Grasping device and method of use

• US 6,679,893 B1
• Filed: 11/16/2000
• Issued: 01/20/2004
• Est. Priority Date: 11/16/2000
• Status: Expired due to Term

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Chestnut Medical Technologies, Inc. (Medtronic Plc)
• Inventors: Tran, Quang Q.
• Primary Examiner(s): NERBUN, PETER P
• Application Number:
  US09/715,667
• Time in Patent Office: 1,160 Days
• Field of Search: 606/127, 606/128, 606/159, 606/198, 606/200
• US Class Current: 606/127
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 2017/2215 having an open distal end

Abstract

The invention is directed to a grasping device and system and the method of using the device and system for capturing a thromboembolism and other objects or masses within a patient'"'"'s body lumen, particularly from within a patient'"'"'s cerebral blood vessels. The grasping device has an elongated core member with a grasping assembly of arms on the distal end of the core member which have an expanded and a contracted configuration. The expanded configuration permits the arms to surround an object such as a thrombus or clot and a contracted configuration to grasp or capture the object. The distal ends of the arms are provided with object grasping members such as one or more teeth to facilitate the capture and removal of the object. A delivery catheter and a shorter guide catheter aid in delivering the grasping device to the desired intravascular location within the patient.

Claims

1. An intracorporeal grasping device having a longitudinal axis, comprising:

a. an elongated core member having proximal and distal end portions, said elongated core member being tapered alone at least a portion of its distal end portion such that the diameter of a portion of said elongated core member intermediate said proximal and distal end portions is greater than the diameter of said tapered portion of said distal end portion; and

b. a grasping assembly on the distal end of the elongated core member having a plurality of arms disposed about the longitudinal axis of the device and having an expanded and contracted configuration, with arms of the grasping assembly having proximal sections secured to the distal end of the elongated core member and distal sections which have free distal ends configured to grasp an object and which in the expanded configuration are essentially parallel to the longitudinal axis of the device.

2. The intracorporeal grasping device of claim 1 wherein the distal end portion of the elongated core member is more flexible than the proximal end portion.

3. The intracorporeal grasping device of claim 2 wherein the distal portion of the core member is at least in part more than 25% more flexible than the proximal portion of the core member.

4. The intracorporeal grasping device of claim 1 wherein the elongated core member has a flexible body disposed about and secured to the tapered portion of said distal end portion.

5. The intracorporeal grasping device of claim 2 wherein the distal end portion of said core is formed of a first material, the proximal end portion of said core is formed of a second material, said first material being more flexible than said second material.

6. The intracorporeal grasping device of claim 1 wherein the arms of the grasping assembly are uniformly disposed about the longitudinal axis.

7. The intracorporeal grasping device of claim 1 wherein at least three arms are disposed about the longitudinal axis.

8. The intracorporeal grasping device of claim 1 wherein 4 to 8 arms are disposed about the longitudinal axis.

9. The intracorporeal grasping device of claim 1 wherein the distal arm sections have lengths of about 0.1 to about 50 mm.

10. The intracorporeal grasping device of claim 1 wherein the distal arm sections have lengths of about 5 to about 35 mm.

11. The intracorporeal grasping device, of claim 1 wherein the proximal arm sections have lengths of about 1 to about 30 mm.

12. The intracorporeal grasping device of claim 1 wherein the proximal arm sections have lengths of about 5 to about 20 mm.

13. The intracorporeal grasping device of claim 1 wherein the proximal arm sections incline outwardly from the distal end of the elongated core member when the grasping assembly is in an expanded configuration.

14. The intracorporeal grasping device of claim 1 wherein the proximal and distal arm sections join at an angle between about 110°

and about 160°

when the grasping assembly is in the expanded configuration.

15. The intracorporeal grasping device of claim 1 wherein the proximal and distal arm sections join at an angle between about 120°

and about 150°

when the grasping assembly is in the expanded configuration.

16. The intracorporeal grasping device of claim 1 wherein the grasping assembly has one pair of opposing arms having a first length and a second pair of opposing arms having a second length greater than the first length.

17. The intracorporeal grasping device of claim 16 wherein the proximal arm sections of the second pair of opposing arms are at least 0.5 mm greater in length than the proximal arm sections of the first pair of opposing arms.

18. The intracorporeal grasping device of claim 16 wherein the distal arm sections of the second pair of opposing arms are at least 0.5 mm greater in length than the distal arm sections of the first pair of opposing arms.

19. The intracorporeal grasping device of claim 1 wherein the distal ends of the distal arm sections have object grasping elements extending inwardly toward the longitudinal axis.

20. The intracorporeal grasping device of claim 19 wherein the object grasping elements are elongated teeth.

21. The intracorporeal grasping device of claim 19 wherein the object grasping elements are shorter than the distal arm sections.

22. The intracorporeal grasping device of claim 19 wherein the object engaging elements are about 0.1 to about 5 mm in length.

23. The intracorporeal grasping device of claim 1 wherein the proximal arm sections have proximal ends which are secured to the distal end portion of the elongated core member.

24. The intracorporeal grasping device of claim 20 wherein the proximal ends of the proximal arm sections are secured to the elongated core member to facilitate the assembly having expanded and contracted configurations.

25. The intracorporeal grasping device of claim 1 wherein the grasping assembly has an expanded configuration with a maximum transverse dimension of about 0.5 to about 10 mm.

26. The intracorporeal grasping device of claim 1 wherein the grasping assembly has an expanded configuration with a maximum transverse dimension of about 2 to about 9 mm.

27. The intracorporeal grasping device of claim 1 wherein the proximal arm sections are at least in part curved.

28. The intracorporeal grasping device of claim 1 wherein the proximal arm sections have a first straight portion inclined at a first angle with respect to the longitudinal axis and a second straight portion distal to the first straight portion at an angle with respect to the longitudinal axis greater than the angle of the first straight portion.

29. An intraluminal grasping system, comprising:

a. an elongated delivery catheter having a distal end, a port in the distal end, a proximal end, a port in the proximal end and an inner lumen which is in fluid communication with the ports in the proximal and distal ends of the delivery catheter; and

b. the grasping device of claim 1 slidably disposed within the inner lumen of the elongated delivery catheter.

30. The intraluminal grasping system of claim 29 wherein the grasping device is longer than the delivery catheter.

31. The intraluminal grasping system of claim 30 wherein the grasping device has a length such that the grasping assembly thereof extends out the port in the distal end of the delivery catheter while a proximal portion of the core member of the grasping device extends out of the proximal end of the delivery catheter.

32. A grasping system for procedures in tortuous intravascular locations, comprising:

a. an elongated guide catheter having proximal end, a port in the proximal end, a distal end, a port in the distal end and an inner lumen extending therein which is in fluid communication with the ports in the proximal and distal ends of the guide catheter

b. an elongated delivery catheter which is longer than the guide catheter, which is slidably disposed within the inner lumen of the guide catheter and which has a proximal end, a port in the proximal end, a distal end, a port in the distal end, and an inner lumen extending therein in fluid communication with the ports in the proximal and distal ends of the delivery catheter; and

c. the grasping device of claim 1 slidably disposed within the inner lumen of the elongated delivery catheter.

33. The system of claim 32 wherein the grasping device is longer than the delivery catheter.

34. The system of claim 32 wherein the plurality of arms have a contracted configuration which has a maximum transverse cross section sufficiently small so that the grasping assembly on the distal end of the grasping device may be slidably advanced within the lumen of the delivery catheter.

35. The system of claim 32 wherein the grasping assembly in the expanded configuration is adapted to be distally advanced within a patient'"'"'s blood vessel and so that the distal arm sections of the grasping assembly will be distally advanced along at least a portion of a cerebral blood vessel to surround an object therein to be captured.

36. The system of claim 32, wherein the grasping device is at least about 150 cm long.

37. The system of claim 32, wherein the guide catheter is about 90 cm to about 135 cm long;

the delivery catheter is about 125 cm to about 175 cm long; and

the grasping device is about 135 cm to about 300 cm long.

38. The system of claim 32, wherein the lumen of the delivery catheter has a diameter not greater than about 0.042 inches.

39. The system of claim 32, wherein the lumen of the delivery catheter has a diameter not greater than about 0.022 inches.

40. The system of claim 32, wherein the lumen of the delivery catheter has a diameter not greater than about 0.018 inches.

41. The system of claim 32, wherein each arm is adjustable from the expanded configuration to a contracted configuration by the application of force to the proximal arm sections thereof.

42. The system of claim 41, wherein a force is applied to the proximal arm sections by pressing the distal end of the delivery catheter against the proximal arm sections of the arms.

43. The system of claim 32, wherein the arms terminate distally with an object grasping member that is oriented radially inwardly toward the longitudinal axis, so that by adjusting the grasping assembly with the arms around the object from the expanded configuration to a contracted configuration, the object grasping members on the distal arm sections are forced into the object.

44. The system of claim 32, wherein in the contracted configurations, the plurality of arms of the grasping assembly are configured to allow an object with a maximum transverse dimension that is not greater than about ⅓

the inner diameter of the expanded configuration to pass through the grasping assembly.

45. The system of claim 32, wherein in the contracted configuration, the plurality of arms are configured to allow an object with a maximum transverse dimension that is not greater than about ¼

the inner diameter of the expanded configuration to pass through the grasping assembly.

60. A method for capturing a thrombus within a cerebral blood vessel of a patient, comprising:

a. positioning a guide catheter within the vasculature of the patient so that a distal port of the guide catheter is positioned within a cervical region associated with the cerebral blood vessel, and a proximal port of the guide catheter is positioned externally of the patient;

b. positioning a delivery catheter within an inner lumen of the guide catheter and distally advancing the delivery catheter within the lumen until a distal portion of the delivery catheter extends distally through the distal port of the guide catheter and a distal port of the delivery catheter is proximally adjacent to the thrombus in the cerebral blood vessel while a proximal portion of the delivery catheter extends proximally through the proximal port of the guide catheter with a proximal port of the delivery catheter being external of the guide catheter and of the patient;

c. advancing the grasping device of claim 1 that is longer than the delivery catheter through the inner lumen of the delivery catheter with the grasping assembly in a contracted configuration until the grasping assembly extends out the port in the distal end of the delivery catheter into the cerebral blood vessel, where the grasping assembly expands into an expanded configuration;

d. further advancing the grasping device until the arms of the grasping assembly at least partially surround the thrombus within the cerebral vessel; and

e. while the arms are positioned around the thrombus, adjusting the grasping assembly from the open condition to a contracted configuration presses the object grasping elements on the distal arm sections into the thrombus, thereby capturing the thrombus.

61. The method of claim 60 including withdrawing the grasping assembly with the captured thrombus from the cerebral blood vessel.

62. The method of claim 60, further comprising the steps of:

a. before the delivery catheter is positioned within the guide catheter, advancing a guide wire through the inner lumen of the guide catheter until a distal extremity of the guide wire extends out the distal port of the guiding catheter;

b. mounting the distal portion of the delivery catheter over a proximal extremity of the guidewire which extends out the proximal end of the guiding catheter;

c. advancing the delivery catheter through the inner lumen of the guide catheter over the guide wire until the distal end of the delivery catheter extends into the cerebral blood vessel and is proximally adjacent to the thrombus therein;

d. withdrawing the guide wire from the delivery catheter; and

e. advancing the grasping device through the inner lumen of the delivery catheter to grasp the thrombus.

63. The method of claim 60, wherein the arms of the grasping assembly are adjusted from the expanded configuration to a contracted configuration by distally advancing the delivery catheter so the distal end thereof presses against the proximal arm sections causing the object grasping members on the distal arm sections to be pressed into the thrombus, thereby capturing the thrombus.

64. The method of claim 63, further comprising:

after capturing the thrombus, withdrawing the delivery catheter and grasping device at least until the grasping assembly and captured thrombus are positioned within the inner lumen of the guide catheter.

65. The method of claim 64, further comprising:

removing the guide catheter, the delivery catheter and the grasping device with captured thrombus from the patient while the delivery catheter grasping assembly and thrombus are located within the inner lumen of the guide catheter.

66. The method of claim 64, further comprising:

removing the grasping device and captured thrombus from the patient proximally through the proximal port of the guide catheter while the distal port of the guide catheter remains within the cervical region of the cerebral blood vessel.

67. A method for removing a thrombus from a blood vessel of a patient, comprising:

a. providing the grasping device of claim 1;

b. advancing the grasping device within the patient'"'"'s vasculature and with the grasping assembly of the grasping device in a contracted configuration until the grasping assembly of the device is proximally adjacent to the thrombus in the blood vessel;

c. expanding the grasping assembly into an expanded configuration;

d. advancing the grasping device with the grasping assembly in an expanded configuration until the arms of the assembly surround at least a portion of the thrombus;

e. adjusting the grasping assembly from the expanded configuration to a contracted configuration to capture the thrombus; and

d. removing the grasping device and the captured thrombus from the patient.

46. An elongated grasping system having a longitudinal axis for capturing and removing a thrombus from a location within a patient'"'"'s blood vessel, comprising:

a. a grasping device having an elongate core member with a proximal end portion and a distal end portion, said elongated core member being tapered along at least a portion of its distal end portion such that the diameter of a portion of said elongated core member intermediate said proximal and distal end portions is greater than the diameter of said tapered portion of said distal end portion, and having a grasping assembly secured to the distal end portion of the core member with a plurality of arms disposed about the longitudinal axis, each arm having an expanded and contracted configuration, a proximal section inclined outwardly in an expanded configuration and a distal section that extends distally from the proximal section and having a free distal end with an inwardly oriented thrombus grasping member; and

b. a means to change the configuration of the arms of the grasping assembly from an expanded configuration to a contracted configuration.

47. The system of claim 46, wherein the grasping assembly has at least three arms.

48. The system of claim 46, wherein the grasping assembly has from four to six arms.

49. The system of claim 46 wherein the arms are uniformly spaced about longitudinal axis.

50. The system of claim 46, wherein in the contracted configuration the plurality of arms of the grasping assembly are configured to allow an embolism with an outer diameter that is equal to or less than about ⅓

the inner diameter of the expanded configuration of the grasping assembly to pass through the arms of the grasping assembly.

51. The system of claim 46, wherein in the contracted configuration the plurality of arms of the grasping assembly are configured to allow an embolism with an outer diameter that is equal to or less than about ¼

the inner diameter of the expanded configuration to pass through the arms of the grasping assembly.

52. The system of claim 46 wherein the means to change the arms of the grasping assembly from an expanded configuration to a contracted configuration applies a distally oriented force to the inclined proximal arm sections of the grasping assembly.

53. The system of claim 52 wherein the means to apply a distally oriented force to the inclined proximal arm sections of the grasping assembly is an elongated catheter that is slidably mounted over the grasping device.

54. The system of claim 52 wherein the means to apply a distally oriented force to the inclined proximal arm sections of the grasping assembly is a relatively short sheath that is slidably mounted over the grasping device and which has a plurality of struts secured to the sheath to advance the sheath over the grasping device.

55. The system of claim 46 wherein the means to change the arms of the grasping assembly from an expanded configuration to a contracted configuration applies an inwardly oriented tensile force to the arms of the grasping assembly.

56. The system of claim 55 wherein the means to apply an inwardly oriented tensile force to the arms of the grasping assembly are strands secured to an inner surface of the arms.

57. The system of claim 46 wherein the arms of the grasping assembly have distal ends with inwardly projecting thrombus grasping members.

58. An elongated grasping system for capturing and removing a thrombus from a location within a patient'"'"'s cerebral blood vessel and having a longitudinal axis, comprising:

a. a grasping device having an elongate core member with a proximal end portion and a distal end portion more flexible at least in part than the proximal end portion, said elongated core member being tapered alone at least a portion of its distal end portion such that the diameter of a portion of said elongated core member intermediate said proximal and distal end portions is greater than the diameter of said tapered portion of said distal end portion, and having a grasping assembly secured to the distal end portion which has a plurality of arms disposed about the longitudinal axis, which has an expanded and contracted configuration and which has proximal arm sections inclined outwardly when the assembly is in an expanded configuration and distal arm sections that extend distally from the proximal arm sections and that have free distal ends with inwardly oriented thrombus grasping elements; and

b. a delivery catheter having a proximal end, a port in the proximal end, a distal end, a port in the distal end and an inner lumen which extends between and in fluid communication with the ports in the proximal and distal ends and which is configured to slidably receive the grasping device; and

c. the grasping device and the delivery catheter having distal portions which are sufficiently flexible to be advanced together through the patient'"'"'s cerebral blood vessel to a location adjacent to the thrombus.

59. The system of claim 58, wherein a distal portion of the grasping device including the tapered distal portion of the elongate core member and the grasping assembly are adapted to be advanced through a cerebral blood vessel having an inner diameter not greater than about 4 millimeters and having at least two bends of at least 180°

with a radius of curvature not greater than about 2 cm and a spacing between bends not greater than about 10 cm.

68. An intracorporeal grasping device having a longitudinal axis, comprising:

a. an elongated core member having a proximal end portion and a distal end portion which is at least in part more flexible than the proximal end portion, said elongated core member being tapered along at least a portion of its distal end portion such that the diameter of a portion of said elongated core member intermediate said proximal and distal end portions is greater than the diameter of said tapered portion of said distal end portion;

b. a grasping assembly mounted on the distal end portion of said elongated core member, said grasping assembly having a plurality of arms disposed about the longitudinal axis of the device and having an expanded and contracted configuration, with arms of the grasping assembly having proximal arm sections secured to the distal end portion of said core member and distal arm sections which have free distal ends configured to grasp an object and which in the expanded configuration are essentially parallel to the longitudinal axis of the device.

69. The intracorporeal grasping device of claim 68 wherein the distal portion of the core member is at least in part more than 25% more flexible than the proximal portion of the core member.

70. The intracorporeal grasping device, of claim 68 wherein the elongated core member has a flexible body disposed about and secured to the tapered distal end portion.

71. The intracorporeal grasping device of claim 68 wherein the distal end portion of said core member is formed of a first flexible material, the proximal end portion of said core member is formed of a second material, and wherein said first material is more flexible than said second material.