ATHERECTOMY DEVICES AND METHODS

• US 20080004646A1
• Filed: 10/19/2006
• Published: 01/03/2008
• Est. Priority Date: 06/30/2006
• Status: Active Grant

• Current Assignee: Atheromed, Inc. (Koninklijke Philips N.V.)
• Original Assignee: Atheromed, Inc. (Koninklijke Philips N.V.)
• Inventors: To, John, Danek, Christopher James
• Granted Patent: US 8,007,506 B2
• Time in Patent Office: Days
• US Class Current: 606/159
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00685 Archimedes screw
• CPC Class Codes: A61B 2017/22039 eccentric
• CPC Class Codes: A61B 2017/22068 Centering
• CPC Class Codes: A61B 2017/22071 Steering
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 2017/320032 Details of the rotating or oscillating shaft, e.g. using a flexible shaft
• CPC Class Codes: A61B 2017/320775 Morcellators, impeller or propeller like means
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61F 2/86 Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure

Abstract

The devices and methods generally relate to treatment of occluded body lumens. In particular, the present devices and method relate to removal of the occluding material from the blood vessels as well as other body lumens.

Claims

1-62. -62. (canceled)

63. A method for debulking material within a totally or partially occluded blood vessel, the method comprising:

inserting a catheter body having a cutter assembly within the blood vessel;

rotating the cutter assembly to remove the material and form a first opening in the body lumen;

deflecting the first cutter assembly relative to an axis of the catheter body;

rotating the catheter body while rotating the cutter assembly to form a second opening in the body lumen where the second is larger than the first opening.

64. The method of claim 63, further comprising providing a burr surface on a distal end of the catheter body, and grinding a hardened material in the blood vessel with the burr surface.

65. The method of claim 63, where the cutter assembly comprises at least one cutter edge, where the cutter edge protrudes beyond an outer surface of a housing surrounding the cutter assembly to cut tissue outside the housing

66. The method of claim 63, where, the cutter is rotated such that only a partial number of cutter edges are aligned with the openings in the housing.

67. The method of claim 63, where the catheter body includes a guidewire lumen and where inserting the catheter body within the blood vessel comprises advancing the catheter body over a guidewire.

68. The method of claim 63, where the catheter head is deflected by a deflecting sheath coupled to the catheter body.

69. The method of claim 68, where the deflecting sheath is rotated to orient the deflected tip in the desired direction.

70. The method of claim 63, where the catheter head is deflected by a pre-shaped mandrel slidably located in the catheter body, where at least the distal end the catheter body assumes the shape of the pre-shaped mandrel when advanced therein.

71. The method of claim 63, where the catheter head is deflected by a pre-shaped tube slidably located in the catheter body, where at least the distal end the catheter body assumes the shape of the pre-shaped mandrel when advanced therein

72. The method of claim 63, where deflecting the catheter body comprises advancing a pre-curved sheath distally along the catheter body.

73. The method of claim 63, where the catheter tip is deflected by positioning the offset curve on the wire near the catheter tip.

74. The method of claim 63, where deflecting the cutter assembly relative to the axis of the catheter body further includes locking the cutter assembly in position relative to the axis of the catheter body.

75. The method of claim 63, where a distal portion of the catheter body includes at least one fluid port coupled to a fluid source, and further comprising delivering fluid through the fluid port.

76. The method of claim 63, further comprising withdrawing fluid and the material through the cutter assembly.

77. The method of claim 76, further comprising providing a helical conveyor member within the catheter body and transporting the debris material out of the body via helical conveyor member.

78. The method of claim 63, further comprising providing a guidewire through the cutter assembly, where the guidewire includes a fluid delivery lumen terminating in a guidewire fluid delivery port, the method further comprising delivering fluid through the guidewire fluid delivery port

79-100. -100. (canceled)

101. A method for circulating fluid for contrast, the method comprising:

inserting the support catheter within the blood vessel, where the support catheter comprises a support catheter body having a proximal end and a distal end, the distal end containing at least one port on the surface for injection or aspiration of fluid;

injecting the fluid for contrast through a lumen or port in the support catheter body;

aspirating the fluid for contrast into a lumen or port in the support catheter body.

102. The method of claim 101, where the support catheter is centered within the blood vessel using at least one basket or at least one balloon.

103. The method of claim 101, further comprising:

inserting a catheter body having a coring cutter assembly within the blood vessel;

driving the coring cutter assembly through the tough fibrous cap in the vessel to form a first body opening in the vessel;

removing the coring cutter assembly from the body;

inserting a second cutter assembly with a guidewire, where the guidewire is inserted through the first opening.

104. The method of claim 103, where the coring cutter assembly contains a shoulder that rests upon the support catheter.

106. The method of claim 103, where the coring cutter collects the cored-out portion of the tough fibrous cap.

105. The method of 103, where the coring cutter assembly comprises a helical groove or cylinder to drive itself through the tough fibrous cap.