METHODS FOR RESTORING BLOOD FLOW WITHIN BLOCKED VASCULATURE

• US 20070198029A1
• Filed: 03/09/2007
• Published: 08/23/2007
• Est. Priority Date: 02/03/2006
• Status: Abandoned Application

• Current Assignee: Lazarus Effect, Inc. (Medtronic Plc)
• Original Assignee: Lazarus Effect, Inc. (Medtronic Plc)
• Inventors: Martin, Brian, Dieck, Martin
• Application Number:
  US11/684,546
• Publication Number:
  US 20070198029A1
• Time in Patent Office: Days
• US Class Current: 606/127
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• 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 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2017/00778 Operations on blood vessels A61B2017/22097, A61B2017/320741 take precedence
• CPC Class Codes: A61B 2017/00853 low friction, hydrophobic and corrosion-resistant fluorocarbon resin coating (ptf, ptfe, polytetrafluoroethylene)
• CPC Class Codes: A61B 2017/00862 elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• 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 2017/2215 having an open distal end

Abstract

The devices and methods described herein relate to clearing of blockages within body lumens, such as the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.

Claims

1-78. -78. (canceled)

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

advancing an obstruction removal device comprising at least a plurality of filaments from a near end of the obstruction to beyond a far end of the obstruction;

expanding at least one filament towards a wall of the blood vessel;

withdrawing the plurality of filaments, such that the filament is located towards an exterior of and span across at least a portion of the obstruction; and

surrounding the obstruction with at least a portion of the obstruction removal device.

80. The method of claim 79, where withdrawing the plurality of filaments comprises relocating the plurality of filaments without substantially dislocating or mobilizing the obstruction within the blood vessel.

81. The method of claim 79, further comprising withdrawing the surrounded obstruction from the blood vessel by withdrawing the obstruction removal device from the vessel.

82. The method of claim 79, where the obstruction removal device further comprises a surrounding portion attached to an end portion of the filaments, and where surrounding the obstruction comprises continuing to withdraw the plurality of filaments until the surrounding portion covers the obstruction.

84. The method of claim 79, where withdrawing the plurality of filaments comprises locating the surrounding portion of the device substantially around the obstruction without substantially dislocating or mobilizing the obstruction within the blood vessel.

85. The method of claim 79, where surrounding the obstruction comprises rotating a first portion of the plurality of filaments relative to a second portion of the plurality of filaments to wrap the plurality of filaments around the obstruction.

86. The method of claim 79, where the plurality of filaments comprises a plurality of sets of filaments, and where rotation of the plurality of filaments comprises rotating one set relative to another set.

87. The method of claim 79, where advancing the obstruction removal device comprises advancing the obstruction removal device through the obstruction.

88. The method of claim 79, where advancing the obstruction removal device comprises advancing the obstruction removal device around the obstruction.

89. The method of claim 79, further comprising advancing a catheter adjacent to the obstruction and where advancing the obstruction removal device comprises advancing the obstruction removal device through the catheter to the obstruction.

90. The method of claim 79, after surrounding the obstruction, further comprising withdrawing at least a portion of the obstruction removal device within the catheter and removing the catheter from the vessel.

91. The method of claim 79, where the plurality of filaments comprise a mesh of filaments.

92. The method of claim 79, where the plurality of filaments each comprise a first and second end and where each end is attached to at least a near connector.

93. The method of claim 92, where the near connector comprises a shape selected from an arcuate shape, a partial circular shape, a loop, an oval, a square, a rectangle, a polygon, an overlapping loop, a pair of semi-circles, a flower shape, and a FIG. 8.

94. The method of claim 92, where the near connector is discontinuous.

95. The method of claim 92, where the near connector is adjustable in size.

96. The method of claim 92, where the near connector has a 3-dimensional profile such that portions thereof lie in a plurality of planes.

97. The method of claim 92, where the near connector comprises a plurality of connector sections.

98. The method of claim 79, where the plurality of filaments each comprise a first and second end and where the second end is attached to at least a far connector.

99. The method of claim 98, where the plurality of filaments comprises a plurality of sets of filaments such that the first set of filaments is connected to the near and far connector and where additional sets of filaments are each connected to at least two additional connectors.

100. The method of claim 98, where the far connector comprises a shape selected from an arcuate shape, a partial circular shape, a loop, an oval, a square, a rectangle, a polygon, an overlapping loop, a pair of semi-circles, a flower shape, and a FIG. 8.

101. The method of claim 98, where far near connector is discontinuous.

102. The method of claim 98, where far connector is adjustable in size.

103. The method of claim 98, where far connector has a 3-dimensional profile such that portions thereof lie in a plurality of planes.

104. The method of claim 98, where the far connector comprises a plurality of connector sections.

105. The method of claim 79, where the obstruction comprises a blood clot, plaque, cholesterol, thrombus, a naturally occurring foreign body, a non-naturally occurring foreign body or a combination thereof.

106. The method of claim 79, further comprising expanding the vessel adjacent to the obstruction to decrease a friction between the vessel and the obstruction.

107. The method of claim 106, where expanding the vessel comprises expanding a balloon member adjacent to the obstruction.

108. The method of claim 106, where expanding the vessel comprises expanding a coil member adjacent to the obstruction.

109-134. -134. (canceled)

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

advancing an obstruction removal device within the blood vessel, where the obstruction removal device comprises a near and far connector each having a reduced profile and each having an expanded shape when unconstrained, where the obstruction removal device includes a plurality of filaments extending between the connectors;

positioning the far connector distal to the far end of the obstruction, such that the far connector expands towards the expanded shape in the vessel;

positioning the near connector proximal to the near end of the obstruction such that the near connector expands towards the expanded shape in the vessel and such that the filaments span across the obstruction;

spacing at least one of the filaments from an adjacent filament such that the respective filament separate about the obstruction;

ensnaring the obstruction removal device about the obstruction; and

withdrawing the obstruction removal device and obstruction from the blood vessel.

136. The method of claim 135, where spacing the filaments comprises tensioning the filaments.

137. The method of claim 135, where ensnaring the obstruction removal device comprises rotating the near connector relative to the far connector to wrap the filaments about the obstruction.

138. The method of claim 137, comprises rotating the near connector while holding the far connector stationary.

139. The method of claim 137, comprises rotating the far connector while holding the near connector stationary.

140. The method of claim 137, comprises rotating the near connector and rotating the far connector in an opposite direction.

141. The method of claim 137, further comprising a third connector adjacent to the near connector, and a plurality of non-rotating filaments connecting joining the far connector and the third connector, where the third connector remains stationary during rotation of the near connector.

142. The method of claim 135, where spacing the filament occurs without substantially dislocating or mobilizing the obstruction within the blood vessel.

143. The method of claim 135, further comprising a blood permeable member located distal to the far connector, where ensuring the obstruction removal device comprises translating the obstruction removal device until the blood permeable bag covers the obstruction.

144. The method of claim 143, where the blood permeable member comprises a structure selected from the group consisting of a basket, a filter, a bag, a coil, a helical wire structure, a mesh, a corrugated sheet, a braided wires, a single wound wire, a plurality of crossing wires, a tube, a filled tube, a casting, a solid wire, a membranes, and a film.

145. The method of claim 135, where ensnaring the obstruction removal device about the obstruction comprises withdrawing the plurality of filaments and locating a capturing portion of the device substantially around the obstruction without dislocating or mobilizing the obstruction within the blood vessel.

146. The method of claim 135, where advancing the obstruction removal device comprises advancing the obstruction removal device through the obstruction.

147. The method of claim 135, where advancing the obstruction removal device comprises advancing the obstruction removal device around the obstruction.

148. The method of claim 135, further comprising advancing a catheter through the obstruction and where advancing the obstruction removal device comprises advancing the obstruction removal device through the catheter.

149. The method of claim 135, where the arcuate shape comprises a shape selected from an arcuate shape, a partial circular shape, a loop, an oval, a square, a rectangle, a polygon, an overlapping loop, a pair of semi-circles, a flower shape, and a FIG. 8.

150. The method of claim 135, where the connector is discontinuous.

151. The method of claim 135, where the obstruction comprises a blood clot, plaque, cholesterol, thrombus, a naturally occurring foreign body, a non-naturally occurring foreign body or a combination thereof.

152. The method of claim 135, further comprising expanding a balloon member adjacent to the obstruction to expand the vessel.

153. The method of claim 135, further comprising expanding a coil member adjacent to the obstruction to expand the vessel.

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

advancing an obstruction removal device within the blood vessel, where the obstruction removal device comprises a near connector being constrained in a reduced profile and having an expanded profile when unconstrained, where the obstruction removal device includes a plurality of filaments connected to the near connector;

positioning the near connector proximal to the near end of the obstruction such that the near connector portion expands towards the expanded shape in the vessel and such that the filaments span across the obstruction;

spacing at least one of the filaments from an adjacent filament such that the respective filament separate about the obstruction;

ensnaring the obstruction removal device about the obstruction; and

withdrawing the obstruction removal device and obstruction from the blood vessel.

155. The method of claim 154, where ensnaring the obstruction removal device comprises rotating the near connector to wrap the filaments about the obstruction.

156. The method of claim 154, where spacing the filament occurs without substantially dislocating or mobilizing the obstruction within the blood vessel.

157. The method of claim 156, where ensnaring the obstruction removal device comprises locating a blood permeable member over the obstruction.

158. The method of claim 156, where the blood permeable member comprises a structure selected from the group consisting of a basket, a filter, a bag, a coil, a helical wire structure, a mesh, a corrugated sheet, a braided wires, a single wound wire, a plurality of crossing wires, a tube, a filled tube, a casting, a solid wire, a membrane, and a film.

159. The method of claim 156, where ensaring the obstruction removal device about the obstruction comprises locating a blood permeable member over the obstruction without dislocating or mobilizing the obstruction within the blood vessel.

160. The method of claim 154, where advancing the obstruction removal device comprises advancing the obstruction removal device through the obstruction.

161. The method of claim 154, where advancing the obstruction removal device comprises advancing the obstruction removal device around the obstruction.

162. The method of claim 154, further comprising advancing a catheter through the obstruction and where advancing the obstruction removal device comprises advancing the obstruction removal device through the catheter.

163. The method of claim 154, where the near connector comprises a shape selected from an arcuate shape, a partial circular shape, a loop, an oval, a square, a rectangle, a polygon, an overlapping loop, a pair of semi-circles, a flower shape, and a FIG. 8.

164. The method of claim 154, where the connector is discontinuous.

165. The method of claim 154, where the obstruction comprises a blood clot, plaque, cholesterol, thrombus, a naturally occurring foreign body, a non-naturally occurring foreign body or a combination thereof.

166. The method of claim 154, further comprising expanding a balloon member adjacent to the obstruction to expand the vessel.

167. The method of claim 154, further comprising expanding a coil member adjacent to the obstruction to expand the vessel.