ANTI-JAMMING AND MACERATING THROMBECTOMY APPARATUSES AND METHODS

• US 20170303948A1
• Filed: 04/25/2017
• Published: 10/26/2017
• Est. Priority Date: 04/25/2016
• Status: Active Grant

• Current Assignee: Stryker Corporation
• Original Assignee: Stryker Corporation
• Inventors: Wallace, Michael P., Greenhalgh, E. Skott, Garabedian, Robert
• Granted Patent: US 10,028,759 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/22031 Gripping instruments, e.g. forceps, for removing or smashing calculi A61B17/221 takes precedence
• 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 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/22001 Angioplasty, e.g. PCTA
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22079 with suction of debris
• CPC Class Codes: A61B 2017/2215 having an open distal end
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/3435 using everted sleeves

Abstract

Mechanical thrombectomy apparatuses that may be configured to prevent or reduce jamming (e.g., “anti-jamming” thrombectomy devices), grab clot, and/or macerate the thrombus, e.g., clot, being removed. These mechanical thrombectomy apparatuses may include a tractor comprising a flexible tube of material that inverts as it rolls over itself while being drawn into a catheter in a conveyor-like motion. In particular, described herein are mechanical thrombectomy apparatuses having tractors selectably extendable projections that may aid in grabbing and/or macerating a clot. Also described herein are seesawing tractors for mechanical thrombectomy apparatuses.

Claims

1. A mechanical thrombectomy apparatus for removing a clot from a vessel without jamming, the apparatus comprising:

an elongate inversion support comprising a catheter having a distal end and a distal end opening;

a tractor comprising a flexible tube that extends distally in an un-inverted configuration within the catheter, inverts over the distal end opening of the catheter and extends proximally in an inverted configuration along the distal end of the catheter, wherein the tractor comprises a tubular wall, further wherein the tractor is configured to invert by rolling over the distal end opening of the catheter when a first end of the tractor is pulled proximally within the catheter,

wherein the tractor is biased to expand to have an inner diameter that is greater than the outer diameter of the catheter in the inverted configuration and is biased to expand to have an inner diameter that is greater than the inner diameter of the catheter in the un-inverted configuration; and

an elongate puller coupled to the first end of the tractor.

2. The apparatus of claim 1, wherein the tractor comprises a woven tube.

3. The apparatus of claim 1, wherein the tractor comprises a braided tube.

4. The apparatus of claim 1, wherein the tractor comprises a knitted material.

5. The apparatus of claim 1, further comprising an outer catheter within which the elongate inversion support extends distally.

6. The apparatus of claim 1, further comprising outer catheter within which the elongate inversion support extends distally and a vacuum source coupled to a proximal end of the outer catheter.

7. The apparatus of claim 1, further comprising outer catheter within which the elongate inversion support extends distally, and a vacuum source coupled to a proximal end of the outer catheter, wherein there is at least about 0.002 inches or greater between the outer diameter of the catheter and the inner diameter of the outer catheter.

8. The apparatus of claim 1, wherein the tractor is sufficiently soft such that without support from the catheter, it collapses radially under an axial compression of less than 200 g of force when inverting.

9. The apparatus of claim 1, wherein the elongate inversion support is configured to withstand buckling of an axial compression of greater than 500 g of force.

10. The apparatus of claim 1, wherein the elongate inversion support is configured to withstand buckling of an axial compression of greater than 1500 g of force.

11. The apparatus of claim 1, wherein the tractor comprises one or more coatings from the group of:

a lubricious coating, a metal coating, a heparin coating, an adhesive coating, and a drug coating.

12. A mechanical thrombectomy apparatus for removing a clot from a vessel without jamming, the apparatus comprising:

an elongate inversion support comprising a catheter having a distal end and a distal end opening;

a tractor comprising a flexible tube that extends distally in an un-inverted configuration within the catheter, inverts over the distal end opening of the catheter and extends proximally in an inverted configuration along the distal end of the catheter, wherein the tractor comprises a tubular wall, further wherein the tractor is configured to invert by rolling over the distal end opening of the catheter when a first end of the tractor is pulled proximally within the catheter,

wherein the tractor is biased to expand to greater than the outer diameter of the catheter in the inverted configuration and is biased to expand to greater than the inner diameter of the catheter in the un-inverted configuration;

an elongate puller coupled to a first end of the tractor and configured to pull the tractor proximally to invert the tractor over the distal end opening; and

a guidewire lumen extending through the elongate inversion support, puller, and tractor that is configured to pass a guidewire.

13. The apparatus of claim 12, wherein the tractor comprises a woven tube.

14. The apparatus of claim 12, wherein the tractor comprises a braided tube.

15. The apparatus of claim 12, wherein the tractor comprises a knitted material.

16. The apparatus of claim 12, further comprising an outer catheter within which the elongate inversion support extends distally.

17. The apparatus of claim 12, further comprising outer catheter within which the elongate inversion support extends distally and a vacuum source coupled to a proximal end of the outer catheter.

18. The apparatus of claim 12, further comprising outer catheter within which the elongate inversion support extends distally, and a vacuum source coupled to a proximal end of the outer catheter, wherein there is at least about 0.002 inches or greater between the outer diameter of the catheter and the inner diameter of the outer catheter.

19. The apparatus of claim 12, wherein the tractor is sufficiently soft such that without support from the catheter, it collapses radially under an axial compression of less than 200 g of force when inverting.

20. The apparatus of claim 12, wherein the elongate inversion support is configured to withstand buckling of an axial compression of greater than 500 g of force.

21. The apparatus of claim 12, wherein the elongate inversion support is configured to withstand buckling of an axial compression of greater than 1500 g of force.

22. The apparatus of claim 12, wherein the tractor comprises one or more coatings from the group of:

a lubricious coating, a metal coating, a heparin coating, an adhesive coating, and a drug coating.