Atherectomy device and method

• US 4,979,951 A
• Filed: 01/18/1989
• Issued: 12/25/1990
• Est. Priority Date: 05/30/1984
• Status: Expired due to Term

• Current Assignee: Advanced Cardiovascular Systems Incorporated (Abbott Laboratories)
• Original Assignee: John B. Simpson
• Inventors: Simpson, John B.
• Primary Examiner(s): Bennet, Henry A.
• Application Number:
  US07/298,846
• Time in Patent Office: 706 Days
• Field of Search: 128/751, 128/752, 128/755, 604/101, 604/96, 606/159
• US Class Current: 606/159
• CPC Class Codes: A61B 10/0275 with sample notch, e.g. on the side of inner stylet
• CPC Class Codes: A61B 10/04 Endoscopic instruments
• CPC Class Codes: A61B 17/22031 Gripping instruments, e.g. forceps, for removing or smashing calculi A61B17/221 takes precedence
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/3205 Excision instruments
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/00845 of moving parts with respect to each other
• CPC Class Codes: A61B 2017/00853 low friction, hydrophobic and corrosion-resistant fluorocarbon resin coating (ptf, ptfe, polytetrafluoroethylene)
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22052 eccentric
• CPC Class Codes: A61B 2017/22074 the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
• CPC Class Codes: A61B 2017/22075 with motorized advancing or retracting means
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 2090/3933 Liquid markers
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for
• CPC Class Codes: A61F 2/01 Filters implantable into blood vessels
• CPC Class Codes: A61M 2025/1093 having particular tip characteristics
• CPC Class Codes: A61M 25/104 used for angioplasty

Abstract

Atherectomy device having a generally cylindrical housing formed of a relatively rigid material. The housing has rounded distal and proximal end portions. The housing is formed with a cutout extending longitudinally of the housing on one side of the housing. An atheroma cutter is disposed to the proximal end of the housing and is used for advancing the housing into the arterial passage. A flexible drive cable extends through the flexible guide and is connected to the atheroma cutter for operation of the atheroma cutter.

Claims

1. An atherectomy device comprising:

a flexible member having proximate and distal ends;

a housing disposed at the distal end of the flexible member, said housing having a cutout extending longitudinally on one side thereof and having a length greater than the width of the housing;

cutting means disposed within the housing;

drive means for translating the cutting means relative to the housing so that said cutting means will move past the cutout in the housing; and

means on the housing for urging the housing in the direction of the cutout when the housing is in a blood vessel.

2. An atherectomy device as in claim 1, wherein the means for urging the housing in the direction of the cutout comprises a balloon mounted externally on the housing at a position opposite the cutout and means for inflating the balloon.

3. An atherectomy device as in claim 1, wherein the cutting means includes an arcuate cutting edge and the means for translating includes means for simultaneously rotating the arcuate cutting edge as it is moved past the cutout.

4. An atherectomy device as in claim 3, wherein the arcuate cutting edge defines a continuous cutting edge.

5. An atherectomy device as in claim 3, wherein the means for translating and rotating the cutting means includes an elongate torque member extending from the proximate end of the flexible member to the cutting means.

6. An atherectomy device as in claim 5, wherein the means for translating and rotating includes a motor attached to a proximal end of the elongate torque member.

7. An atherectomy device as in claim 1, further comprising means on the housing for guiding the flexible member through a patient'"'"'s vascular system.

8. An atherectomy device as in claim 7, wherein the guiding means on the housing comprises a fixed guide wire.

9. An atherectomy device as in claim 7, wherein the guiding means comprises an axial passage in the housing capable of receiving a guide wire therethrough.

10. An atherectomy device comprising:

a flexible member having proximate and distal ends;

a housing disposed at the distal end of the flexible member, said housing having a cutout extending longitudinally on one side thereof and having a length greater than the width of the housing;

cutting means having an arcuate cutting edge disposed within the housing;

means for longitudinally translating the cutting means relative to the housing so that said cutting means will move past the cutout in the housing; and

means for rotating the cutting means while it is being longitudinally translated, whereby atheroma extending through the cutout into the housing may be severed.

11. An atherectomy device as in claim 10, wherein the rotating means includes a motor disposed at the proximal end of the flexible member and an elongate torque member coupling the motor to the cutting means.

12. An atherectomy device as in claim 11, wherein the motor can rotate the cutting means at from 1500 to 2500 revolutions per minute.

13. An atherectomy device as in claim 10, further comprising means on the housing for urging the housing in the direction of the cutout when the housing is in a blood vessel.

14. An atherectomy device as in claim 10, further comprising means on the housing for guiding the flexible member through a patient'"'"'s vascular system.

15. An atherectomy device as in claim 14, wherein the guiding means comprises a fixed guide wire.

16. An atherectomy device as in claim 14, wherein the guiding means comprises an axial passage capable of receiving a guide wire therethrough.

17. An atherectomy device as in claim 10, wherein the arcuate cutting edge is a circle or an ellipse.

18. An atherectomy device comprising:

a flexible member having proximate and distal ends;

a housing disposed at the distal end of the flexible member, said housing having a cutout extending longitudinally on one side thereof and having a length greater than the width of the housing;

cutting means disposed within the housing;

drive means for translating the cutting means relative to the housing so that said cutting means will move past the cutout in the housing; and

means on the housing for guiding the flexible member through a patient'"'"'s vascular system.

19. An atherectomy device as in claim 18, wherein the means on the housing for guiding the flexible member is a fixed guide wire.

20. An atherectomy device as in claim 18, wherein the means on the housing for guiding the flexible member is an axial passage capable of receiving a guide wire.

21. An atherectomy device as in claim 18, further comprising means on the housing for urging the housing in the direction of the cutout when the housing is in a blood vessel.

22. An atherectomy device as in claim 18, wherein the cutting means includes an arcuate cutting edge and the means for translating includes means for simultaneously rotating the arcuate cutting edge as it is move past the cutout.

23. An atherectomy device as in claim 22, wherein the arcuate cutting edge defines a continuous cutting edge.

24. An atherectomy device as in claim 22, wherein the means for translating and rotating the cutting means includes an elongate torque member extending from the proximate end of the flexible member to the cutting means.

25. An atherectomy device as in claim 24, wherein the means for translating and rotating includes a motor attached to a proximal end of the elongate torque member.

26. An atherectomy device comprising:

a flexible member having a proximate and distal ends and a lumen extending between said proximate and distal ends;

a cylindrical housing disposed at the distal end of the flexible member, said housing having a cutout extending longitudinally on one side thereof and having a length greater than the diameter of the housing;

an elongate torque member disposed within the lumen and extending from the proximal end of the flexible member in to the cylindrical housing;

a cutter member having an arcuate cutting edge attached to a distal end of the flexible torque cable within the housing;

means for axially translating a proximal end of the torque cable, whereby the cutter may be moved past the cutout in the cylindrical housing;

a motor attached to the proximal end of the elongate torque member, whereby the cutter member may be rotated while it is being axially moved;

means on the housing for urging the housing in the direction of the cutout when the housing is in a blood vessel; and

means on the housing for guiding the flexible member through a patient'"'"'s vascular system.

27. An atherectomy device as in claim 26, wherein the arcuate cutting edge defines a continuous cutting edge.

28. An atherectomy device as in claim 26, wherein the means for translating includes a pair of mutually reciprocable members, with one member attached to the flexible member and the other member attached to the elongate torque member, wherein the reciprocable members may be manually reciprocated with one hand.

29. An atherectomy device as in claim 26, wherein the motor is mounted within the reciprocable member attached to the elongate torque member.

30. An atherectomy device as in claim 26, wherein the means for urging the housing in the direction of the cutout comprises a balloon mounted externally on the housing at a position opposite the cutout and means for inflating the balloon.

31. An atherectomy device as in claim 26, wherein the means on the housing for guiding the flexible member is a fixed guide wire.

32. An atherectomy device as in claim 26, wherein the means on the housing for guiding the flexible member is an axial passage capable of receiving a guide wire.

33. A method for removing atheromic material from a blood vessel, said method comprising:

(a) positioning a housing having a longitudinally extending cutout within the blood vessel proximate an atheroma, said cutout having a length greater than the width of the housing;

(b) urging the cutout against the atheroma so that an elongate portion of the atheromic material enters the housing; and

(c) translating a cutting blade past the cutout while the housing is held generally in place relative to the atheroma, whereby the elongate portion of the atheromic material is severed and captured within the housing.

34. A method as in claim 33, wherein the housing is positioned over a guide wire.

35. A method as in claim 33, wherein the housing is positioned using a fixed guide wire attached to the housing.

36. A method as in claim 33, wherein the cutout is urged against the atheroma by inflating a balloon secured to the housing on a side opposite the cutout.

37. A method as in claim 33, wherein the cutting blade is translated longitudinally across the cutout.

38. A method as in claim 37, wherein the cutting blade is arcuate and is rotated while it is translated longitudinally across the cutout.

39. A method as in claim 36, wherein the cutting blade is rotated at from about 1500 to 2500 revolutions per minute.

40. A method as in claim 39, wherein the blade is rotated by a motor.

41. A method as in claim 33, wherein steps (b) and (c) are repeated in order to remove additional portions of atheromic material.

42. A method as in claim 41, wherein steps (b) and (c) are repeated without removing the housing from the blood vessel.

43. A method as in claim 41, wherein the housing is repositioned between successive translations of the cutting blade.

44. A method for removing atheromic material from a blood vessel, said method comprising:

(a) positioning a housing having a longitudinally-extending cutout within the blood vessel proximate an atheroma, said cutout having a length greater than the width of the housing;

(b) urging the cutout against the atheroma so that an elongate portion of the atheromic material enters the housing; and

(c) translating and rotating a cup-shaped blade past the cutout while the housing remains urged against the atheroma, whereby the elongate portion of the atheromic material is severed and collected within the housing and the likelihood of releasing severed atheromic material into the blood vessel is minimized.

45. A method as in claim 44, wherein the housing is positioned over a guide wire.

46. A method as in claim 44, wherein the housing is positioned using a fixed guide wire attached to the housing.

47. A method as in claim 44, wherein the cutout is urged against the atheroma by inflating a balloon secured to the housing on a side opposite the cutout.

48. A method as in claim 47, wherein the blade is rotated at from about 1500 to 2500 revolutions per minute.

49. A method as in claim 46, wherein the blades is rotated by a motor.

50. A method as in claim 44, wherein steps (b) and (c) are repeated in order to remove additional portions of atheromic material.

51. A method as in claim 50, wherein steps (b) and (c) are repeated without removing the housing from the blood vessel.

52. A method as in claim 50, wherein the housing is repositioned between successive translations of the cutting blade.

53. An atherectomy device comprising:

a flexible member having proximate and distal ends;

a housing disposed at the distal end of the flexible member, said housing having a cutout extending longitudinally on one side thereof, wherein the cutout has a length greater than the width of the housing and the remaining portion of the housing in the vicinity of the cutout forms substantially a semi-cylinder;

cutting means having an arcuate cutting edge disposed within the housing;

means for longitudinally translating the cutting means relative to the housing so that said cutting means will advance past the cutout in the housing; and

means for rotating the cutting means while it is being longitudinally translated, whereby atheroma extending through the cutout into the housing may be severed.

54. An atherectomy device as in claim 53, wherein the rotating means includes a motor disposed at the proximal end of the flexible member and an elongate torque member coupling the motor to the cutting means.

55. An atherectomy device as in claim 54, wherein the motor can rotate the cutting means at from 1500 to 2500 revolutions per minute.

56. An atherectomy device as in claim 53, further comprising means on the housing for urging the housing in the direction of the cutout when the housing is in a blood vessel.

57. An atherectomy device as in claim 53, further comprising means on the housing for guiding the flexible member through a patient'"'"'s vascular system.

58. An atherectomy device as in claim 57, wherein the guiding means comprises a fixed guide wire.

59. An atherectomy device as in claim 57, wherein the guiding means comprises an axial passage capable of receiving a guide wire therethrough.

60. An atherectomy device as in claim 53, wherein the arcuate cutting edge is a circle or an ellipse.