System and method of use for revascularizing stenotic bypass grafts and other occluded blood vessels
First Claim
1. An intravascular system for opening a lumen in a portion of an occluded blood vessel of a living being'"'"'s vascular system, the occluded blood vessel portion being occluded by an occlusive material and being located downstream of a patent blood vessel portion, said system comprising a first catheter, a vessel-opening catheter, a debris blocking member, and a debris extraction system, said first catheter having a distal end portion including an opening, a passageway extending therethrough and in communication with said opening, and at least one blood entrance port, said vessel-opening catheter extending through said first catheter and having a working head, said working head being arranged to be located immediately adjacent the occlusive material for operating on the occlusive material to open a lumen for the freer flow of blood therethrough, whereupon some debris may be produced, said debris blocking member being located distally of said working head to prevent debris from flowing distally thereof, said debris extraction system being operative to introduce a liquid adjacent said working head and to cause debris and said liquid to flow proximally through said opening and said passageway for extraction, said at least one blood entrance port of said first catheter being in communication with said passageway and with the patent blood vessel portion, whereupon blood from said patent blood vessel portion may enter for merger with said liquid and the debris.
1 Assignment
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Accused Products
Abstract
A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The system comprises an atherectomy catheter having a working head, e.g., a rotary impacting impeller, and a debris extraction sub-system. The atherectomy catheter is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head and withdraws that liquid and some blood at a second and higher flow rate, through the guide catheter to create a differential flow adjacent the working head, whereupon the debris is withdrawn in the infusate liquid and blood for collection outside the being'"'"'s body. The introduction of the infusate liquid may also be used to establish an unbalanced flow adjacent the working head to enable the atherectomy catheter to be steered hydrodynamically. A guide wire having an inflatable balloon on its distal end may be used with the atherectomy catheter to block the flow of debris distally, while enabling distal tissues to be perfused with an oxygenating liquid. At least one flow control port may be provided in the guide catheter to prevent collapse of the vessel being revascularized. A cradle is provided to fix the guide catheter and guide wire in position within the body of the being while enabling the atherectomy catheter to be advanced along the guide wire and through the guide catheter.
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Citations
44 Claims
- 1. An intravascular system for opening a lumen in a portion of an occluded blood vessel of a living being'"'"'s vascular system, the occluded blood vessel portion being occluded by an occlusive material and being located downstream of a patent blood vessel portion, said system comprising a first catheter, a vessel-opening catheter, a debris blocking member, and a debris extraction system, said first catheter having a distal end portion including an opening, a passageway extending therethrough and in communication with said opening, and at least one blood entrance port, said vessel-opening catheter extending through said first catheter and having a working head, said working head being arranged to be located immediately adjacent the occlusive material for operating on the occlusive material to open a lumen for the freer flow of blood therethrough, whereupon some debris may be produced, said debris blocking member being located distally of said working head to prevent debris from flowing distally thereof, said debris extraction system being operative to introduce a liquid adjacent said working head and to cause debris and said liquid to flow proximally through said opening and said passageway for extraction, said at least one blood entrance port of said first catheter being in communication with said passageway and with the patent blood vessel portion, whereupon blood from said patent blood vessel portion may enter for merger with said liquid and the debris.
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35. A method for opening a lumen in a portion of an occluded blood vessel of a living being'"'"'s vascular system, the occluded blood vessel portion being occluded by an occlusive material, the occluded blood vessel portion being located distally of a patent blood vessel portion, said method comprising:
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(a) extending a first catheter through said patent blood vessel portion into said occluded blood vessel portion, said first catheter having a distal end portion and a port located proximally of said distal end portion; (b) blocking the flow of blood and debris distally of a working head; (c) providing a vessel-opening catheter having said working head and extending said vessel-opening catheter through said first catheter so that said working head is located in the occluded blood vessel portion, said first catheter and said vessel-opening catheter defining a passageway therebetween; (d) operating said working head to open the occluded blood vessel portion for the freer flow of blood therethrough; (e) introducing a liquid at a first flow rate adjacent said working head and withdrawing said liquid at a second and higher flow rate to create a differential flow adjacent said working head, whereupon blocked debris is withdrawn with said liquid for passage proximally through said passageway; and (g) providing a path for blood within said patent blood vessel portion to flow into said passageway for merger with said liquid and debris. - View Dependent Claims (36, 37)
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38. A method for opening a lumen in a portion of an occluded blood vessel of a living being'"'"'s vascular system, the occluded blood vessel portion being occluded by an occlusive material, the occluded blood vessel portion being located distally of a patent blood vessel portion, said method comprising:
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(a) extending a first catheter through said patent blood vessel portion into said occluded blood vessel portion, said first catheter having a distal end portion and a port located proximally of said distal end portion; (b) extending a second catheter through said first catheter so that a working portion of said second catheter is located in the occluded blood vessel portion; (c) blocking the occluded blood vessel portion distally of said working portion of said second catheter; (d) using said second catheter to open a lumen in the occluded portion of the blood vessel for the freer flow of blood therethrough; (e) introducing a liquid into said occluded blood vessel portion and withdrawing said liquid and any debris produced by the opening of the occluded portion of the blood vessel through a passageway in said first catheter; and (g) providing a path for blood from the patent blood vessel portion to flow through said port into said passageway for merger with said liquid and debris. - View Dependent Claims (39, 40, 41, 42, 43, 44)
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Specification