Methods and devices for cutting tissue

• US 8,998,937 B2
• Filed: 04/28/2009
• Issued: 04/07/2015
• Est. Priority Date: 08/19/1999
• Status: Expired due to Fees

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Simpson, John B., Rosenthal, Michael H., Patel, Himanshu, Venegas, Gautama B.
• Primary Examiner(s): Houston, Elizabeth
• Assistant Examiner(s): DANG, PHONG SON H
• Application Number:
  US12/431,210
• Publication Number:
  US 20090299394A1
• Time in Patent Office: 2,170 Days
• Field of Search: 606/159, 606/167, 606/170, 606/171, 606/180, 600/564
• US Class Current: 606/167
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/05 characterised by the image sensor, e.g. camera, being in the distal end portion
• CPC Class Codes: A61B 1/3137 for examination of the interior of blood vessels
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/00685 Archimedes screw
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/320032 Details of the rotating or oscillating shaft, e.g. using a flexible shaft
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/320791 with cutter extending outside the cutting window
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/373 using light, e.g. by using optical scanners
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/0066 Optical coherence imaging
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance

Abstract

A method of removing material from a blood flow lumen generally includes providing a device having a cutting element and an opening, advancing the device through the blood flow lumen to a site where material is to be removed, forcing the opening toward a wall of the site where material is to be removed, and moving the cutting element and the opening so that material in the blood flow lumen is cut by the cutting element and directed into the opening for removal as the cutting element and opening are moved through the blood flow lumen. In some embodiments, the device may be deflected or bent to force the opening toward a wall to remove material. The cutting element may be rotatable and may have an axis that is movable, that is not parallel to the longitudinal axis of the device, or both.

Claims

1. A device for cutting tissue, comprising:

an elongate body having a distal and proximal ends and a longitudinal axis;

a rotatable cutting element, the rotatable cutting element being coupled to a torque transmitting element which extends through the elongate body; and

a movable cover having distal and proximal ends and a longitudinal axis, the proximal end of the movable cover being slidably connected to the distal end of the elongate body, the cover being movable from a stored position, in which the rotatable cutting element is covered by the cover, to a working position, in which at least part of the rotatable cutting element is exposed outside the cover, the proximal end of the cover being axially aligned with the distal end of the elongate body when the cover is in the stored position, the proximal end of the cover being axially offset in a radial direction from the distal end of the elongate body when the cover is in the working position, the longitudinal axis of the cover being axially aligned with the longitudinal axis of the elongate body when the cover is in the stored position, the longitudinal axis of the cover being axially offset in a radial direction from the longitudinal axis of the elongate body when the cover is in the working position.

2. The device of claim 1, wherein:

the cover further includes a tissue collection chamber, and wherein the cover is configured such that during use tissue cut by the cutting element is directed into the collection chamber.

3. The device of claim 1, wherein:

the cover forms a distal tip.

4. The device of claim 1, wherein:

the longitudinal axis of the cover is substantially parallel to the longitudinal axis of the elongate body when the cover is in the working position.

5. The device of claim 1, wherein:

the cover is configured to be slidable relative to the elongate body to a plurality of different working positions, an amount of the rotatable cutting element exposed being different in each working position.

6. The device of claim 1, wherein:

the cover is configured to translate when moving to the working position without substantial deformation of the cover.

7. The device of claim 1, further comprising:

a visualization element positioned at a radially outer position relative to the elongate body.

8. The device of claim 7, wherein:

the visualization element is movable relative to the elongate body.

9. The device of claim 1, wherein:

the cover is naturally biased to the stored position.

10. The device of claim 1, wherein:

the cover is linearly slidable relative to the elongate body at an angle which is not parallel to a longitudinal axis of the elongate body.

11. The device of claim 1, wherein:

the cover is connected to the body by a slot and pin engagement so that the cover translates linearly relative to the body when moved from its stored position to its working position.