Expansible shearing catheters for thrombus and occlusive material removal

• US 20030055445A1
• Filed: 10/31/2002
• Published: 03/20/2003
• Est. Priority Date: 03/31/2000
• Status: Abandoned Application

• Current Assignee: Valleylab Holding Corporation (Medtronic Plc)
• Original Assignee: Bacchus Vascular Incorporated (Medtronic Plc)
• Inventors: Eversull, Christian S., Leeflang, Stephen A., Evans, Michael A., Demarais, Denise M.
• Application Number:
  US10/285,843
• Publication Number:
  US 20030055445A1
• Time in Patent Office: Days
• US Class Current: 606/159
• 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 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 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/00685 Archimedes screw
• 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 2090/08021 of the patient or his organs

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.

Claims

1. A method for removing obstructive material from a blood vessel of a patient, the method comprising:

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.

2. A method of removing a total occlusion from the vessel of a patient, the method comprising:

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.

3. A method of removing a total occlusion from the vessel of a patient comprising the following steps:

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.