Endarterectomy apparatus and method

• US 4,890,611 A
• Filed: 04/05/1988
• Issued: 01/02/1990
• Est. Priority Date: 04/05/1988
• Status: Expired due to Term

• Current Assignee: Thomas J. Fogarty
• Original Assignee: Thomas J. Fogarty
• Inventors: Monfort, Michelle Y., Mollenauer, Kenneth H., Chin, Albert K.
• Primary Examiner(s): Thaler, Michael H.
• Assistant Examiner(s): Lewis, William
• Application Number:
  US07/178,029
• Time in Patent Office: 637 Days
• Field of Search: 128/304, 128/305, 128/341, 128/344, 128/348.1, 128/303 R, 128/774, 604/53, 604/101, 604/104, 604/264, 604/266, 604/267, 73/862.53, 73/862.39, 73/862.62
• 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 2017/2212 having a closed distal end, e.g. a loop
• 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: A61B 90/03 Automatic limiting or abutting means, e.g. for safety

Abstract

Radially expansible, helically configured wire loops are employed to grip and shear arteriosclerotic deposits from the lumen of an artery wall. Shearing action is achieved by pulling the loops through the artery by means of a handle which is freely rotatable to avoid the application of torsional forces to the loops. A shear force gauge may be provided to measure and limit the pulling force applied to the loops.

Claims

1. An endarterectomy instrument for removing an arteriosclerotic deposit adhered around the interior of an artery, said instrument comprising:

a flexible catheter having a proximal and a distal end;

a flexible guidewire having a proximal and a distal end, said guidewire slidably extending through and protruding from said catheter and having affixed to its proximal end a handle;

collapsible plaque gripping and shearing means comprising at least one flexible wire having a first end affixed to the distal end of said guidewire and a second end affixed to the distal end of said catheter, said means being variably expansible and contractible by longitudinal movement of said guidewire relative to said catheter between a first reduced diameter condition of a cross-section enabling the means to be passed through the artery and into the deposit without abrading the artery and a second expanded diameter condition embedded in gripping engagement with the deposit without substantial contact of the means with the artery; and

,

a shear force gauge to apply pulling force to the catheter and measure the pulling force applied to the plaque gripping and shearing means through the catheter, said gauge comprising;

a gauge block affixed to the proximal end of the catheter, said block having gradation indicia on the external surface thereof;

a pulling member slidably and rotatably received on the catheter adjacent the distal end thereof, said member having a portion thereof alignable with the indicia on the block; and

a compression coil spring received on the catheter intermediate the gauge block and pulling member.

2. A method for removing an arteriosclerotic deposit adhered around the interior of an artery, said method comprising:

providing an endarterectomy device comprising first and second telescopically interrelated members having secured therebetween a resilient wire capable of assuming a radially expanded configuration upon relative movement of said members in a first direction and assuming a radially contracted condition upon relative movement of said members in a second direction;

making an incision in an artery adjacent to the deposit;

introducing the endarterectomy device into the artery through said incision with the wire radially contracted by movement of said telescopically interrelated members in the second direction to pass the wire through the artery without abrading the interior thereof;

feeding the endarterectomy device longitudinally of said artery to emplace the wire within the deposit;

radially expanding the wire by movement of said telescopically interrelated members in the first direction to embed the wire in gripping engagement with the deposit without substantial contact of the wire with the artery; and

pulling the device through said incision to withdraw the device from the artery with the wire in the radially expanded condition, thereby traversing and shearing away at least a portion of the deposit and removing said portion from the artery.

3. A method for removing an arteriosclerotic deposit adhered around the interior of an artery, said method comprising:

providing an endarterectomy device having a proximal end and a distal end and comprising first and second telescopically interrelated members having secured therebetween a resilient wire capable of assuming a radially expanded configuration upon relative movement of said members in first direction and assuming a radially contracted condition upon relative movement of said members in a second direction;

making a proximal and a distal incision in an artery adjacent to the deposit;

introducing the proximal end of said endarterectomy device into the artery through the distal incision;

feeding the proximal end longitudinally through said artery toward and out of the proximal incision;

introducing the distal end of said device through the distal incision, with the wire radially contracted by movement of said telescopically interrelated members in the second direction to pass the wire through the artery without abrading the interior thereof, by pulling said device longitudinally through said artery from the proximal incision, thereby emplacing the endarterectomy device within said artery and the wire within deposit therein;

radially expanding the wire by movement of said telescopically interrelated members in the first direction to embed the wire in gripping engagement with the deposit without substantial contact of the wire with the artery; and

pulling the device through the proximal incision to withdraw the device from the artery with the wire in the radially expanded condition, thereby traversing and shearing away at least a portion of the deposit.