Neovascularization catheter

• US 6,117,153 A
• Filed: 07/27/1998
• Issued: 09/12/2000
• Est. Priority Date: 10/03/1996
• Status: Expired due to Term

• Current Assignee: Lary Research & Development LLC
• Original Assignee: Interventional Technologies Incorporated (Boston Scientific Corporation)
• Inventors: Radisch, Herbert R. Jr., Lary, Banning Gray
• Primary Examiner(s): Dawson, Glenn K.
• Application Number:
  US09/123,758
• Time in Patent Office: 778 Days
• Field of Search: 606/1, 606/108, 606/159, 606/167, 606/170, 606/171, 606/185, 606/198, 606/7, 604/96-104, 604/164, 604/264, 128/898
• US Class Current: 606/170
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/22044 with a pointed tip
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising
• CPC Class Codes: A61B 2017/22072 with an instrument channel, e.g. for replacing one instrument by the other
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation

Abstract

The present invention is a device and a method for boring a perfusion channel from a coronary artery into a cardiac muscle of a patient. Structurally, the present invention includes a positioning catheter, anchoring structure and a cutting catheter. The cutting catheter includes a plurality of blades and is advanceable through a deployment lumen of the positioning catheter. Advancement of the cutting catheter through the deployment lumen causes a distal end of the cutting catheter to project laterally from the positioning catheter. In use, the positioning catheter is positioned within the coronary artery. The anchoring structure is then expanded to anchor the positioning catheter within the artery. The cutting catheter is then advanced through the deployment lumen to bore one or more perfusion channels in the myocardial tissue.

Claims

1. A device for boring a perfusion channel from a vessel into a muscle of a patient, the device comprising:

a positioning catheter;

anchoring means attached to the positioning catheter for selectively anchoring the positioning catheter in the vessel, the anchoring means substantially contacting a circumference of the vessel; and

a cutting catheter which selectively projects from the positioning catheter, the cutting catheter including a cutting catheter body and a blade which extends substantially radially from the cutting catheter body, the cutting catheter being adapted to create the perfusion channel from the vessel into the muscle.

2. The device of claim 1 wherein the positioning catheter includes a catheter outer surface, a deployment lumen which receives the cutting catheter and a deployment aperture extending from the catheter outer surface into the deployment lumen, the deployment aperture allowing the cutting catheter to extend laterally from the positioning catheter.

3. The device of claim 2 wherein the positioning catheter includes a plurality of spaced apart, deployment apertures extending from the catheter outer surface into the deployment lumen, the deployment apertures allowing the cutting catheter to selectively extend laterally from the positioning catheter at a plurality of spaced apart locations along the positioning catheter.

4. The device of claim 2 including a radiopaque deployment marker positioned proximate to the deployment aperture.

5. The device of claim 1 wherein the blade is movable between a first position wherein the blade is substantially contained within the cutting catheter body and a second position wherein the blade extends radially from the cutting catheter body.

6. The device of claim 1 wherein the anchoring means comprises a cylindrical sleeve attached to the positioning catheter, the cylindrical sleeve having a distal sleeve end and a proximal sleeve end, and wherein the sleeve radially expands during movement of the sleeve ends together to anchor the positioning catheter substantially around the circumference of the vessel.

7. The device of claim 6 wherein said cylindrical sleeve is fabricated from a wire mesh.

8. The device of claim 1 wherein the anchoring means includes an inflatable balloon attached to the positioning catheter for selectively anchoring the positioning catheter in the vessel.

9. The device of claim 1 including a flow lumen which is adapted to allow for the flow of blood past the anchoring means.

10. The device of claim 1 further comprising a cutting guidewire and wherein the cutting catheter is formed with a cutting catheter lumen for advancement of the cutting guidewire therethrough.

11. The device of claim 10 further comprising a source of medication and wherein the cutting guidewire includes a cutting guidewire lumen in fluid communication with the source of medication for selectively releasing the medication from the cutting guidewire lumen into the muscle.

12. The device of claim 10 further comprising a source of contrast medium and wherein the cutting guidewire includes a cutting guidewire lumen in fluid communication with the source of contrast medium for selectively releasing the contrast medium from the cutting guidewire lumen into the muscle.

13. The device of claim 10 further comprising a pressure sensor adapted for measuring pressure and wherein the cutting guidewire includes a cutting guidewire tip and a cutting guidewire lumen in fluid communication with the pressure sensor, thereby allowing the pressure sensor to measure the pressure at the cutting guidewire tip.

14. A device for boring a perfusion channel from a vessel into a muscle of a patient, the device comprising:

a positioning catheter;

anchoring means attached to the positioning catheter for selectively anchoring the positioning catheter in the vessel, the anchoring means substantially contacting a circumference of the vessel; and

a cutting catheter which selectively projects laterally from the positioning catheter, the cutting catheter including a cutting catheter body and a plurality of spaced apart blades, wherein, in a first position each blade is substantially contained within the cutting catheter body and in a second position each blade extends substantially radially from the cutting catheter body.

15. The device of claim 14 wherein the positioning catheter includes a catheter outer surface, a deployment lumen which receives the cutting catheter and a plurality of spaced apart deployment apertures extending from the catheter outer surface into the deployment lumen, the deployment apertures allowing the cutting catheter to selectively extend laterally from the positioning catheter at a plurality of spaced apart locations along the positioning catheter.

16. The device of claim 14 wherein the anchoring means comprises a cylindrical sleeve secured to the positioning catheter, the cylindrical sleeve having a distal sleeve end and a proximal sleeve end, and wherein the sleeve radially expands during movement of the sleeve ends together to anchor the positioning catheter substantially around the circumference of the vessel.

17. The device of claim 14 further comprising a cutting guidewire and wherein the cutting catheter is formed with a cutting catheter lumen for advancement of the cutting guidewire therethrough.

18. The device of claim 17 further comprising a source of medication and wherein the cutting guidewire includes a cutting guidewire lumen in fluid communication with the source of medication for selectively releasing the medication from the cutting guidewire lumen into the muscle.

19. The device of claim 17 further comprising a source of contrast medium and wherein the cutting guidewire includes a cutting guidewire lumen in fluid communication with the source of contrast medium for selectively releasing the contrast medium from the cutting guidewire lumen into the muscle.

20. The device of claim 17 further comprising a pressure sensor adapted for measuring pressure and wherein the cutting guidewire includes a cutting guidewire tip and a cutting guidewire lumen in fluid communication with the pressure sensor, thereby allowing the pressure sensor to measure the pressure at the cutting guidewire tip.

21. A device for boring a perfusion channel from a vessel into a muscle of a patient, the device comprising:

a positioning catheter;

anchoring means attached to the positioning catheter for selectively anchoring the positioning catheter in the vessel; and

a cutting catheter which selectively projects from the positioning catheter, the cutting catheter including a blade, the cutting catheter being adapted to create the perfusion channel from the vessel into the muscle.

22. The device of claim 21 wherein the anchoring means is adapted to substantially contact a circumference of the vessel.

23. The device of claim 21 wherein the positioning catheter includes a catheter outer surface, a deployment lumen which receives the cutting catheter and a deployment aperture extending from the catheter outer surface into the deployment lumen, the deployment aperture allowing the cutting catheter to extend substantially laterally from the positioning catheter.

24. The device of claim 23 wherein the positioning catheter includes a plurality of spaced apart, deployment apertures extending from the catheter outer surface into the deployment lumen, the deployment apertures allowing the cutting catheter to selectively extend substantially laterally from the positioning catheter at a plurality of spaced apart locations along the positioning catheter.

25. The device of claim 24 including a radiopaque deployment marker positioned proximate to each of the deployment apertures.

26. The device of claim 21 wherein the blade is movable between a first position wherein the blade is substantially contained within a cutting catheter body and a second position wherein the blade extends radially from the cutting catheter body.

27. The device of claim 21 wherein the anchoring means comprises a cylindrical sleeve attached to the positioning catheter, the cylindrical sleeve having a distal sleeve end and a proximal sleeve end, and wherein the sleeve radially expands during movement of the sleeve ends together to anchor the positioning catheter substantially around the circumference of the vessel.

28. The device of claim 21 further comprising a cutting guidewire and wherein the cutting catheter is formed with a cutting catheter lumen for advancement of the cutting guidewire therethrough.

29. The device of claim 28 further comprising a source of medication and wherein the cutting guidewire includes a cutting guidewire lumen in fluid communication with the source of medication for selectively releasing the medication from the cutting guidewire lumen into the muscle.

30. The device of claim 28 further comprising a pressure sensor adapted for measuring pressure and wherein the cutting guidewire includes a cutting guidewire tip and a cutting guidewire lumen in fluid communication with the pressure sensor, thereby allowing the pressure sensor to measure the pressure at the cutting guidewire tip.