METHOD AND APPARATUS FOR INCREASING BLOOD FLOW THROUGH AN OBSTRUCTED BLOOD VESSEL

• US 20110270178A1
• Filed: 07/15/2011
• Published: 11/03/2011
• Est. Priority Date: 02/01/2006
• Status: Active Grant

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Inventors: Fiorella, David, Woo, Henry
• Granted Patent: US 8,317,748 B2
• Time in Patent Office: Days
• US Class Current: 604/103.02
• 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 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22061 for spreading elements apart
• CPC Class Codes: A61B 2017/22084 stone- or thrombus-dissolving
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/320008 Scrapers
• CPC Class Codes: A61B 2017/320733 with a flexible cutting or scraping element, e.g. with a whip-like distal filament member
• CPC Class Codes: A61B 2017/320741 for stripping the intima or the internal plaque from a blood vessel, e.g. for endarterectomy
• CPC Class Codes: A61M 2025/1088 having special surface characteristics depending on material properties or added substances, e.g. for reducing friction
• CPC Class Codes: A61M 2025/1095 with perfusion means for enabling blood circulation while the balloon is in an inflated state or in a deflated state, e.g. permanent by-pass within catheter shaft
• 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 25/1027 Making of balloon catheters
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

A method of increasing blood flow through an obstructed blood vessel includes providing an expandable member substantially made of a mesh having a plurality of interstices. The expandable member is inserted into the blood vessel, positioned within the blood vessel with the proximal member end upstream of the distal member end and the member body located radially adjacent at least a portion of an obstruction, and expanded to bring at least a portion of the member body into contact with the obstruction. An outward radial force is exerted on the obstruction to dislodge at least one fragment from the obstruction and to enhance blood flow through the blood vessel past the obstruction. The at least one fragment is passed through at least one interstice of the member body in the radial direction, and is selectively retained within the expandable member.

Claims

1. An expandable member, comprising:

a proximal member end;

a distal member end, longitudinally spaced from the proximal member end;

a tubular member body extending between the proximal and distal member ends and adapted to selectively contact at least a portion of an obstruction within a blood vessel in a radial direction, to dislodge at least one fragment from the obstruction, and to enhance blood flow through the blood vessel past the obstruction;

at least one of the proximal and distal member ends being closed;

the member body being made of a first mesh having a plurality of first interstices, at least one of the first interstices being adapted to allow passage of at least one fragment therethrough in a radial direction into the member body; and

a closed one of the proximal and distal member ends being made of a second mesh having a plurality of second interstices, at least one of the second interstices being adapted to selectively allow passage of at least one fragment therethrough.

2. The expandable member of claim 1, including at least one radiopaque portion.

3. The expandable member of claim 1, being at least partially constructed of a self-expanding material.

4. The expandable member of claim 1, wherein the blood vessel is a cerebral blood vessel.

5. The expandable member of claim 1, being at least partially adapted to elute a pharmaceutical agent.

6. The expandable member of claim 5, wherein the pharmaceutical agent is adapted to at least partially lyse the at least one fragment.

7. The expandable member of claim 1, wherein the first mesh is formed integrally with the second mesh.

8. The expandable member of claim 1, wherein at least one of the first interstices is defined by a plurality of first strands, and at least one of the plurality of first strands is adapted to penetrate into the obstruction to longitudinally separate the at least one fragment from a remaining portion of the obstruction.

9. The expandable member of claim 1, wherein at least one of the second interstices is defined by a plurality of second strands, at least one of the plurality of second strands is adapted to break the at least one fragment into a plurality of subfragments, and at least one of the second interstices is adapted to selectively allow passage therethrough of at least one subfragment to release the at least one subfragment from the expandable member.

10. The expandable member of claim 1, wherein at least one of the plurality of second interstices is smaller than at least one of the plurality of first interstices.

11. The expandable member of claim 1, wherein the size of at least one of the plurality of second interstices is chosen depending upon an allowable particulate size of the blood vessel.

12. The expandable member of claim 1, wherein the tubular member body is adapted to compress at least a portion of the obstruction against a vessel wall of the blood vessel.

13. The expandable member of claim 1, wherein the member body defines a body interior, the expandable member including a guidewire extending longitudinally between the distal and proximal member ends through the body interior, the guidewire being attached to a closed one of the distal and proximal member ends.

14. The expandable member of claim 13, wherein the guidewire extends beyond at least one of the distal and proximal member ends and is adapted to removably attach the expandable member to a delivery system.

15. The expandable member of claim 1, including a plurality of strands forming the first and second meshes and wherein each of the strands is oriented in at least one of a helical, longitudinal, and radial direction with respect to the member body.

16. An apparatus for increasing blood flow through an obstructed blood vessel, the apparatus comprising:

a delivery catheter, having proximal and distal catheter ends separated by a hollow catheter lumen and defining a longitudinal axis, the distal catheter end adapted for placement within the blood vessel adjacent an obstruction;

a guidewire, having proximal and distal guidewire ends longitudinally separated by a guidewire body, the guidewire being adapted for selective insertion through the catheter lumen; and

an expandable member removably attached to the guidewire adjacent the distal guidewire end, being selectively moveable between a first, collapsed condition and a second, expanded condition, and adapted for passage through the catheter lumen in the collapsed condition and selective release from the catheter lumen and placement into the expanded condition adjacent the obstruction, the expandable member including;

a proximal member end;

a distal member end, longitudinally spaced from the proximal member end;

a tubular member body extending between the proximal and distal member ends and adapted to selectively contact at least a portion of the obstruction in a radial direction, to dislodge at least one fragment from the obstruction and to enhance blood flow through the blood vessel past the obstruction, when the expandable member is in the expanded condition;

at least one of the proximal and distal member ends being closed;

the tubular member body being made of a first mesh having a plurality of first interstices, at least one of the first interstices being adapted to allow passage of the at least one fragment therethrough in a radial direction into the member body; and

a closed one of the proximal and distal member ends being made of a second mesh having a plurality of second interstices, at least one of the second interstices being adapted to selectively allow passage of the at least one fragment therethrough.

17. The apparatus of claim 16, wherein at least one of the delivery catheter, guidewire, and expandable member includes at least one radiopaque portion.

18. The apparatus of claim 16, wherein the expandable member is constrained in the collapsed condition by the delivery catheter and self-expands into the expanded condition upon removal from the delivery catheter.

19. The apparatus of claim 16, including an inflation catheter adapted for selective insertion through the catheter lumen and operative to selectively manually expand the expandable member adjacent at least a portion of the obstruction.

20. The apparatus of claim 16, wherein the blood vessel is a cerebral blood vessel.

21. The apparatus of claim 16, wherein the delivery catheter is operative to provide a pharmaceutical agent to the blood vessel at a location adjacent the obstruction.

22. The apparatus of claim 21, wherein the pharmaceutical agent is a lysing agent and is operative upon at least one of the obstruction and the at least one fragment.

23. The apparatus of claim 16, wherein at least one of the first interstices is defined by a plurality of first strands, and at least one of the plurality of first strands is adapted to penetrate into the obstruction as the expandable member expands, to longitudinally separate the fragment from a remaining portion of the obstruction.

24. The apparatus of claim 16, wherein at least one of the second interstices is defined by a plurality of second strands, at least one of the plurality of second strands is adapted to break the at least one fragment into a plurality of subfragments, and at least one of the second interstices is adapted to selectively allow passage therethrough of at least one subfragment to release the at least one subfragment from the expandable member.

25. The apparatus of claim 16, including an aspiration catheter adapted for selective insertion through the catheter lumen and operative to selectively remove at least one fragment from the expandable member under suction power.

26. The apparatus of claim 16, wherein the expandable member is adapted to compress at least a portion of the obstruction against a vessel wall of the blood vessel.

27. The apparatus of claim 16, wherein the expandable member is collapsed from the expanded condition to the collapsed condition and removed from the blood vessel through the delivery catheter.

28. The apparatus of claim 27, wherein at least one fragment is carried from the blood vessel within the expandable member.

29. The apparatus of claim 16, wherein the expandable member is collapsed from the expanded condition to the collapsed condition, moved within the blood vessel, and re-expanded from the collapsed condition to the expanded condition.

30. The apparatus of claim 16, wherein the distal guidewire end is attached to the expandable member and the expandable member is adapted for release from the guidewire body when the expandable member is in the expanded condition.