Methods for restoring blood flow within blocked vasculature

• US 9,931,128 B2
• Filed: 09/26/2013
• Issued: 04/03/2018
• Est. Priority Date: 02/03/2006
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Martin, Brian B., Dieck, Martin S.
• Primary Examiner(s): ALEMAN, SARAH WEBB
• Application Number:
  US14/038,461
• Publication Number:
  US 20140188143A1
• Time in Patent Office: 1,650 Days
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• 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 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 2017/00778 Operations on blood vessels A61B2017/22097, A61B2017/320741 take precedence
• CPC Class Codes: A61B 2017/00853 low friction, hydrophobic and corrosion-resistant fluorocarbon resin coating (ptf, ptfe, polytetrafluoroethylene)
• CPC Class Codes: A61B 2017/00862 elastic or resilient
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• 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 2017/2215 having an open distal end

Abstract

The devices and methods described herein relate to clearing of blockages within body lumens, such as the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.

Claims

1. A method of improving blood flow in a blood vessel having an obstruction, the method comprising:

advancing a microcatheter into the blood vessel, the microcatheter containing an obstruction removal device having an expandable structure located at the end of a leading member, the expandable structure including an intermediate portion extending between a proximal end and a distal end and including first and second regions, the expandable structure comprising a plurality of filaments and having a central longitudinal axis;

positioning an opening of the microcatheter beyond a distal end of the obstruction;

deploying the distal end of the obstruction removal device beyond the distal end of the obstruction such that the distal end of the obstruction removal device self-expands towards the blood vessel wall;

withdrawing the microcatheter proximal to the obstruction while maintaining the expandable structure of the obstruction removal device in position such that the proximal and distal ends of the expandable structure span across the obstruction and where the proximal end self-expands within the vessel while spaced apart from the obstruction, thereby allowing the intermediate portion to embed into the obstruction;

holding the obstruction via the intermediate portion of the expandable structure between the first and second regions, wherein the filaments of the expandable structure converge radially inwardly toward the central longitudinal axis to meet within each of the first and second regions; and

withdrawing the obstruction removal device and obstruction from the vessel to improve blood flow in the blood vessel.

2. The method of claim 1, further comprising positioning the obstruction removal device across the obstruction such that the obstruction removal device is initially offset from a longitudinal axis of the obstruction.

3. The method of claim 1, where deploying the distal end of the obstruction removal device beyond the distal end of the obstruction comprises withdrawing the microcatheter relative to the obstruction removal device such that the distal end of the obstruction removal device remains distal to the obstruction.

4. The method of claim 1, where allowing the intermediate portion to embed into the obstruction reduces a friction between the obstruction and a wall of the vessel.

5. The method of claim 1, where the expandable structure of the obstruction removal device is self-expanding.

6. The method of claim 1, where allowing the intermediate portion to embed into the obstruction comprises allowing the intermediate portion to embed into the obstruction without substantially dislocating or mobilizing the obstruction within the blood vessel.

7. The method of claim 1, where the obstruction removal device further comprises a surrounding portion attached to the distal end of the obstruction removal device and further comprising covering the obstruction with the surrounding portion.

8. The method of claim 7, where the surrounding portion comprises a structure selected from the group consisting of a basket, a filter, a bag, a coil, a helical wire structure, a mesh, a corrugated sheet, braided wires, a single wound wire, a plurality of crossing wires, a tube, a membranes, a filled tube, a solid wire, a casting, and a film.

9. The method of claim 1, where the obstruction removal device is fabricated from a process selected from the group consisting of a photochemical etching, mechanical drilling, weaving, braiding, and laser cutting.

10. The method of claim 1, further comprising advancing a catheter adjacent to the obstruction and where advancing the obstruction removal device comprises advancing the obstruction removal device and microcatheter through the catheter to the obstruction.

11. The method of claim 10, further comprising withdrawing at least a portion of the obstruction removal device within the catheter and removing the catheter from the vessel.

12. The method of claim 1, where the obstruction comprises a blood clot, plaque, cholesterol, thrombus, a naturally occurring foreign body, a non-naturally occurring foreign body or a combination thereof.

13. The method of claim 1, further comprising expanding the vessel adjacent to the obstruction to decrease a friction between the vessel and the obstruction.

14. The method of claim 1, where the intermediate portion forms a shaped section about the obstruction between the first and second regions.

15. The method of claim 1, where the proximal and distal ends of the expandable structure remain expanded towards the vessel wall when the first and second regions of the intermediate portion converge radially inwardly.

16. The method of claim 1 wherein the filaments are prevented from moving apart where they meet along the first and second regions.

17. A method of improving blood flow in a blood vessel having an obstruction, the method comprising:

advancing an obstruction removal device within the blood vessel where the obstruction removal device comprises an expandable structure with an intermediate portion extending between a proximal end and a distal end and including first and second regions, the expandable structure comprising a plurality of filaments and having a central longitudinal axis;

deploying the distal end and the proximal end of the expandable such that the expandable structure spans across the obstruction and the intermediate portion expands within the vessel to embed into the obstruction;

holding the obstruction via the intermediate portion of the expandable structure between the first and second regions, wherein the filaments of the expandable structure converge radially inwardly toward the central longitudinal axis to meet within each of the first and second regions; and

withdrawing the obstruction removal device and obstruction from the vessel to improve blood flow in the blood vessel.

18. The method of claim 17, where the intermediate portion forms a shaped section about the obstruction between the first and second regions.

19. The method of claim 17, further comprising positioning the obstruction removal device across the obstruction such that the obstruction removal device is initially offset from a longitudinal axis of the obstruction.

20. The method of claim 17, where the expandable structure of the obstruction removal device is self-expanding.

21. The method of claim 17, where the obstruction removal device is fabricated from a process selected from the group consisting of a photochemical etching, mechanical drilling, weaving, braiding, and laser cutting.

22. The method of claim 17, further comprising withdrawing at least a portion of the obstruction removal device within a catheter and removing the catheter from the vessel.