Tissue cutting/tissue removing device with vacuum feature
First Claim
1. A device for cutting tissue including:
- an elongate catheter having a proximal end and a distal end, a catheter wall defining a compartment within the catheter, a window through the catheter wall open to the compartment, and at least one lumen passing between a first opening in the proximal end and a second opening in the compartment, the first opening being connected to a vacuum source;
a cartridge at least partially disposed within the compartment, said cartridge having a cutting edge with a cutting element disposed along the cutting edge, and an energy source operatively coupled to the cutting element, the cartridge being operable to urge tissue into the compartment when the first opening is connected to the vacuum source; and
a controller coupled to the cartridge and operable to selectively position and move the cartridge relative to the catheter and thereby provide a controlled movement of the cutting edge along the window.
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Accused Products
Abstract
A tissue cutting device includes a catheter with a window at its distal tip for admitting tissue into a catheter compartment. A cylindrical cartridge in the compartment has a cutting edge that supports an electrically conductive cutting element, e.g. a band or wire. The cutting element and adjacent tissue can be heated to a selected temperature by generating an electrical current through the cutting element. The catheter is maneuverable to position its distal end near the tissue to be cut. The catheter incorporates a vacuum feature that urges tissue into the compartment prior to cutting or severing and assists in holding the tissue during the cutting or severing process. Then, the cartridge is manipulated from the catheter'"'"'s proximal end to move the cutting edge across the window, cutting the tissue. According to alternative embodiments, the cartridge is either rotated or moved axially relative to the catheter and, in either event may be capable of closing the catheter window when the cut is complete. Further alternatives involve either placing an indifferent electrode on the patient and providing an RF signal via a single conductor to the cutting element for ohmic heating, or providing an RF (or a DC) current through the cutting element and two separate conductors for direct resistive heating of the cutting element. Additional feature of the device include therapeutic infusion before, during or after the cut.
314 Citations
20 Claims
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1. A device for cutting tissue including:
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an elongate catheter having a proximal end and a distal end, a catheter wall defining a compartment within the catheter, a window through the catheter wall open to the compartment, and at least one lumen passing between a first opening in the proximal end and a second opening in the compartment, the first opening being connected to a vacuum source;
a cartridge at least partially disposed within the compartment, said cartridge having a cutting edge with a cutting element disposed along the cutting edge, and an energy source operatively coupled to the cutting element, the cartridge being operable to urge tissue into the compartment when the first opening is connected to the vacuum source; and
a controller coupled to the cartridge and operable to selectively position and move the cartridge relative to the catheter and thereby provide a controlled movement of the cutting edge along the window. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A tissue cutting system comprising:
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a tissue cutting device comprising;
an elongate catheter having a proximal end and a distal end, a catheter wall defining a compartment within the catheter, a window through the catheter wall open to the compartment, a first lumen passing between a first opening in the proximal end and a first opening in the compartment, and a second lumen passing between a second opening in the proximal end and a second opening in the compartment, a cartridge at least partially disposed within the compartment, said cartridge having a cutting edge with a cutting element disposed along the cutting edge, and an energy source operatively coupled to the cutting element, and a controller coupled to the cartridge and operable to selectively position and move the cartridge relative to the catheter and thereby provide a controlled movement of the cutting edge along the window, wherein the catheter is maneuverable to locate the window against a tissue wall segment;
a vacuum source connectable to the first lumen; and
a fluid source connectable to the second lumen, wherein the cartridge is operable to urge tissue into the compartment when the first lumen is connected to the vacuum source. - View Dependent Claims (20)
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17. A method of cutting tissue, the method comprising:
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providing a tissue cutting device comprising;
an elongate catheter having a proximal end and a distal end, a catheter wall defining a compartment within the catheter, a window through the catheter wall open to the compartment, and a first lumen passing between a first opening in the proximal end and a first opening in the compartment, a cartridge at least partially disposed within the compartment, said cartridge having a cutting edge with a cutting element disposed along the cutting edge, and an energy source operatively coupled to the cutting element, and a controller coupled to the cartridge and operable to selectively position and move the cartridge relative to the catheter and thereby provide a controlled movement of the cutting edge along the window, a drive tube coupling the controller to the cartridge, the drive tube including a second lumen having an opening in the compartment and being configured to be connected to a vacuum source, wherein the catheter is maneuverable to locate the window against a tissue wall segment;
connecting a vacuum source to one of the first lumen and the second lumen;
applying a vacuum to the tissue cutting device, wherein the cartridge is operable to urge tissue into the compartment when one of the first lumen and the second lumen is connected to the vacuum source;
connecting a fluid source to the other of the first lumen and the second lumen; and
applying a fluid to the tissue cutting device to supply the fluid to the tissue. - View Dependent Claims (18, 19)
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Specification