Shape-set textile structure based mechanical thrombectomy methods
First Claim
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1. A method of treating a thrombus in a vessel with self-expanding bulbs, the method comprising:
- advancing a guidewire in the vessel proximal to the thrombus;
advancing a guide catheter in the vessel and over the guidewire;
after advancing the guide catheter, removing the guidewire from the vessel;
advancing a microwire in the vessel and through the guide catheter, wherein advancing the microwire includes crossing the thrombus by 0.5 mm to 5 mm;
advancing a microcatheter in the vessel and over the microwire, wherein advancing the microcatheter includes crossing the thrombus with a distal end of the microcatheter;
after advancing the microcatheter, removing the microwire from the vessel;
after removing the microwire, inserting a thrombectomy device from an introducer sheath into the microcatheter, the thrombectomy device including;
an elongate support structure including a plurality of wires woven to form a textile fabric, the elongate support structure comprisingfive to twenty said self-expanding bulbs,a plurality of necks longitudinally between and radially inward of the self-expanding bulbs, anda distal neck radially inward of a distal-most bulb of the self-expanding bulbs; and
a delivery system coupled to the elongate support structure, the delivery system including a hypotube including a plurality of longitudinally-spaced kerfs including a plurality of interspersed cut patterns, wherein a pitch of the plurality of longitudinally-spaced kerfs varies longitudinally along the hypotube, and wherein each of the plurality of longitudinally-spaced kerfs includes rounded edges;
after inserting the thrombectomy device from the introducer sheath into the microcatheter, advancing the thrombectomy device in the vessel and through the microcatheter proximate to the distal end of the microcatheter, wherein advancing the thrombectomy device includes crossing the thrombus;
after advancing the thrombectomy device, maintaining a location of the delivery system of the thrombectomy device while retracting the microcatheter, wherein upon being unsheathed from the microcatheter at least some of the self-expanding bulbs of the elongate support structure of the thrombectomy device self-expand from a radially compressed state to a radially expanded state, wherein retracting the microcatheter is at least until the distal end of the microcatheter is proximal to the thrombus; and
retracting the microcatheter and the delivery system of the thrombectomy device into the guide catheter, wherein during retraction of the microcatheter and the delivery system of the thrombectomy device, the at least some of the self-expanding bulbs of the elongate support structure of the thrombectomy device in the radially expanded state remain in the radially expanded state and others of the self-expanding bulbs of the elongate support structure of the thrombectomy device in the radially compressed state remain in the radially compressed state.
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Abstract
A biomedical shape-set textile structure based mechanical thrombectomy systems and methods are described. In one of the embodiments, the mechanical thrombectomy device can be customized to the length of the clot in each patient. In one of the embodiments, the mechanical thrombectomy device because of the textile structure has a very low overall profile or thickness that is less than 0.0125 inches (0.317 mm) and therefore can be deployed within microcatheters with inner lumen diameter as small as 0.014 inches (0.355 mm).
249 Citations
13 Claims
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1. A method of treating a thrombus in a vessel with self-expanding bulbs, the method comprising:
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advancing a guidewire in the vessel proximal to the thrombus; advancing a guide catheter in the vessel and over the guidewire; after advancing the guide catheter, removing the guidewire from the vessel; advancing a microwire in the vessel and through the guide catheter, wherein advancing the microwire includes crossing the thrombus by 0.5 mm to 5 mm; advancing a microcatheter in the vessel and over the microwire, wherein advancing the microcatheter includes crossing the thrombus with a distal end of the microcatheter; after advancing the microcatheter, removing the microwire from the vessel; after removing the microwire, inserting a thrombectomy device from an introducer sheath into the microcatheter, the thrombectomy device including; an elongate support structure including a plurality of wires woven to form a textile fabric, the elongate support structure comprising five to twenty said self-expanding bulbs, a plurality of necks longitudinally between and radially inward of the self-expanding bulbs, and a distal neck radially inward of a distal-most bulb of the self-expanding bulbs; and a delivery system coupled to the elongate support structure, the delivery system including a hypotube including a plurality of longitudinally-spaced kerfs including a plurality of interspersed cut patterns, wherein a pitch of the plurality of longitudinally-spaced kerfs varies longitudinally along the hypotube, and wherein each of the plurality of longitudinally-spaced kerfs includes rounded edges; after inserting the thrombectomy device from the introducer sheath into the microcatheter, advancing the thrombectomy device in the vessel and through the microcatheter proximate to the distal end of the microcatheter, wherein advancing the thrombectomy device includes crossing the thrombus; after advancing the thrombectomy device, maintaining a location of the delivery system of the thrombectomy device while retracting the microcatheter, wherein upon being unsheathed from the microcatheter at least some of the self-expanding bulbs of the elongate support structure of the thrombectomy device self-expand from a radially compressed state to a radially expanded state, wherein retracting the microcatheter is at least until the distal end of the microcatheter is proximal to the thrombus; and retracting the microcatheter and the delivery system of the thrombectomy device into the guide catheter, wherein during retraction of the microcatheter and the delivery system of the thrombectomy device, the at least some of the self-expanding bulbs of the elongate support structure of the thrombectomy device in the radially expanded state remain in the radially expanded state and others of the self-expanding bulbs of the elongate support structure of the thrombectomy device in the radially compressed state remain in the radially compressed state. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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Specification