Expandable tip atherectomy method and apparatus
First Claim
1. An apparatus for removing an obstruction from a vessel, comprising:
- a coil;
said coil being capable of elongation thereby reducing the circumference as said coil is elongated;
.[.means for selectively elongating.]. .Iadd.an elongator engageable with said coil and movable between first and second positions wherein .Iaddend.said coil .Iadd.is elongated in one of said positions.Iaddend.;
.[.means for introducing said coil.]. .Iadd.an introducer extendable .Iaddend.inside .[.a.]. .Iadd.the .Iaddend.vessel proximate to .[.an.]. .Iadd.the .Iaddend.obstruction.Iadd., wherein said introducer supports said coil.Iaddend.;
said coil having .[.an abrasive surface covering.]. at least part of its outer surface .Iadd.treated to form a roughened surface.Iaddend.; and
.[.means for.]. .Iadd.a drive shaft attached to said coil and capable of .Iaddend.selectively rotating said coil.
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Accused Products
Abstract
A device for removing obstructions from vessels or small openings in the body, comprising a rotatable ablator tip which is guided to the obstruction in a reduced diameter configuration, expanded and rotated to remove the obstruction, and contracted to remove the device from the body. The variably expandable abrasive tip coil in one embodiment of the invention is actuated by a piston means disposed within the coil. A pair of collars is attached to the ends of the coil, and the piston effects relative longitudinal axial movement of the collars and, hence, the respective ends of the coil tip. When the ends of the coil tip are so moved with respect to one another, expansion and contraction of the diameter of the coil tip results. In another embodiment of the invention, the expansion tip coil is actuated by an expandable and contractible bellows means disposed within the coil, instead of the piston means. In another embodiment of the invention, the expansion and contraction of the coil tip are effected by longitudinal axial movement of an internal coil attached to one end of the coil tip, within an outer coil attached to the other end of the coil tip. In another embodiment of the invention, expansion and contraction of the coil tip are effected by an inflatable balloon disposed within the coil tip. The balloon expansion means enlarges preferably at the central portion of the coil to make a bulge.
The questions raised in reexamination request No. 90/003,360, filed Mar. 15, 1994, and 90/003,723 filed Feb. 14, 1995, have been considered and the results thereof are reflected in this reissue patent which constitutes the reexamination certificate required by 35 U.S.C. 307 as provided in 37 CFR 1.570(e).
136 Citations
61 Claims
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1. An apparatus for removing an obstruction from a vessel, comprising:
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a coil; said coil being capable of elongation thereby reducing the circumference as said coil is elongated; .[.means for selectively elongating.]. .Iadd.an elongator engageable with said coil and movable between first and second positions wherein .Iaddend.said coil .Iadd.is elongated in one of said positions.Iaddend.; .[.means for introducing said coil.]. .Iadd.an introducer extendable .Iaddend.inside .[.a.]. .Iadd.the .Iaddend.vessel proximate to .[.an.]. .Iadd.the .Iaddend.obstruction.Iadd., wherein said introducer supports said coil.Iaddend.; said coil having .[.an abrasive surface covering.]. at least part of its outer surface .Iadd.treated to form a roughened surface.Iaddend.; and .[.means for.]. .Iadd.a drive shaft attached to said coil and capable of .Iaddend.selectively rotating said coil. - View Dependent Claims (2, 3, 56, 57)
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4. An apparatus for removing an obstruction from a vessel, comprising:
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a coil; the circumference of said coil being capable of enlargement by unwinding and compressing the coil; .[.means for selectively unwinding and compressing.]. .Iadd.an elongator connected to said coil and movable between a first position and a second position wherein .Iaddend.said coil .[.for effecting such enlargement of.]. .Iadd.is unwound and compressed in one of said positions to enlarge .Iaddend.the circumference of said coil; .[.means for introducing said coil in.]. .Iadd.an introducer extendable inside .Iaddend.the vessel proximate to the obstruction.Iadd., wherein said introducer supports said coil.Iaddend.; said coil having .[.an abrasive surface.]. .Iadd.projections .Iaddend.covering at least part of its outer surface .Iadd.for frictionally engaging the obstruction for removal.Iaddend.; and .[.means for.]. .Iadd.a drive shaft attached to said coil and capable of .Iaddend.selectively rotating said coil. - View Dependent Claims (5)
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6. An apparatus for removing an obstruction from a vessel, comprising:
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a length of coil preformed in an ovaloid shape; .[.means for.]. .Iadd.a drive shaft connected to said length of coil and capable of .Iaddend.rotating said length of coil; said length of coil having an abrasive surface covering at least a part of its outer surface; a tubular catheter with a central lumen .Iadd.disposed within said rotating member.Iaddend.; said catheter terminating in a tip with an opening in said tip communicating with the central lumen of said catheter; said length of coil surrounding the terminal end of said catheter with the terminal end of said length of coil fixed to the terminal end of said tip of said catheter; .[.means for elongating.]. .Iadd.an elongator attached to said length of coil and movable between a first position and a second position wherein .Iaddend.said length of coil .Iadd.is elongated in one of said positions .Iaddend.thereby reducing the circumference of said length of coil; and said .[.elongation means.]. .Iadd.elongator .Iaddend.being disposed between said catheter and said length of coil. - View Dependent Claims (7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30)
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31. An apparatus for removing an obstruction from a vessel, comprising:
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a coil capable of an enlarged circumference forming a bulge in said coil after partial unwinding and compression of said coil; said coil having an abrasive surface covering at least part of its outer surface; means for rotating said coil; a tubular catheter with a central lumen; said catheter terminating in a tip with an opening in the tip communicating with the central lumen of the catheter; said coil surrounding the terminal end of said catheter; an expandable means disposed between said catheter and said coil and engageable with the inner surface of said coil when activated to expand said coil and allow the free end of said coil to unwind and at the same time to allow for compression of the length of said coil thereby enlarging the circumference and diameter of said coil, and upon deactivation contracting away from said inner surface of said coil allowing said coil to rewind and assume its smaller circumference and diameter; and means for remotely activating the expandable means to selectively increase and decrease the diameter of said coil. - View Dependent Claims (32, 33, 34)
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35. An apparatus for removing an obstruction from a vessel, comprising:
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a coil; the diameter of said coil being changeable by winding and unwinding said coil; means for selectively winding and unwinding said coil for effecting such change in diameter of said coil; means for introducing said coil in the vessel proximate to the obstruction; said coil having .[.an abrasive.]. .Iadd.a grainy .Iaddend.surface covering at least part of its outer surface .Iadd.for removing the obstruction by sanding.Iaddend.; and means for selectively rotating said coil.
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36. A method for removing an obstruction from a vessel, comprising .[.the steps of.].:
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introducing a variable diameter coil .[.with an abrasive.]. .Iadd.treated to form a .Iaddend.surface .Iadd.with sharp edges .Iaddend.covering at least part of its outer surface into the vessel proximate to the obstruction in a reduced coil diameter state; unwinding the coil at the site of the obstruction to increase the diameter of the coil; rotating the increased diameter coil at high speed .Iadd.for the sharp edges .Iaddend.to .[.abrade.]. .Iadd.grind .Iaddend.away the obstruction; subsequent to such high speed rotation, rewinding the coil to reduce its diameter; and withdrawing the coil from the vessel. - View Dependent Claims (37)
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38. A method for removing an obstruction from a vessel, comprising .[.the steps of.].:
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introducing a variable diameter coil with .[.an abrasive.]. .Iadd.a .Iaddend.surface .Iadd.coated with an abrasive .Iaddend.covering at least part of its outer surface into the vessel proximate to the obstruction in a reduced coil diameter state; axially compressing the coil at the site of the obstruction to increase the diameter of the coil; rotating the increased diameter coil at high speed .[.to abrade away the obstruction.].; .Iadd.frictionally engaging the obstruction with the abrasive coating to remove the obstruction by grinding;
.Iaddend.subsequent to such high speed rotation, axially elongating the coil to reduce its diameter; and withdrawing the coil from the vessel. - View Dependent Claims (39)
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40. A method for removing an obstruction from a vessel, comprising the steps of:
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introducing a variable diameter coil with an abrasive surface covering at least part of its outer surface into the vessel proximate to the obstruction in a reduced coil diameter state; activating an expansion means disposed within said coil into expanding engagement with the interior of said coil to increase its diameter; rotating the increased diameter coil at high speed to abrade away the obstruction; subsequent to such high speed rotation, deactivating the expansion means to remove it from expanding engagement with the interior of said coil to reduce its diameter; and withdrawing the coil from the vessel. .Iadd.
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41. An apparatus for removing an obstruction from a vessel, comprising:
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an adjustable diameter tip; said adjustable diameter tip being capable of elongation thereby reducing its diameter as said tip is elongated; an elongator engageable with said tip and movable between first and second positions wherein said adjustable diameter tip is elongated in one of said positions; an introducer extendable inside the vessel proximate to the obstruction, wherein said introducer supports said adjustable diameter tip; said adjustable diameter tip having at least part of its outer surface treated to form a roughened surface; a drive shaft connected to said tip and being capable of selectively rotating said adjustable diameter tip; and said roughened surface being formed by a plurality of projections on said outer surface..Iaddend..Iadd. - View Dependent Claims (42)
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44. obstruction and grinding the obstruction for removal..Iaddend..Iadd.48. An apparatus for removing an obstruction from a vessel, comprising:
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an expandable removal member having a plurality of wire-like members which traverse the longitudinal axis of the vessel; said expandable removal member being capable of elongation thereby reducing the circumference as said expandable removal member is elongated; an elongator engageable with said expandable removal member and movable between a first position and a second position wherein said expandable removal member is elongated in one of said positions; an introducer extendable inside the vessel proximate to the obstruction, wherein said introducer supports said expandable removal member; said expandable removal member having at least part of its outer surface processed to form a roughened surface; a drive shaft attached to said expandable removal member and being capable of selectively rotating said expandable removal member; and said outer surface of said expandable removal member being processed to - View Dependent Claims (43)
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50. capable of positively shifting said inner member..Iaddend..Iadd.66. An apparatus for removing an obstruction from a vessel, comprising:
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a motor; an expandable removal member having a plurality of wire-like members insertable into the vessel; a hollow drive shaft operatively connecting said motor to said removal member and being capable of rotating said removal member within the vessel; a hollow inner member insertable through said removal member and said hollow drive shaft; said inner member being shiftable within said drive shaft and said removal member; said removal member being responsive to shifting said inner member; a control member operatively connected to said inner member and being capable of positively shifting said inner member; and a guidewire extending through said inner member..Iaddend..Iadd.67. The apparatus of claim 65 wherein said removal element includes an abrasive disposed thereon..Iaddend..Iadd.68. An apparatus for removing an obstruction from a vessel, comprising; a motor; an expandable removal member insertable into the vessel; a hollow drive shaft operatively connecting said motor to said removal member and being capable of rotating said removal member within the vessel; an inner member insertable through said removal member and said hollow drive shaft; said inner member being shiftable within said drive shaft and said removal member; said removal member being responsive to shifting said inner member; a control member operatively connected to said inner member and being capable of positively shifting said inner member; and said removal element having a proximal end and a distal end, said proximal end being connected to said drive shaft and said distal end being connected to an annular member with an aperture with said inner member
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51. extending into said aperture..Iaddend..Iadd.69. An apparatus for removing an obstruction from a vessel, comprising:
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a motor; an expandable removal member insertable into the vessel; a hollow drive shaft operatively connecting said motor to said removal member and being capable of rotating said removal member within the vessel; an inner member insertable through said removal member and said hollow drive shaft; said inner member being shiftable within said drive shaft and said removal member; said removal member being responsive to shifting said inner member; a control member operatively connected to said inner member and being capable of positively shifting said inner member; and said removal element having a distal end with a tip having an abrasive
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52. surface..Iaddend..Iadd.70. An apparatus for removing an obstruction from a vessel, comprising:
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a motor; an expandable removal member insertable into the vessel; a hollow drive shaft operatively connecting said motor to said removal member and being capable of rotating said removal member within the vessel; an inner member insertable through said removal member and said hollow drive shaft; said inner member being shiftable within said drive shaft and said removal member; said removal member being responsive to shifting said inner member; a control member operatively connected to said inner member and being capable of positively shifting said inner member; and said removal element including a plurality of helical wires forming a ridged surface..Iaddend..Iadd.71. An apparatus for removing an obstruction from a vessel, comprising; a motor; an expandable removal member insertable into the vessel; a hollow drive shaft operatively connecting said motor to said removal member and being capable of rotating said removal member within the vessel; an inner member insertable through said removal member and said hollow drive shaft; said inner member being shiftable within said drive shaft and said removal member; said removal member being responsive to shifting said inner member; a control member operatively connected to said inner member for positively shifting said inner member; and
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53. said drive shaft comprising a coil..Iaddend..Iadd.72. The apparatus of claim 71 further comprising a sheath over said coil..Iaddend..Iadd.73. An apparatus for removing an obstruction from a vessel, comprising:
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a removal member which is expandable and insertable in the vessel for removing the obstruction; an expansion control operatively associated with said expandable removal member and being capable of limiting expansion of said expandable removal member; and said expansion control including a first member connected to one end of said removal member and a second member connected to another end of said removal member, said first and second members engaging to limit the expansion of said removal member..Iaddend..Iadd.74. An apparatus for removing an obstruction from a vessel, comprising; a removal member which is expandable and insertable in the vessel to remove the obstruction; an expansion control operatively associated with said expandable removal member to limit expansion of said expandable removal member; and said expansion control including an expandable member having a first end connected to one end of said removal member and a second end connected to another end of said removal member to limit the expansion of said removal - View Dependent Claims (46, 47)
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54. member..Iaddend..Iadd.75. A method for removing an obstruction from a vessel comprising:
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navigating a guidewire to the obstruction; navigating a removal member having a plurality of wire-like members to the obstruction over the guidewire; compressing and expanding the wire-like members; limiting the expansion of the wire-like members; energizing the removal member to remove the obstruction; and frictionally engaging the obstruction with an abrasive on the wire-like members to remove the obstruction..Iaddend..Iadd.76. A method for removing an obstruction from a vessel comprising; navigating a guidewire to the obstruction; navigating a removal member to the obstruction over the guidewire; expanding the removal member; engaging the removal member with another member disposed around the guidewire near the obstruction to limit the expansion of the removal member; energizing the removal member to remove the obstruction; and
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55. variably expanding the removal member..Iaddend..Iadd.77. A method for removing an obstruction from a vessel comprising:
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navigating a guidewire to the obstruction; navigating a removal member having a plurality of wire-like members to the obstruction over the guidewire; expanding the removal member; engaging the removal member with another member disposed around the guidewire near the obstruction to limit the expansion of the removal member; energizing the removal member to remove the obstruction; and supplying a fluid to the removal member..Iaddend..Iadd.78. A method for removing an obstruction from a vessel comprising; navigating a guidewire to the obstruction; navigating a removal member to the obstruction over the guidewire; expanding the removal member; limiting the expansion of the removal member; energizing the removal member to remove the obstruction; and expanding a dilating member adjacent the obstruction..Iaddend..Iadd.79. The method of claim 75 wherein the limiting element includes abutting members connected to the ends of the removal member..Iaddend..Iadd.80. The method of claim 75 further including activating a motor capable of rotating the
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58. vascular occlusion material..Iaddend..Iadd.94. An intravascular device as defined in claim 91 wherein at least a portion of said expandable removal element is made from a radiopaque material..Iaddend..Iadd.95. A vascular occlusion material removal device for removing vascular occlusion material in a vascular lumen, the material removal device comprising:
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an expandable material removal element having a first and a second end and including a plurality of wires generally disposed between the first and second ends of the removal element, and the expandable material removal element being movable between an expanded position and a contracted position; a drive shaft connected to the first end of the expandable material removal element and being capable of rotating the removal element; an elongator operatively connected to the second end of the removal element and movable between first and second positions wherein said material removal element is operatively variably moved between the expanded position and the contracted position; and at least one of said wires being treated to form sharp projections on the surface of said wires..Iaddend..Iadd.96. A vascular occlusion material removal device as defined in claim 95 further comprising a removal element expansion control to positively control movement of the removal element between the expanded position and the contracted position, the control
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59. being adjacent the removal element..Iaddend..Iadd.97. A vascular occlusion material removal device as defined in claim 95 further comprising a dilatation member connected to the elongating member adjacent the removal element..Iaddend..Iadd.98. A vascular occlusion material removal device as defined in claim 95 further comprising an abrasive disposed on said at least one of the wires..Iaddend..Iadd.99. A vascular occlusion material removal device as defined in claim 98 wherein the abrasive comprises particles deposited on the surface of the wire..Iaddend..Iadd.100. A vascular occlusion material removal device as defined in claim 95 further comprising a cutting surface disposed distally on the removal element and capable of removing vascular occlusion material..Iaddend..Iadd.101. A vascular occlusion material removal device as defined in claim 95 wherein the expandable material removal element has an axial length and a radius;
- and wherein the axial length is reducible responsive to shifting of the elongator with respect to the drive shaft, wherein the radius is expanded..Iaddend..Iadd.102. A vascular occlusion material removal device as defined in claim 95 wherein the wires are
- View Dependent Claims (45, 48, 49)
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60. preformed..Iaddend..Iadd.103. A vascular occlusion removal device as defined in claim 95 further comprising an expansion control to limit expansion of the expandable material removal element..Iaddend..Iadd.104. A vascular occlusion material removal device as defined in claim 95 wherein the elongation member comprises a cylindrical portion having a hollow interior with an aperture in the cylindrical portion to allow fluid to flow through the interior of the cylindrical portion..Iaddend..Iadd.105. A vascular occlusion material removal device as defined in claim 95 further comprising a balloon member connected to the elongating member..Iaddend..Iadd.106. The device of claim 95 wherein the expandable removal element is sufficiently deformable so that the element assumes a configuration corresponding to the configuration defined by the non-occluded diameter upon expansion of the element..Iaddend..Iadd.107. The device of claim 95 wherein said projections are formed by peening the surface of the wires..Iaddend..Iadd.108. The device of class 95 wherein said removal element includes a plurality of groupings of said wires..Iaddend..Iadd.109. An apparatus for removing an obstruction from a vessel, comprising:
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a drive shaft disposed within a catheter; a helical coil mounted on the end of said drive shaft; said coil having at least part of its outer surface treated to form a roughened surface; and said drive shaft being capable of selectively rotating said coil to remove
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61. the obstruction..Iaddend..Iadd.110. The apparatus of claim 109 wherein said coil includes a helical wire-like member..Iaddend..Iadd.111. The apparatus of claim 109 wherein said coil has an abrasive coating..Iaddend.
Specification