Unitary removal of plaque

• US 5,665,098 A
• Filed: 07/23/1996
• Issued: 09/09/1997
• Est. Priority Date: 11/09/1992
• 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: Wiita, Thomas A., Kelly, Thomas L.
• Primary Examiner(s): LEWIS, WILLIAM W
• Application Number:
  US08/685,393
• Time in Patent Office: 413 Days
• Field of Search: 606/1, 606/108, 606/159, 606/170, 606/171, 606/180, 128/751-755, 128/899, 604/22
• 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 blunt suture needles A61B2017/06085
• 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 material comprising plaque from an artery comprising the steps of:

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

placing the instrument adjacent to the material comprising plaque in the artery;

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

maintaining the grasp of material comprising plaque while displacing the instrument thereby generally axially separating a length of the material comprising plaque from other material in the artery;

removing the dislodged length of material comprising plaque from the artery.

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

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

applying force to the material comprising plaque generally along the length of the artery to part a segment of said material from other wall material in the artery without longitudinally cutting the segment;

withdrawing the segment of material comprising plaque 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 material comprising plaque;

gripping the material comprising plaque at the site with the gripping instrument;

tearing at least some the material comprising plaque from the artery without appreciably cutting the material comprising plaque along the axis of the artery by displacing the instrument while the instrument is gripping the material comprising plaque;

removing the instrument and the gripped material comprising plaque through the manmade opening.

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

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

5. A method of treating material comprising 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 material comprising plaque within the artery;

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

pulling on the material comprising plaque through the head thereby parting a segment of the material comprising plaque intact from the artery;

retrieving the head and connected severed segment of the material comprising 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 material comprising plaque.

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

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

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

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

15. A method according to claim 5 wherein the severing step comprises shearing the material comprising 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 material comprising plaque from the artery.

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

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

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

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

23. A method according to claim 5 wherein the removably connecting step comprises snagging the material comprising 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 material comprising arterial plaque in an artery to increase blood flow comprising the steps of:

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

inserting a connecting head into an artery;

locating the head adjacent to the preliminarily loosened material comprising arterial plaque within the artery;

removably connecting the head to the material comprising arterial plaque;

pulling on the material comprising arterial plaque through the head thereby part severing a segment of the material comprising arterial plaque intact from other material remaining in the artery;

retrieving the head and the connected severed segment of the material comprising arterial plaque from the other material remaining in the artery.

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

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

inserting a connecting head into an artery;

locating the head adjacent to the material comprising plaque within the artery;

removably connecting the head to the material comprising plaque;

pulling on the material comprising plaque through the head thereby severing a segment of the material comprising plaque intact from a remainder of material in the artery;

retrieving the head and the connected severed segment of the material comprising plaque from the remainder of material in the artery.

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

inserting a connecting head into an artery;

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

removably connecting the head to the material comprising plaque;

pulling on the material comprising plaque through the head thereby dividing a segment of the material comprising plaque intact from a remaining wall portion of the artery;

retrieving the head and the connected divided segment of the material comprising plaque from the wall portion of the artery.

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

inserting a connecting head into an artery;

locating the head adjacent to the material comprising plaque within the artery;

removably connecting the head to the material comprising the plaque by compressively engaging and holding the material comprising plaque at the head;

pulling on the material comprising plaque through the head thereby parting a segment of the material comprising plaque intact from material remaining in the artery;

retrieving the head and the connected severed segment of the material comprising plaque from the material remaining in the artery.

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

inserting a connecting head into an artery;

locating the head adjacent to the material comprising plaque within the artery;

removably connecting the head to the material comprising plaque;

pulling on the material comprising plaque through the head by stretching the material comprising plaque thereby separating a segment of the material comprising plaque intact from other material remaining in the artery;

retrieving the head and the connected severed segment of the material comprising plaque from the other material remaining in the artery.

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

inserting a connecting head into an artery;

locating the head adjacent to the material comprising plaque within the artery;

removably connecting the head to the material comprising plaque;

pulling on the material comprising plaque through the head thereby causing a segment of the material comprising plaque to peel intact from other material remaining in the artery;

retrieving the head and the connected severed segment of the material comprising plaque from the other material remaining in the artery.

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

inserting a connecting head into an artery;

locating the head adjacent to the material comprising plaque within the artery;

removably connecting the head to the material comprising plaque;

pulling on the material comprising plaque through the head thereby removing a segment of the material comprising plaque intact from the other material remaining in the artery by both axially separating the segment from the other material remaining within the artery and displacing the segment in respect to the other material remaining in the artery;

retrieving the head and the connected severed segment of the material comprising plaque from the other material remaining in the artery.

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

inserting a connecting head into an artery;

locating the head adjacent to the material comprising plaque within the artery;

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

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

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