Unitary removal of plaque

• US 5,571,122 A
• Filed: 06/06/1995
• Issued: 11/05/1996
• Est. Priority Date: 11/09/1992
• Status: Expired due to Term

• 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: Kelly, Thomas L., Wiita, Thomas A.
• Primary Examiner(s): Buiz, Michael Powell
• Assistant Examiner(s): Lewis, William W.
• Application Number:
  US08/470,805
• Time in Patent Office: 518 Days
• Field of Search: 606/159, 606/170, 606/171, 606/180, 606/104-108, 604/22, 128/899, 128/750-755
• US Class Current: 606/159
• 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 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 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/00685 Archimedes screw
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 2017/320008 Scrapers
• CPC Class Codes: A61B 2017/320044 Blunt dissectors
• CPC Class Codes: A61M 25/104 used for angioplasty

Abstract

Novel apparatus and related methods are disclosed by which plaque is connected to the head of a removal instrument for removal of a unitary segment of plaque from an artery intact to increase blood flow through the artery.

Claims

1. A method of excising plaque from an artery comprising the steps of:

inserting an instrument into the artery, the artery having an axis;

placing the instrument adjacent to plaque in the artery;

grasping the plaque with the instrument without materially cutting the plaque by the instrument;

maintaining grasp while displacing the instrument along the axis of the artery thereby generally axially dislodging a length of plaque from the artery;

removing the dislodged length of plaque from the artery.

2. A method of removing arterial plaque comprising the steps of:

grabbing hold of plaque within an artery with a removal instrument;

applying force to the plaque generally along the length of the artery to sever without longitudinally cutting a segment of plaque from a portion of a wall of the artery;

withdrawing the plaque segment from the artery.

3. A method of increasing blood flow in an artery comprising the steps of:

introducing a gripping instrument into an artery through a man-made opening therein;

displacing the gripping instrument along the artery to a site where the artery is obstructed at least in part by plaque;

gripping plaque at the site with the gripping instrument;

tearing plaque from the artery without cutting the plaque along the axis of the artery by displacing the instrument while the instrument is gripping the plaque;

removing the instrument and the gripped plaque through the man-made opening.

4. A method of increasing blood flow in an artery comprising the steps of:

tethering arterial plaque to an indwelling instrument at a site within the artery with immaterial axial cutting of tethered plaque, pulling the instrument and plaque along the length of the artery thereby forcibly tearing a segment of plaque, in the direction of the length of the artery, from a portion of the artery and removing the torn plaque segment from the artery.

5. A method of treating plaque in an artery having an elongated length to increase blood flow comprising the steps of:

inserting a connecting head into an artery;

locating the head adjacent to plaque within the artery;

removably connecting the head to the plaque without cutting plaque from the artery along its length;

pulling on the plaque through the head thereby severing a segment of plaque intact from the artery;

retrieving the head and connected severed segment of plaque from the artery.

6. A method according to claim 5 wherein the inserting step is preceded by creating at least one man-made opening in the artery.

7. A method according to claim 6 wherein the inserting step comprises placing a guidewire through the opening and advancing the head into the artery along the guidewire.

8. A method according to claim 5 wherein the inserting step is preceded by preliminarily loosening the plaque.

9. A method according to claim 8 wherein the loosening step comprises making at least one radial cut in the plaque.

10. A method according to claim 5 wherein the locating step comprises placing the head within a central lumen of the artery.

11. A method according to claim 5 wherein the removably connecting step comprises taking hold of the plaque by the head.

12. A method according to claim 5 wherein the removably connecting step comprises grasping the plaque by the head.

13. A method according to claim 5 wherein the removably connecting step comprises grabbing the plaque by the head.

14. A method according to claim 5 wherein the removably connecting step comprises engaging the plaque by the head.

15. A method according to claim 5 wherein the severing step comprises shearing the plaque intact from a wall of the artery.

16. A method according to claim 5 wherein the retrieving step comprises removing the head and the severed segment of plaque from the artery.

17. A method according to claim 5 wherein the removably connecting step comprises hooking the plaque with the head.

18. A method according to claim 5 wherein the removably connecting step comprises piercing the plaque with the head.

19. A method according to claim 5 wherein the removably connecting step occurs due to rotating the head.

20. A method according to claim 19 wherein the rotating step comprises causing the head to bindingly bite into the plaque.

21. A method according to claim 19 wherein the rotating step comprises embedding plaque within the head in binding relation.

22. A method according to claim 5 wherein the removably connecting step comprises binding the plaque and the head together.

23. A method according to claim 5 wherein the removably connecting step comprises snagging the plaque with the head.

24. A method according to claim 5 wherein the locating step comprises advancing the head to an arterial location remote from the insertion site.

25. A method of treating plaque in an artery to increase blood flow comprising the steps of:

preliminarily loosening the arterial plaque by subjecting the plaque to be removed to dottering;

inserting a connecting head into an artery;

locating the head adjacent to plaque within the artery;

removably connecting the head to the plaque;

pulling on the plaque through the head thereby severing a segment of plaque intact from the artery;

retrieving the head and connected severed segment of plaque from the artery.

26. A method of treating plaque in an artery to increase blood flow comprising the steps of:

preliminarily displacing the plaque by subjecting the plaque to be removed to balloon angioplasty;

inserting a connecting head into an artery;

locating the head adjacent to plaque within the artery;

removably connecting the head to the plaque;

pulling on the plaque through the head thereby severing a segment of plaque intact from the artery;

retrieving the head and connected severed segment of plaque from the artery.

27. A method of treating plaque in an artery to increase blood flow comprising the steps of:

inserting a connecting head into an artery;

locating the head adjacent to plaque within the artery by placing the head within the artery between the plaque and a wall of the artery so that insertion of the head separates in part the plaque and the artery at the interface between the two;

removably connecting the head to the plaque;

pulling on the plaque through the head thereby severing a segment of plaque intact from the artery;

retrieving the head and connected severed segment of plaque from the artery.

28. A method of treating plaque in an artery to increase blood flow comprising the steps of:

inserting a connecting head into an artery;

locating the head adjacent to plaque within the artery;

removably connecting the head to the plaque by compressively holding the engaged plaque at the head;

pulling on the plaque through the head thereby severing a segment of plaque intact from the artery;

retrieving the head and connected severed segment of plaque from the artery.

29. A method of treating plaque in an artery to increase blood flow comprising the steps of:

inserting a connecting head into an artery;

locating the head adjacent to plaque within the artery;

removably connecting the head to the plaque;

pulling on the plaque through the head by stretching the plaque thereby severing a segment of plaque intact from the artery;

retrieving the head and connected severed segment of plaque from the artery.

30. A method of treating plaque in an artery to increase blood flow comprising the steps of:

inserting a connecting head into an artery;

locating the head adjacent to plaque within the artery;

removably connecting the head to the plaque;

pulling on the plaque through the head thereby severing a segment of plaque intact from the artery by progressively peeling the plaque intact from a wall of the artery;

retrieving the head and connected severed segment of plaque from the artery.

31. A method of treating plaque in an artery to increase blood flow comprising the steps of:

inserting a connecting head into an artery;

locating the head adjacent to plaque within the artery;

removably connecting the head to the plaque;

pulling on the plaque through the head thereby severing a segment of plaque intact from the artery by both separating the plaque segment from other plaque within the artery and separating the plaque segment from a wall of the artery;

retrieving the head and connected severed segment of plaque from the artery.

32. A method of treating plaque in an artery to increase blood flow comprising the steps of:

inserting a connecting head into an artery;

locating the head adjacent to plaque within the artery;

removably connecting the head to the plaque by clamping the head to the plaque;

pulling on the plaque through the head thereby severing a segment of plaque intact from the artery;

retrieving the head and connected severed segment of plaque from the artery.