Methods and devices for cutting tissue

• US 20040167553A1
• Filed: 04/22/2003
• Published: 08/26/2004
• Est. Priority Date: 12/20/2000
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Foxhollow Technologies Incorporated (Medtronic Plc)
• Inventors: Patel, Himanshu, Rosenthal, Michael H., Simpson, John B., Venegas, Gautama B.
• Granted Patent: US 7,713,279 B2
• Time in Patent Office: Days
• US Class Current: 606/159
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/3137 for examination of the interior of blood vessels
• 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 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/320032 Details of the rotating or oscillating shaft, e.g. using a flexible shaft
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/320791 with cutter extending outside the cutting window
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/0066 Optical coherence imaging
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance

Abstract

A method of removing material from a blood flow lumen generally includes providing a device having a cutting element and an opening, advancing the device through the blood flow lumen to a site where material is to be removed, forcing the opening toward a wall of the site where material is to be removed, and moving the cutting element and the opening so that material in the blood flow lumen is cut by the cutting element and directed into the opening for removal as the cutting element and opening are moved through the blood flow lumen. In some embodiments, the device may be deflected or bent to force the opening toward a wall to remove material. The cutting element may be rotatable and may have an axis that is movable, that is not parallel to the longitudinal axis of the device, or both. In some embodiments, the cutting element is movable between retracted and deployed positions for advancing the device to a site for treatment and for removing material, respectively.

Claims

1. A device for cutting tissue, comprising:

an elongate body having an opening therein;

a rotatable cutting element having a torque transmitting element extending through the elongate body; and

a visualization element, the visualization element being movable from a stored position to a working position, the visualization element moving to a radially outward position relative to the elongate body when in the working position.

2. The device of claim 1, wherein:

the visualization element emits energy selected from the group of ultrasound and infrared.

3. The device of claim 1, wherein:

the visualization element moves to a position proximate to the opening at a position radially outward relative to the opening.

4. The device of claim 1, wherein:

the rotatable cutting element is movable from a stored position to a working position, the cutting element moving to a position which exposes at least part of the cutting element through the opening when moving from the stored position to the working position.

5. The device of claim 1, wherein:

the cutting element is movable to a number of different working positions to expose varying amounts of the cutting element.

6. The device of claim 1, wherein:

the elongate body has a deformable portion with a length of at least 2 cm

7. A device for cutting tissue, comprising:

an elongate body;

a rotatable cutting element, the rotatable cutting element being coupled to a torque transmitting element which extends through the elongate body; and

a movable cover coupled to the body, the cover being movable from a stored position, in which the rotatable cutting element is covered by the cover, to a working position, in which at least part of the rotatable cutting element is exposed.

8. The device of claim 7, wherein:

the cover also has a tissue collection chamber, wherein tissue cut by the cutting element is directed into the collection chamber.

9. The device of claim 7, wherein:

the cover is disposed at the distal end of the elongate body and forms a tip.

10. The device of claim 7, wherein:

the cover is slidable relative to the elongate body.

11. The device of claim 7, wherein:

the cover is slidable relative to the elongate body in a number of different working positions to expose varying amounts of the rotatable cutting element.

12. The device of claim 7, wherein:

the cover translates when moving to the working position without substantial deformation of the cover.

13. The device of claim 7, further comprising:

a visualization element positioned at a radially outer position relative to the elongate body.

14. The device of claim 13, wherein:

the visualization element is movable relative to the elongate body.

15. The device of claim 7, wherein:

the elongate body has a longitudinal axis; and

the cover also has a longitudinal axis which is aligned with a longitudinal axis of the elongate body when the cover is in the stored position, wherein the longitudinal axis of the cover remains substantially parallel to the longitudinal axis of the elongate body when the cover is in the working position.

16. The device of claim 7, wherein:

the cover is naturally biased to the stored position.

17. The device of claim 7, wherein:

the cover translates without substantially deforming.

18. The device of claim 17, wherein:

the cover is linearly slidable relative to the elongate body at an angle which is not parallel to a longitudinal axis of the elongate body.

19. A method of removing material from a vascular location, comprising the steps of:

providing a cutting device having an elongate body and a rotatable cutting element, the elongate body having an opening therein, the rotatable cutting element being coupled to a torque transmitting element which extends through the elongate body, the elongate body having a deformable portion;

advancing the cutting device through a patient'"'"'s vascular system, the cutting element being in a stored position in which the cutting element is not exposed;

deforming the deformable portion after the advancing step; and

moving the cutting element and the opening through the vascular system with the cutting element being in a working position, wherein at least part of the rotatable cutting element is exposed to cut tissue which is directed through the opening.

20. The method of claim 19, wherein:

the deforming step is carried out with the deformable portion being S-shaped when in the deformed position.

21. The method of claim 19, wherein:

the elongate body has a first pivot point and a second pivot point, the first and second pivot points being positioned on opposite sides of the cutting element.

22. The method of claim 19, wherein:

the deformable portion forms a helical shape.

23. The method of claim 22, wherein:

the helical shape has a diameter of about 2.0 to 7.5 mm and the elongate body has an outer diameter of about 1.0 to 2.5 mm

24. The method of claim 22, wherein:

the deformable part has a length of at least 1 cm.

25. A device for cutting tissue, comprising:

an elongate body movable between a stored position and working position, the elongate body having an opening in the working position;

a rotatable cutting element, the rotatable cutting element being coupled to a torque transmitting element which extends through the elongate body, the cutting element directing material cut by the cutting element through the opening;

a first pivot point on the elongate body on one side of the rotatable cutting element; and

a second pivot point on the other side of the rotatable cutting element.

26. The device of claim 25, further comprising:

a tissue collection chamber, wherein tissue cut by the cutting element is directed through the opening and into the collection chamber.

27. The device of claim 25, further comprising:

a visualization element positioned at a radially outer position relative to the elongate body.

28. The device of claim 27, wherein:

the visualization element is movable relative to the elongate body.