Method and apparatus for micro-dissection of vascular occlusions

• US 20020143358A1
• Filed: 02/12/2002
• Published: 10/03/2002
• Est. Priority Date: 02/13/2001
• Status: Abandoned Application

• Current Assignee: Cordis Corporation (Cardinal Health, Inc.)
• Original Assignee: Cordis Corporation (Cardinal Health, Inc.)
• Inventors: Deckman, Robert K., Seybold, Brent D., Domingo, Nicanor A., Sparks, Kurt D.
• Application Number:
  US10/074,546
• Publication Number:
  US 20020143358A1
• Time in Patent Office: Days
• US Class Current: 606/190
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/2909 Handles
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22039 eccentric
• CPC Class Codes: A61B 2017/22042 Details of the tip of the guide wire
• CPC Class Codes: A61B 2017/22074 the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
• CPC Class Codes: A61B 2017/2931 with releasable head
• CPC Class Codes: A61B 2017/2933 camming or guiding means
• CPC Class Codes: A61B 2017/2936 Pins in guiding slots
• CPC Class Codes: A61B 2017/2938 Independently actuatable jaw members, e.g. two actuating rods
• CPC Class Codes: A61B 2017/2939 Details of linkages or pivot points
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 2090/306 using optical fibres
• 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: A61M 2025/0004 having two or more concentrically arranged tubes for forming a concentric catheter system
• CPC Class Codes: A61M 25/0054 with regions for increasing flexibility
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

A method and apparatus for micro-dissection of vascular occlusions are provided wherein two or more tissue expansion members are coupled with a base section and an actuation assembly so that they rotate radially outward from the central axis of the base. The actuating assembly occupies a channel within the base such that it is free to move in a longitudinal direction. As an external force is applied to the actuation assembly, the actuation assembly engages the tissue expansion members causing them to move in a radial outward direction with respect to the base section. The resulting motion causes the tissue expansion members to contact the tissue walls and/or the occlusion. The tissue expansion members can stretch the tissue walls causing the occlusion to tear, fracture or be disrupted or displaced.

Claims

1. A tissue expansion apparatus comprising:

a base section;

a hinge assembly coupled with the distal region of the base section having two hinge assembly arms extending in the distal direction;

a plurality of tissue expansion members;

an actuating assembly (comprising an actuating member and an actuation plate) for the application of a force perpendicular to the central axis of the base section on a tissue expansion member; and

a coupling system for engaging the tissue expansion members to the actuation plate; and

a coupling system for engaging the tissue expansion members to the base section for simultaneous outward movement of the tissue expansion members relative to the central axis of the base section.

2. The apparatus of claim 1, wherein the coupling system is offset from the central longitudinal axis.

3. The apparatus of claim 1, wherein the base section includes an actuation channel along a longitudinal axis passing completely through the base section on the distal face for accommodating the actuation plate.

4. The apparatus of claim 3, wherein the base section includes a base aperture along the longitudinal axis beginning at the proximal end of the base section and terminating in the actuation channel.

5. The apparatus of claim 4, wherein the base section includes a hinge assembly having a hinge assembly aperture in each hinge assembly arm along the transverse axis with respect to the actuation channel.

6. The apparatus of claim 5, wherein each tissue expansion member includes a plurality of apertures for coupling each tissue expansion member to the hinge assembly and actuation plate.

7. The apparatus of claim 1, wherein the coupling system further comprises a hinge pin enabling the coupling of each tissue expansion member to the hinge assembly and a plurality of coupling pins enabling the coupling of each tissue expansion member to the actuation plate.

8. The apparatus of claim 7, wherein each tissue expansion member is coupled to the hinge assembly arms at the hinge assembly aperture by the hinge pin passing transverse to the central axis of the apparatus.

9. The apparatus of claim 8, wherein the actuating member is coupled to the actuation plate.

10. The apparatus of claim 9, wherein the actuation plate includes a plurality of actuation plate apertures.

11. The apparatus of claim 10, wherein the actuation plate apertures are oval.

12. The apparatus of claim 11, wherein each tissue expansion member is coupled to the actuating plate at said actuation plate aperture by a coupling pin.

13. The apparatus of claim 9, wherein the actuating member is fixed to the actuation plate.

14. The apparatus of claim 1, wherein the base section includes retention fins enabling a coupling of a catheter tube to the base section.

15. The apparatus of claim 1, wherein the base section includes a mounting set channel enabling a coupling of a catheter tube to the base section.

16. The apparatus of claim 1, wherein the actuating member and actuation plate are placed within the base aperture and actuation channel respectively allowing movement of the actuation assembly within said base section.

17. The apparatus of claim 1, wherein the shape of the tissue expansion members is modifiable.

19. The method of claim 18, further comprising enabling the passage of a guide-wire or other intervention device through a dissection tract produced by the tissue expansion apparatus.

20. The method of claim 18, wherein disrupting includes tearing the vascular occlusion.

21. The method of claim 18, wherein disrupting includes fracturing the vascular occlusion.

22. The method of claim 18, wherein disrupting includes separating the vascular occlusion from the vasculature wall.

23. The method of claim 18, wherein disrupting includes separating vessel wall tissue and creating a dissection tract within the vessel wall.

24. The method of claim 18, further comprising placing the tissue expansion apparatus near the occlusion by guiding the tissue expansion apparatus via a guide-wire.

25. The method of claim 18, wherein the coupling further comprises placing the actuation assembly within the base section allowing longitudinal movement of the actuating assembly relative to the base section.

26. The method of claim 18, wherein placing the tissue expansion apparatus further comprises the coupling of the tissue expansion apparatus to a catheter tube.

18. A method of vascular micro-dissection comprising;

placing a tissue expansion apparatus in the proximity of a vascular occlusion wherein the tissue expansion apparatus comprises a base section, a hinge assembly coupled with distal region of the base section having two hinge assembly arms extending in the distal direction, an actuating assembly, and a plurality of tissue expansion members, wherein each actuation assembly includes an actuating member and an actuation plate for the application of a force perpendicular to the central axis of the base section on each tissue expansion member;

coupling the tissue expansion members to the base section;

coupling the tissue expansion members to the actuating assembly;

applying a force along the longitudinal axis of the tissue expansion apparatus to the actuating assembly, wherein the force simultaneously rotates the tissue expansion members outward relative to the longitudinal axis of the tissue expansion apparatus; and

disrupting the vascular occlusion in response to the force.