Methods for aortic artherectomy

• US 6,682,543 B2
• Filed: 10/24/2001
• Issued: 01/27/2004
• Est. Priority Date: 07/17/1996
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: C Edwards Lifesciences Corporation
• Inventors: Barbut, Denise R., Root, Jonathan D., Pastrone, Giovanni
• Primary Examiner(s): Woo, Julian W.
• Assistant Examiner(s): NGUYEN, VI X
• Application Number:
  US10/055,216
• Publication Number:
  US 20020123761A1
• Time in Patent Office: 825 Days
• Field of Search: 606/200, 606/198, 606/194, 606/108, 606/170, 606/181, 606/159, 604/104, 604/94
• US Class Current: 606/159
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 17/22031 Gripping instruments, e.g. forceps, for removing or smashing calculi A61B17/221 takes precedence
• 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 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• 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 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2010/0225 for taking multiple samples
• CPC Class Codes: A61B 2017/00287 Bags for minimally invasive surgery
• CPC Class Codes: A61B 2017/22068 Centering
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising
• CPC Class Codes: A61B 2017/2215 having an open distal end
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/32004 having a laterally movable cutting member at its most distal end which remains within the contours of said end
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 8/0808 for diagnosis of the brain
• CPC Class Codes: A61F 2/0105 Open ended, i.e. legs gathered only at one side
• CPC Class Codes: A61F 2/013 Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
• CPC Class Codes: A61F 2002/018 made from tubes or sheets of material, e.g. by etching or laser-cutting
• CPC Class Codes: A61F 2230/0006 circular
• CPC Class Codes: A61F 2230/0067 : conical
• CPC Class Codes: A61F 2230/0071 : spherical
• CPC Class Codes: A61F 2230/008 : paraboloidal
• CPC Class Codes: A61M 2210/127 : Aorta
• CPC Class Codes: A61M 25/00 : Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00

Abstract

A method for removing plaque from the aorta is disclosed. A filter is introduced into a region of interest within the patient'"'"'s aorta. The filter is deployed downstream of a mobile aortic plaque within the aorta. An atherectomy assembly is operated to excise the plaque from the aorta. Emboli are captured by the filter. The filter and plaque are removed from the region of interest.

Claims

1. A method for removing plaque from the aorta of a patient during open surgery, comprising the steps of:

introducing a distal region of a filter into a region of interest within the patient'"'"'s aorta;

deploying the filter downstream of the plaque within the aorta;

contacting an atherectomy assembly with the plaque within the aorta;

excising the plaque from the aorta by operating the atherectomy assembly, wherein emboli are captured by the filter; and

removing the filter and the plaque entrapped therein from the region of interest.

2. The method of claim 1, wherein the filter comprises an arterial catheter system comprising a flexible elongate member having an outer surface, a distal region adapted to enter an aorta, a proximal region, a filter mesh, and an atherectomy assembly disposed within the distal region of the elongate member, the atherectomy assembly comprising a plaque cutter and a trapping element.

3. The method of claim 2, wherein the plaque is trapped and held by the atherectomy assembly by use of the trapping element.

4. The method of claim 2, wherein the distal region of the filter is introduced through the femoral artery.

5. The method of claim 2, wherein the catheter further comprises expansion frame disposed about the distal region of the flexible elongate member which is expandable between a contracted condition and an enlarged condition, and a mesh having a first edge attached to the expansion frame and a second edge disposed circumferentially about and closely associated with the outer surface of the flexible elongate member, and wherein the method further comprises the steps of:

expanding the expansion frame until it achieves contact with the lumen of the aorta so that embolic material dislodged during the cutting procedure is captured by the mesh; and

contracting the expansion frame to the contracted condition before removing the arterial catheter system from the region of interest and the femoral artery.

6. The method of claim 1, wherein the filtration system is disposed within the distal region of the flexible elongate member and proximal to and downstream of the atherectomy assembly.

7. The method of claim 5, wherein the expansion frame comprises an umbrella frame.

8. The method of claim 1, wherein the step of contacting the atherectomy assembly with the plaque includes the step of deploying one or more positioning fingers to bias the flexible elongate member toward or away from a plaque.

9. The method of claim 1, wherein the step of excising plaque from the aorta further includes the step of using transcranial doppler ultrasound for cerebral monitoring of emboli.

10. The method of claim 1, wherein the step of contacting the atherectomy assembly with the plaque includes the step of operating a steering mechanism to maneuver the atherectomy assembly toward a plaque.

11. The method of claim 1, wherein the step of excising plaque further includes the step of guiding excised plaque to a cavity in the elongate member, said cavity being adapted to receive and store plaque material.

12. The method of claim 11, further comprising the step of grinding or abrading excised plaque material.

13. The method of claim 11, further comprising the step of aspirating the excised plaque material.