DEVICES AND METHODS FOR VASCULAR RECANALIZATION

• US 20110213403A1
• Filed: 02/23/2011
• Published: 09/01/2011
• Est. Priority Date: 02/23/2010
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Aboytes, Maria
• Granted Patent: US 9,211,396 B2
• Time in Patent Office: Days
• US Class Current: 606/194
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• 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 2017/00778 Operations on blood vessels A61B2017/22097, A61B2017/320741 take precedence
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22054 with two balloons
• CPC Class Codes: A61B 2017/22055 with three or more balloons
• 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
• CPC Class Codes: A61F 2/013 Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
• CPC Class Codes: A61F 2002/018 made from tubes or sheets of material, e.g. by etching or laser-cutting
• CPC Class Codes: A61F 2230/0006 circular
• CPC Class Codes: A61F 2230/0067 conical
• CPC Class Codes: A61F 2230/0069 cylindrical
• CPC Class Codes: A61F 2230/0076 ellipsoidal or ovoid
• CPC Class Codes: A61F 2230/008 paraboloidal
• CPC Class Codes: A61M 2025/0004 having two or more concentrically arranged tubes for forming a concentric catheter system
• CPC Class Codes: A61M 2025/0681 Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
• CPC Class Codes: A61M 2025/109 having balloons for removing solid matters, e.g. by grasping or scraping plaque, thrombus or other matters that obstruct the flow
• CPC Class Codes: A61M 25/0074 Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

In some embodiments, a medical device for recanalizing a vessel having a blockage and restoring blood flow through an obstructed blood vessel includes an expandable member coupled to a core wire and a hypotube that are movable relative to each other to manipulate the expandable member between various configurations. The expandable member having a capture structure in an expanded configuration. The expandable member can include multiple interstices formed by woven mesh filaments or braided strands through which the material blocking the vessel can pass. The capture structure can include a shape on its external surface that facilitates dislodgement and capture of the material within capture spaces created by the expandable member. Some embodiments include a capture sack or cap for capturing material and preventing material from migrating down stream of the blockage. Superoxygenated blood can be infused distal to the blockage to minimize loss of function during an ischemic event.

Claims

1. An apparatus, comprising:

an elongate member; and

an expandable member coupled to a distal portion of the elongate member and configured to be inserted into a blood vessel, the expandable member defining a plurality of openings in a wall of the expandable member,

the expandable member having a collapsed configuration for insertion into the blood vessel and an expanded configuration, the expandable member when in the expanded configuration defining an interior volume in fluid communication with the plurality of openings and configured to receive therein at least a first portion of a bodily tissue,

the expandable member including a first portion having a first outer perimeter, a second portion having a second outer perimeter and a third portion having a third outer perimeter, the second outer perimeter being smaller than the first outer perimeter and smaller than the third outer perimeter such that the expandable member defines a capture region between the first portion and the third portion configured to receive at least a second portion of the bodily tissue.

2. The apparatus of claim 1, further comprising:

a tubular member defining a lumen, the elongate member being movably disposed within the lumen of the tubular member.

3. The apparatus of claim 1, wherein the expandable member is a first expandable member, the apparatus further comprising:

a second expandable member coupled to the distal portion of the elongate member at a non-zero distance from the first expandable member, the second expandable member having a collapsed configuration for insertion into the blood vessel and an expanded configuration, the second expandable member when in the expanded configuration configured to prevent migration of at least one of the second portion of the bodily tissue or a third portion of the bodily tissue within the blood vessel past the second expandable member.

4. The apparatus of claim 1, wherein the first portion of the expandable member forms a substantially parabolic shape when the expandable member is in the expanded configuration, the first portion of the expandable member configured to prevent migration of at least one of the second portion of the bodily tissue or a third portion of the bodily tissue within the blood vessel past the first portion of the expandable member.

5. The apparatus of claim 1, wherein when the expandable member is in the expanded configuration the interior volume defined by the expandable member includes a first interior region associated with the first portion of the expandable member and a second interior region associated with the third portion of the expandable member.

6. The apparatus of claim 1, wherein the elongate member defines a lumen configured to communicate one of oxygenated blood and superoxygenated blood within the blood vessel distal to a blood clot.

7. An apparatus, comprising:

an elongate member;

a first expandable member coupled to a distal portion of the elongate member; and

a second expandable member coupled to the distal portion of the elongate member at a non-zero distance from the first expandable member, the first expandable member defining a plurality of openings in a wall of the first expandable member,

the first expandable member and the second expandable member each configured to be inserted into a blood vessel when in a collapsed configuration,

the first expandable member and the second expandable member each being movable to an expanded configuration when disposed within the blood vessel, the first expandable member when in its expanded configuration defining an interior volume in fluid communication with the plurality of openings and configured to receive at least a first portion of a bodily tissue within the blood vessel through the openings and within the interior volume of the first expandable member;

the second expandable member when in its expanded configuration configured to prevent at least a second portion of the bodily tissue from migrating within the blood vessel past the second expandable member,

the first expandable member and the second expandable member defining a capture region between the first expandable member and the second expandable member, the capture region configured to receive at least one of the second portion of the bodily tissue or a third portion of the bodily tissue,

the first expandable member and the second expandable member being movable to their collapsed configurations while within the blood vessel such that the capture region moves from a first configuration to a second configuration in which the capture region substantially inhibits passage of at least one of the second portion of the bodily tissue or the third portion of the bodily tissue to an area outside the capture region.

8. The apparatus of claim 7, further comprising:

a tubular member defining a lumen, the elongate member being movably disposed within the lumen of the tubular member.

9. The apparatus of claim 7, wherein the second expandable member defines a proximal opening in a wall of the second expandable member, the proximal opening defined at an angle transverse to a longitudinal axis defined by the elongate member.

10. The apparatus of claim 7, wherein the capture region is a first capture region, the first expandable member can be moved from the expanded configuration to a tortuous configuration while disposed within the blood vessel such that a second capture region is defined between a first portion of the first expandable member and a second portion of the first expandable member.

11. The apparatus of claim 7, wherein the capture region is a first capture region, the first expandable member includes a first portion having a first outer perimeter, a second portion having a second outer perimeter and a third portion having a third outer perimeter, the second outer perimeter being smaller than the first outer perimeter and smaller than the third outer perimeter such that the first expandable member defines a second capture region between the first portion and the third portion of the first expandable member.

12. The apparatus of claim 7, wherein the first expandable member includes a first portion and a second portion, the first portion defining a first set of openings from the plurality of openings, the second portion defining a second set of openings from the plurality of openings, the first set of openings having a first size the second set of openings having a second size greater than the first size.

13. A method, comprising:

inserting a distal portion of a medical device into a blood vessel, the medical device including an elongate member and an expandable member coupled to a distal portion of the elongate member, the expandable member defining a plurality of openings in a wall of the expandable member and being in a collapsed configuration during the inserting;

positioning the distal portion of the medical device adjacent a blood clot within the blood vessel;

actuating the medical device at a first time period to move the expandable member from the collapsed configuration to a first expanded configuration in which the expandable member defines an interior region in fluid communication with the plurality of openings and such that the expandable member contacts the blood clot and at least a first portion of the blood clot enters through at least one opening from the plurality of openings and into the interior region of the expandable member; and

actuating the medical device at a second time period to move the expandable member from the first expanded configuration to a second expanded configuration in which the expandable member defines at least one capture region configured to receive a second portion of the blood clot therein.

14. The method of claim 13, wherein the medical device includes a tubular member defining a lumen and the elongate member is movably disposed within the lumen of the tubular member, the actuating at the second time period to move the expandable member to the second expanded configuration includes rotating at least one of the elongate member or the tubular member such that the expandable member is twisted into a tortuous configuration.

15. The method of claim 13, further comprising:

after the actuating the medical device at the second time period, actuating the medical device to move the expandable member to its collapsed configuration while disposed within the blood vessel such that at least a portion of the blood clot is trapped within the expandable member.

16. The method of claim 15, further comprising:

removing the medical device from the blood vessel.

17. The method of claim 13, further comprising:

rotating the expandable member while disposed within the blood vessel and in one of the first expanded configuration and the second expanded configuration such that at least a third portion of the blood clot is moved through at least one opening from the plurality of openings and into the interior volume of the expandable member.

18. The method of claim 13, wherein the expandable member is a first expandable member, the medical device includes a second expandable member coupled to the distal portion of the elongate member at a non-zero distance from the first expandable member, the first expandable member and the second expandable member defining a capture region between the first expandable member and the second expandable member, the method further comprising:

actuating the medical device such that the second expandable member is moved toward the first expandable member and at least one of the second portion of the blood clot or a third portion of the blood clot is trapped between the first expandable member and the second expandable member.

19. The method of claim 13, wherein the elongate member defines a lumen, the method further comprising:

infusing one of oxygenated blood and superoxygenated blood through the lumen of the elongate member and into the blood vessel distal to the blood clot.