DEVICES AND METHODS FOR REMOVING A MATTER FROM A BODY CAVITY OF A PATIENT

• US 20080045881A1
• Filed: 07/27/2007
• Published: 02/21/2008
• Est. Priority Date: 03/26/2004
• Status: Abandoned Application

• Current Assignee: University of Southern California
• Original Assignee: University of Southern California
• Inventors: Teitelbaum, George, Larsen, Donald
• Application Number:
  US11/829,879
• Publication Number:
  US 20080045881A1
• Time in Patent Office: Days
• US Class Current: 604/21
• CPC Class Codes: A61B 17/22031 Gripping instruments, e.g. forceps, for removing or smashing calculi A61B17/221 takes precedence
• 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 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• 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 2017/22082 after introduction of a substance
• CPC Class Codes: A61B 2017/2215 having an open distal end
• CPC Class Codes: A61B 2017/2217 single wire changing shape to a gripping configuration

Abstract

Disclosed are systems and methods for removing a matter from a body cavity of a patient. Exemplary systems of the present invention generally comprise a delivery catheter device, a central matter retrieval device and a device retriever. The central matter retrieval device has an elongated body and shape memory foam attached thereon. In use, the central matter retrieval device is housed within a parking segment of the delivery catheter and delivered to a desired body cavity in a patient. The retriever device is separately deployed to securely remove the matter and the central matter retrieval device from the patient.

Claims

1. A system for removing a matter from a body cavity of a patient, comprising:

a delivery catheter device having a proximal end, a middle park segment, and a distal end, wherein the catheter device is capable of allowing a guidewire to slidably fit within its hallow inner space, and wherein the distal portion is adapted for positioning inside the body cavity;

a central matter retrieval device having an elongated body with a proximal end and a distal end, wherein the distal end has one or more formations of a shape memory polymer disposed thereon and wherein the central retrieval device is slidably positioned within the park segment of the delivery catheter device; and

a device retriever having an elongated body with a pusher proximal portion and an introducer sleeve slidably mounted thereon.

2. The system of claim 1, wherein the shape memory polymer is a foam selected from a group consisting of polyurethane, polyethylene, polyethylene terephthalate, polyisoprene, styrene-butadiene copolymers and other styrenes, copolyester, ethylene-vinylacetate and other ethylene copolymers, polyacrylamide gel, polyacrylic acid and other acrylates, norbornane, polystyrene, and polynorbornene.

3. The system of claim 1, wherein the park segment of the catheter delivery device form a sheath that covers the central matter retrieval device.

4. The system of claim 1, wherein the transition of the shape memory polymer between the compressed configuration and the expanded configuration is triggered by withdrawing the catheter to unsheathe the shape memory polymer.

5. The system of claim 1, wherein the polymer comprises a predetermined amount of a therapeutic agent.

6. The system of claim 5, wherein the therapeutic agent is released when the polymer transitions to the expanded configuration.

7. The system of claim 5, wherein the therapeutic agent is selected from a group consisting of anti-thrombogenic, thrombolytic, anti-proliferative, anti-spasmodic, anticoagulant, anti-platelet adhesion drugs, endothelial cells, and gene vectors.

8. The system of claim 2, wherein said foam is a shape memory foam having an original expanded configuration that can be compressed at a temperature above a glass transition temperature, Tg, to form the compressed configuration, wherein the foam retains its compressed configuration at a temperature below the Tg but returns substantially to its original expanded configuration when it is exposed to a temperature above the Tg.

9. The system of claim 8, wherein the Tg is above a body temperature and the device further comprises an external source of heat.

10. The system of claim 9, wherein the external source of heat is selected from a group consisting of electrical resistance, inductive, optical, and convective heating elements.

11. The system of claim 10, wherein the electrical resistance element comprises a metal coil or a semi-conductive plastic that is circumferentially attached to the distal portion of the carrier and electrically connected to a controller through an insulated pathway, the controller capable of adjusting a voltage applied to the resistance element to maintain a predetermined temperature.

12. The system of claim 8, wherein the Tg is below a body temperature and the foam spontaneously transitions into the expanded configuration after being exposed to the body temperature for a predetermined time.

13. The system of claim 1, wherein the distal portion of the elongated carrier further comprises a steerable tip.

14. The system of claim 13, wherein the steerable tip is a shapeable platinum or stainless steel wire.

15. The system of claim 2, wherein the foam has a shape selected from one of those shown in FIG. 14.

16. The system of claim 1, wherein the shape memory foam is configured as one or more reticular foam discs.

17. The system of claim 1, wherein the device retriever comprises a self-expanding trumpet-like structure on the distal end, wherein the trumpet-like structure is capable of being collapsed inside a catheter by sliding the introducer over the trumpet-like structure.

18. The system of claim 17, wherein the trumpet-like structure is constructed from a soft polyurethane layer mounted on a Nitonol wire skeleton.

19. The system of claim 1, wherein the body cavity is selected from a group consisting of lumens of blood vessels, lumens of the alimentary tract, lumens of the genitourinary system, ventricles and cisterns of the brain, urinary bladder, cysts, vagina, uterine cavity, pseudocysts, abcesses, fistuae.

20. The system of claim 1, wherein the body cavity is a blood vessel lumen, the polymer coating carries a positive charge, a negative charge, or both and wherein the coating is capable of attracting or repealing blood clots.

21. The system of claim 1, wherein the matter is a clot, an embolus, calculus, atherosclerotic plaque, loose tissue or neoplasm, inspissated fluid or secretion, or a foreign body.

22. A method of retrieving a matter from a body cavity of a patient comprising:

(a) providing an system according to claim 1;

(b) positioning the central retrieval device inside the body cavity of the patient;

(c) engaging a matter within the body cavity with the central retrieval device;

(d) securing the central retrieval device and the engaged matter using the device retriever; and

(e) withdrawing the system from the patient, thereby removing the matter from the patient.

23. The method of claim 22, wherein the matter is blood clot from deep venous thrombosis.

24. A method for securely and safely removing a clot from a blood vessel, comprising:

(a) providing a system according to claim 17;

(b) positioning the delivery catheter device inside a blood vessel such that the distal end of the catheter passes through the clot and the park segment is positioned inside of the clot;

(c) withdrawing the catheter delivery device to expose the central matter retrieval device and allow the memory shape foam to engage the clot;

(d) deploying the device retriever to secure the central matter retrieval device and the clot, wherein the deploying step involves expanding the trumpet-like structure to capture the central matter retrieval device; and

(e) removing the entire system from the patient, wherein the blood clot is removed together with the system from the patient.