Method and apparatus for increasing blood flow through an obstructed blood vessel

• US 8,052,640 B2
• Filed: 02/01/2007
• Issued: 11/08/2011
• Est. Priority Date: 02/01/2006
• Status: Active Grant

• Current Assignee: Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Fiorella, David, Woo, Henry
• Primary Examiner(s): Lucchesi; Nicholas D
• Assistant Examiner(s): AUGUSTINE, VICTORIA PEARL
• Application Number:
  US11/700,987
• Publication Number:
  US 20070208367A1
• Time in Patent Office: 1,741 Days
• Field of Search: 604/96.01, 604/97.01, 604/99.01, 60410301-10303, 604/103.05, 604/103.06, 604/103.08, 604/103.09
• US Class Current: 604/103.08
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• 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 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22061 for spreading elements apart
• CPC Class Codes: A61B 2017/22084 stone- or thrombus-dissolving
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/320008 Scrapers
• CPC Class Codes: A61B 2017/320733 with a flexible cutting or scraping element, e.g. with a whip-like distal filament member
• CPC Class Codes: A61B 2017/320741 for stripping the intima or the internal plaque from a blood vessel, e.g. for endarterectomy
• CPC Class Codes: A61M 2025/1088 having special surface characteristics depending on material properties or added substances, e.g. for reducing friction
• CPC Class Codes: A61M 2025/1095 with perfusion means for enabling blood circulation while the balloon is in an inflated state or in a deflated state, e.g. permanent by-pass within catheter shaft
• CPC Class Codes: A61M 25/10 Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 25/1027 Making of balloon catheters
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

A method of increasing blood flow through an obstructed blood vessel includes providing an expandable member substantially made of a mesh having a plurality of interstices. The expandable member is inserted into the blood vessel, positioned within the blood vessel with the proximal member end upstream of the distal member end and the member body located radially adjacent at least a portion of an obstruction, and expanded to bring at least a portion of the member body into contact with the obstruction. An outward radial force is exerted on the obstruction to dislodge at least one fragment from the obstruction and to enhance blood flow through the blood vessel past the obstruction. The at least one fragment is passed through at least one interstice of the member body in the radial direction, and is selectively retained within the expandable member.

Claims

1. A method of increasing blood flow through an obstructed blood vessel, the method comprising the steps of:

providing an expandable member substantially made of a mesh having a plurality of interstices, the expandable member having a proximal member end and a distal member end spaced longitudinally apart by a tubular member body, the expandable member being substantially closed at the distal member end;

inserting the expandable member into the blood vessel;

positioning the expandable member within the blood vessel with the proximal member end upstream of the distal member end and the member body located radially adjacent at least a portion of an obstruction;

expanding the expandable member to bring at least a portion of the member body into contact with the obstruction;

exerting an outward radial force on the obstruction to dislodge at least one fragment from the obstruction and to enhance blood flow through the blood vessel past the obstruction;

passing the at least one fragment through at least one interstice of the member body in the radial direction; and

selectively retaining the at least one fragment within the expandable member.

2. The method of claim 1, wherein at least one of the plurality of interstices is defined by a plurality of strands, and the step of exerting an outward radial force on the obstruction to dislodge the at least one fragment from the obstruction and to enhance blood flow through the blood vessel past the obstruction includes the steps of:

forcing the plurality of strands into penetrating contact with the obstruction; and

longitudinally separating the at least one fragment from a remaining portion of the obstruction through radial penetration of the strands into the obstruction.

3. The method of claim 1, wherein a size of a chosen interstice varies depending upon a location of the chosen interstice on the expandable member.

4. The method of claim 1, further including the steps of:

breaking the at least one fragment into a plurality of subfragments; and

permitting at least one subfragment to pass through at least one interstice to exit the expandable member.

5. The method of claim 4, wherein the step of breaking the at least one fragment into a plurality of subfragments is performed using at least one of a mechanical lysis process and a chemical lysis process.

6. The method of claim 1, wherein the step of expanding the expandable member to bring at least a portion of the member body into contact with the obstruction includes the step of allowing the expandable member to self-expand.

7. The method of claim 1, wherein the step of expanding the expandable member to bring at least a portion of the member body into contact with the obstruction includes the step of manually expanding the expandable member.

8. The method of claim 1, further including the steps of:

at least partially collapsing the expandable member;

and removing the expandable member from the blood vessel.

9. The method of claim 1, further including the steps of:

at least partially collapsing the expandable member;

moving the expandable member to a different position with the proximal member end upstream of the distal member end and the member body located radially adjacent at least a portion of the obstruction; and

expanding the expandable member to bring at least a portion of the member body into contact with the obstruction.

10. The method of claim 1, further including the step of compressing at least a portion of the obstruction against a vessel wall of the blood vessel.

11. The method of claim 1, further including the step of further expanding the expandable member in response to at least one of congested blood flow through the blood vessel and dislodgement of the at least one fragment of the obstruction.

12. The method of claim 1, wherein the blood vessel is a cerebral blood vessel.