Apparatus and methods for treating stroke and controlling cerebral flow characteristics

• US 20050267323A1
• Filed: 06/06/2005
• Published: 12/01/2005
• Est. Priority Date: 08/22/2001
• Status: Abandoned Application

• Current Assignee: W. L. Gore & Associates (W.L. Gore & Associates)
• Original Assignee: W. L. Gore & Associates (W.L. Gore & Associates)
• Inventors: Dorros, Gerald, Hogendijk, Michael, Parodi, Juan Carlos, Schonholz, Claudio Javier
• Application Number:
  US11/146,636
• Publication Number:
  US 20050267323A1
• Time in Patent Office: Days
• US Class Current: 600/16
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• 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 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 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/3435 using everted sleeves
• CPC Class Codes: A61M 2025/09008 having a balloon
• CPC Class Codes: A61M 2025/09083 having a coil around a core
• CPC Class Codes: A61M 2025/09166 having radio-opaque features
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 25/1002 characterised by balloon shape A61M25/1006, A61M25/1009 take precedence

Abstract

Apparatus and methods for treatment of stroke are provided. In a preferred embodiment, the present invention disposes at least one catheter having a distal occlusive member in either the common carotid artery (CCA) or both the vertebral artery (VA) and the CCA on the hemisphere of the cerebral occlusion. Blood flow in the opposing carotid and/or vertebral arteries may be inhibited. Retrograde or antegrade flow may be provided through either catheter independently to effectively control cerebral flow characteristics. Under such controlled flow conditions, a thrombectomy device may be used to treat the occlusion, and any emboli generated are directed into the catheter(s).

Claims

1. Apparatus suitable for manipulating cerebral blood flow characteristics, the apparatus comprising:

a first catheter having proximal and distal ends, a lateral surface, and a lumen extending therebetween;

an occlusive element affixed to the distal end of the first catheter;

at least one intake port disposed in the lateral surface of the first catheter; and

an inner sheath configured for longitudinal sliding motion within the first catheter, the inner sheath configured to cover the intake port in a distalmost position.

2. The apparatus of claim 1 wherein the distal end of the first catheter is adapted to be disposed in a common carotid artery.

3. The apparatus of claim 1 further comprising a venous return catheter configured to induce retrograde flow through the lumen of the first catheter.

4. The apparatus of claim 3 further comprising a flow controller, the flow controller configured to selectively permit or inhibit communication between the venous return catheter and the lumen of the first catheter.

5. The apparatus of claim 1 further comprising:

a second catheter having proximal and distal ends, a lateral surface, and a lumen extending therebetween;

an occlusive element affixed to the distal end of the second catheter;

at least one intake port disposed in the lateral surface of the second catheter; and

an inner sheath configured for longitudinal sliding motion within the second catheter, the inner sheath configured to cover the intake port in a distalmost position.

6. The apparatus of claim 5 wherein the distal end of the second catheter is adapted to be disposed in a vertebral artery.

7. The apparatus of claim 5 further comprising a venous return catheter configured to induce retrograde flow through each of the lumens of the first and second catheters.

8. The apparatus of claim 7 further comprising a flow controller, the flow controller configured to selectively permit or inhibit communication between the venous return catheter and each of the lumens of the first and second catheters.

9. The apparatus of claim 1 wherein the occlusive element is a balloon.

10. The apparatus of claim 9 wherein the balloon comprises a proximal taper configured to channel antegrade flow into the intake port.

11. The apparatus of claim 10 wherein the balloon comprises a distal taper configured to channel retrograde flow into the lumen of the catheter.

12. The apparatus of claim 1 wherein proximally retracting the inner sheath exposes the intake port to cause antegrade blood to flow into intake port.

13. A method for manipulating cerebral blood flow characteristics, the method comprising:

providing apparatus comprising a first catheter having proximal and distal ends, a lateral surface, a lumen extending therebetween, an occlusive element affixed to the distal end of the first catheter, at least one intake port disposed in the lateral surface of the first catheter, and an inner sheath configured for longitudinal sliding motion within the first catheter;

positioning the distal end of the first catheter in a selected vessel in a contracted state; and

deploying the occlusive element to occlude antegrade flow in the selected vessel.

14. The method of claim 13 wherein the selected vessel is a common carotid artery.

15. The method of claim 13 further comprising:

providing apparatus comprising a second catheter having proximal and distal ends, a lateral surface, a lumen extending therebetween, an occlusive element affixed to the distal end of the second catheter, at least one intake port disposed in the lateral surface of the second catheter, and an inner sheath configured for longitudinal sliding motion within the second catheter;

positioning the distal end of the second catheter in a selected vessel in a contracted state; and

deploying the occlusive element to occlude antegrade flow in the selected vessel.

16. The method of claim 15 wherein the selected vessel is a vertebral artery.

17. The method of claim 13 wherein proximally retracting the inner sheath exposes the intake port to permit antegrade flow to enter the lumen of the first catheter.

18. The method of claim 17 wherein exposing the intake port provides antegrade flow to selected regions of the cerebral vasculature.

19. The method of claim 13 further comprising:

providing a venous return catheter that communicates with the lumen of the first catheter; and

inducing retrograde flow through the lumen of the first catheter.

20. The method of claim 19 wherein inducing retrograde flow through the lumen of the first catheter induces retrograde flow at selected locations in the cerebral vasculature.

21. The method of claim 19 further comprising:

providing a retrograde flow controller; and

utilizing the retrograde flow controller to selectively permit or inhibit communication between the venous return catheter and the lumen of the first catheter.