BLOOD FLOW RESTORATION AND THROMBUS MANAGEMENT METHODS
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Accused Products
Abstract
Systems, methods, and devices for the treatment of acute ischemic stroke that provide immediate blood flow restoration to a vessel occluded by a clot and, after reestablishing blood flow, address the clot itself. Immediate blood flow restoration advantageously can facilitate natural lysis of the clot and also can reduce or obviate the concern for distal embolization due to fragmentation of the clot. Several embodiments of the invention provide for progressive, or modular, treatment based upon the nature of the clot. For example, the progressive treatment can comprise a three-step progressive treatment process that includes immediate restoration of blood flow, in-situ clot management, and/or clot removal depending on the particular circumstances of the treatment. The in-situ clot management can include, for example, lysis and maceration. The progressive, or modular, treatment can be provided by a system or kit of one or more treatment devices.
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Citations
38 Claims
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1-10. -10. (canceled)
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11. A thrombus management method without distal embolic protection for the treatment of ischemic stroke, the method comprising:
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identifying a cerebral artery having an occlusive thrombus; inserting a guide catheter into a patient; inserting a guide wire through the guide catheter into the cerebral artery and through the thrombus; inserting a microcatheter over the guidewire and through the thrombus; positioning a distal end of the microcatheter within about a centimeter past the thrombus; inserting an expandable tip assembly comprising a scaffold through the microcatheter; retracting the microcatheter, thereby causing the scaffold to expand; wherein said expansion compresses the thrombus against a wall of the cerebral artery; wherein said compression of the thrombus restores blood flow within the cerebral artery; wherein said restored blood flow facilitates natural lysis of the thrombus; and macerating the thrombus by resheathing the scaffold and unsheathing the scaffold, thereby facilitating mechanical lysis and fragmentation of the thrombus to release embolic particles; wherein the embolic particles flow in the direction of the blood flow and are not captured by any distal embolic protection member, but are instead lysed through the natural lysis process due to the restored blood flow. - View Dependent Claims (12, 13, 14, 21, 22, 23, 24, 25, 26, 32, 33, 34, 35)
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15. A thrombus management method for the treatment of ischemic stroke, the method comprising:
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identifying an occluded blood vessel having an occlusive thrombus; selecting an expandable tip assembly based, at least in part, on a diameter of the identified occluded blood vessel, the expandable tip assembly comprising a proximal elongate member and a distal self-expanding scaffold; inserting the selected expandable tip assembly within the occluded vessel through a microcatheter such that the self-expanding scaffold is positioned at a location of the thrombus in a non-expanded configuration; retracting the microcatheter, thereby causing the scaffold to expand to an expanded configuration; wherein said expansion compresses the thrombus against a wall of the blood vessel; wherein said compression of the thrombus restores blood flow within the blood vessel; wherein said restored blood flow facilitates natural lysis of the thrombus; and macerating the thrombus by resheathing the self-expanding scaffold and unsheathing the self-expanding scaffold within the microcatheter, thereby facilitating mechanical lysis and fragmentation of the thrombus. - View Dependent Claims (16, 17, 18, 19, 20, 27, 28, 29, 30, 31, 36, 37, 38)
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Specification