Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
First Claim
1. An embolectomy catheter for removing a blood clot or other such obstructive matter from a blood vessel, the catheter comprising:
- an elongate flexible catheter body having a proximal end, a distal end, an inner tube, a distal tip attached to a distal end of the inner tube, and a guidewire lumen, a part of which extends longitudinally through the inner tube, the guidewire lumen being sized to receive a guidewire therein and being open on its distal end to permit the guidewire so received to project distally from the distal end of the catheter body;
a clot removal device having a distal end attached to the inner tube and a proximal end free to slide axially over the inner tube; and
, an outer tube that is moveable between a distal position wherein it constrains the clot removal device in a collapsed state, and a proximal position wherein the clot removal device is substantially unconstrained and allowed to deploy to a radially expanded state;
wherein the distal tip defines a proximal mouth for receiving a short length of the outer tube, wherein the distal end of the outer tube is thereby prevented from catching on the clot as the catheter body passes therethrough.
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Accused Products
Abstract
Embolectomy catheters, rapid exchange microcatheters, systems and methods for removing clots or other obstructive matter (e.g., thrombus, thromboemboli, embolic fragments of atherosclerotic plaque, foreign objects, etc.) from blood vessels. This invention is particularly useable for percutaneous removal of thromboemboli or other obstructive matter from small blood vessels of the brain, during an evolving stroke or period of cerebral ischemia. In some embodiments, the embolectomy catheters of this invention are advanceable with or over a guidewire which has been pre-inserted through or around the clot. Also, in some embodiments, the embolectomy catheters include clot removal devices which are deployable from the catheter after the catheter has been advanced at least partially through the clot. The clot removal device may include a deployable wire nest that is designed to prevent a blood clot from passing therethrough. The delivery catheter may include telescoping inner and outer tubes, with the clot removal device being radially constrained by the outer tube. Retraction of the outer tube removes the constraint on the clot removal device and permits it to expand to its deployed configuration. An infusion guidewire is particularly useful in conjunction with the embolectomy catheter, and permits infusion of medicaments or visualization fluids distal to the clot.
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Citations
110 Claims
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1. An embolectomy catheter for removing a blood clot or other such obstructive matter from a blood vessel, the catheter comprising:
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an elongate flexible catheter body having a proximal end, a distal end, an inner tube, a distal tip attached to a distal end of the inner tube, and a guidewire lumen, a part of which extends longitudinally through the inner tube, the guidewire lumen being sized to receive a guidewire therein and being open on its distal end to permit the guidewire so received to project distally from the distal end of the catheter body;
a clot removal device having a distal end attached to the inner tube and a proximal end free to slide axially over the inner tube; and
,an outer tube that is moveable between a distal position wherein it constrains the clot removal device in a collapsed state, and a proximal position wherein the clot removal device is substantially unconstrained and allowed to deploy to a radially expanded state;
wherein the distal tip defines a proximal mouth for receiving a short length of the outer tube, wherein the distal end of the outer tube is thereby prevented from catching on the clot as the catheter body passes therethrough. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 33, 34, 35, 36, 37)
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29. An embolectomy catheter for removing a blood clot or other such obstructive matter from a blood vessel, the catheter comprising:
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an elongate flexible catheter body having a proximal end, a distal end, an inner tube, and an outer tube terminating just short of a distal end of the catheter body;
a clot removal device having a distal end attached to the inner tube and a proximal end free to slide axially over the inner tube, the clot removal device being initially collapsed and constrained in its collapsed configuration by a portion of the outer tube;
a distal tip of the catheter body located on the inner tube and adapted to pass through a blood clot to be removed, the distal tip having a proximal mouth;
wherein the outer tube that extends distally within the proximal mouth of the distal tip prior to being retracted and is proximally movable to remove the constraint on the clot removal device, allowing axial displacement of the proximal end of the clot removal device toward the distal end to expand the clot removal device from a second, longitudinally stretched and radially constricted, state passable through the clot, to a first, deployed state. - View Dependent Claims (30, 31, 32, 38, 39, 40, 41, 42, 43, 44)
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45. An embolectomy catheter for removing a blood clot or other such obstructive matter from a blood vessel, the catheter comprising:
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an elongate flexible catheter body having a proximal end, a distal end, an inner tube, and an outer tube terminating just short of a distal end of the catheter body, the catheter body becoming more flexible in a direction from the proximal end to the distal end;
a clot removal device having a distal end attached to the inner tube and a proximal end free to slide axially over the inner tube, the clot removal device being initially collapsed and constrained in its collapsed configuration by a portion of the outer tube;
a distal tip of the catheter body located on the inner tube and adapted to pass through a blood clot to be removed;
wherein the outer tube is proximally movable to remove the constraint on the clot removal device, allowing axial displacement of the proximal end of the clot removal device toward the distal end to expand the clot removal device from a second, longitudinally stretched and radially constricted, state passable through the clot, to a first, deployed state; and
wherein a portion of the outer tube that constrains the clot removal device in its collapsed configuration has a substantially lower column strength than a portion of the inner tube about which the clot removal device is mounted. - View Dependent Claims (46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60)
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61. An embolectomy catheter for removing a blood clot or other such obstructive matter from a blood vessel, the catheter comprising:
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an elongate flexible catheter body having a proximal end, a distal end, an inner tube, and a guidewire lumen a part of which extends longitudinally through the inner tube, the guidewire lumen being sized to receive a guidewire therein and being open on its distal end to permit the guidewire so received to project distally from the distal end of the catheter body;
a clot removal device having a distal end attached to the inner tube and a proximal end free to slide axially over the inner tube;
an outer tube that is moveable between a distal position wherein it constrains the clot removal device in a collapsed state, and a proximal position wherein the clot removal device is substantially unconstrained and allowed to deploy to its radially expanded state;
a handle and an insertion portion of the catheter body extending distally from handle, the insertion portion being defined by the inner tube and a co-axial outer tube extending substantially to the distal end of the catheter body, the clot removal device being radially constricted about the inner tube in a second state prior to its deployment to the first state, the catheter body and clot removal device in the second state being passable through the clot, wherein the inner and outer tubes are relatively axially displaceable to cause the clot removal device to transition between the first and second states;
an actuator on the handle for proximally displacing the outer tube with respect to the inner tube an infusion port mounted to a slide that is axially displaceable on the handle, the infusion port being in fluid communication with an annular space defined between the inner and outer tubes;
an inner hypotube extending substantially the length of the handle and attached at its distal end to the catheter body inner tube; and
a guidewire introducer on a proximal end of the handle leading to the lumen of the inner hypotube, wherein the slide includes a throughbore receiving the hypotube. - View Dependent Claims (62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81)
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82. An embolectomy catheter for removing a blood clot or other such obstructive matter from a blood vessel, the catheter comprising:
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an elongate flexible catheter body having a proximal end, a distal end, an inner tube, and a guidewire lumen a part of which extends longitudinally through the inner tube, the guidewire lumen being sized to receive a guidewire therein and being open on its distal end to permit the guidewire so received to project distally from the distal end of the catheter body;
a clot removal device having a distal end attached to the inner tube and a proximal end free to slide axially over the inner tube, the clot removal device comprising a plurality of separate wires attached at their distal ends to the inner tube and looped about the inner tube at their proximal ends, the wires being spring biased to radially expand when unconstrained; and
,an outer tube that is moveable between a distal position wherein it constrains the clot removal device in a collapsed state, and a proximal position wherein the clot removal device is substantially unconstrained and allowed to deploy to its radially expanded state. - View Dependent Claims (83, 84, 85, 86, 87, 88, 89, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110)
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Specification