Guided atherectomy system

• US 5,135,531 A
• Filed: 03/27/1990
• Issued: 08/04/1992
• Est. Priority Date: 05/14/1984
• Status: Expired due to Fees

• Current Assignee: Surgical Systems & Instruments, Inc.
• Original Assignee: Surgical Systems & Instruments, Inc.
• Inventors: Shiber, Samuel
• Primary Examiner(s): Hafer, Robert A.
• Assistant Examiner(s): Owens, Kerry
• Application Number:
  US07/499,726
• Time in Patent Office: 861 Days
• Field of Search: 606/159, 606/170, 606/180, 604/98, 604/22
• 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 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00685 Archimedes screw
• CPC Class Codes: A61B 2017/00845 of moving parts with respect to each other
• 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 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2090/378 using ultrasound
• 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: A61M 25/09 Guide wires
• 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 a void for holding obstruction material during the atherectomy process and for accurately guiding a flexible catheter in the vessel. Coupling means at the proximal end of the flexible catheter for coupling it to drive means.

Claims

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

a flexible guide wire insertable into said vessel, said flexible guide wire defining a void for holding the obstruction material,

a flexible catheter with a coring means at its distal end having a continuous passage for ingesting the cored obstruction material, said flexible catheter being guided by and slidableover said flexible guide wire,

coupling means at a proximal end of said flexible catheter for connecting said flexible catheter to drive means.

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

3. An atherectomy system as in claim 1, said coring means being a tubular blade having at least one tooth.

4. An atherectomy system as in claim 1, said coring means utilizing auxiliary energy.

5. An atherectomy system as in claim 1, said coring means being a tubular blade utilizing an auxiliary energy to assist in coring the obstruction material.

6. An atherectomy system as in claim 1, having a flexible sleeve in which said flexible catheter is disposed.

7. An atherectomy system as in claim 6, said flexible sleeve having a means for biasing it in said vessel.

8. An atherectomy system as in claim 7, said biasing means comprise an inflatable chamber formed at said distal end of said flexible sleeve.

9. An atherectomy system as in claim 7, said flexible sleeve having a tongue at its distal end for biasing said flexible sleeve in said vessel.

10. An atherectomy system as in claim 9, said tongue being selectively actuatable.

11. An atherectomy system as in claim 6, wherein fluid transmitting means to said vessel are connected to said flexible sleeve.

12. An atherectomy system as in claim 1, wherein suction is applied to pull the cored obstruction material proximally in said continuous passage.

13. An atherectomy system as in claim 12, wherein said suction is provided by a positive displacement pump means.

14. An atherectomy system as in claim 1, wherein a portion of said flexible guide-wire is inserted distally to said flexible catheter, into said vessel, concentrically aligns said flexible catheter with said vessel.

15. An atherectomy system as in claim 1, wherein a portion of said flexible guide-wire which extends distally from said flexible catheter into said vessel provides a lever arm which angularly aligns said flexible catheter with said vessel.

16. An atherectomy system as in claim 1, wherein at least a portion of said flexible guide wire is shaped as an auger.

17. An atherectomy system as in claim 16, said auger comprising a helical wire made of at least two layers, decreasing its cross section modulus around a neutral axis perpendicular to the auger'"'"'s main axis.

18. An atherectomy system as in claim 1, wherein said flexible guide wire comprises a flexible pilot wire and a flexible casing slidable thereon, said flexible casing defines a void for holding the obstruction material.

19. An atherectomy system as in claim 18, said flexible pilot wire has an auxiliary energy pod at its distal portion.

20. An atherectomy system as in claim 19 wherein said auxiliary energy is emitted by said pilot wire to assist said helical wire in crossing the obstruction material.

21. An atherectomy system as in claim 18, said flexible pilot wire being a tube.

22. An atherectomy system as in claim 18, a portion of said flexible pilot wire is inserted distally to said flexible casing, into said vessel, and provides a lever arm to angularly align said flexible casing with said vessel.

23. An atherectomy system as in claim 18, at least a portion of said flexible casing being a helical wire.

24. An atherectomy system as in claim 23, said helical wire'"'"'s distal end is closed with a thin gate.

25. An atherectomy system as in claim 24, said gate being a short tube attached to the distal end of said helical wire.

26. An atherectomy system as in claim 24, said gate being a tube section attached to the distal end of said helical wire.

27. An atherectomy system as in claim 23, wherein said helical wire emits auxiliary energy through its distal end.

28. An atherectomy system as in claim 23, said helical wire is made of a wire having a decreased cross section modulus around a neutral axis perpendicular to the helical wire'"'"'s main axis.

29. An atherectomy system as in claim 28, said helical wire made of at least two layers, decreasing said helical wire'"'"'s cross section modulus around a neutral axis perpendicular to the helical wire'"'"'s main axis.

30. An atherectomy system as in claim 1, said flexible guide wire having a radially protruding barrier means.

31. An atherectomy system as in claim 30, wherein said barrier means can be selectively expanded.

32. An atherectomy system as in claim 1, said flexible guide wire having a pod at its distal portion for emitting and receiving auxiliary energy.

33. An atherectomy system as in claim 32, said distal end of said flexible guide wire having means to drill through the obstruction material.

34. An atherectomy system as in claim 33, wherein said drilling means comprise sharp protrusions.

35. An atherectomy system as in claim 33, wherein said drilling means utilize auxiliary energy.

36. An atherectomy system as in claim 1, having biasing means to deflect the trajectory of said flexible guide wire in said vessel.

37. An atherectomy system as in claim 36, said biasing means comprising a selectively inflatable asymmetrical chamber formed at said distal end of said flexible sleeve.

38. 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 guide wire, holding the obstruction material with the flexible guide wire,

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

advancing the coring means into the obstruction and coring the obstruction while the coring means is guided in and aligned with the vessel by the flexible guide wire.

39. A process as in claim 38, wherein the insertion of the flexible guide wire into the vessel is assisted by signals generated by auxiliary energy.

40. A process as in claim 38, wherein a radio-opaque fluid is injected through the flexible guide wire to facilitate fluoroscopic imaging of the vessel.

41. A process as in claim 38, wherein suction is used to assist in proximally moving the cored obstruction material in the flexible catheter.

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

43. 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 defining a void for holding the obstruction material,

advancing over the flexible casing a coring means located at a distal end of a flexible catheter,

advancing the coring means into the obstruction and coring the obstruction while the coring means is guided in and aligned with the vessel by the flexible casing.

44. A process as in claim 43, wherein the insertion of the flexible pilot wire into the vessel is assisted by signals generated by auxiliary energy.

45. A process as in claim 43, wherein a radio-opaque fluid is injected through the flexible pilot wire to facilitate fluoroscopic imaging of the vessel.

46. A process as in claim 43, wherein suction is used to assist in proximally moving the cored obstruction material in the flexible catheter.

47. A process as in claim 46, wherein the suction is provided by a positive displacement pump means.