Aspiration method

• US 20030009146A1
• Filed: 08/05/2002
• Published: 01/09/2003
• Est. Priority Date: 03/06/1997
• Status: Active Grant

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular (Medtronic Plc)
• Inventors: Zadno-Azizi, Gholam Reza, Muni, Ketan P., Bagaoisan, Celso
• Granted Patent: US 6,805,692 B2
• Time in Patent Office: Days
• US Class Current: 604/500
• 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 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2017/22084 stone- or thrombus-dissolving
• CPC Class Codes: A61B 2017/320716 comprising means for preventing embolism by dislodged material
• CPC Class Codes: A61M 2025/09183 having tools at the distal tip
• CPC Class Codes: A61M 2025/1015 having two or more independently movable balloons where the distance between the balloons can be adjusted, e.g. two balloon catheters concentric to each other forming an adjustable multiple balloon catheter system
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2025/109 having balloons for removing solid matters, e.g. by grasping or scraping plaque, thrombus or other matters that obstruct the flow
• CPC Class Codes: A61M 2025/1093 having particular tip characteristics
• CPC Class Codes: A61M 25/104 used for angioplasty

Abstract

A method for the treatment of a stenosis or an occlusion in a blood vessel in which an occlusive device is first delivered and activated at a site distal to the occlusion to at least partially occlude the vessel. A therapy catheter is then introduced to treat the occlusion and a debris removal device is delivered to aspirate debris from the vessel. The present invention eliminates the need for a separate irrigation catheter and irrigation fluid which allows the procedure to be performed quickly and efficiently, and is especially useful in the removal of occlusion from saphenous vein grafts, the coronary and carotid arteries, arteries above the aortic arch and vessels of similar size and pressure.

Claims

1. A system for evacuating emboli from a treatment site in a patient'"'"'s vasculature, comprising:

a tubular structure defining at least one lumen there through and having a distal end and a proximal end;

a hollow guidewire having an expandable device at a distal end thereof, wherein said expandable device allows perfusion of blood therethrough when in its expanded state while preventing emboli in said vasculature from migrating past the expandable device, the hollow guidewire being adapted to be positioned within the at least one lumen of the tubular structure; and

a source of negative pressure operatively coupled to said tubular structure and configured to draw fluid and emboli through said lumen.

2. The system of claim 1, wherein said guidewire is made of nitinol.

3. The system of claim 1, wherein said expandable device is an occlusive filter.

4. The system of claim 1, wherein said expandable device is self-expanding.

5. The system of claim 1, wherein said expandable device has a proximal end connected to the guidewire and a distal end connected to a wire extending through a lumen of said guidewire.

6. The system of claim 1, wherein said source of negative pressure is a pump.

7. The system of claim 1, wherein said source of negative pressure is a syringe.

8. The system of claim 1, wherein said tubular structure is a guide catheter.

9. The system of claim 8, further comprising a treatment catheter deliverable through the lumen of said tubular structure.

10. The system of claim 9, wherein said treatment catheter is positionable over said guidewire.

11. The system of claim 1, wherein said tubular structure is an aspiration catheter.

13. The system of claim 12, wherein the guidewire is hollow.

14. The system of claim 13, wherein the occlusive filter has a proximal end connected to said guidewire and a distal end connected to a wire extending through a lumen of said guidewire.

15. The system of claim 12, wherein the guidewire body comprises nitinol.

16. The system of claim 12, wherein the occlusive filter is self-expanding.

17. The system of claim 12, further comprising a source of negative pressure capable of establishing fluid communication with the lumen of the aspiration catheter.

19. The method of claim 18, wherein the guidewire is hollow.

20. The method of claim 18, wherein the expandable device is an inflatable balloon.

21. The method of claim 18, wherein the expandable device is a filter.

22. The method of claim 18, further comprising, prior to drawing blood into the aspiration opening of the catheter, performing therapy within said blood vessel, the performing of therapy resulting in emboli within said vessel.

23. The method of claim 22, wherein therapy is performed by a therapy catheter delivered over the guidewire.

24. The method of claim 23, further comprising withdrawing the therapy catheter from the vessel prior to drawing blood.

25. The method of claim 24, further comprising advancing the aspiration catheter over the guidewire after withdrawing the therapy catheter from the vessel.

27. The method of claim 26, wherein the guidewire is delivered through an outer catheter, said outer catheter having a lumen extending there through.

28. The method of claim 26, further comprising, prior to aspirating fluid from said blood vessel, performing therapy at said treatment site, said performing of therapy resulting in emboli in said vessel proximal to said expandable filter.

29. The method of claim 28, wherein said therapy is performed by a therapy catheter delivered over said guidewire.

30. The method of claim 29, further comprising removing said therapy catheter prior to positioning said catheter over said guidewire.

31. The method of claim 26, wherein the distal opening of the catheter is positioned proximal to the treatment site.

32. The method of claim 26, wherein the distal opening of the catheter is positioned distal to the treatment site.

12. A system for removing particles from a blood vessel, comprising:

a guidewire having a proximal end and a distal end;

an occlusive filter disposed near the distal end of the guidewire, the occlusive filter being expandable to prevent at least a portion of the particles in said vessel from migrating past said filter; and

an aspiration catheter having a proximal end and a distal end and at least one lumen extending therethrough, the aspiration catheter capable of being advanced over the proximal end of the guidewire through the lumen of the aspiration catheter.

18. A method for the evacuation of emboli from a blood vessel, comprising:

delivering a guidewire into the blood vessel, the guidewire having a proximal end and a distal end and an expandable device disposed near its distal end, the expandable device being actuatable between a nonexpanded state and an expanded state;

actuating said expandable device at a location distal to a treatment site within said vessel to expose said expandable device to blood flowing within said vessel to prevent emboli in said vessel from moving past said expandable device;

advancing an aspiration catheter over the guidewire to a position near said emboli, said aspiration catheter having a lumen in fluid communication with an aspiration opening in said catheter; and

drawing blood from the vessel into the aspiration opening, whereby emboli are carried by said blood from said vessel into said aspiration opening and through said lumen of said catheter.

26. A method for the evacuation of emboli from a treatment site in a blood vessel comprising:

delivering a guidewire into said blood vessel such that a distal end portion of said guidewire is located distal to said treatment site, said guidewire having an expandable filter coupled to said distal end portion thereof;

expanding said filter in said blood vessel to prevent emboli in said vessel from migrating past the filter;

advancing a catheter over said guidewire such that a distal opening in said catheter is located proximal to the expandable filter, said catheter having a lumen extending there through and defining a fluid pathway in fluid communication with said distal opening; and

aspirating fluid from said blood vessel into said distal opening such that said emboli are carried by said fluid flow from said blood vessel into said distal opening and through said lumen of said catheter.

33. A method for treating an occlusion in a blood vessel of a patient, comprising:

delivering an elongate body into said blood vessel such that a distal end portion of said elongate body is located distal to a treatment site, said elongate body having an occlusive filter coupled to said distal end portion thereof;

delivering a therapy catheter having a proximal end, a distal end and a lumen extending there through over the elongate body until a distal end portion of the therapy catheter is adjacent to the occlusion;

expanding said occlusive filter in said blood vessel distal to said occlusion such that the filter is exposed to blood flow in said vessel;

performing therapy on said occlusion using the therapy catheter while said filter is exposed to blood flow in said vessel, the performing of therapy resulting in particles proximal to the occlusive filter; and

drawing fluid from said blood vessel at a location proximal to said occlusive filter to remove said particles from the blood vessel.

34. The method of claim 33, wherein said elongate body is hollow.

35. The method of claim 33, wherein said elongate body is guidewire.

36. The method of claim 33, wherein the therapy catheter is delivered after expanding said occlusive filter.

37. The method of claim 33, wherein the fluid is drawn through an aspiration catheter advanced over the elongate body.

38. The method of claim 37, further comprising removing the therapy catheter from the patient and then advancing said aspiration catheter over the elongate body.