Device for removal of intraluminal occlusions

• US 5,350,390 A
• Filed: 06/30/1993
• Issued: 09/27/1994
• Est. Priority Date: 03/25/1992
• Status: Expired due to Term

• Current Assignee: Arieh Sher
• Original Assignee: Arieh Sher
• Inventors: Sher, Arieh
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Lewis, William W.
• Application Number:
  US08/083,760
• Time in Patent Office: 454 Days
• Field of Search: 606/159, 606/170, 606/171, 606/180, 604/22, 128/751, 128/755, 128/898, 15/104.05, 15/104.14, 15/104.15, 15/104.16
• US Class Current: 606/159
• 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 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/32113 with extendable or retractable guard or blade
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: B08B 9/0436 provided with mechanical cleaning tools, e.g. scrapers, with or without additional fluid jets B08B9/045, B08B9/047 take precedence
• CPC Class Codes: B25D 2216/0023 Tools having a percussion-and-rotation mode
• CPC Class Codes: B25D 9/02 of the tool-carrier piston type, i.e. in which the tool is connected to an impulse member
• CPC Class Codes: E21B 37/00 Methods or apparatus for cleaning boreholes or wells E21B21/00 takes precedence
• CPC Class Codes: E21B 4/18 Anchoring or feeding in the borehole
• CPC Class Codes: E21B 4/20 combined with surface drive E21B4/10 takes precedence

Abstract

A method and device for removal of intraluminal occlusions which includes a catheter having a cutting head in a distal end thereof. The cutting head undergoes a simultaneous longitudinal and rotational movement by means of fluid pressure applied to a distal piston to which the cutting head is attached, The proximal end of the catheter includes a reciprocating pump which applies the fluid pressure to the distal piston. The cutting head is retractable to a sheathed or retracted position during insertion and movement in a patient. Material removed by the cutting head can either be collected in a chamber located between the distal piston and the cutting head or aspirated through the proximal end of the catheter.

Claims

1. A device for removal of intraluminal occlusions which comprising:

a catheter having a distal end for insertion into a patient and a proximal end;

a distal piston located within said distal end of said catheter for simultaneous longitudinal and rotational movement therein, said distal piston including a closed wave-shaped groove in a circumferential surface thereof which receives at least one stationary pin fixed to an inner portion of said distal end of said catheter; and

a cutting head, said cutting head being attached to said distal piston for simultaneous longitudinal and rotational movement together with said distal piston.

2. A device for removal of intraluminal occlusions according to claim 1, wherein said cutting head is positioned within the distal end of the catheter so that at a one position of a path along its longitudinal motion said cutting head is within a distal end of said catheter and at another position along the path of its longitudinal motion said cutting head extends beyond the distal end of said catheter.

3. A device for removal of intraluminal occlusions according to claim 1, wherein said cutting head includes at least one cutting blade.

4. A device for removal of intraluminal occlusions according to claim 1, wherein said catheter includes a chamber between said distal piston and said cutting head for receiving material cut by said cutting head, and said cutting head includes at least one through bore through which the cut material can pass into said chamber.

5. A device for removal of intraluminal occlusions according to claim 4, wherein said chamber is connected to a passage which extends to said proximal end of said catheter.

6. A device for removal of intraluminal occlusions according to claim 1, wherein said catheter includes a guide wire which extends through said distal piston and said cutting head.

7. A device for removal of intraluminal occlusions according to claim 6, wherein said guide wire extends beyond said distal end of said catheter.

8. A device for removal of intraluminal occlusions according to claim 6, wherein said catheter includes a branched fitting near said proximal end thereof and said guide wire enters said catheter through said branched fitting.

9. A device for removal of intraluminal occlusions according to claim 8, wherein said branched fitting includes means to secure said guide wire.

10. A device for removal of intraluminal occlusions according to claim 1, wherein a pump means is provided at said proximal end of said catheter for applying fluid pressure to said distal piston for driving said distal piston.

11. A device for removal of intraluminal occlusions according to claim 10, wherein said pump means comprises a reciprocating pump means.

12. A device for removal of intraluminal occlusions according to claim 11, wherein said pump means comprises dual pumping means to apply fluid pressure to said distal piston for driving said distal piston and for applying a vacuum to aspirate material cut by said cutting head from said distal end of said catheter.

13. A device for removal of intraluminal occlusions according to claim 12, wherein said pump means includes a single piston which performs said dual pumping.

14. A device for removal of intraluminal occlusions according to claim 12, wherein said pump means includes a chamber for collecting material aspirated from said distal end of said catheter.

15. A device for removal of intraluminal occlusions according to claim 10, wherein said pump means is attached to a support block through which a guide wire passes.

16. A device for removal of intraluminal occlusions according to claim 15, wherein said support block includes means to secure said guide wire.

17. A method of removing intraluminal occlusions which comprises:

providing a catheter having a distal end for insertion into a patient with a cutting head for simultaneous longitudinal and rotational movement;

inserting said distal end of said catheter into a lumen of a patient while maintaining said cutting head within said distal end of said catheter;

positioning said distal end of said catheter near an object to be removed and;

causing said cutting head to simultaneously move in both a longitudinal and a rotational movement so as to extend from said distal end of said catheter and cut said object to be removed, said step of causing including the steps of applying a pulsatile driving force to said cutting head to cause said cutting reciprocate longitudinally, and rotating said cutting response to longitudinal reciprocation of the cutting head.

18. A method of removing intraluminal occlusions according to claim 17, further including the step of collecting material cut by said cutting head in a chamber provided in said distal end of said catheter behind said cutting head.

19. A method of removing intraluminal occlusions according to claim 17, further including the step of aspirating material cut by said cutting head and removing said aspirated material from a proximal end of said catheter.

20. The method of claim 17:

wherein said step of applying a pulsatile driving force includes applying said force to a piston secured to said cutting head and disposed in a chamber of said device; and

wherein said step of rotating comprises projecting a pin, positionally fixed relative to said chamber, radially into said chamber and into a closed wave-shaped groove defined circumferentially in said piston to guide said piston rotationally as the piston moves longitudinally.

21. A device for removal of intraluminal occlusions which comprising:

a catheter having a distal end for insertion into a patient and a proximal end;

a distal piston located within said distal end of said catheter for simultaneous longitudinal and rotational movement therein, said distal piston including at least one stationary pin fixed thereto which is received in a closed wave-shaped groove formed in an inner surface of said distal end of said catheter; and

a cutting head attached to said distal piston for simultaneous longitudinal and rotational movement together with said distal piston.

22. A device for removal of intraluminal occlusions comprising:

a catheter having a longitudinal axis and a distal end adapted for insertion into a passage in a patient'"'"'s body;

a driven member located within said catheter;

means for simultaneously reciprocating said driven member longitudinally in said catheter and rotating said driven member about said longitudinal axis; and

a device head secured to said driven member for reciprocation longitudinally and rotating therewith, said device head projecting from said distal end when reciprocating longitudinally and rotating to remove occluding material from said passage in the patient'"'"'s body;

wherein said means comprises;

driving means for longitudinally reciprocating said driven member within said catheter; and

further means responsive to longitudinal reciprocation of said driven member for rotating said driven member about said longitudinal axis.

23. The device of claim 22 wherein said further means comprises:

a closed wave-shaped groove defined circumferentially in said driven member; and

a stationary pin projecting radially into said groove to cause said piston, while longitudinally reciprocating, to rotate as said pin rides along said groove.

24. In a device for removing intraluminal occlusions, the method of simultaneously reciprocating a cutting head longitudinally and rotating the reciprocating cutting head, said method comprising the steps of:

longitudinally reciprocating said cutting head by applying a pulsating force to said device; and

in response to longitudinal reciprocation of said cutting head, directing said cutting head rotationally about its longitudinal axis.