Aspiration method
DCFirst Claim
1. A method of treatment of a blood vessel in which blood fluid flows proximally to distally, said method comprising:
- delivering an expandable device to form a barrier sufficient to inhibit emboli suspended in said fluid from migrating past the barrier in a proximal to distal direction;
preventing emboli from moving in a distal to proximal direction by exposing said expandable device to blood fluid pressure within said vessel;
advancing a catheter having a lumen in fluid communication with a distal opening in the catheter, said advancing comprising moving said distal opening relative to said expandable device within the blood vessel such that said opening is distal to at least a portion of an occlusive substance within said blood vessel, said occlusive substance comprising said emboli suspended in said fluid;
drawing fluid from the vessel into the distal opening such that (a) a fluid flow is created in the lumen in a distal to proximal direction, and (b) said fluid flow is simultaneously created in said vessel in a proximal to distal direction, whereby said emboli are carried by said fluid flow from said vessel into said distal opening and through said lumen of said catheter.
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Abstract
A method for the treatment of a stenosis or an occlusion in a blood vessel in which an occlusive device is first delivered and activated at a site distal to the occlusion to at least partially occlude the vessel. A therapy catheter is then introduced to treat the occlusion and a debris removal device is delivered to aspirate debris from the vessel. The present invention eliminates the need for a separate irrigation catheter and irrigation fluid which allows the procedure to be performed quickly and efficiently, and is especially useful in the removal of occlusion from saphenous vein grafts, the coronary and carotid arteries, arteries above the aortic arch and vessels of similar size and pressure.
384 Citations
59 Claims
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1. A method of treatment of a blood vessel in which blood fluid flows proximally to distally, said method comprising:
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delivering an expandable device to form a barrier sufficient to inhibit emboli suspended in said fluid from migrating past the barrier in a proximal to distal direction; preventing emboli from moving in a distal to proximal direction by exposing said expandable device to blood fluid pressure within said vessel; advancing a catheter having a lumen in fluid communication with a distal opening in the catheter, said advancing comprising moving said distal opening relative to said expandable device within the blood vessel such that said opening is distal to at least a portion of an occlusive substance within said blood vessel, said occlusive substance comprising said emboli suspended in said fluid; drawing fluid from the vessel into the distal opening such that (a) a fluid flow is created in the lumen in a distal to proximal direction, and (b) said fluid flow is simultaneously created in said vessel in a proximal to distal direction, whereby said emboli are carried by said fluid flow from said vessel into said distal opening and through said lumen of said catheter. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A method for the evacuation of emboli from a blood vessel comprising:
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positioning a catheter having a lumen in fluid communication with a distal opening in the catheter such that said opening is distal to at least a portion of an occlusive substance within said blood vessel, said occlusive substance comprising said emboli suspended in fluid; drawing fluid from the vessel into the distal opening such that emboli are carried by said fluid flow from said vessel into said distal opening and through said lumen of said catheter; and moving the distal opening in the catheter until it is proximal to said occlusive substance during the drawing of fluid into the distal opening. - View Dependent Claims (13, 14)
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15. A method for the treatment of an occlusion in a blood vessel having a fluid pressure of at least about 0.2 psi, comprising:
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inserting a first catheter having an occlusive device at its distal end into said blood vessel, until said occlusive device is distal to said occlusion; activating said occlusive device to at least partially occlude said vessel distal to said occlusion and create a working area surrounding said occlusion; advancing a therapy catheter into said blood vessel until it reaches said occlusion; performing therapy on said occlusion; utilizing fluid pressure within said vessel to inhibit particles produced during therapy from substantial migration in a direction proximal to said occlusion; removing said therapy catheter; creating a flow of fluid within said vessel in a proximal to distal direction by aspirating fluid from said working area inside the vessel at a location proximal to the occlusive device and distal to at least some of said particles whereby said particles are removed from the working area and said fluid pressure provides fluid to replace fluid aspirated from the working area; and deactivating said occlusive device and removing said catheter. - View Dependent Claims (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38)
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39. A method for the treatment of an occlusion in a blood vessel having a fluid pressure of at least about 0.2 psi, comprising:
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inserting a catheter having an occlusive device at its distal end into said blood vessel, until said occlusive device is distal to said occlusion; activating said occlusive device to at least partially occlude said vessel distal to said occlusion and create a working area surrounding said occlusion; simultaneously delivering a therapy catheter and a debris removal device into said blood vessel until they reach said occlusion; performing therapy on said occlusion; utilizing fluid pressure within said vessel to inhibit particles produced during therapy from substantial migration in a direction proximal to said occlusion; creating a flow of fluid within said vessel across said occlusion in a proximal to distal direction by aspirating fluid from said working area inside the vessel at a location proximal to the occlusive device, whereby said particles are removed from the working area and said fluid pressure provides fluid to replace fluid aspirated from the working area; and removing said therapy catheter; removing said debris removal device; and deactivating said occlusive device and removing said catheter. - View Dependent Claims (40, 41, 42, 43, 44, 45, 46, 47, 48)
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49. A method for the removal of an occlusion in a blood vessel having a fluid pressure of at least about 0.2 psi, comprising:
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inserting a catheter having an occlusive device at its distal end into said vessel, until said occlusive device is distal to said occlusion; activating said occlusive device to at least partially occlude said vessel distal said occlusion and create a working area surrounding said occlusion; allowing said fluid pressure within said vessel to prevent any particles dislodged during insertion of said catheter from flowing against said pressure and out of said working area; inserting a distal end of a debris removal device to a position just proximal to said occlusive device; aspirating fluid from said working area inside the vessel just proximal to the occlusive device to aspirate said occlusion and said particles while allowing said fluid pressure to provide irrigation fluid within said area; removing said debris removal device; and deactivating said occlusive device and removing said catheter. - View Dependent Claims (50)
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51. A method for the treatment of an occlusion in a blood vessel having a fluid pressure of at least about 0.2 psi, comprising in the following order:
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inserting a catheter having an occlusive device at its distal end into said blood vessel, until said occlusive device is distal to said occlusion; activating said occlusive device to at least partially occlude said vessel distal said occlusion and create a working area surrounding said occlusion; simultaneously delivering a therapy catheter and a debris removal device into said blood vessel until they reach said occlusion; performing therapy on said occlusion; utilizing fluid pressure within said vessel to inhibit particles produced during therapy from substantial migration in a direction proximal to said occlusion; removing said therapy catheter; creating a flow of fluid within said vessel across said occlusion in a proximal to distal direction by aspirating fluid from said working area inside the vessel at a location proximal to the occlusive device, whereby said particles are removed from the working area and fluid pressure provides fluid to replace fluid aspirated from the working area; removing said debris removal device; and deactivating said occlusive device and removing said catheter.
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52. A method of treatment of a blood vessel in which blood flows proximally to distally, said method comprising:
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delivering an expandable device to form a barrier sufficient to inhibit emboli suspended in said blood from migrating past the barrier in a proximal to distal direction; preventing emboli from moving in a distal to proximal direction by exposing said expandable device to blood flowing in a proximal to distal direction; advancing a catheter having a lumen in fluid communication with a distal opening in the catheter, said advancing comprising moving said distal opening relative to said expandable device within the blood vessel such that said opening is distal to at least a portion of an occlusive substance within said blood vessel, said occlusive substance comprising said emboli suspended in said blood; drawing blood from the vessel into the distal opening such that (a) a blood flow is created in the lumen in a distal to proximal direction, and (b) said blood flow is simultaneously created in said vessel in a proximal to distal direction, whereby said emboli are carried by said blood flow from said vessel into said distal opening and through said lumen of said catheter. - View Dependent Claims (53, 54, 55, 56, 57, 58, 59)
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Specification