DEVICES AND METHODS FOR CROSSING CHRONIC TOTAL OCCLUSIONS

• US 20100030251A1
• Filed: 05/22/2007
• Published: 02/04/2010
• Est. Priority Date: 05/24/2006
• Status: Abandoned Application

• Current Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic)
• Original Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic)
• Inventors: Rihal, Charanjit S., Sandhu, Gurpreet S.
• Application Number:
  US12/302,142
• Publication Number:
  US 20100030251A1
• Time in Patent Office: Days
• US Class Current: 606/194
• 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 2017/00858 high friction or non-slip
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61M 2025/006 having a special surface topography or special surface properties, e.g. roughened or knurled surface
• CPC Class Codes: A61M 25/0043 characterised by structural features
• CPC Class Codes: A61M 25/0662 Guide tubes
• CPC Class Codes: A61M 29/00 Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00

Abstract

Devices and methods for crossing total chronic occlusions in body lumens (e.g., blood vessels, etc.). The devices and methods may involve guidewire assisted delivery of a device designed to both traverse a chronic total occlusion (CTO) and create a passageway through the CTO for a treatment device (e.g., an angioplasty balloon, stent, etc.). Some devices of the present invention may include an expandable sleeve constructed of material that expands in response to temperature changes. In other devices, an expandable sleeve may be provided in which two or more interlocking cylindrical sections can be arranged such that the cylindrical sections have a first, smaller diameter at which the expandable sleeve can be inserted through a CTO. The expandable sleeve also has a second, larger diameter that can be achieved by moving the two or more interlocking cylindrical sections relative to each other such that the expandable sleeve moves from the first diameter to the second diameter when the expandable sleeve is located across the CTO. In other aspects, a guide catheter may include a friction-enhanced outer surface to assist in maintaining the guide catheter in a selected location during use. The friction-enhanced property may be provided using, e.g., materials with an increased coefficient of friction, adding features to the surface of an otherwise smooth guide catheter, etc.

Claims

1. A chronic total occlusion expansion device comprising:

an elongated body comprising a proximal end and a distal end;

a thermoelectric expandable sleeve on the elongated body proximate the distal end of the elongated body, wherein the thermoelectric expandable sleeve comprises a first diameter and a second diameter larger than the first diameter when the thermoelectric expandable sleeve is heated above a selected temperature;

an electric conductor extending from the thermoelectric expandable sleeve towards the proximal end of the elongated body; and

an optional electric power source adapted for electrical connection to the electric conductor element to provide electric energy to raise the temperature of the thermoelectric expandable sleeve;

wherein raising the temperature of the thermoelectric expandable sleeve to the selected temperature or higher causes the thermoelectric expandable sleeve to expand from the first diameter to the second diameter.

2. A device according to claim 1, wherein the thermoelectric expandable sleeve comprises a metal, and wherein, optionally, the metal has a coefficient of thermal expansion of about 10 or more.

3. A device according to claim 1, wherein the thermoelectric expandable sleeve consists essentially of a metal with a coefficient of thermal expansion of about 10 or more.

4. A device according to claim 1, wherein the thermoelectric expandable sleeve comprises a bimetallic element.

5. A device according to claim 1, wherein the thermoelectric expandable sleeve comprises an expandable gel/polymer.

6. A device according to claim 1, wherein the expandable sleeve comprises a mesh.

7. A device according to claim 1, wherein the second diameter of the thermoelectric expandable sleeve is 105% or more of the first diameter of the thermoelectric expandable sleeve.

8. A device according to claim 1, further comprising one or more cutting blades proximate the distal end of the elongated body.

9. A chronic total occlusion expansion device comprising:

an elongated body comprising a proximal end and a distal end, the proximal end and distal end defining a longitudinal axis extending along the elongated body;

an expandable sleeve on the elongated body proximate the distal end of the elongated body, wherein the expandable sleeve comprises two or more interlocking sections having a first diameter when the two or more interlocking sections are in a first configuration such that and a second diameter when the two or interlocking sections are in a second configuration, wherein the second diameter is greater than the first diameter, and further wherein moving the two or more interlocking sections between the first configuration and the second configuration comprises moving the interlocking sections such that they are offset from each other along the longitudinal axis.

10. A device according to claim 9, wherein the expandable sleeve comprises only two interlocking sections.

11. A device according to claim 9, wherein each interlocking section of the two or more interlocking sections comprises a plurality of ramp surfaces.

12. A device according to claim 9, wherein one interlocking section of the two or more interlocking sections comprises an actuating member operably attached thereto and extending towards the proximal end of the elongated body, whereby the actuating member is capable of translating the one interlocking section in a direction aligned with the longitudinal axis.

13. A device according to claim 9, wherein the two or more interlocking sections comprise one or more cutting blades proximate the distal end of the elongated body.

14. A chronic total occlusion expansion device comprising:

an elongated body comprising a proximal end and a distal end, the proximal end and distal end defining a longitudinal axis extending along the elongated body;

a tapered screw operably attached to the elongated body; and

an expandable sleeve on the elongated body proximate the distal end of the elongated body, wherein the expandable sleeve comprises two or more interlocking sections having a first diameter when the two or more interlocking sections are in a first configuration such that and a second diameter when the two or more interlocking sections are in a second configuration, wherein the second diameter is greater than the first diameter, and further wherein moving the two or more interlocking sections between the first configuration and the second configuration comprises driving the tapered screw along the longitudinal axis through the two or more interlocking sections.

15. A device according to claim 14, wherein the expandable sleeve comprises only two interlocking sections.

16. A device according to claim 14, further comprising an actuating member operably attached thereto and extending towards the proximal end of the elongated body, whereby the actuating member is capable of rotating the tapered screw about the longitudinal axis.

17. A device according to claim 14, wherein the two or more interlocking sections comprise one or more cutting blades proximate the distal end of the elongated body.

18-24. -24. (canceled)

25. A guide catheter comprising:

a tubular body comprising a length extending between a proximal end and a distal end;

a lumen extending through the tubular body, the lumen comprising an opening at the distal end of the tubular body;

wherein an outer surface of the tubular body proximate the distal end includes a function-enhanced portion that has a static coefficient of friction that is higher than the static coefficient of friction of the outer surface of the guide catheter surrounding the friction-enhanced portion.

26. A guide catheter according to claim 25, wherein the friction-enhanced portion comprises a structured surface.

27. A guide catheter according to claim 26, wherein the structured surface comprises ribs formed in the outer surface.

28. A guide catheter according to claim 25, wherein the structured surface comprises particles embedded in the outer surface of the tubular body.

29. A guide catheter according to claim 25, wherein the friction-enhanced portion extends along only a portion of the length of the tubular body.

30. A guide catheter according to claim 25, wherein the friction-enhanced portion extends about only a portion of the circumference of the tubular body.