Expandable intravascular occlusion material removal devices and methods of use

• US 5,490,859 A
• Filed: 04/29/1993
• Issued: 02/13/1996
• Est. Priority Date: 11/13/1992
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Ressemann, Thomas V., Hackett, Steven S., Vrba, Anthony C., Mische, Hans A.
• Primary Examiner(s): Pellegrino, Stephen C.
• Assistant Examiner(s): Lewis, William W.
• Application Number:
  US08/055,995
• Time in Patent Office: 1,020 Days
• Field of Search: 606/159, 606/170, 606/171, 606/180, 606/191-200, 604/22, 604/96, 604/104, 604/105
• US Class Current: 606/159
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2017/22042 Details of the tip of the guide wire
• CPC Class Codes: A61B 2017/22075 with motorized advancing or retracting means
• CPC Class Codes: A61B 2017/320012 Brushes
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers

Abstract

An intravascular occlusion material removal device for removing vascular occlusion material in a vascular lumen comprises an expandable material removal element movable between an expanded position and a contracted position. The material removal element has a distal end and a proximal end. A drive shaft is operatively connected to the distal end of the expandable material removal element for rotating the removal element. A catheter surrounds a portion of the drive shaft. The catheter has a distal end for operatively variably contacting the proximal end of the material removal element such that the removal element is rotatable with respect to the catheter. The catheter is shiftable with respect to the drive shaft for moving the material removal element between the expanded position and the contracted position. A number of novel methods for removing vascular occlusion material are also provided. One such method comprises the steps of: providing a vascular occlusion material removal device having an expandable occlusion material removal element, wherein the removal element comprises a plurality of braided wires, further comprising an abrasive disposed on the wires; providing a drive shaft disposed in and shiftable with respect to the removal element; intravascularly positioning the removal element distally of the occlusion material; shifting the drive shaft with respect to the removal element to expand the element intravascularly; and moving the removal element proximally within the vascular lumen to remove occlusion material. The removal element can also be moved distally within the vascular lumen to engage the occlusion material. Also, removed occlusion material can be collected by a collection portion on the removal element.

Claims

1. An intravascular device for removing vascular occlusion material within a vascular lumen in a patient, wherein the occlusion material defines a configuration, the intravascular device comprising:

an expandable material removal element having first and second ends and including a plurality of wires disposed between the first and second ends;

a catheter shaft extending to the first end of the expandable material removal element;

a drive shaft for energizing the material removal element intravascularly;

the drive shaft having a proximal end and a distal end, the drive shaft being connected to the second end of the material removal element proximate the distal end of the drive shaft extending through the material removal element and being shiftable with respect to the material removal element and the catheter shaft;

the drive shaft being disposed within the catheter shaft;

the material removal element being expandable responsive to shifting of the drive shaft; and

the expandable removal element being sufficiently deformable so that the element assumes a configuration corresponding to the configuration defined by the non-occluded diameter upon expansion of the element; and

a collection portion disposed on the material removal element for collecting removed occlusion material, the collection portion including a retention member disposed on the wires of the removal element.

2. An intravascular device as defined in claim 1 further comprising:

a motor operatively connected to the drive shaft proximate the proximal end of the drive shaft for rotating the expandable material removal element intravascularly;

wherein removing force is generated by rotation of the element intravascularly for removing vascular occlusion material; and

wherein the configuration of the removal element relatively concentrates removing force on the occlusion material upon rotation of the removal element.

3. An intravascular device as defined in claim 1 further comprising:

means operatively connected to the removal element for rotating the element intravascularly, rotation of the element generating a force which is relatively concentrated on the occlusion material as compared to the vascular lumen.

4. A method for removing occlusion material from a vascular lumen within a patient comprising the steps of:

a) providing an occlusion material removal device having an expandable material removal element, a single rotatable drive shaft and a catheter shaft, the removal element having first and second ends, the catheter shaft extending to the first end and the drive shaft being connected to the second end, the single rotatable drive shaft extending through the material removal element, and the material removal element being variably expandable responsive to shifting of the single rotatable drive shaft with respect to the removal element and the catheter shaft;

b) navigating the material removal element distally through the occlusion material;

c) shifting the single rotatable drive shaft with respect to the material removal element and the catheter shaft thereby expanding the removal element; and

d) moving the expanded material removal element proximally within the vascular lumen to engage the occlusion material.

5. A method as defined in claim 4 further comprising the step of:

e) positioning the material removal element in a contracted position distally of the occlusion material.

6. A method as defined in claim 4 wherein the providing step a) includes providing a collection portion on a distal portion of the material removal element for collecting removed occlusion material, and further comprising the step of:

e) collecting removed occlusion material in the collection portion.

7. A method as defined in claim 6 wherein the shifting step c) comprises shifting the single rotatable drive shaft with respect to the removal element to deploy the collection portion.

8. A vascular occlusion material removal device for removing vascular occlusion material in a vascular lumen, the removal device comprising:

an expandable material removal element having a distal end and a proximal end insertable intravascularly into a patient;

a catheter shaft extending to the proximal end of the removal element;

a drive shaft disposed through the removal element and connected to the distal end of the expandable material removal element;

the drive shaft being shiftable within the material removal element;

the material removal element being expandable responsive to shifting of the drive shaft with respect to the removal element and the catheter shaft;

the drive shaft being disposed within the catheter shaft;

a plurality of braided wires comprising the removal element; and

an abrasive disposed on the wires for removing vascular occlusion material.

9. A vascular occlusion material removal device as defined in claim 8 further comprising:

a retention member disposed on the removal element for collecting removed occlusion material.

10. A vascular occlusion material removal device as defined in claim 9 wherein the retention member comprises a filter.

11. A vascular occlusion material removal device as defined in claim 9 wherein the retention member comprises a fabric.

12. A vascular occlusion material removal device as defined in claim 9 wherein the retention member comprises a polymeric coating.

13. A vascular occlusion material removal device as defined in claim 9 wherein the abrasive and the retention member are located on opposite ends of the removal element.

14. A vascular occlusion material removal device as defined in claim 9 wherein the retention member includes an aperture for permitting fluid flow therethrough.

15. A vascular occlusion material removal device as defined in claim 14 wherein the aperture has a diameter measuring about 5 microns.

16. A vascular occlusion material removal device for removing vascular occlusion material in a vascular lumen, the removal device comprising:

an expandable material removal element insertable intravascularly into a patient, the removal element having first and second ends;

a catheter shaft extending to the first end;

a drive shaft disposed through and connected to the second end of the expandable material removal element for energizing the removal element;

the drive shaft being disposed within the catheter shaft;

the drive shaft being shiftable with respect to the material removal element and the catheter shaft;

the material removal element being expandable responsive to shifting of the drive shaft;

a plurality of braided wires comprising the removal element; and

the wires being made from a super-elastic alloy.

17. A vascular occlusion material removal device as defined in claim 16 wherein the super-elastic alloy is nitinol.

18. A method for removing vascular occlusion material from a vascular lumen comprising the steps of:

providing a vascular occlusion material removal device having an expandable occlusion material removal element, the removal element having first and second ends, the removal element including a plurality of braided wires and an abrasive disposed on the wires;

providing a catheter shaft extending to the first end of the removal element;

providing a drive shaft disposed in and connected to the second end of the removal element, the drive shaft being shiftable with respect to the removal element and the catheter shaft;

intravascularly positioning the removal element distally of the occlusion material;

shifting the drive shaft with respect to the removal element and the catheter shaft to expand the element intravascularly; and

moving the removal element proximally within the vascular lumen to remove occlusion material.

19. A method according to claim 18 further comprising the step of rotating the drive shaft to cause rotation of the removal element intravascularly.

20. A vascular occlusion material removal device for removing vascular occlusion material in a vascular lumen, the material removal device comprising:

an expandable material removal element movable between an expanded position and a contracted position having a distal end and a free-wheeling proximal end;

a catheter shaft having a proximal and a distal end extending to the free-wheeling proximal end of the removal element;

a drive shaft operatively connected to the distal end of the expandable material removal element to rotate the removal element, the drive shaft being shiftable with respect to the removal element and the catheter shaft to move the removal element between the expanded position and the contracted position, the distal end of the catheter shaft surrounding a portion of the drive shaft; and

a bearing surface located at the distal end of the catheter variably engageable with the free-wheeling proximal end of the removal element to move the removal element between the expanded position and the contracted position.

21. A vascular occlusion material removal device as defined in claim 20 further comprising a removal element expansion control mechanism for positively controlling movement of the removal element between the expanded position and the contracted position, the control mechanism being at an end of the drive shaft opposite the removal element.

22. A vascular occlusion material removal device as defined in claim 21 wherein the removal element expansion control mechanism includes a groove and a tab;

the tab being selectively movable into and out of the groove; and

the drive shaft being movable with respect to the removal element responsive to movement of the tab into and out of the groove.

23. A vascular occlusion material removal device as defined in claim 21 wherein the removal element expansion control mechanism includes an actuation portion for accepting force from a treating physician to positively control movement of the removal element between the expanded position and the contracted position.

24. A vascular occlusion material removal device as defined in claim 21 further comprising scaling means operatively associated with the removal element expansion control mechanism for providing an indication of position of the removal element between the expanded position and the contracted position.

25. A vascular occlusion material removal device as defined in claim 20 further comprising

c) a catheter having a distal end surrounding a portion of the drive shaft;

d) a bearing surface located at the distal end of the catheter variably engagable with the free-wheeling proximal end of the removal element to move the removal element between the expanded position and the contracted position.

26. A vascular occlusion material removal device as defined in claim 20 further comprising a bearing surface located at the free-wheeling proximal end of the removal element;

and wherein the bearing surface on the free-wheeling proximal end has a configuration for facilitating rotation of the removal element with respect to the catheter.

27. A vascular occlusion material removal device as defined in claim 26 wherein one of the bearing surfaces has an enlarged portion such that the other of the bearing surfaces is rotatable within and relative to the enlarged portion.

28. A vascular occlusion material removal device as deemed in claim 26 wherein one of the bearing surfaces comprises a hypotube.

29. A vascular occlusion material removal device as defined in claim 26 further comprising a lubricous or low friction substance disposed on at least on of the bearing surfaces for facilitating relative rotation of the bearing surfaces.

30. A vascular occlusion material removal device as defined in claim 20 further comprising a collection portion located on the removal element for collecting removed occlusion material.

31. A vascular occlusion material removal device as defined in claim 30 wherein the collection portion comprises a retention member disposed on the removal element.

32. A vascular occlusion material removal device as defined in claim 31 wherein the retention member comprises a fabric filter.

33. A vascular occlusion material removal device as defined in claim 31 wherein the retention member comprises a polymer coated on the removal element.

34. A vascular occlusion material removal device as defined in claim 31 wherein the retention member includes an aperture for allowing fluid to flow therethrough.

35. A vascular occlusion material removal device as defined in claim 34 wherein the aperture has a diameter measuring about 5 microns.

36. A vascular occlusion material removal device as defined in claim 20 further comprising a dilatation member connected to the catheter shaft adjacent the removal element.

37. A method for removing vascular occlusion material from a vascular lumen comprising the steps of:

a) providing a vascular occlusion material removal device having an expandable occlusion material removal element, the material removal element having first and second ends;

a catheter shaft extending to the first end of the removal element;

a drive shaft disposed in and connected to the second end of the material removal element;

the material removal element being expandable responsive to shifting of the drive shaft with respect to the removal element and the catheter shaft;

the catheter shaft surrounding a portion of the drive shaft;

b) intravascularly navigating the removal element to the occlusion material;

c) energizing the removal element to remove occlusion material;

d) supplying a first pressure through the drive shaft;

e) supplying a second pressure through the catheter; and

f) generating a pressure differential with the first pressure and the second pressure within the vascular lumen sufficient to draw removed occlusion material into the catheter.

38. A method as defined in claim 37 wherein the providing step a) further comprises providing a dilation member on the material removal device.

39. A method as defined in claim 37 further comprising the step of

g) inflating the dilation member.

40. A method for removing vascular occlusion material from a vascular lumen comprising the steps of:

a) providing a vascular occlusion material removal device having an expandable occlusion material removal element, the material removal element having first and second ends;

a catheter shaft extending to the first end of the removal element; and

a drive shaft operably connected to the second end of the removal element wherein the removal element includes a plurality of braided wires, including an abrasive disposed on the wires;

b) intravascularly navigating the removal element to the occlusion material;

c) energizing the removal element to remove occlusion material;

d) supplying a first pressure through the drive shaft;

e) supplying a second pressure through the catheter shaft; and

f) generating a pressure differential with the first pressure and the second pressure within the vascular lumen sufficient to draw removed occlusion material into the catheter.

41. A method as defined in claim 40 wherein the providing step a) further comprises providing a dilation member on the material removal device.

42. A method as defined in claim 41 further comprising the step of

g) inflating the dilation member.

43. A vascular occlusion material removal device for removing vascular occlusion material in a vascular lumen, the material removal device comprising:

a) an expandable material removal element having a first and a second end and including a plurality of braid wires generally disposed between the first and second ends of the removal element, and the expandable material removal element being movable between an expanded position and a contracted position;

b) a drive shaft connected to the first end of the expandable material removal element for rotating the removal element;

c) a catheter surrounding a portion of the drive shaft;

the catheter having a distal end for operatively variably contracting the second end of the material removal element such that the removal element is rotatable with respect to the catheter; and

the catheter being shiftable with respect to the drive shaft for moving the material removal element between the expanded position and the contracted position.

44. A vascular occlusion material removal device as defined in claim 43 further comprising

d) a prime mover operatively connected to the drive shaft for rotating the drive shaft with respect to the catheter.

45. A vascular occlusion material removal device as defined in claim 44 wherein the prime mover rotates the material removal element intravascularly at a rate of about 20,000 revolutions per minute.

46. A vascular occlusion material removal device as defined in claim 44 wherein the prime mover rotates the material removal element intravascularly at a rate substantially within the range of 0 to 100,000 revolutions per minute.

47. A vascular occlusion material removal device as defined in claim 44 wherein the prime mover comprises a direct current electric motor.

48. A vascular occlusion material removal device as defined in claim 43 further comprising at least eight braided wires.

49. A vascular occlusion material removal device as defined in claim 43 wherein the wires are made of a super-elastic alloy.

50. A vascular occlusion material removal device as defined in claim 43 further comprising an abrasive disposed on the wires.

51. A vascular occlusion material removal device as defined in claim 50 wherein the abrasive comprises at least one of a diamond grit and a synthetic abrasive disposed onto the wires.

52. A vascular occlusion material removal device as defined in claim 43 further comprising

d) a cutting surface disposed distally of the removal element for removing vascular occlusion material, the cutting surface being connected to the removal element at the first end of the removal element.

53. A vascular occlusion material removal device as defined in claim 43 wherein the expandable material removal element has an axial length and a radius;

and wherein the axial length is reducible responsive to shifting of the catheter, thereby expanding the radius.

54. A vascular occlusion material removal device as defined in claim 43 wherein the expandable removal element comprises a plurality of wires;

and wherein the wires are braided thereby enabling the wires to store spring energy during expansion of the removal element.

55. A vascular occlusion removal device as defined in claim 43 further comprising means for limiting expansion of the expandable material removal element.

56. A vascular occlusion material removal device as defined in claim 43 wherein the drive shaft comprises a coil having a proximal end and a distal end;

wherein a braid having a proximal end and a distal end surrounds at least a portion of the coil;

wherein the proximal end of the braid is attached to the proximal end of the coil;

wherein the distal end of the braid is attached to the coil at a location offset proximally of the distal end of the coil; and

wherein the braid is tensioned between the proximal end and distal end thereof.

57. A vascular occlusion material removal device as defined in claim 43 wherein the drive shaft comprises a coil having a proximal end and a distal end;

wherein a braid having a proximal end and a distal end surrounds the coil;

wherein the proximal end of the braid is attached to the proximal end of the coil;

wherein the distal end of the braid is attached to the distal end of the coil; and

wherein the braid is tensioned between the proximal end and distal end thereof.

58. A vascular occlusion material removal device as defined in claim 43 wherein the drive shaft comprises a cylindrical portion having a hollow interior and a coiled portion;

and further comprising an aperture in the cylindrical portion for allowing fluid to flow into the hollow interior of the cylindrical portion.

59. A vascular occlusion material removal device as defined in claim 58 further comprising a manifold assembly;

further comprising a lumen within the manifold assembly for accepting the cylindrical portion; and

further comprising a fluid seal within the lumen for insuring that fluid within the lumen flows through the aperture into the hollow interior.

60. A vascular occlusion material removal device as defined in claim 58 wherein the cylindrical portion has a proximal end;

further comprising a fluid seal located at the proximal end of the cylindrical portion for limiting fluid flow proximally of the proximal end of the cylindrical portion.

61. A vascular occlusion removal device as defined in claim 43 further comprising:

d) a removal element movement control mechanism for positively controlling movement of the removal element between the expanded position and the contracted position, the control mechanism being located at an end of the drive shaft opposite the removal element.

62. A vascular occlusion material removal device as defined in claim 61 wherein the removal element movement control mechanism comprises an actuation portion engagable by a physician;

the actuation portion being operatively connected to the catheter for transferring force applied to the actuation portion to the catheter; and

a tab operatively connected to the actuation portion for allowing positive incremental shifting of the catheter. PG,78

63. A vascular occlusion material removal device as defined in claim 43 further comprising a balloon dilating member connected to the catheter for performing at least one of centering the device intravascularly, stabilizing the device intravascularly, occluding fluid flow through a vascular lumen, and angioplasticly displacing occlusion material.