TETHERED COIL FOR TREATMENT OF BODY LUMENS

• US 20120016396A1
• Filed: 09/23/2011
• Published: 01/19/2012
• Est. Priority Date: 11/09/2007
• Status: Active Grant

• Current Assignee: DePuy Synthes Products LLC (Johnson & Johnson)
• Original Assignee: Micrus Endovascular LLC (Johnson & Johnson)
• Inventors: DEHNAD, Houdin
• Granted Patent: US 8,366,738 B2
• Time in Patent Office: Days
• US Class Current: 606/159
• 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 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016

Abstract

Disclosed is an apparatus and a method for removable of undesired material from body lumens. The apparatus may be used for fragmenting or removing a thrombus or occlusion from a blood vessel. The apparatus includes first shape segments and second shape segments connected to form a coiled member. A longitudinally extending tether is positioned inside the first shape segments and outside the second shape segments along the length of the coil. Applying a proximal force on the tether produces a change in the shape of at least a portion of the coil from a first generally linear configuration to a second complex three dimensional shape. A method of using the apparatus to engage and remove, or fragment, the thrombus or occlusion is disclosed.

Claims

1. A method of treatment of a body lumen, comprising:

positioning a catheter inside a body lumen proximate to a region of the body lumen to be treated;

positioning a longitudinal member inside the catheter, the longitudinal member including a plurality of longitudinally connected first shape coil elements and a plurality of longitudinally connected second shape coil elements and having a first flexion point disposed along a length of the longitudinal member, the plurality of first shape coil elements being longitudinally connected with the plurality of second shape coil elements, the plurality of first shape coil elements forming a plurality of first shape coil segments, the plurality of second shape coil elements forming a plurality of second shape coil segments, said plurality of first shape coil segments and said plurality of second shape coil segments being alternatingly longitudinally connected together, and the plurality of first shape coil elements and plurality of second shape coil elements having dissimilar cross sectional configurations, and a tether having a distal end portion attached with the longitudinal member, a proximal end portion disposed proximally to a proximal end of the longitudinal member and having a free end adapted to remain outside of the blood vessel for application of a substantially longitudinal proximally directed force on the tether by a clinician, and an intermediate length portion therebetween extending longitudinally inside a lumen of the first shape coil elements and outside an inner lumen of the second shape coil elements, wherein a first angle of greater than zero degrees is formed at the first flexion point when the substantially longitudinal proximally directed force is applied to the tether free end;

maintaining a free end of the proximal end portion of the tether outside of a proximal end of the catheter throughout the treatment;

delivering a portion of the longitudinal member distal to a distal end of the catheter;

transforming the portion of the longitudinal member from a generally linear configuration to a secondary generally three dimensional configuration by applying a proximally directed force on the proximal end portion of the tether; and

sliding the longitudinal member proximally within the body lumen.

2. The method of treatment of a body lumen of claim 1, further comprising the step of expanding a distal opening of the catheter.

3. The method of treatment of a body lumen of claim 1, further comprising the step of removing an occlusion from the region of the body lumen to be treated.

4. The method of treatment of a body lumen of claim 1, further comprising the step of releasing the proximally directed force on the free end of the proximal end portion of the tether and transforming the portion of the longitudinal member from the secondary generally three dimensional configuration to the generally linear configuration.

5. The method of treatment of a body lumen of claim 1, further including transforming the portion of the longitudinal member from the secondary generally three dimensional configuration to the generally linear configuration by slidingly positioning the catheter over the portion of the longitudinal member.

6. A method of treating a thrombus within a region of a blood vessel, comprising:

positioning a portion of a thrombus engaging device at a region of the blood vessel to be treated, the thrombus engaging device being formed from a plurality of first shape coil segments alternatingly longitudinally connected with a plurality of second shape coil segments, the first shape coil segments being formed from a plurality of first shape coil elements longitudinally connected together and having an inner lumen and a first cross sectional area, and the second shape coil segments being formed from a plurality of second shape coil elements longitudinally connected together and longitudinally connected with said plurality of first coil elements, said second shape coil segments having an inner lumen and a second cross sectional area that is less than the first cross sectional area, the coiled member having a proximal end and a distal end, a first generally linear configuration, and a secondary complex three dimensional configuration, and further including a tether including a distal tether portion, a proximal tether portion, and an intermediate tether portion therebetween, the distal tether portion being connected with the coiled member of the device at an attachment point, and the intermediate tether portion being slidingly disposed generally longitudinally inside the inner lumen of at least one of said plurality of first shape coil segments and outside the inner lumen of at least one of said plurality of second shape coil segments, the proximal tether portion extending proximally beyond the proximal end of the coiled member and adapted for application of a proximal longitudinal force, wherein application of the proximal longitudinal force changes a shape of the coiled member from the first generally linear configuration to the secondary complex three dimensional configuration;

transforming the portion of the thrombus engaging device from the first generally linear configuration to the secondary complex three dimensional configuration by applying a proximally directed force on the tether; and

engaging the thrombus with the thrombus engaging device.

7. The method of claim 6, further comprising the steps of:

positioning a catheter within the blood vessel;

positioning a distal end of the catheter in proximity to the region of the blood vessel to be treated; and

delivering the portion of a thrombus engaging device through the catheter to the region of the blood vessel to be treated.

8. The method of claim 7, further comprising the step of delivering the portion of the thrombus engaged by the thrombus engaging device into the catheter.

9. The method of claim 8, further comprising the step of expanding an opening of the distal end of the catheter to receive the portion of the thrombus therein.

10. The method of claim 8, further comprising the step of transforming the portion of the thrombus engaging device from the secondary complex three dimensional configuration to the first generally linear configuration.

11. A method of treating a thrombus within a region of a blood vessel, comprising:

positioning a portion of a coiled member at a region of the blood vessel to be treated, the coiled member having a plurality of first shape coil segments alternatingly longitudinally connected with a plurality of second shape coil segments, the first shape coil segments having an inner lumen and a first cross sectional area, and the second shape coil segments having an inner lumen and a second cross sectional area that is dissimilar from the first cross sectional area, the coiled member having a proximal end and a distal end, and a tether having a proximal tether portion, a distal tether portion, and an intermediate tether portion between said proximal and distal tether portions, the distal tether portion being connected with the coiled member of the device at an attachment point, and the intermediate tether portion being slidingly disposed inside the inner lumen of said plurality of first shape coil segments and outside the inner lumen of said plurality of second shape coil segments;

transforming the portion of the coiled member from a first generally linear configuration to a secondary complex three dimensional configuration by applying a proximally directed force on the tether; and

engaging the thrombus with the coiled member.

12. The method of claim 11, further comprising the steps of:

positioning a catheter within the blood vessel;

positioning a distal end of the catheter in proximity to the region of the blood vessel to be treated; and

delivering the portion of a coiled member through the catheter to the region of the blood vessel to be treated.

13. The method of claim 12, further comprising the step of delivering the portion of the thrombus engaged by the coiled member into the catheter.

14. The method of claim 13, further comprising the step of expanding an opening of the distal end of the catheter to receive the portion of the thrombus therein.

15. The method of claim 13, further comprising the step of transforming the portion of the coiled member from the secondary complex three dimensional configuration to the first generally linear configuration.