Rotational atherectomy device with improved exchangeable drive shaft cartridge

• US 6,024,749 A
• Filed: 03/16/1998
• Issued: 02/15/2000
• Est. Priority Date: 10/27/1997
• Status: Expired due to Term

• Current Assignee: Cardiovascular Systems Incorporated (Abbott Laboratories)
• Original Assignee: Shturman Cardiology Systems, Inc.
• Inventors: Morov, Georgiy, Shturman, Leonid
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US09/039,732
• Time in Patent Office: 701 Days
• Field of Search: 606/1, 606/107, 606/159, 606/166, 606/167, 606/170, 606/171, 606/185, 604/19, 604/22
• 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 2017/0046 with a releasable handle; with handle and operating part separable
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00685 Archimedes screw
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/320766 eccentric
• CPC Class Codes: F16D 43/14 with centrifugal masses actuating the clutching members directly in a direction which has at least a radial component; with centrifugal masses themselves being the clutching members

Abstract

A rotational atherectomy device which includes a handle housing and an exchangeable drive shaft cartridge removably attachable to the handle housing. A rotatable prime mover is carried by a prime mover carriage disposed within the handle housing, the prime mover carriage being longitudinally movable with respect to the handle housing. The exchangeable cartridge includes a cartridge housing which is removably attachable to the handle housing, a longitudinally movable tube which is removably attachable to the prime mover carriage, and a rotatable flexible drive shaft which is removably attachable to the prime mover. The rotational atherectomy device includes a cartridge latch, which removably locks the cartridge housing to the handle housing, and a tube latch which selectively locks the longitudinally movable tube against longitudinal movement with respect to the cartridge housing. The exchangeable cartridge also includes a slide which is longitudinally movable with respect to the cartridge housing among at least three positions: a working position where the slide causes the tube latch to unlock the longitudinally movable tube, a neutral position where the slide causes the tube latch to lock the tube against longitudinal movement with respect to the cartridge housing, and a cartridge unlocked position where the slide causes the tube latch to maintain the longitudinally movable tube in its locked position and unlocks the cartridge latch, thereby permitting the cartridge housing to be removed from the handle housing.

Claims

1. A rotational atherectomy device comprising:

a handle housing;

a rotatable prime mover carried by a prime mover carriage which is disposed within the handle housing, the prime mover carriage being longitudinally movable with respect to the handle housing;

an exchangeable drive shaft cartridge including;

a cartridge housing which is removably attachable to the handle housing;

a longitudinally movable tube disposed within the cartridge housing and having a proximal end portion which is removably attachable to the prime mover carriage for longitudinal movement therewith; and

a rotatable flexible drive shaft having a proximal portion which is disposed within the longitudinally movable tube and a distal portion which includes a tissue removal implement; and

a drive shaft attachment mechanism removably attaching the proximal portion of the drive shaft to the prime mover;

a cartridge latch removably locking the cartridge housing to the handle housing; and

a slide which is longitudinally movable with respect to the cartridge housing from a neutral position, where the cartridge latch is locked, to a cartridge unlocked position where the slide unlocks the cartridge latch, thereby permitting the cartridge housing to be removed from the handle housing.

2. The rotational atherectomy device of claim 1 wherein the slide is generally tubular in shape.

3. The rotational atherectomy device of claim 2 wherein the tubular slide is disposed about the cartridge housing.

4. The rotational atherectomy device of claim 1 wherein the handle housing includes a pair of openings sized and positioned so that the slide may be grasped through the openings and moved longitudinally with respect to both the cartridge housing and the handle housing.

5. The rotational atherectomy device of claim 1 wherein the cartridge latch comprises at least one radially resilient finger which is carried by the cartridge housing and which is removably engageable with a complementary structure carried by the handle housing.

6. The rotational atherectomy device of claim 5 wherein the complementary structure comprises a radially inwardly extending shoulder.

7. The rotational atherectomy device of claim 6 wherein the shoulder is generally annular and is positioned near the distal end of the handle housing.

8. The rotational atherectomy device of claim 6 wherein the shoulder comprises a distal wall of a generally annular groove formed in a wall of the handle housing, the groove removably receiving therein a latching portion of the radially resilient finger.

9. The rotational atherectomy device of claim 5 wherein the cartridge latch includes two or more radially resilient fingers carried by the cartridge housing.

10. The rotational atherectomy device of claim 5 wherein the radially resilient finger has a portion with an outer surface slanting distally radially outwardly, the slide having an abutment surface positioned so that when the slide is moved distally with respect to the radially resilient finger the abutment surface of the slide engages the slanted outer surface of the radially resilient finger to move the finger radially inwardly, thereby disengaging the finger from the complementary structure of the handle housing and permitting the cartridge housing to be removed from the handle housing.

11. The rotational atherectomy device of claim 10 wherein the abutment surface comprises a distal end of the slide.

12. The atherectomy device of claim 1 further comprising a tube latch for selectively locking the longitudinally movable tube against longitudinal movement with respect to the cartridge housing.

13. The atherectomy device of claim 12 wherein the tube latch is capable of selectively locking the slide against longitudinal movement with respect to the cartridge housing.

14. The atherectomy device of claim 13 wherein the tube latch is configured and arranged so that whenever the tube is locked against longitudinal movement then the slide is longitudinally movable, and whenever the slide is locked against longitudinal movement then the tube is longitudinally movable.

15. The atherectomy device of claim 1 further comprising a tube latch positioned to selectively lock the longitudinally movable tube and the slide against longitudinal movement with respect to the cartridge housing.

16. The atherectomy device of claim 15 wherein the tube latch is configured and arranged so that whenever the tube is locked against longitudinal movement then the slide is longitudinally movable, and whenever the slide is locked against longitudinal movement then the tube is longitudinally movable.

17. The rotational atherectomy device of claim 16 wherein the tube latch includes a tube locking element carried by the cartridge housing, the tube locking element being radially movable between at least two positions, a tube locked position, where the tube locking element is moved radially inwardly, thereby restricting longitudinal movement of the tube with respect to the cartridge housing, and a tube unlocked position, where the tube locking element is moved radially outwardly, thereby permitting longitudinal movement of the tube with respect to the cartridge housing.

18. The rotational atherectomy device of claim 17 wherein the tube locking element is disposed within a radial bore in a wall of the cartridge housing.

19. The rotational atherectomy device of claim 17 wherein the tube latch includes a generally annular recess formed in an outer surface of the longitudinally movable tube, the recess receiving an inner portion of the tube locking element when the tube locking element is moved radially inwardly to its tube locked position.

20. The rotational atherectomy device of claim 17 wherein the tube latch includes a generally annular recess formed in an inner surface of the slide, the annular recess receiving an outer portion of the tube locking element when the tube locking element is moved radially outwardly to its tube unlocked position.

21. The rotational atherectomy device of claim 20 wherein the tube latch permits longitudinal movement of the slide when the annular recess of the longitudinally moveable tube is longitudinally aligned with the tube locking element carried by the cartridge housing.

22. The rotational atherectomy device of claim 1 further comprising at least one tube locking element carried by the cartridge housing and radially movable between at least two positions, a tube locked position, where the tube locking element is moved radially inwardly, thereby restricting longitudinal movement of the tube with respect to the cartridge housing, and a tube unlocked position, where the tube locking element is moved radially outwardly, thereby permitting longitudinal movement of the tube with respect to the cartridge housing.

23. The rotational atherectomy device of claim 22 wherein the tube locking element is disposed within a radial bore in a wall of the cartridge housing.

24. The rotational atherectomy device of claim 22 wherein the slide is generally tubular and includes an inner surface having a generally annular recess which receives an outer portion of the tube locking element when the tube locking element is moved radially outwardly to its tube unlocked position.

25. The rotational atherectomy device of claim 22 wherein an outer surface of the longitudinally movable tube has a generally annular recess which receives an inner portion of the tube locking element when the tube locking element is moved radially inwardly to its tube locked position.

26. The rotational atherectomy device of claim 22 wherein the slide is movable proximally from its neutral position, where the cartridge latch is locked and the tube locking element is in its tube locked position, to a working position where the cartridge latch remains locked while the tube locking element is movable to its tube unlocked position, thereby permitting the longitudinally moveable tube to be moved proximally out of its tube lockable position.

27. The atherectomy device of claim 26 wherein the slide is generally tubular and includes a generally annular recess in its inner surface, the annular recess in the slide being positioned so that movement of the slide to its working position longitudinally aligns the annular recess of the slide with the tube locking element, permitting the tube locking element to move radially outwardly to unlock the longitudinally movable tube.

28. The atherectomy device of claim 27 wherein an annular recess in the outer surface of the longitudinally movable tube is positioned so that whenever the tube is moved proximally out of its tube lockable position the tube locking element is moved radially outwardly so that an outer portion of the tube locking element is moved into the annular recess of the slide, the tube locking element being retained in such position by an outer surface of the longitudinally movable tube, thereby locking the slide in its working position.

29. The atherectomy device of claim 27 wherein the annular recess in the tubular slide is positioned so that whenever the slide is moved distally out of its working position the tube locking element is moved radially inwardly so that an inner portion of the tube locking element is moved into an annular recess in an outer surface of the longitudinally movable tube, the tube locking element being retained in such position by the inner surface of the slide, thereby locking the longitudinally movable tube against longitudinal movement with respect to the cartridge housing.

30. The rotational atherectomy device of claim 26 wherein the cartridge latch comprises at least one radially resilient finger which is carried by the cartridge housing and which is removably engageable with a complementary structure carried by the handle housing.

31. The rotational atherectomy device of claim 30 wherein the radially resilient finger carries a catch positioned to engage a catch-engaging element of the slide, the catch restricting free movement of the slide between the neutral position and the working position.

32. The rotational atherectomy device of claim 31 wherein the catch includes proximal and distal engagement surfaces, the distal engagement surface being slanted proximally radially outwardly so that movement of the slide proximally from its neutral position causes the catch-engaging element to engage the distal engagement surface of the catch to move the catch, together with the radially resilient finger, radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved from its neutral position to its working position.

33. The rotational atherectomy device of claim 31 wherein the catch includes proximal and distal engagement surfaces, the proximal engagement surface being slanted distally radially outwardly so that movement of the slide distally from its working position causes the catch-engaging element to engage the proximal engagement surface of the catch to move the catch, together with the radially resilient finger, radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved distally out of its working position to and beyond its neutral position.

34. The rotational atherectomy device of claim 31, 32, or 33 wherein the catch of the finger and the catch engaging element of the slide are sized and positioned so that the slide may be moved between its neutral and working positions without unlocking the cartridge latch.

35. The rotational atherectomy device of claim 31 wherein at least one of the catch and the catch-engaging element has an engagement surface which is slanted proximally radially outwardly so that movement of the slide proximally from its neutral position forces the catch, together with the radially resilient finger, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved from its neutral position to its working position.

36. The rotational atherectomy device of claim 31 wherein at least one of the catch and the catch-engaging element has an engagement surface which is slanted distally radially outwardly so that movement of the slide distally from its working position forces the catch, together with the radially resilient finger, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved distally out of its working position to and beyond its neutral position.

37. The rotational atherectomy device of claim 31 further comprising a spring biasing the slide toward its working position, the catch and the catch-engaging element having complementary engagement surfaces which are generally perpendicular to a longitudinal axis of the cartridge housing and which restrict proximal movement of the slide from its neutral position to its working position.

38. The rotational atherectomy device of claim 37 wherein the complementary engagement surfaces are sized and positioned so that they become disengaged when the radially resilient finger is deflected radially inwardly, thereby allowing the spring to move the slide from its neutral position to its working position.

39. The rotational atherectomy device of claim 31 further comprising a spring biasing the slide toward its working position, the catch and the catch-engaging element being sized and positioned so that insertion of the cartridge housing into the handle housing causes the radially resilient finger, together with the catch, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby allowing the spring to move the slide from its neutral position to its working position.

40. The rotational atherectomy device of claim 39 wherein the slide biasing spring comprises a coil spring disposed about the cartridge housing.

41. The rotational atherectomy device of claim 39 wherein the slide biasing spring is compressed between opposing spring abutting surfaces of the slide and the cartridge housing.

42. The rotational atherectomy device of claim 26 wherein the handle housing includes a pair of openings sized and positioned so that the slide may be grasped through the openings by a user when the cartridge housing is attached to the handle housing.

43. The rotational atherectomy device of claim 42 wherein the openings are sufficiently long to permit manual movement of the slide between the neutral and working positions when the cartridge housing is attached to the handle housing.

44. The rotational atherectomy device of claim 42 wherein the openings are sufficiently long that a user, by a single movement, may move the slide from the slide'"'"'s working position to a position where the cartridge housing is at least partially moved out of the handle housing, the single movement including a first phase, where the slide is moved from its working position to its cartridge unlocked position, and a second phase where the slide, together with the cartridge housing, is moved distally with respect to the handle housing.

45. The rotational atherectomy device of claim 42 wherein the openings have a longitudinal length of at least about one inch.

46. A rotational atherectomy device comprising:

a handle housing;

a rotatable prime mover carried by a prime mover carriage which is disposed within the handle housing, the prime mover carriage being longitudinally movable with respect to the handle housing;

an exchangeable drive shaft cartridge including;

a cartridge housing which is removably attachable to the handle housing;

a longitudinally movable tube disposed within the cartridge housing and having a proximal end portion which is removably attachable to the prime mover carriage for longitudinal movement therewith;

a tube latch which selectively locks the longitudinally moveable tube against longitudinal movement with respect to the cartridge housing; and

a rotatable flexible drive shaft having a proximal portion which is disposed within the longitudinally movable tube and a distal portion which includes a tissue removal implement; and

a drive shaft attachment mechanism removably attaching the proximal portion of the drive shaft to the prime mover.

47. The rotational atherectomy device of claim 46 further comprising a slide which is longitudinally moveable with respect to the cartridge housing from a neutral position where the slide causes the tube latch to lock the longitudinally movable tube, to a working position, where the slide causes the tube latch to unlock the tube, thereby permitting its longitudinal movement with respect to the cartridge housing.

48. The atherectomy device of claim 47 wherein the tube latch is capable of selectively locking the slide against longitudinal movement with respect to the cartridge housing.

49. The atherectomy device of claim 48 wherein the tube latch is configured and arranged so that whenever the tube is locked against longitudinal movement then the slide is longitudinally movable, and whenever the slide is locked against longitudinal movement then the tube is longitudinally movable.

50. The rotational atherectomy device of claim 49 wherein the tube latch includes a tube locking element which is radially movable between at least two positions, a tube locked position, where the tube locking element is moved radially inwardly, thereby restricting longitudinal movement of the tube with respect to the cartridge housing, and a tube unlocked position, where the tube locking element is moved radially outwardly, thereby permitting longitudinal movement of the tube with respect to the cartridge housing.

51. The rotational atherectomy device of claim 50 wherein the tube latch includes three or more tube locking elements circumferentially spaced away from each other.

52. The rotational atherectomy device of claim 50 wherein the tube locking element is disposed within a radial bore in a wall of the cartridge housing.

53. The rotational atherectomy device of claim 50 wherein the tube locking element comprises a radially movable locking pin.

54. The rotational atherectomy device of claim 50 wherein the tube locking element comprises a radially movable locking ball.

55. The rotational atherectomy device of claim 50 wherein the tube latch includes a generally annular recess formed in an outer surface of the longitudinally movable tube, the recess receiving an inner portion of the tube locking element when the tube locking element is moved radially inwardly to its tube locked position.

56. The rotational atherectomy device of claim 55 wherein the tube latch includes a generally annular recess formed in an inner surface of the slide, the annular recess receiving an outer portion of the tube locking element when the tube locking element is moved radially outwardly to its tube unlocked position.

57. The rotational atherectomy device of claim 56 wherein the tube latch permits longitudinal movement of the slide when the annular recess of the longitudinally moveable tube is longitudinally aligned with the tube locking element disposed within a radial bore in a wall of the cartridge housing.

58. The atherectomy device of claim 46 further comprising a cartridge latch removably locking the cartridge housing to the handle housing.

59. The rotational atherectomy device of claim 58 wherein the drive shaft cartridge includes a slide which is longitudinally moveable with respect to the cartridge housing among at least three positions, a working position where the slide causes the tube latch to unlock the longitudinally movable tube, a neutral position where the slide causes the tube latch to lock the tube against longitudinal movement with respect to the cartridge housing, and a cartridge unlocked position where the slide causes the tube latch to maintain the longitudinally movable tube in its locked position and unlocks the cartridge latch, thereby permitting the cartridge housing to be removed from the handle housing.

60. The rotational atherectomy device of claim 59 wherein the cartridge latch comprises at least one radially resilient finger which is carried by the cartridge housing and which is removably engageable with a complementary structure carried by the handle housing.

61. The rotational atherectomy device of claim 60 wherein the radially resilient finger has a portion with an outer surface slanting distally radially outwardly, the slide having an abutment surface positioned so that when the slide is moved distally with respect to the radially resilient finger the abutment surface of the slide engages the slanted outer surface of the radially resilient finger to move the finger radially inwardly, thereby disengaging the finger from the complementary structure of the handle housing and permitting the cartridge housing to be removed from the handle housing.

62. The rotational atherectomy device of claim 61 wherein the cartridge latch includes two or more radially resilient fingers carried by the cartridge housing.

63. The rotational atherectomy device of claim 59 further comprising a catch positioned to engage a catch-engaging element of the slide, the catch restricting free movement of the slide between the neutral position and the working position.

64. The rotational atherectomy device of claim 63 wherein the cartridge latch comprises at least one radially resilient finger which is carried by the cartridge housing and which is removably engageable with a complementary structure carried by the handle housing.

65. The rotational atherectomy device of claim 64 wherein the catch comprises a radially outwardly extending shoulder carried by the resilient finger.

66. The rotational atherectomy device of claim 65 wherein the radially outwardly extending shoulder of the finger and the catch engaging element of the slide are sized and positioned so that the slide may be moved between its neutral and working positions without unlocking the cartridge latch.

67. The rotational atherectomy device of claim 65 wherein the catch includes proximal and distal engagement surfaces, the distal engagement surface being slanted proximally radially outwardly so that movement of the slide proximally from its neutral position causes the catch-engaging element to engage the distal engagement surface of the catch to move the catch, together with the radially resilient finger, radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved from its neutral position to its working position.

68. The rotational atherectomy device of claim 65 wherein the catch includes proximal and distal engagement surfaces, the proximal engagement surface being slanted distally radially outwardly so that movement of the slide distally from its working position causes the catch-engaging element to engage the proximal engagement surface of the catch to move the catch, together with the radially resilient finger, radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved distally out of its working position to and beyond its neutral position.

69. The rotational atherectomy device of claim 65 wherein at least one of the catch and the catch-engaging element has an engagement surface which is slanted proximally radially outwardly so that movement of the slide proximally from its neutral position forces the catch, together with the radially resilient finger, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved from its neutral position to its working position.

70. The rotational atherectomy device of claim 65 wherein at least one of the catch and the catch-engaging element has an engagement surface which is slanteddistally radially outwardly so that movement of the slide distally from its working position forces the catch, together with the radially resilient finger, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved distally out of its working position to and beyond its neutral position.

71. The rotational atherectomy device of claim 65 further comprising a spring biasing the slide toward its working position, the catch and the catch-engaging element having complementary engagement surfaces which are generally perpendicular to a longitudinal axis of the cartridge housing and which restrict proximal movement of the slide from its neutral position to its working position.

72. The rotational atherectomy device of claim 71 wherein the complementary engagement surfaces are sized and positioned so that they become disengaged when the radially resilient finger is deflected radially inwardly, thereby allowing the spring to move the slide from its neutral position to its working position.

73. The rotational atherectomy device of claim 65 further comprising a spring biasing the slide toward its working position, the catch and the catch-engaging element being sized and positioned so that insertion of the cartridge housing into the handle housing causes the radially resilient finger, together with the catch, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby allowing the spring to move the slide from its neutral position to its working position.

74. The rotational atherectomy device of claim 73 wherein the slide biasing spring comprises a coil spring disposed about the cartridge housing.

75. The rotational atherectomy device of claim 73 wherein the slide biasing spring is compressed between opposing spring abutting surfaces of the slide and the cartridge housing.

76. The rotational atherectomy device of claim 59 wherein the handle housing includes a pair of openings sized and positioned so that the slide may be grasped through the openings by a user when the cartridge housing is attached to the handle housing.

77. The rotational atherectomy device of claim 76 wherein the openings are sufficiently long to permit manual movement of the slide between the neutral and working positions when the cartridge housing is attached to the handle housing.

78. The rotational atherectomy device of claim 76 wherein the openings are sufficiently long that a user, by a single movement, may move the slide from the slide'"'"'s working position to a position where the cartridge housing is at least partially moved out of the handle housing, the single movement including a first phase, where the slide is moved from its working position to its cartridge unlocked position, and a second phase where the slide, together with the cartridge housing, is moved distally with respect to the handle housing.

79. The rotational atherectomy device of claim 76 wherein the openings have a longitudinal length of at least about one inch.

80. A rotational atherectomy device comprising:

a handle housing;

a rotatable prime mover carried by a prime mover carriage which is disposed within the handle housing, the prime mover carriage being longitudinally movable with respect to the handle housing;

an exchangeable drive shaft cartridge including;

a cartridge housing which is removably attachable to the handle housing;

a longitudinally movable tube disposed within the cartridge housing and having a proximal end portion which is removably attachable to the prime mover carriage for longitudinal movement therewith;

a tube latch which selectively locks the longitudinally movable tube against longitudinal movement with respect to the cartridge housing; and

a rotatable flexible drive shaft having a proximal portion which is disposed within the longitudinally movable tube and a distal portion which includes a tissue removal implement;

a drive shaft attachment mechanism removably attaching the proximal portion of the drive shaft to the prime mover;

a cartridge latch removably locking the cartridge housing to the handle housing; and

a slide which is longitudinally movable with respect to the cartridge housing among at least three positions, a working position where the slide causes the tube latch to unlock the longitudinally movable tube, a neutral position where the slide causes the tube latch to lock the tube against longitudinal movement with respect to the cartridge housing, and a cartridge unlocked position where the slide causes the tube latch to maintain the longitudinally movable tube in its locked position and unlocks the cartridge latch, thereby permitting the cartridge housing to be removed from the handle housing.

81. The rotational atherectomy device of claim 80 wherein the cartridge latch comprises at least one radially resilient finger which is carried by the cartridge housing and which is removably engageable with a complementary structure carried by the handle housing.

82. The rotational atherectomy device of claim 81 wherein the radially resilient finger has a portion with an outer surface slanting distally radially outwardly, the slide having an abutment surface positioned so that when the slide is moved distally with respect to the radially resilient finger the abutment surface of the slide engages the slanted outer surface of the radially resilient finger to move the finger radially inwardly, thereby disengaging the finger from the complementary structure of the handle housing and permitting the cartridge housing to be removed from the handle housing.

83. The rotational atherectomy device of claim 82 wherein the cartridge latch includes two or more radially resilient fingers carried by the cartridge housing.

84. The rotational atherectomy device of claim 81 wherein the radially resilient finger carries a catch positioned to engage a catch-engaging element of the slide, the catch restricting free movement of the slide between the neutral position and the working position.

85. The rotational atherectomy device of claim 84 wherein the catch includes proximal and distal engagement surfaces, the distal engagement surface being slanted proximally radially outwardly so that movement of the slide proximally from its neutral position causes the catch-engaging element to engage the distal engagement surface of the catch to move the catch, together with the radially resilient finger, radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved from its neutral position to its working position.

86. The rotational atherectomy device of claim 84 wherein the catch includes proximal and distal engagement surfaces, the proximal engagement surface being slanted distally radially outwardly so that movement of the slide distally from its working position causes the catch-engaging element to engage the proximal engagement surface of the catch to move the catch, together with the radially resilient finger, radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved distally out of its working position to and beyond its neutral position.

87. The rotational atherectomy device of claim 84, 85, or 86 wherein the catch of the finger and the catch engaging element of the slide are sized and positioned so that the slide may be moved between its neutral and working positions without unlocking the cartridge latch.

88. The rotational atherectomy device of claim 84 wherein at least one of the catch and the catch-engaging element has an engagement surface which is slanted proximally radially outwardly so that movement of the slide proximally from its neutral position forces the catch, together with the radially resilient finger, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved from its neutral position to its working position.

89. The rotational atherectomy device of claim 84 wherein at least one of the catch and the catch-engaging element has an engagement surface which is slanted distally radially outwardly so that movement of the slide distally from its working position forces the catch, together with the radially resilient finger, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved distally out of its working position to and beyond its neutral position.

90. The rotational atherectomy device of claim 84 further comprising a spring biasing the slide toward its working position, the catch and the catch-engaging element having complementary engagement surfaces which are generally perpendicular to a longitudinal axis of the cartridge housing and which restrict proximal movement of the slide from its neutral position to its working position.

91. The rotational atherectomy device of claim 90 wherein the complementary engagement surfaces are sized and positioned so that they become disengaged when the radially resilient finger is deflected radially inwardly, thereby allowing the spring to move the slide from its neutral position to its working position.

92. The rotational atherectomy device of claim 84 further comprising a spring biasing the slide toward its working position, the catch and the catch-engaging element being sized and positioned so that insertion of the cartridge housing into the handle housing causes the radially resilient finger, together with the catch, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby allowing the spring to move the slide from its neutral position to its working position.

93. The rotational atherectomy device of claim 92 wherein the slide biasing spring comprises a coil spring disposed about the cartridge housing.

94. The rotational atherectomy device of claim 92 wherein the slide biasing spring is compressed between opposing spring abutting surfaces of the slide and the cartridge housing.

95. The rotational atherectomy device of claim 80 wherein the handle housing includes a pair of openings sized and positioned so that the slide may be grasped through the openings by a user when the cartridge housing is attached to the handle housing.

96. The rotational atherectomy device of claim 95 wherein the openings are sufficiently long to permit manual movement of the slide between the neutral and working positions when the cartridge housing is attached to the handle housing.

97. The rotational atherectomy device of claim 95 wherein the openings are sufficiently long that a user, by a single movement, may move the slide from the slide'"'"'s working position to a position where the cartridge housing is at least partially moved out of the handle housing, the single movement including a first phase, where the slide is moved from its working position to its cartridge unlocked position, and a second phase where the slide, together with the cartridge housing, is moved distally with respect to the handle housing.

98. The rotational atherectomy device of claim 95 wherein the openings have a longitudinal length of at least about one inch.

99. A device comprising:

a handle housing;

a carriage which is disposed within the handle housing, the carriage being longitudinally movable with respect to the handle housing;

an exchangeable cartridge including;

a cartridge housing which is removably attachable to the handle housing;

a longitudinally movable tube disposed within the cartridge housing and having a proximal end portion which is removably attachable to the carriage for longitudinal movement therewith;

a tube latch which selectively locks the longitudinally movable tube against longitudinal movement with respect to the cartridge housing; and

a cartridge latch removably locking the cartridge housing to the handle housing; and

a slide which is longitudinally movable with respect to the cartridge housing among at least three positions, a working position where the slide causes the tube latch to unlock the longitudinally movable tube, a neutral position where the slide causes the tube latch to lock the tube against longitudinal movement with respect to the cartridge housing, and a cartridge unlocked position where the slide causes the tube latch to maintain the longitudinally movable tube in its locked position and unlocks the cartridge latch, thereby permitting the cartridge housing to be removed from the handle housing.

100. The device of claim 99 wherein the cartridge latch comprises at least one radially resilient finger which is carried by the cartridge housing and which is removably engageable with a complementary structure carried by the handle housing.

101. The device of claim 100 wherein the radially resilient finger has a portion with an outer surface slanting distally radially outwardly, the slide having an abutment surface positioned so that when the slide is moved distally with respect to the radially resilient finger the abutment surface of the slide engages the slanted outer surface of the radially resilient finger to move the finger radially inwardly, thereby disengaging the finger from the complementary structure of the handle housing and permitting the cartridge housing to be removed from the handle housing.

102. The device of claim 101 wherein the cartridge latch includes two or more radially resilient fingers carried by the cartridge housing.

103. The device of claim 100 wherein the radially resilient finger carries a catch positioned to engage a catch-engaging element of the slide, the catch restricting free movement of the slide between the neutral position and the working position.

104. The device of claim 103 wherein the catch includes proximal and distal engagement surfaces, the distal engagement surface being slanted proximally radially outwardly so that movement of the slide proximally from its neutral position causes the catch-engaging element to engage the distal engagement surface of the catch to move the catch, together with the radially resilient finger, radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved from its neutral position to its working position.

105. The device of claim 103 wherein the catch includes proximal and distal engagement surfaces, the proximal engagement surface being slanted distally radially outwardly so that movement of the slide distally from its working position causes the catch-engaging element to engage the proximal engagement surface of the catch to move the catch, together with the radially resilient finger, radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved distally out of its working position to and beyond its neutral position.

106. The device of claim 103, 104, or 105 wherein the catch of the finger and the catch engaging element of the slide are sized and positioned so that the slide may be moved between its neutral and working positions without unlocking the cartridge latch.

107. The device of claim 103 wherein at least one of the catch and the catch-engaging element has an engagement surface which is slanted proximally radially outwardly so that movement of the slide proximally from its neutral position forces the catch, together with the radially resilient finger, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved from its neutral position to its working position.

108. The device of claim 103 wherein at least one of the catch and the catch-engaging element has an engagement surface which is slanted distally radially outwardly so that movement of the slide distally from its working position forces the catch, together with the radially resilient finger, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved distally out of its working position to and beyond its neutral position.

109. The device of claim 103 further comprising a spring biasing the slide toward its working position, the catch and the catch-engaging element having complementary engagement surfaces which are generally perpendicular to a longitudinal axis of the cartridge housing and which restrict proximal movement of the slide from its neutral position to its working position.

110. The device of claim 109 wherein the complementary engagement surfaces are sized and positioned so that they become disengaged when the radially resilient finger is deflected radially inwardly, thereby allowing the spring to move the slide from its neutral position to its working position.

111. The device of claim 103 further comprising a spring biasing the slide toward its working position, the catch and the catch-engaging element being sized and positioned so that insertion of the cartridge housing into the handle housing causes the radially resilient finger, together with the catch, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby allowing the spring to move the slide from its neutral position to its working position.

112. The device of claim 111 wherein the slide biasing spring comprises a coil spring disposed about the cartridge housing.

113. The device of claim 111 wherein the slide biasing spring is compressed between opposing spring abutting surfaces of the slide and the cartridge housing.

114. The device of claim 99 wherein the slide is generally tubular in shape.

115. The device of claim 114 wherein the slide is disposed about the cartridge housing.

116. The device of claim 99 wherein the handle housing includes a pair of openings sized and positioned so that the slide may be grasped through the openings by a user when the cartridge housing is attached to the handle housing.

117. The device of claim 116 wherein the openings are sufficiently long to permit manual movement of the slide between the neutral and working positions when the cartridge housing is attached to the handle housing.

118. The device of claim 116 wherein the openings are sufficiently long that a user, by a single movement, may move the slide from the slide'"'"'s working position to a position where the cartridge housing is at least partially moved out of the handle housing, the single movement including a first phase, where the slide is moved from its working position to its cartridge unlocked position, and a second phase where the slide, together with the cartridge housing, is moved distally with respect to the handle housing.

119. The device of claim 116 wherein the openings have a longitudinal length of at least about one inch.

120. The device of claim 99 wherein the tube latch is capable of selectively locking the slide against longitudinal movement with respect to the cartridge housing.

121. The claim 120 wherein the tube latch is configured and arranged so that whenever the tube is locked against longitudinal movement then the slide is longitudinally movable, and whenever the slide is locked against longitudinal movement then the tube is longitudinally movable.

122. The device of claim 121 wherein the tube latch includes a tube locking element which is radially movable between at least two positions, a tube locked position, where the tube locking element is moved radially inwardly, thereby restricting longitudinal movement of the tube with respect to the cartridge housing, and a tube unlocked position, where the tube locking element is moved radially outwardly, thereby permitting longitudinal movement of the tube with respect to the cartridge housing.

123. The device of claim 122 wherein the tube latch includes three or more tube locking elements circumferentially spaced away from each other.

124. The device of claim 122 wherein the tube locking element is disposed within a radial bore in a wall of the cartridge housing.

125. The device of claim 122 wherein the tube locking element comprises a radially movable locking pin.

126. The device of claim 122 wherein the tube locking element comprises a radially movable locking ball.

127. The device of claim 122 wherein the tube latch includes a generally annular recess formed in an outer surface of the longitudinally movable tube, the recess receiving an inner portion of the tube locking element when the tube locking element is moved radially inwardly to its tube locked position.

128. The device of claim 127 wherein the tube latch includes a generally annular recess formed in an inner surface of the slide, the annular recess receiving an outer portion of the tube locking element when the tube locking element is moved radially outwardly to its tube unlocked position.

129. An exchangeable cartridge attachable to a handle housing comprising:

a cartridge housing which is removably attachable to the handle housing;

a longitudinally movable tube disposed within the cartridge housing;

a rotatable drive shaft having a proximal portion which is disposed within the longitudinally movable tube and a distal portion which includes a material removal implement;

a cartridge latch; and

a slide which is longitudinally movable with respect to the cartridge housing from a neutral position, where the cartridge latch is locked, to a cartridge unlocked position where the slide unlocks the cartridge latch, thereby permitting the cartridge housing to be removed from the handle housing.

130. The exchangeable cartridge of claim 129 wherein the slide is generally tubular in shape.

131. The exchangeable cartridge of claim 129 wherein the cartridge latch comprises at least one radially resilient finger which is carried by the cartridge housing and which is removably engageable with a complementary structure carried by the handle housing.

132. The exchangeable cartridge of claim 131 wherein the cartridge latch includes two or more radially resilient fingers carried by the cartridge housing.

133. The exchangeable cartridge of claim 131 wherein the radially resilient finger has a portion with an outer surface slanting distally radially outwardly, the slide having an abutment surface positioned so that when the slide is moved distally with respect to the radially resilient finger the abutment surface of the slide engages the slanted outer surface of the radially resilient finger to move the finger radially inwardly, thereby disengaging the finger from the complementary structure of the handle housing and permitting the cartridge housing to be removed from the handle housing.

134. The exchangeable cartridge of claim 133 wherein the abutment surface comprises a distal end of the slide.

135. The exchangeable cartridge of claim 129 further comprising a tube latch for selectively locking the longitudinally movable tube against longitudinal movement with respect to the cartridge housing.

136. The exchangeable cartridge of claim 135 wherein the tube latch is capable of selectively locking the slide against longitudinal movement with respect to the cartridge housing.

137. The exchangeable cartridge of claim 136 wherein the tube latch is configured and arranged so that whenever the tube is locked against longitudinal movement then the slide is longitudinally movable, and whenever the slide is locked against longitudinal movement then the tube is longitudinally movable.

138. The exchangeable cartridge of claim 129 further comprising a tube latch positioned to selectively lock the longitudinally movable tube and the slide against longitudinal movement with respect to the cartridge housing.

139. The exchangeable cartridge of claim 138 wherein the tube latch is configured and arranged so that whenever the tube is locked against longitudinal movement then the slide is longitudinally movable, and whenever the slide is locked against longitudinal movement then the tube is longitudinally movable.

140. The exchangeable cartridge of claim 139 wherein the tube latch includes a tube locking element carried by the cartridge housing, the tube locking element being radially movable between at least two positions, a tube locked position, where the tube locking element is moved radially inwardly, thereby restricting longitudinal movement of the tube with respect to the cartridge housing, and a tube unlocked position, where the tube locking element is moved radially outwardly, thereby permitting longitudinal movement of the tube with respect to the cartridge housing.

141. The exchangeable cartridge of claim 140 wherein the tube latch includes three or more tube locking elements circumferentially spaced away from each other.

142. The exchangeable cartridge of claim 140 wherein the tube locking element is disposed within a radial bore in a wall of the cartridge housing.

143. The exchangeable cartridge of claim 140 wherein the tube locking element comprises a radially movable locking pin.

144. The exchangeable cartridge of claim 140 wherein the tube locking element comprises a radially movable locking ball.

145. The exchangeable cartridge of claim 140 wherein the tube latch includes a generally annular recess formed in an outer surface of the longitudinally movable tube, the recess receiving an inner portion of the tube locking element when the tube locking element is moved radially inwardly to its tube locked position.

146. The exchangeable cartridge of claim 145 wherein the tube latch includes a generally annular recess formed in an inner surface of the slide, the annular recess receiving an outer portion of the tube locking element when the tube locking element is moved radially outwardly to its tube unlocked position.

147. The exchangeable cartridge of claim 146 wherein the tube latch permits longitudinal movement of the slide when the annular recess of the longitudinally moveable tube is longitudinally aligned with the tube locking element carried by the cartridge housing.

148. The exchangeable cartridge of claim 129 further comprising at least one tube locking element carried by the cartridge housing and radially movable between at least two positions, a tube locked position, where the tube locking element is moved radially inwardly, thereby restricting longitudinal movement of the tube with respect to the cartridge housing, and a tube unlocked position, where the tube locking element is moved radially outwardly, thereby permitting longitudinal movement of the tube with respect to the cartridge housing.

149. The exchangeable cartridge of claim 148 wherein the tube locking element is disposed within a radial bore in a wall of the cartridge housing.

150. The exchangeable cartridge of claim 148 wherein the slide is generally tubular and includes an inner surface having a generally annular recess which receives an outer portion of the tube locking element when the tube locking element is moved radially outwardly to its tube unlocked position.

151. The exchangeable cartridge of claim 148 wherein an outer surface of the longitudinally movable tube has a generally annular recess which receives an inner portion of the tube locking element when the tube locking element is moved radially inwardly to its tube locked position.

152. The exchangeable cartridge of claim 148 wherein the slide is movable proximally from its neutral position, where the cartridge latch is locked and the tube locking element is in its tube locked position, to a working position where the cartridge latch remains locked while the tube locking element is movable to its tube unlocked position, thereby permitting the longitudinally moveable tube to be moved proximally out of its tube lockable position.

153. The exchangeable cartridge of claim 152 wherein the slide is generally tubular and includes a generally annular recess in its inner surface, the annular recess in the slide being positioned so that movement of the slide to its working position longitudinally aligns the annular recess of the slide with the tube locking element, permitting the tube locking element to move radially outwardly to unlock the longitudinally movable tube.

154. The exchangeable cartridge of claim 153 wherein an annular recess in the outer surface of the longitudinally movable tube is positioned so that whenever the tube is moved proximally out of its tube lockable position the tube locking element is moved radially outwardly so that an outer portion of the tube locking element is moved into the annular recess of the slide, the tube locking element being retained in such position by an outer surface of the longitudinally movable tube, thereby locking the slide in its working position.

155. The exchangeable cartridge of claim 153 wherein the annular recess in the tubular slide is positioned so that whenever the slide is moved distally out of its working position the tube locking element is moved radially inwardly so that an inner portion of the tube locking element is moved into an annular recess in an outer surface of the longitudinally movable tube, the tube locking element being retained in such position by the inner surface of the slide, thereby locking the longitudinally movable tube against longitudinal movement with respect to the cartridge housing.

156. The exchangeable cartridge of claim 152 wherein the cartridge latch comprises at least one radially resilient finger which is carried by the cartridge housing and which is removably engageable with a complementary structure carried by the handle housing.

157. The exchangeable cartridge of claim 156 wherein the radially resilient finger carries a catch positioned to engage a catch-engaging element of the slide, the catch restricting free movement of the slide between the neutral position and the working position.

158. The exchangeable cartridge of claim 157 wherein the catch includes proximal and distal engagement surfaces, the distal engagement surface being slanted proximally radially outwardly so that movement of the slide proximally from its neutral position causes the catch-engaging element to engage the distal engagement surface of the catch to move the catch, together with the radially resilient finger, radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved from its neutral position to its working position.

159. The exchangeable cartridge of claim 157 wherein the catch includes proximal and distal engagement surfaces, the proximal engagement surface being slanted distally radially outwardly so that movement of the slide distally from its working position causes the catch-engaging element to engage the proximal engagement surface of the catch to move the catch, together with the radially resilient finger, radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved distally out of its working position to and beyond its neutral position.

160. The exchangeable cartridge of claim 157, 158 or 159 wherein the catch of the finger and the catch engaging element of the slide are sized and positioned so that the slide may be moved between its neutral and working positions without unlocking the cartridge latch.

161. The exchangeable cartridge of claim 157 wherein at least one of the catch and the catch-engaging element has an engagement surface which is slanted proximally radially outwardly so that movement of the slide proximally from its neutral position forces the catch, together with the radially resilient finger, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved from its neutral position to its working position.

162. The exchangeable cartridge of claim 157 wherein at least one of the catch and the catch-engaging element has an engagement surface which is slanted distally radially outwardly so that movement of the slide distally from its working position forces the catch, together with the radially resilient finger, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby permitting the slide to be manually moved distally out of its working position to and beyond its neutral position.

163. The exchangeable cartridge of claim 157 further comprising a spring biasing the slide toward its working position, the catch and the catch-engaging element having complementary engagement surfaces which are generally perpendicular to a longitudinal axis of the cartridge housing and which restrict proximal movement of the slide from its neutral position to its working position.

164. The exchangeable cartridge of claim 163 wherein the complementary engagement surfaces are sized and positioned so that they become disengaged when the radially resilient finger is deflected radially inwardly, thereby allowing the spring to move the slide from its neutral position to its working position.

165. The exchangeable cartridge of claim 157 further comprising a spring biasing the slide toward its working position, the catch and the catch-engaging element being sized and positioned so that insertion of the cartridge housing into the handle housing causes the radially resilient finger, together with the catch, to move radially inwardly a distance sufficient to release the catch-engaging element of the slide from the catch, thereby allowing the spring to move the slide from its neutral position to its working position.

166. The exchangeable cartridge of claim 165 wherein the slide biasing spring comprises a coil spring disposed about the cartridge housing.

167. The exchangeable cartridge of claim 165 wherein the slide biasing spring is compressed between opposing spring abutting surfaces of the slide and the cartridge housing.