Method for performing a partial atherectomy

• US 5,282,484 A
• Filed: 07/28/1992
• Issued: 02/01/1994
• Est. Priority Date: 08/18/1989
• Status: Expired due to Fees

• Current Assignee: Synectic Ventures III LLC (Synectic Asset Management, Inc.), Synectic Ventures II LLC (Synectic Asset Management, Inc.), Synectic Ventures I LLC (Synectic Asset Management, Inc.)
• Original Assignee: Endovascular Instruments, Inc.
• Inventors: Reger, Vincent A.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US07/922,115
• Time in Patent Office: 553 Days
• Field of Search: 606/159, 606/170, 606/180, 604/22, 128/898
• US Class Current: 128/898
• CPC Class Codes: A61B 17/00008 Vein tendon strippers tube strippers A61M1/83
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• 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 2090/062 penetration depth
• CPC Class Codes: A61M 2025/09183 having tools at the distal tip

Abstract

A catheter atherotome and method for its use for performing partial atherectomy in an artery and 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 cathether'"'"'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.

Claims

1. A method for performing partial atherectomy of an artery to enlarge the effective lumen thereof, comprising:

making an opening through a wall of the artery at a location spaced apart from an atheroma and more proximal to a patient'"'"'s heart than said atheroma;

inserting a catheter atherotome having a basket knife including a plurality of blades in a closed orientation into said artery through said opening;

directing said catheter atherotome along the interior of said artery to the vicinity of said atheroma;

directing and moving said catheter atherotome further along the interior of said artery until said basket knife passes beyond said atheroma;

opening said basket knife to a first desired manually variable diametral cutting size orientation; and

thereafter retracting said catheter atherotome along said artery a distance great enough to bring cutting blade edges of said basket knife into proximally disposed cutting engagement with said atheroma; and

cutting away a portion of said atheroma only when said basket knife is not being moved distally by only energy supplied for longitudinal retrogression of said catheter atherotome and said blades of said basket knife thereof.

2. The method of claim 1 further including the steps of redirecting said catheter distally across said atheroma with said basket knife in the first open orientation without cutting additional tissue from said atheroma, and thereafter opening said basket knife to a second desired manually variable diametral size orientation prior to said steps of retracting and cutting to thereby cut away another portion of atheroma.

3. The method of claim 1 including the steps of inserting a balloon tipped catheter through a lumen defined by said catheter atherotome and inflating said balloon at a position beyond said atheroma prior to performing said step of retracting said catheter atherotome to cut away a portion of said atheroma, and including the further step of withdrawing said balloon-tipped catheter with said balloon inflated after completion of said step of retracting said catheter atherotome to cut away a portion of said atheroma, in order to retrieve material cut from said atheroma.

4. The method of claim 1 wherein said step of making an opening in said artery is performed percutaneously by inserting a hollow needle into said artery and thereafter inserting a guide wire through said hollow needle, thereafter removing said hollow needle and directing a dilator along said guide wire into said artery, and thereafter retracting said dilator and inserting said catheter atherotome along said guide wire into said artery.