positioned in the outer member;

the plurality of fingers being moved between the open and closed positions by relative movement of the inner and outer members.

41. The medical device of claim 39, wherein:

each of the plurality of fingers has a flexible actuator attached thereto, wherein the actuator is manipulated to move the fingers between the open and closed positions.

42. The medical device of claim 39, further comprising:

a sheath positioned to cover at least one of an inner and outer surface of the frame.

43. The medical device of claim 39, further comprising:

an obstruction engaging element extending through the outer member.

44. The medical device of claim 39, wherein:

the fingers are independent from one another and extend independently from the outer member

46. The medical device of claim 45, further comprising:

a cover positioned to cover at least one of an inner and outer surface of the frame.

47. The medical device of claim 45, further comprising:

an obstruction engaging element extending through the inner member.

48. The medical device of claim 45, wherein:

the frame is integrally formed.

49. A. The medical device of claim 45, wherein:

the frame has a ring at the distal end.

50. A. The medical device of claim 49, wherein:

the ring is formed by v-shaped elements.

51. A. The medical device of claim 49, wherein:

the first set of connectors and second set of connectors are connected to the ring at space-apart locations one after the other.

53. The medical device of claim 50, further comprising:

a cover positioned to cover at least one of an inner and outer surface of the frame.

54. The medical device of claim 50, further comprising:

an obstruction engaging element extending through the inner member.

55. The medical device of claim 50, wherein:

the frame is integrally formed.

56. The medical device of claim 50, wherein:

the frame comprises a shape-memory material, wherein application of the electrical energy causes the shape-memory material to change shape.

57. The medical device of claim 54, wherein:

the frame moves to the closed position upon application of the electrical energy.

13. A method of removing an obstruction from a blood vessel, comprising the steps of:

providing a obstruction engaging element having a collapsed position and an expanded position, the obstruction engaging element having at least one filament which is coated with fibrin;

advancing the obstruction engaging element through a patient'"'"'s vascular system to an obstruction with the obstruction engaging element in the collapsed position;

positioning the obstruction engaging element to engage the obstruction; and

removing the obstruction with the obstruction engaging element.

14. A device for removing an obstruction from a blood vessel, comprising:

a delivery element having a lumen; and

a obstruction engaging element having a collapsed position and an expanded position, the obstruction engaging element having at least one filament which is coated with fibrin, the obstruction engaging element being contained within the lumen of the delivery element.

18. A method of removing an obstruction from a blood vessel, comprising the steps of:

providing a capture element and an obstruction engaging element;

moving the obstruction with the obstruction engaging element into the capture element, wherein the capture element has an inverting portion which inverts when the obstruction is moved into the capture element; and

removing the obstruction from the patient.

28. A device for removing an obstruction from a blood vessel, comprising:

a capture element having an inverting portion which inverts to capture an obstruction, the inverting portion inverting upon application of a compressive force to the inverting portion.

39. A medical device, comprising:

an outer member;

a plurality of fingers extending distally from the outer member, the plurality of fingers forming an end, the end being movable between an open position to a closed position, the plurality of fingers being bent when moving from the open position to the closed position.

58. A method for removing an obstruction from a blood vessel using the devices of claims 39-54.

45. A medical device, comprising:

an outer member;

an inner member positioned within the outer member;

a frame extending distally from the inner and outer members, the frame having an end which is movable from an open position to a closed position, the frame having a first set of connectors coupled to the outer member and a second set of connectors coupled to the inner member;

wherein the inner and outer members are movable relative to one another to move the open end between the open and closed positions.

52. A medical device, comprising:

an outer member;

a frame extending distally from the outer member, the frame having an end which is movable from an open position to a closed position;

wherein the frame moves between the open and closed positions by applying electrical energy to the frame.

59. A system for removing an obstruction from a blood vessel, comprising:

a catheter having a lumen;

an expandable capture element which is contained within the lumen of the catheter, the capture element being slidable within the lumen of the catheter between a collapsed position contained within the lumen and an expanded position in which the capture element is positioned outside the lumen; and

an obstruction engaging device having a filament, the filament being movable from a collapsed position to an expanded position, the obstruction engaging element passing through the catheter.

60. A method of removing an obstruction from a blood vessel comprising the steps of:

providing a catheter, an obstruction engaging device and an expandable capture element, the capture element being contained within a lumen of the catheter in a collapsed position, the capture element moving to an expanded position when positioned outside the lumen, the obstruction engaging device having a filament which is movable from a collapsed position to an expanded position;

introducing the catheter into a blood vessel of a patient;

engaging an obstruction with the filament;

expanding the capture element; and

moving the obstruction into the capture element with the engaging device after the engaging and expanding steps.

61. A system for removing an obstruction from a blood vessel, comprising:

a catheter having a lumen;

an expandable capture element contained within the lumen of the catheter, the capture element being in a collapsed position when contained within the lumen and being in an expanded position when positioned outside the lumen, the expandable capture element having a support structure forming a closed loop having a plurality of integrally formed hinges; and

an obstruction engaging device which extends through the expandable capture element, the engaging device having a collapsed shape and an expanded shape.

62. A system for removing an obstruction from a blood vessel, comprising:

a catheter having a lumen;

an expandable capture element which is contained within the lumen of the catheter, the capture element being slidable within the lumen of the catheter, the capture element having an actuator for manually expanding and contracting the capture element; and

an obstruction engaging device which passes through the capture element.

63. A catheter for capturing an obstruction, comprising:

a catheter having a lumen;

a capture element positioned in the lumen of the catheter, the capture element being expandable, the capture element having an expandable support structure and a cover attached to the support structure, the cover having a length which is at least three times a diameter of the support structure in the expanded position.

64. A device for removing an obstruction from a blood vessel, comprising:

an expandable loop which is movable from a collapsed position to an expanded position;

a cover coupled to the loop, the distal end of the cover being moving from a closed position to an open position when the loop moves from the collapsed to expanded positions; and

a tube having an actuator extending therethrough, the actuator being coupled to the loop so that relative movement between the tube and the actuator causes the loop to move between the expanded and collapsed positions.

65. A device for removing an obstruction from a blood vessel, comprising:

a tube;

a support structure movable between a collapsed position and an expanded position, the support structure extending through the tube and being naturally biased toward the expanded position, wherein the support structure expands when moved out of the distal end of the tube and is in the collapsed position when contained within the tube, the support structure being bowed outward;

a cover coupled to the structure, the cover moving from a closed position to an open position when the loop moves from the collapsed position to the expanded position.