Embolectomy Catheters And Methods For Treating Stroke And Other Small Vessel Thromboembolic Disorders

• US 20080015541A1
• Filed: 07/05/2007
• Published: 01/17/2008
• Est. Priority Date: 05/01/1998
• Status: Active Grant

• Current Assignee: Brian Cox, George Green, Richard Monetti, Robert Rosenbluth, Sean Chow, Thomas Sternweiler
• Original Assignee: Brian Cox, George Green, Richard Monetti, Robert Rosenbluth, Sean Chow, Thomas Sternweiler
• Inventors: Green, George, Cox, Brian, Sternweiler, Thomas, Rosenbluth, Robert, Chow, Sean, Monetti, Richard
• Granted Patent: US 8,100,935 B2
• Time in Patent Office: Days
• US Class Current: 604/509
• CPC Class Codes: A61B 17/135 inflatable for measuring blood pressure A61B5/022; inflatable pressure pads A61F5/34
• CPC Class Codes: A61B 17/22032 having inflatable gripping elements balloon catheters A61M25/10
• 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 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22044 with a pointed tip
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/22084 stone- or thrombus-dissolving
• 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 2017/320716 comprising means for preventing embolism by dislodged material
• CPC Class Codes: A61F 2002/016 made from wire-like elements
• CPC Class Codes: A61F 2002/018 made from tubes or sheets of material, e.g. by etching or laser-cutting
• CPC Class Codes: A61F 2230/008 paraboloidal
• CPC Class Codes: A61F 2230/0091 helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
• CPC Class Codes: A61M 2025/0042 Microcatheters, cannula or the like having outside diameters around 1 mm or less
• CPC Class Codes: A61M 2025/0183 Rapid exchange or monorail catheters

Abstract

Embolectomy catheters, rapid exchange microcatheters, systems and methods for removing clots or other obstructive matter (e.g., thrombus, thromboemboli, embolic fragments of atherosclerotic plaque, foreign objects, etc.) from blood vessels. This invention is particularly useable for percutaneous removal of thromboemboli or other obstructive matter from small blood vessels of the brain, during an evolving stroke or period of cerebral ischemia. In some embodiments, the embolectomy catheters of this invention are advanceable with or over a guidewire which has been pre-inserted through or around the clot. Also, in some embodiments, the embolectomy catheters include clot removal devices which are deployable from the catheter after the catheter has been advanced at least partially through the clot. The clot removal device may include a deployable wire nest that is designed to prevent a blood clot from passing therethrough. The delivery catheter may include telescoping inner and outer tubes, with the clot removal device being radially constrained by the outer tube. Retraction of the outer tube removes the constraint on the clot removal device and permits it to expand to its deployed configuration. An infusion guidewire is particularly useful in conjunction with the embolectomy catheter, and permits infusion of medicaments or visualization fluids distal to the clot.

Claims

1. A method for removing obstructive matter from a vessel of a patient comprising:

advancing a distal end of a guidewire toward obstructive matter within said vessel;

advancing an embolectomy catheter over said guidewire;

advancing a distal end of said embolectomy catheter through said obstructive matter;

expanding an obstructive matter capturing receptacle on said distal end of said embolectomy catheter; and

retracting said embolectomy catheter so as to capture said obstructive matter within said obstructive matter capturing receptacle.

2. The method of claim 1, wherein expanding an obstructive matter capturing receptacle on said distal end of said embolectomy catheter further comprises retracting an outer tube of said embolectomy catheter and thereby expanding said obstructive matter capturing receptacle.

3. The method of claim 2, wherein retracting an outer tube of said embolectomy catheter further comprises removing a distal end of said outer tube from a tip of said distal end of said embolectomy catheter.

4. The method of claim 1, wherein expanding an obstructive matter capturing receptacle on said distal end of said embolectomy catheter further comprises deploying said obstructive matter capturing receptacle from an unexpanded state to a radially expanded state.

5. The method of claim 1, wherein advancing a distal end of said guidewire through said obstructive matter within said vessel is followed by preventing longitudinal retraction of said guidewire.

6. The method of claim 1, wherein expanding an obstructive matter capturing receptacle on said distal end of said embolectomy catheter further comprises advancing an actuator within said embolectomy catheter.

7. The method of claim 1, wherein expanding an obstructive matter capturing receptacle on said distal end of said embolectomy catheter further comprises radially expanding a plurality of wires from said embolectomy catheter.

8. A method of removing an obstruction within a vessel comprising:

inserting a guidewire into said vessel of a patient;

advancing said guidewire toward said obstruction;

advancing a catheter over said guidewire until an obstruction removal device of said catheter has at least partially passed through said obstruction;

deploying said obstruction removal device from an unexpanded state to an expanded state;

retracting said catheter; and

capturing said obstruction with said removal device.

9. The method of claim 8, wherein advancing a catheter over said guidewire until an obstruction removal device of said catheter has at least partially passed through said obstruction further comprises passing a distal tip of said catheter through said obstruction.

10. The method of claim 8, wherein said deploying said obstruction removal device from an unexpanded state to an expanded state further comprises manipulating a deployment actuator at a proximal end of said catheter which is operatively connected to said obstruction removal device.

11. The method of claim 8, wherein deploying said obstruction removal device from an unexpanded state to an expanded state further comprises radially expanding a plurality of elongated members.

12. The method of claim 8, wherein capturing said obstruction with said removal device further comprises entangling said obstruction with elongated members of said obstruction removal device.

13. The method of claim 8, wherein deploying said obstruction removal device from an unexpanded state to an expanded state further comprises retracting an outer tube on said catheter relative to said obstruction removal device.

14. The method of claim 8, wherein advancing a catheter over said guidewire until an obstruction removal device of said catheter has at least partially passed through said obstruction further comprises advancing a tapered distal tip of said catheter through said obstruction.

15. A method of clearing a vessel obstruction within a patient comprising:

positioning a guidewire within said vessel;

advancing a distal end of said guidewire toward said obstruction;

sliding an obstruction removal device over said guidewire;

penetrating said obstruction with a distal end of said obstruction removal device;

deploying a capture device from said obstruction removal device, distally of said obstruction;

retracting said obstruction removal device to capture said obstruction in said capture device.

16. The method of claim 15, wherein deploying a capture device from said obstruction removal device, distally of said obstruction further comprises expanding a plurality of elongated members.

17. The method of claim 16, wherein expanding a plurality of elongated members further comprises forming a nest with said elongated members.

18. The method of claim 15, wherein deploying a capture device from said obstruction removal device, distally of said obstruction further comprises axially sliding an outer tube of said obstruction removal device relative to an inner tube of said obstruction removal device.

19. The method of claim 15, wherein obstruction removal device is progressively more flexible along a distal direction of its longitudinal axis.

20. The method of claim 15, wherein said obstruction removal device includes at least one infusion port.