Atherectomy catheter with first and second imaging devices

• US 8,597,315 B2
• Filed: 07/01/2010
• Issued: 12/03/2013
• Est. Priority Date: 08/19/1999
• Status: Expired due to Fees

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Snow, David W., Flom, James R.
• Primary Examiner(s): Severson, Ryan
• Assistant Examiner(s): DANG, ANH TIEU
• Application Number:
  US12/828,444
• Publication Number:
  US 20100298850A1
• Time in Patent Office: 1,251 Days
• Field of Search: 606/159, 606/170, 606/171, 606/174, 606/169, 606/180, 606/184, 604/22, 600/467, 600/439, 600/459, 623/1.11, 623/1.12
• US Class Current: 606/159
• 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 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/00353 one mechanical instrument performing multiple functions, e.g. cutting and grasping channel for multiple instruments A61B2017/3445; instrument channel A61B2017/22072; replaceable heads A61B2017/2931; suction A61M1/00
• CPC Class Codes: A61B 2017/320791 with cutter extending outside the cutting window
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3784 both receiver and transmitter being in the instrument or receiver being also transmitter

Abstract

An atherectomy catheter is provided for excising and imaging material in a body lumen. In one embodiment, the catheter comprises a catheter body, a cutting blade, and an imaging device. The cutting blade is mounted on the catheter body and configured to move between a first position and a second position relative to an aperture or cutting window. When the cutting blade is in the second position, the blade substantially closes the aperture on the catheter body. The imaging device which is mounted on or otherwise coupled to the cutting blade is configured to be in an imaging position when the cutting blade substantially closes the aperture or cutter window. This allows the imaging device to survey material within the cutting zone of the atherectomy catheter. By allowing the imaging device to view materials within this cutting zone, material may be imaged and then removed from the body lumen without having to reposition the catheter between each step.

Claims

1. A catheter for removing material from a body lumen comprising:

a catheter body having a proximal end, a distal end, and a side opening window;

a cutting blade configured to excise material from the body lumen, the cutting blade being positioned such that the excised material is received into the side opening window;

a first imaging device positioned at a first axial location with respect to the catheter body, the first imaging device being configured to image the body lumen; and

a second imaging device positioned at a second axial location with respect to the catheter body, the second location being axially spaced from the first axial location, the second imaging device being configured to image the body lumen,

wherein each of the first and second imaging devices is configured to produce an image of the body lumen independent of one another.

2. The catheter of claim 1 wherein at least one of the first and second imaging devices comprises an ultrasonic imaging device.

3. The catheter of claim 1 wherein at least one of the first and second imaging devices comprises an optical coherence tomography imaging device.

4. The catheter of claim 1 wherein at least one of the first and second imaging devices comprises optical fibers.

5. The catheter of claim 1 wherein the first imaging device is coupled to a distal portion of the catheter body and the second imaging device is adjacent the side opening window.

6. The catheter of claim 5 wherein the second imaging device is mounted on the cutting blade.

7. The catheter of claim 5 wherein the second imaging device is mounted on the catheter body.

8. A method for removing material from a body lumen comprising:

providing a catheter including a body having a side cutting window, a cutting mechanism including a cutting blade movable relative to the body, a first imaging device configured to image the body lumen and positioned at a first axial location with respect to the catheter body, and a second imaging device configured to image the body lumen and positioned at a second axial location with respect to the catheter body spaced axially from the first axial location, wherein each of the first and second imaging devices is configured to produce an image of the body lumen independent of one another;

introducing the catheter into a body lumen;

advancing the catheter body within the body lumen to position the first imaging device at a first location within the body lumen;

imaging a first area in the body lumen with the first imaging device while the position of the first imaging device is maintained at the first location within the body lumen;

imaging the body lumen with the second imaging device; and

cutting material from the body lumen using the cutting blade.

9. A method as in claim 8 further comprising repositioning the catheter in the body lumen so that the second imaging device is at a second location within the body lumen after said imaging a first area and before said imaging the body lumen with the second imaging device.

10. A method as in claim 9 further comprising imaging the body lumen with at least one of the first and second imaging devices during said repositioning of the catheter.

11. A method as in claim 8 wherein:

the providing step is carried out with each of said first and second imaging devices being an ultrasound transducer array.

12. A method as in claim 8 wherein:

the providing step is carried out with each of said first and second imaging devices having at least one optical fiber.

13. A method as in claim 8 wherein:

the providing step is carried out with each of said first and second imaging devices being an optical coherence tomography device.

14. A method as in claim 8 wherein each of said imaging a first area and said imaging the body lumen with the second imaging device is performed before said cutting material.

15. A method as in claim 8 wherein at least one of said imaging a first area and said imaging the body lumen with the second imaging device is performed after the cutting step.

16. A method as in claim 8 wherein the second imaging device is coupled to the cutting blade.

17. A method as in claim 16 wherein the second imaging device is movable relative to the cutting window.

18. A method as in claim 16 wherein the catheter includes a telescoping member which extends from a distal end of the catheter body, the cutting blade being coupled to the telescoping member.

19. A method as in claim 18 wherein the cutting blade includes a proximally pointing cutting edge.

20. A method as in claim 19 wherein the cutting window has a perimeter defined by the distal end of the catheter body and the proximally pointing cutting edge.

21. A method as in claim 20 wherein the proximally pointing cutting edge is moveable from a first position which substantially closes the cutting window to a second position in which the cutting window is open, the proximally pointing cutting edge being contained within the catheter body when the proximally pointing cutting edge is in the first position.

22. A method as in claim 21 wherein said imaging the first area is performed when the proximally pointing cutting edge is in the first position.

23. A method as in claim 8 wherein the first imaging device is coupled to the catheter body.

24. A method as in claim 23 wherein the first imaging device is coupled to the catheter body at a location distal to the cutting window.

25. A method as in claim 24 wherein a distance between the cutting window and the first imaging device remains constant during said cutting material.

26. A method as in claim 8 wherein during said imaging the body lumen with the second imaging device, at least a portion of the cutting mechanism extends through the side opening window beyond an outer diameter of the catheter body.

27. A method as in claim 8 wherein said imaging the body lumen with the second imaging device is performed while moving the cutting blade during the cutting step.

28. A method as in claim 8 wherein the step of cutting material from the body lumen is performed at the first area in the body lumen after said imaging a first area.