Catheter atherotome
First Claim
1. An elongate blade for use in a catheter atherotome basket knife which selectively surgically pares away atherosclerotic plaque from an interior lumen of an artery only when the basket knife is drawn proximally across a site comprising the plaque, said elongate blade comprising:
- means for interconnecting each end of the elongate blade to a knife forming fitting;
means centrally disposed along the length of the elongate blade for surgically paring the plaque from the interior lumen of the artery comprising a sharpened plaque planing edge only along the side of the paring means to be proximally disposed in the knife fitting;
in combination, means to be proximally and distally disposed in the basket knife between the surgically paring means and the interconnecting means for radially bowing the blade outwardly when the interconnecting means are moved closer one to the other or when the relative radial position of said interconnecting means is appropriately changed, the radially bowing means comprising structure which is more flexible than the surgically paring means and therefore being principally responsible for bowing the elongate blade to form a circumferentially extended planing portion of the basket knife and for varying angles of incidence and attack of the surgically paring means while the radius of curvature of the surgical paring means relative to a longitudinal axis of the catheter remains relatively unchanged.
3 Assignments
0 Petitions
Accused Products
Abstract
A catheter atherotome and method for its use for performing partial atherectomy in an artery and thereby enlarging the lumen effectively available for blood flow through the artery. Several blades are mounted at a distal end of a catheter, in a helical basket configuration and spaced angularly apart from one another about the associated ends of two concentric sheaths in such a way that longitudinal and rotary relative movement of the sheaths selectively bows the blades arcuately outwardly into a cutting position or draws the blades flat into alignment with the sheaths. The blades have sharpened cutting edges extending helically and directed toward the catheter'"'"'s proximal end when the blades are bowed. Partial removal of an atheroma is effected by manually pulling the basket knife past an atheroma with the basket blades in their outwardly bowed cutting positions, with the speed, force, and amount of expansion of the blades determined by the operator. Removal of cut-away pieces of atherosclerotic plaque material is accomplished either by pull-back of a balloon embolectomy catheter or by use of a latex membrane enshrouding the spiral wire blades to trap the shavings within the membrane.
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Citations
35 Claims
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1. An elongate blade for use in a catheter atherotome basket knife which selectively surgically pares away atherosclerotic plaque from an interior lumen of an artery only when the basket knife is drawn proximally across a site comprising the plaque, said elongate blade comprising:
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means for interconnecting each end of the elongate blade to a knife forming fitting; means centrally disposed along the length of the elongate blade for surgically paring the plaque from the interior lumen of the artery comprising a sharpened plaque planing edge only along the side of the paring means to be proximally disposed in the knife fitting; in combination, means to be proximally and distally disposed in the basket knife between the surgically paring means and the interconnecting means for radially bowing the blade outwardly when the interconnecting means are moved closer one to the other or when the relative radial position of said interconnecting means is appropriately changed, the radially bowing means comprising structure which is more flexible than the surgically paring means and therefore being principally responsible for bowing the elongate blade to form a circumferentially extended planing portion of the basket knife and for varying angles of incidence and attack of the surgically paring means while the radius of curvature of the surgical paring means relative to a longitudinal axis of the catheter remains relatively unchanged. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. An elongate blade for use in a catheter atherotome basket knife which selectively surgically pares away atherosclerotic plaque from an interior lumen of an artery only when the basket knife is drawn proximally across a site comprising the plaque, said elongate blade comprising:
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means for interconnecting each end of the elongate blade to a knife forming fitting; means centrally disposed along the length of the elongate blade for surgically paring the plaque from the interior lumen of the artery comprising a sharpened plaque planing knife-edge only along a side to be proximally disposed in the knife fitting; in combination, means to be proximally and distally disposed in the basket knife between the surgically paring means and the interconnecting means for radially bowing the blade outwardly when the interconnecting means are moved closer one to the other or when the relative radial position of said interconnecting means is appropriately changed, the radially bowing means comprising structure which is more flexible than the surgically paring means and therefore being principally responsible for bowing the elongate blade to form a circumferentially extended planing portion of the basket knife and for varying angles of incidence and attack of the surgically paring means while the radius of curvature of the surgical paring means relative to a longitudinal axis of the catheter remains relatively unchanged;
the bowing and varying means comprising a segment which everts the surgically paring means responsive to contact with irregular plaque surfaces proximally disposed to the basket knife in the arterial lumen and thereby changes the angles of incidence and attack of the plaque planing knife-edge to cut more effectively.
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10. A catheter atherotome basket knife which selectively surgically pares away atherosclerotic plaque from an interior lumen of an artery only when the basket knife is drawn proximally across a site comprising the plaque, said basket knife comprising:
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at least two elongate blades; a first knife forming end fitting comprising means for securely attaching one end of the basket knife to a distal end of a first elongated member of a catheter atherotome; a second knife forming end fitting comprising means for securely attaching an opposing end of the basket knife to a second elongated member of the catheter atherotome which is translationally and rotationally movable relative to the first elongated member; the first knife forming end fitting comprising means for affixing one end of each of the elongate blades thereat; the second knife forming end fitting comprising means for affixing the other end of each of the elongate blades thereat such that the angular separation of the ends of each of the elongate blades is substantially the same; each of the elongate blades comprising; means for interconnecting each end of each elongate blade to a predetermined knife forming end fitting; means centrally disposed along the length of the elongate blade for surgically paring the plaque from the interior lumen of the artery, the paring means comprising a sharpened plaque planing knife-edge only along the side of the surgically paring means proximally disposed in the basket knife; in combination, flexible means disposed proximally and distally in the basket knife between the surgically paring means and the interconnecting means for bowing the elongate blade to form an outwardly extended planing portion of the basket knife and for varying angles of incidence and attack of the surgically paring means responsive to translational and rotational movement of the elongate members of the catheter atherotome. - View Dependent Claims (11, 12, 13, 14, 15, 16)
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17. A catheter atherotome basket knife which selectively surgically pares away atherosclerotic plaque from an interior lumen of an artery only when the basket knife is drawn proximally across a site comprising the plaque, said basket knife comprising:
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at least two elongate blades; a first knife forming end fitting comprising means for securely attaching one end of the basket knife to a distal end of a first elongated member of a catheter atherotome; a second knife forming end fitting comprising means for securely attaching an opposing end of the basket knife to a distal end of a second elongated member of the catheter atherotome which is translationally and rotationally movable relative to the first elongated member; the first knife forming end fitting comprising means for affixing a predetermined end of each of the elongate blades thereat; the second knife forming end fitting comprising means for affixing the other end of each of the elongate blades thereat; each of the elongate blades comprising; means for interconnecting each end of the elongate blade to the knife forming fitting; means centrally disposed along the length of the elongate blade for surgically paring the plaque from the interior lumen of the artery, the paring means comprising a sharpened plaque planing edge only along the side of the surgically paring means which is proximally disposed in the basket knife; in combination, flexible means proximally and distally disposed between the surgically paring means and the interconnecting means for bowing the elongate blade to form an outwardly extended planing portion of the basket knife and for varying angles of incidence and attack of the surgically paring means responsive to translational and rotational movement of the elongated members of the catheter atherotome; the proximally disposed flexible bowing and angle varying means comprising a segment which everts the surgically paring means responsive to contact with irregular plaque surfaces in the arterial lumen and thereby effectively changes the angles of incidence and attack of the plaque planing edge.
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18. A catheter atherotome which is sufficiently flexible to follow a path of an artery in which the atherotome is insertably guided and is used in surgical removal of plaque from an interior wall site of the artery, said catheter atherotome comprising:
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an elongate flexible tubular outer sheath having respective proximal and distal ends; an elongate flexible tubular inner member disposed within and translationally and rotationally movable relative to said outer sheath and having proximal and distal ends; a basket knife having a predetermined proximal and distal orientation involving a basket knife proximal end and a basket knife distal end, means for attaching one basket knife end at the distal end of the outer sheath and means for attaching the other basket knife end at the distal end of the inner member such that the basket knife proximal end is proximally disposed; the basket knife comprising a plurality of elongate blades each longate blade comprising flexible intermediate portions having a predetermined proximal and distal orientation associated with the orientation of the basket knife and attached to the basket knife such that, when the distal end of the outer sheath and the distal end of the inner member are disposed closer to each other, the elongate blades flex into a radially outwardly bowed arcuate configuration and, when the distal end of the outer sheath and the distal end of the inner member are moved to remove the flex of the elongate blades from the radially outwardly bowed arcuate configuration, the basket knife assumes a collapsed structure having substantially the same axial diameter as the catheter at the proximal end of the basket knife. at least some of the elongate blades defining a respective medially disposed knife-like sharpened edge oriented on the elongate blade such that when the elongate blades flex into a radially outwardly bowed arcuate configuration, each knife-like sharpened edge is proximally disposed so as to cuttingly engage plaque associated with an inner wall of an artery as said catheter atherotome is moved within said artery in a proximal direction. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35)
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Specification