Atherectomy system with a guide wire

• US 4,979,939 A
• Filed: 05/12/1989
• Issued: 12/25/1990
• Est. Priority Date: 05/14/1984
• Status: Expired due to Term

• Current Assignee: Surgical Systems & Instruments, Inc.
• Original Assignee: Surgical Systems & Instruments, Inc.
• Inventors: Shiber, Samuel
• Primary Examiner(s): Hafer, Robert A.
• Assistant Examiner(s): ROONEY, KEVIN
• Application Number:
  US07/350,020
• Time in Patent Office: 592 Days
• Field of Search: 606/159, 606/170, 606/180, 604/22, 604/95, 604/264, 604/267
• US Class Current: 606/159
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• 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
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22052 eccentric
• CPC Class Codes: A61B 2017/320084 Irrigation sleeves
• CPC Class Codes: A61B 2090/031 torque limiting
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 2090/3784 both receiver and transmitter being in the instrument or receiver being also transmitter
• CPC Class Codes: A61B 2090/3933 Liquid markers
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/445 Details of catheter construction
• CPC Class Codes: A61M 1/75 Intermittent or pulsating suction A61M1/63, A61M1/772 take precedence
• CPC Class Codes: F16C 1/02 for conveying rotary movements
• CPC Class Codes: F16C 2316/10 : in medical appliances, e.g. in diagnosis, dentistry, instruments, prostheses, medical imaging appliances
• CPC Class Codes: F16D 7/02 : of the friction type

Abstract

An atherectomy system for coring, ingesting and removing an obstruction material from within a patient'"'"'s vessel having a flexible guide-wire defining voids for containing obstruction material and defining a diametrical envelope, a flexible rotary-catheter slidable and rotatable over the diametrical envelope having a rotary coring means at its distal end, a continuous passage defined around the flexible guide-wire by the flexible rotary-catheter for ingesting the cored obstruction material, and coupling means at the proximal end of the flexible rotary-catheter for coupling to rotating means.

Claims

1. An atherectomy system for coring, ingesting and removing an obstruction material from within a patient'"'"'s vessel, comprising in combination:

a flexible guide-wire insertable into the vessel,

a flexible rotary-catheter slidable over said flexible guide-wire, having a rotary coring means at its distal end,

a continuous passage defined around said flexible guide-wire by said flexible rotary-catheter for ingesting the cored obstruction material,

coupling means at a proximal end of said flexible rotary-catheter for coupling to rotating means,

said flexible guide-wire having a diametrical envelope over which- said flexible rotary-catheter is rotatably and slidably supported, said envelope defining voids for containing the obstruction material.

2. An atherectomy system as in claim 1, wherein said diametrical envelope concentrically aligns the flexible rotary-catheter with the flexible guide-wire and the artery.

3. An atherectomy system as in claim 1, said flexible guide-wire'"'"'s portion which is inserted into said vessel distally to said flexible rotary-catheter provides a lever arm to angularly align said flexible rotary-catheter with the flexible guide-wire and the artery.

4. An atherectomy system as in claim 1, wherein said flexible guide-wire comprises a flexible pilot wire and a flexible casing slidable thereon.

5. An atherectomy system as in claim 4, a portion of said flexible pilot wire which is inserted in said vessel distally to said casing provides a lever arm to angularly align said casing with the flexible pilot-wire and the artery.

6. An atherectomy system as in claim 1, wherein said diametrical envelope comprises at least one radially protruding elongated ridge.

7. An atherectomy system as in claim 6, wherein said elongated ridge is a helix.

8. An atherectomy system as in claim 6, wherein said protrusion of said elongated radially protruding ridge is selectively controlled.

9. An atherectomy system as in claim 8, wherein said envelope comprise an expandable tube with at least one elongated ridge on its periphery.

10. An atherectomy system as in claim 1, said rotary coring means being a tubular-blade.

11. An atherectomy system as in claim 1, said rotary coring means being a variable diameter tubular-blade.

12. An atherectomy system as in claim 1, said rotary coring means being a heated tubular-blade.

13. An atherectomy system as in claim 1, said rotary coring means being a radiation emitting device.

14. An atherectomy system as in claim 1, said diametrical envelope comprises a radially protruding barrier means.

15. An atherectomy system as in claim 14, wherein said barrier means can elastically contract to pass through a narrowed lumen.

16. An atherectomy system as in claim 14, wherein said barrier means can be selectively contracted to pass through a narrowed lumen.

17. An atherectomy system as in claim 1, wherein said flexible rotary-catheter is stiffer and has a higher torque carrying capacity in the vicinity of said proximal end than in the vicinity of said distal end.

18. An atherectomy system as in claim 1, having a flexible sleeve in which said flexible rotary-catheter is rotatably disposed.

19. An atherectomy system as in claim 18, said flexible sleeve having a biasing means for eccentrically biasing said flexible sleeve in the vessel.

20. An atherectomy system as in claim 19, said biasing means comprise a selectively inflatable asymmetrical chamber formed at said distal end of said flexible sleeve.

21. An atherectomy system as in claim 19, said flexible sleeve having a tongue at its distal end for eccentrically biasing said flexible sleeve in the vessel.

22. An atherectomy system as in claim 21, said tongue being selectively actuatable.

23. An atherectomy system as in claim 18, wherein means for introducing fluids into the vessel are connected to said flexible sleeve.

24. An atherectomy system as in claim 1, wherein said flexible rotary-catheter comprises a helical member which pushes the cored obstruction material proximally while said flexible rotary-catheter rotates around said flexible guide-wire.

25. An atherectomy system as in claim 1, wherein suction is applied at said Proximal end of said continuous passage to proximally pull the cored obstruction material in said continuous passage.

26. An atherectomy system as in claim 25, wherein said suction is formed by a positive displacement pump means.

27. An atherectomy system as in claim 1, wherein said flexible guide-wire comprises a tube for transmitting fluid from its proximal end to its distal end.

28. An atherectomy system as in claim 1, wherein said flexible guide-wire is equipped with an ultrasound transducer at its distal end and is connected to a base unit at its proximal end, said flexible guide-wire containing means for transmission of ultrasound energy between said transducer and said base unit.

29. An atherectomy system as in claim 1, wherein said flexible guide-wire is equipped with an laser transducer at its distal end and is connected to a base unit at its proximal end, said flexible guide-wire containing means for transmission of laser energy between said transducer and said base unit.

30. A process for removing an obstruction from an vessel with an atherectomy system, comprising the following steps:

inserting into a vessel, into an obstruction, a flexible guide-wire, having a diametrical envelope which contains voids for accepting the obstruction material,

advancing over the flexible guide-wire a rotary coring means located at a distal end of an atherectomy catheter,

advancing and rotating the rotary coring means into the obstruction and coring the obstruction while the rotary coring means is rotatably supported and aligned with the artery by the diametrical envelope,

removing the atherectomy system containing the obstruction material out of the vessel.

31. A process as in claim 30, wherein said flexible guide-wire is inserted into the vessel under ultrasound guidance.

32. A process as in claim 30, wherein said flexible guide-wire is inserted into the vessel under visual guidance

33. A process as in claim 30, wherein a radio-opaque fluid is injected through the distal end of said flexible guide-wire as it is inserted into the vessel under fluoroscopic guidance.

34. A process as in claim 30, wherein suction is used to assist the mechanical action in enabling the cored obstruction material to move proximally in the continuous passage.

35. A process as in claim 34, wherein said suction is provided by a positive displacement pump means.

36. A process for removing an obstruction from a vessel with an atherectomy system, comprising the following steps:

inserting into a vessel, into an obstruction, a flexible pilot wire,

inserting into a vessel, into an obstruction, over the flexible pilot-wire a flexible casing having a diametrical envelope which contains voids for accepting the obstruction material,

advancing over the casing a rotary coring means located at a distal end of an atherectomy catheter,

advancing and rotating the rotary coring means into the obstruction and coring the obstruction while the rotary coring means is rotatably supported and aligned with the artery by the diametrical envelope,

removing the atherectomy system containing the obstruction material out of the vessel.

37. A process as in claim 36, wherein said flexible guide-wire is inserted into the vessel under ultrasound guidance.

38. A process as in claim 36, wherein said flexible guide-wire is inserted into the vessel under visual guidance.

39. A process as in claim 36, wherein a radio-opaque fluid is injected through the distal end of said flexible guide-wire as it is inserted into the vessel under fluoroscopic guidance.

40. A process as in claim 36, wherein suction is used to assist the mechanical action in enabling the cored obstruction material to move Proximally in the continuous passage.

41. A process as in claim 40, wherein said suction is provided by a positive displacement pump means.