Method for containing and removing occlusions in the carotid arteries
First Claim
1. A method for the treatment of an occlusion in a branch of a bifurcated blood vessel having a common portion and two branches, such as the carotid artery, comprising:
- providing an elongate member having an occlusive device at a distal end portion thereof;
delivering the elongate member through the common portion of the bifurcated vessel and into a branch of the bifurcated vessel, such as the internal carotid artery;
positioning the occlusive device in said branch distal of the occlusion;
sliding a therapy catheter on the elongate member;
occluding said branch only on the distal side of the occlusion by actuating the occlusive device;
treating the occlusion with the therapy catheter;
providing a second catheter having a fluid flow lumen in fluid communication with a fluid flow opening at a distal end portion of the second catheter;
continuing occlusion of said branch using the occlusive device while;
(a) positioning the fluid flow opening of the second catheter in said branch of the vessel at a location between the occlusive device and the treated occlusion;
(b) applying fluid pressure to the fluid flow lumen to cause fluid flow along said branch, between (i) an intersection of said branch with the common portion and (ii) said location, whereby fluid flows across the treated occlusion; and
deactuating the occlusive device.
1 Assignment
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Accused Products
Abstract
A method for the treatment of a stenosis or an occlusion in a blood vessel is disclosed in which a main catheter is first delivered to a site proximal to the occlusion. The main catheter may include an occlusive device at its distal end. An inner catheter or elongate member (e.g., a guidewire) having an occlusive device at its distal end is delivered to the site of the occlusion, and the occlusive device is activated at a site distal to the occlusion. A therapy catheter is then introduced to treat the occlusion. Next, a catheter is delivered just proximal to the occlusive device, and this catheter is used to aspirate and/or irrigate the area removing particles and debris. The aspiration and irrigation steps are preferably repeated until the particles and debris are removed. Perfusion may be performed by using a perfusion-filter distal of the lesion to be treated or a hypotube which extends beyond the occlusive device attached to the guidewire. The present invention provides for a minimally invasive procedure which can be performed quickly and efficiently, with reduced risks to the patient.
271 Citations
41 Claims
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1. A method for the treatment of an occlusion in a branch of a bifurcated blood vessel having a common portion and two branches, such as the carotid artery, comprising:
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providing an elongate member having an occlusive device at a distal end portion thereof;
delivering the elongate member through the common portion of the bifurcated vessel and into a branch of the bifurcated vessel, such as the internal carotid artery;
positioning the occlusive device in said branch distal of the occlusion;
sliding a therapy catheter on the elongate member;
occluding said branch only on the distal side of the occlusion by actuating the occlusive device;
treating the occlusion with the therapy catheter;
providing a second catheter having a fluid flow lumen in fluid communication with a fluid flow opening at a distal end portion of the second catheter;
continuing occlusion of said branch using the occlusive device while;
(a) positioning the fluid flow opening of the second catheter in said branch of the vessel at a location between the occlusive device and the treated occlusion;
(b) applying fluid pressure to the fluid flow lumen to cause fluid flow along said branch, between (i) an intersection of said branch with the common portion and (ii) said location, whereby fluid flows across the treated occlusion; and
deactuating the occlusive device. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
positioning an outer catheter such that a portion of the outer catheter is in the common portion of the vessel, the outer catheter having a radial extent that permits the therapy catheter and the second catheter to pass through the outer catheter; and
irrigating through the second catheter while simultaneously aspirating through the outer catheter.
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17. The method of claim 16, wherein a fluid flow opening of the outer catheter is positioned proximal to the treated lesion.
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18. The method of claim 1, wherein the blood vessel is the carotid artery.
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19. The method of claim 1, wherein said treating the occlusion comprises balloon angioplasty or deploying a stent.
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20. The method of claim 1, wherein said actuating the occlusive device comprises inflating an occlusion balloon.
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21. The method of claim 20, wherein the balloon is of a compliant material.
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22. The method of claim 1, wherein the elongate member is a tubular metallic guidewire.
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23. A method for the treatment of an occlusion in a branch of a bifurcated blood vessel having a common portion and two branches, such as the carotid artery, comprising:
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providing an elongate member having an occlusive device at a distal end portion thereof;
delivering the elongate member through the common portion of the bifurcated vessel and into a branch of the bifurcated vessel, such as the internal carotid artery;
positioning the occlusive device in said branch distal of the occlusion;
sliding a therapy catheter on the elongate member;
occluding said branch on the distal side of the occlusion by actuating the occlusive device;
treating the occlusion with the therapy catheter;
removing the therapy catheter from said branch of the vessel;
providing a second catheter having a fluid flow lumen in fluid communication with a fluid flow opening at a distal end portion of the second catheter;
sliding the second catheter on the elongate member after said removal of the therapy catheter;
continuing occlusion of said branch using the occlusive device while;
(a) positioning the fluid flow opening of the second catheter in said branch of the vessel at a location between the occlusive device and the treated occlusion;
(b) applying fluid pressure to the fluid flow lumen to cause fluid flow along said branch, between (i) an intersection of said branch with the common portion and (ii) said location, whereby fluid flows across the treated occlusion; and
deactuating the occlusive device. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33)
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34. A method for the treatment of an occlusion in a carotid artery, comprising, in order:
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delivering a main catheter into said artery, until a distal end of said catheter is proximal to said occlusion;
delivering an inner catheter having a occlusive device on its distal end into said artery, until said occlusive device is distal to said occlusion;
activating said occlusive device to occlude said artery distal to said occlusion;
delivering a therapy catheter into said artery until it reaches said occlusion;
performing therapy on said occlusion;
removing said therapy catheter from said patient;
delivering a distal end of an intermediate catheter proximal to said occlusive device;
aspirating an area proximal to said occlusive device using said intermediate catheter to remove particles and debris; and
irrigating said area proximal to said occlusive device using said intermediate catheter following said aspirating. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41)
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Specification