System and method of use for agent delivery and revascularizing of grafts and vessels
First Claim
1. An intravascular system for treating a living being via the being'"'"'s vascular system, said intravascular system comprising a catheter, an instrument having a working head, debris extraction means, an infusate liquid and at least one material to be carried by said infusate liquid into the being'"'"'s vascular system, said catheter comprising a distal end portion, said instrument being arranged to be extended through said catheter to form a passageway therebetween, said working head of said instrument being arranged to be located in a portion of a vessel to operate therein, whereupon some debris may be produced by the operation of said working head, said debris extraction means being arranged for introducing said infusate liquid and said at least one material into the being'"'"'s vascular system and creating a differential flow in said lumen, whereupon any debris produced by the operation of said working head is withdrawn by said differential flow through said passageway for collection remote from the vessel portion and is prevented from flowing into any upstream vessel or downstream vessel.
1 Assignment
0 Petitions
Accused Products
Abstract
A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The system comprises an atherectomy catheter having a working head, e.g., a rotary impacting impeller, and a debris extraction sub-system. The atherectomy catheter is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head and withdraws that liquid and some blood at a second and higher flow rate, through the guide catheter to create a differential flow adjacent the working head, whereupon the debris is withdrawn in the infusate liquid and blood for collection outside the being'"'"'s body. The introduction of the infusate liquid may also be used to establish an unbalanced flow adjacent the working head to enable the atherectomy catheter to be steered hydrodynamically. A guide wire having an inflatable balloon on its distal end may be used with the atherectomy catheter to block the flow of debris distally, while enabling distal tissues to be perfused with an oxygenating liquid. At least one flow control port may be provided in the guide catheter to prevent collapse of the vessel being revascularized. A cradle is provided to fix the guide catheter and guide wire in position within the body of the being while enabling the atherectomy catheter to be advanced along the guide wire and through the guide catheter.
229 Citations
89 Claims
- 1. An intravascular system for treating a living being via the being'"'"'s vascular system, said intravascular system comprising a catheter, an instrument having a working head, debris extraction means, an infusate liquid and at least one material to be carried by said infusate liquid into the being'"'"'s vascular system, said catheter comprising a distal end portion, said instrument being arranged to be extended through said catheter to form a passageway therebetween, said working head of said instrument being arranged to be located in a portion of a vessel to operate therein, whereupon some debris may be produced by the operation of said working head, said debris extraction means being arranged for introducing said infusate liquid and said at least one material into the being'"'"'s vascular system and creating a differential flow in said lumen, whereupon any debris produced by the operation of said working head is withdrawn by said differential flow through said passageway for collection remote from the vessel portion and is prevented from flowing into any upstream vessel or downstream vessel.
- 26. An intravascular system for treating a lumen in a portion of vessel of a living being'"'"'s vascular system, the vessel being occluded by an occlusive material, said system comprising a lumen-opening member for introduction into the lumen of the vessel, debris blocking means, pump means, an infusate liquid and at least one material to be carried by said infusate liquid into the being'"'"'s vascular system, said lumen-opening member being arranged to act on the occlusive material in the interior of the occluded vessel to open the lumen for the freer flow of blood therethrough, said lumen opening member comprising a working head, whereupon some debris may be produced from the occlusive material by the action of said lumen-opening member, said debris blocking means being arranged to be located within the occluded vessel distally of said lumen opening member for preventing debris from flowing distally of said debris blocking means, said pump means being arranged for introducing said infusate liquid at a first flow rate and withdrawing said liquid at a second and higher flow rate to create a differential flow adjacent said working head, whereupon any debris produced by the action of said lumen-opening member is withdrawn with said infusate liquid by said differential flow for collection remote from the occluded vessel portion and is prevented from flowing into any upstream vessel or downstream vessel.
- 47. An intravascular system for treating a lumen in a blood vessel of a living being, the blood vessel being occluded by an occlusive material therein, said system comprising a working head, a pump means, barrier means, an infusate liquid and at least one material to be carried by said infusate liquid into the being'"'"'s vascular system, said working head being arranged to operate on the occlusive material in the interior of the occluded blood vessel to open a lumen therein for the freer flow of fluid therethrough, whereupon some debris may be produced from the occlusive material by the operation of said working head, said barrier means being arranged for location downstream of said working head and activatable to restrict the flow of the debris downstream of said barrier means, said pump means introducing an infusate liquid at a first flow rate at said working head and withdrawing said liquid at a second flow rate higher than said first flow rate, thereby creating a differential flow, whereupon any debris produced by the operation of said working head is withdrawn with said liquid by said pump means for collection remote from the occluded vessel portion.
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73. A method for treating a lumen in a portion of a blood vessel of a living being'"'"'s vascular system, the blood vessel portion being occluded by an occlusive material, the occluded blood vessel portion being located distally of a patent blood vessel portion, said method comprising:
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(a) extending a first catheter through said patent blood vessel portion into said occluded blood vessel portion, said first catheter having a distal end portion and a port located proximally of said distal end portion;
(b) extending a second catheter through said first catheter so that a working portion of said second catheter is located in the occluded blood vessel portion;
(c) blocking the occluded blood vessel portion distally of said working portion of said second catheter;
(d) using said second catheter to open a lumen in the occluded portion of the blood vessel for the freer flow of blood therethrough;
(e) introducing an infusate liquid and at least one material to be carried by said infusate liquid into said occluded blood vessel portion and withdrawing said infusate liquid and any debris produced by the opening of the occluded portion of the blood vessel through a passageway in said first catheter; and
(f) providing a path for blood from the patent blood vessel portion to flow through said port into said passageway for merger with said infusate liquid and said debris. - View Dependent Claims (74, 75, 76, 77, 78, 79, 80)
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81. A method for treating a lumen in a portion of a blood vessel of a living being'"'"'s vascular system, the blood vessel being occluded by an occlusive material, the blood vessel being located distally of a patent blood vessel, said method comprising:
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(a) extending a first catheter through said patent blood vessel portion into said occluded blood vessel portion, said first catheter having a distal end portion and a port located proximally of said distal end portion;
(b) blocking the flow of blood and debris distally of a working head;
(c) providing a vessel-opening catheter having said working head and extending said vessel-opening catheter through said first catheter so that said working head is located in the occluded blood vessel portion, said first catheter and said vessel-opening catheter defining a passageway therebetween;
(d) operating said working head to open the occluded blood vessel portion for the freer flow of blood therethrough;
(e) introducing an infusate liquid and at least one material to be carried by said infusate liquid into said occluded blood vessel portion at a first flow rate adjacent said working head and withdrawing said infusate liquid at a second and higher flow rate to create a differential flow adjacent said working head, whereupon blocked debris is withdrawn with said infusate liquid for passage proximally through said passageway; and
(f) providing a path for blood within said patent blood vessel portion to flow into said passageway for merger with said infusate and debris. - View Dependent Claims (82, 83, 84)
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85. A method for treating a lumen in a portion of a blood vessel of a living being'"'"'s vascular system, the blood vessel being occluded by an occlusive material, the occluded blood vessel being located distally of a patent blood vessel portion, said method comprising:
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(a) extending a guide catheter through said patent blood vessel portion into said occluded blood vessel portion;
(b) extending a lumen-opening catheter having a working head through said guide catheter so that said working head is located in the lumen in the occluded blood vessel portion, said guide catheter and said lumen-opening catheter defining a fluid-flow passageway therebetween;
(c) blocking the flow of blood and any debris created distally of said working head;
(d) operating said working head to open the lumen for the freer flow of blood therethrough, wherein said operation comprises introducing an infusate liquid and at least one material to be carried by said infusate liquid into said occluded blood vessel portion at a first flow rate at said working head and withdrawing said infusate liquid at a second and higher flow rate to create a differential flow at said working head, whereupon debris is withdrawn with said infusate liquid for passage proximally through said fluid-flow passageway; and
(e) providing a path for blood within the patent blood vessel portion to flow into said fluid-flow passageway for merger with said infusate liquid and the debris. - View Dependent Claims (86, 87, 88, 89)
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Specification