Systems and methods for removing obstructive matter from body lumens and treating vascular defects

• US 8,425,549 B2
• Filed: 12/23/2008
• Issued: 04/23/2013
• Est. Priority Date: 07/23/2002
• Status: Expired due to Fees

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Reverse Medical Corporation (Medtronic Plc)
• Inventors: Lenker, Jay A., Strauss, Brian Michael, Von Hoffman, Gerard
• Primary Examiner(s): STIGELL, THEODORE J
• Application Number:
  US12/343,374
• Publication Number:
  US 20100114017A1
• Time in Patent Office: 1,582 Days
• Field of Search: 604/103, 604 9901- 9904, 604/93.01, 604/96.01, 604/158, 60416401-16402, 606/198, 606/200, 606/191, 606/192, 606/194, 600/585
• US Class Current: 606/198
• CPC Class Codes: A61B 17/12118 for positioning in conjunction with a stent
• CPC Class Codes: A61B 17/1214 Coils or wires
• CPC Class Codes: A61B 17/12186 liquid materials adapted to be injected
• 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 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/12054 Details concerning the detachment of the occluding device from the introduction device
• CPC Class Codes: A61B 2017/22001 Angioplasty, e.g. PCTA
• CPC Class Codes: A61B 2017/22041 outside the catheter
• CPC Class Codes: A61B 2017/22042 Details of the tip of the guide wire
• CPC Class Codes: A61B 2017/22044 with a pointed tip
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 2017/2212 having a closed distal end, e.g. a loop
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61M 2025/0024 Expandable catheters or sheaths
• CPC Class Codes: A61M 25/0021 characterised by the form of the tubing A61M25/0054 takes precedence
• CPC Class Codes: A61M 25/0023 by the form of the lumen, e.g. cross-section, variable diameter
• CPC Class Codes: A61M 25/0026 : Multi-lumen catheters with stationary elements catheter assemblies comprising a catheter in combination with a guide tube, sheath or sleeve A61M2025/0681; catheters comprising telescoping coaxial elements A61M2025/0175
• CPC Class Codes: A61M 25/0043 : characterised by structural features
• CPC Class Codes: A61M 25/0074 : Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
• CPC Class Codes: A61M 27/002 : Implant devices for drainage of body fluids from one part of the body to another intraocular A61F9/00781; middle ear A61F11/202

Abstract

Systems and methods for removing obstructions from, delivering implantable devices or substances in or near and/or restoring flow through body lumens, such as blood vessel lumens. A catheter having a proximal portion of a first diameter and a distal portion of a second diameter (smaller than the first diameter) is advanced into a body lumen. The distal portion of the catheter is caused to expand to a diameter that is larger than the second diameter but no larger than the first diameter. A working device is then advanced out of the distal end of the catheter and used to remove obstructive matter, deliver an implantable device or substance and/or restore flow. The distal portion can be reduced in diameter prior to removal from the body.

Claims

1. A catheter system comprising;

a guide catheter;

an embolectomy catheter comprising;

an outer shaft characterized by a proximal end and a distal end, said outer shaft having a first lumen extending from the proximal end to the distal end thereof, said lumen having a first diameter;

an inner, distal shaft characterized by a proximal end and a distal end, said inner, distal shaft disposed within the outer shaft, said inner, distal shaft having a second lumen having a second diameter, said second lumen extending from the proximal end to the distal end of said inner, distal shaft, and a constriction disposed within said second lumen of the inner distal shaft;

an expandable member characterized by a proximal end and a distal end, said expandable member secured at its proximal end to the distal end of the outer shaft and secured at its distal end to the distal end of the inner, distal shaft;

wherein the expandable member is expanded and contracted by relative movement of the outer shaft and the inner, distal shaft, and

wherein the constriction is characterized by an inner diameter which is less than the second diameter of the lumen of the inner distal shaft.

2. The catheter system of claim 1, wherein the constriction inner diameter is sized to frictionally engage a guidewire which has an outer diameter smaller than the diameter of the second lumen of the inner distal shaft.

3. The catheter system of claim 1, wherein the guide catheter further comprises a flared distal opening.

4. The catheter system of claim 1, wherein the guide catheter further comprises a flared distal opening, said flared distal opening comprising a radially expandable shape memory element.

5. The catheter system of claim 1, further comprising a cover disposed on a distal portion of the expandable member, said cover being impermeable to liquids.

6. The catheter system of claim 1, further comprising a cover disposed on the entirety of the expandable member, said cover being impermeable to liquids.

7. The catheter system of claim 1, wherein the inner, distal shaft is characterized by an aperture communicating from the lumen to the exterior of the inner, distal shaft, said aperture disposed within the expandable member.

8. The catheter system of claim 1, wherein the inner, distal shaft terminates proximally within the distal end of the outer shaft.

9. The catheter system of claim 1 wherein the expandable member takes on a first, unexpanded configuration when the inner distal shaft is in a first position relative to the outer shaft and takes on a second, expanded configuration when the inner distal shaft is moved to a second position, proximal to the first position, relative to the outer shaft.

10. The catheter system of claim 1, wherein the expandable member is self-expandable, and has a first, small diameter configuration when tensioned by a guidewire inserted into the constriction and a second, large diameter configuration when not tensioned by a guidewire disposed in the constriction.

11. A catheter system comprising;

a guide catheter;

an embolectomy catheter comprising;

an outer shaft characterized by a proximal end and a distal end, said outer shaft having a first lumen extending from the proximal end to the distal end thereof, said lumen having a first diameter;

an inner, distal shaft characterized by a proximal end and a distal end, said inner, distal shaft disposed within the outer shaft, extending distally from the distal end of the outer shaft and terminating proximally within the distal end of the outer shaft, said inner, distal shaft having a second lumen having a second diameter, said second lumen extending from the proximal end to the distal end of said inner, distal shaft, and a constriction disposed within said second lumen of the inner distal shaft;

an expandable member characterized by a proximal end and a distal end, said expandable member secured at its proximal end to the distal end of the outer shaft and secured at its distal end to the distal end of the inner, distal shaft;

wherein the expandable member is expanded and contracted by relative movement of the outer shaft and the inner, distal shaft, and

wherein the constriction is characterized by an inner diameter which is less than the second diameter of the lumen of the inner distal shaft, and said inner diameter is sized to frictionally engage a guidewire which has an outer diameter smaller than the diameter of the second lumen of the inner distal shaft.

12. The catheter system of claim 11, wherein the guide catheter further comprises a flared distal opening.

13. The catheter system of claim 11, wherein the guide catheter further comprises a flared distal opening, said flared distal opening comprising a radially expandable shape memory element.

14. The catheter system of claim 11, further comprising a cover disposed on a distal portion of the expandable member, said cover being impermeable to liquids.

15. The catheter system of claim 11, further comprising a cover disposed on the entirety of the expandable member, said cover being impermeable to liquids.

16. The catheter system of claim 11, wherein the inner, distal shaft is characterized by an aperture communicating from the lumen to the exterior of the inner, distal shaft, said aperture disposed within the expandable member.

17. The catheter system of claim 11 wherein the expandable member takes on a first, unexpanded configuration when the inner distal shaft is in a first position relative to the outer shaft and takes on a second, expanded configuration when the inner distal shaft is moved to a second position, proximal to the first position, relative to the outer shaft.

18. The catheter system of claim 11, wherein the expandable member is self-expandable, and has a first, small diameter configuration when tensioned by a guidewire inserted into the constriction and a second, large diameter configuration when not tensioned by a guidewire disposed in the constriction.