CN104159525A - Clot removal devices and methods - Google Patents

Clot removal devices and methods Download PDF

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Publication number
CN104159525A
CN104159525A CN201280063095.0A CN201280063095A CN104159525A CN 104159525 A CN104159525 A CN 104159525A CN 201280063095 A CN201280063095 A CN 201280063095A CN 104159525 A CN104159525 A CN 104159525A
Authority
CN
China
Prior art keywords
grumeleuse
capture element
joint element
blood vessel
axle
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
CN201280063095.0A
Other languages
Chinese (zh)
Inventor
R·埃克豪斯
尤里·苏丁
希蒙·埃克豪斯
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Medical Co Ltd Rapidly
Rapid Medical Ltd
Original Assignee
Medical Co Ltd Rapidly
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US13/279,880 external-priority patent/US9005237B2/en
Priority claimed from US13/279,870 external-priority patent/US8758364B2/en
Priority claimed from US13/279,898 external-priority patent/US9034008B2/en
Priority claimed from US13/279,891 external-priority patent/US8864792B2/en
Application filed by Medical Co Ltd Rapidly filed Critical Medical Co Ltd Rapidly
Publication of CN104159525A publication Critical patent/CN104159525A/en
Pending legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A61B2017/22042Details of the tip of the guide wire
    • A61B2017/22044Details of the tip of the guide wire with a pointed tip
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2215Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2217Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions single wire changing shape to a gripping configuration
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/08Accessories or related features not otherwise provided for
    • A61B2090/0801Prevention of accidental cutting or pricking
    • A61B2090/08021Prevention of accidental cutting or pricking of the patient or his organs

Abstract

A clot removal device and method for removing a clot from a blood vessel may include an expandable clot engagement element, an expandable clot capture element, and a sheath surrounding and compressing the capture element and the engagement element. The sheath may be removable to thereby enable the capture element to expand in a blood vessel in which the sheath is deployed, and to enable the engagement element to expand within the capture element. Additionally, a clot removal device and method for removing a clot from a blood vessel may employ a tubular clot capture element for deployment in a blood vessel for surrounding a clot, such that when the clot capture element surrounds a clot and is retracted in a longitudinal direction of the blood vessel, the clot capture element is configured to exert a radially inward compression force on the clot.; Further, a clot removal device and method may include a tubular clot capture element having a first internal diameter and a clot engaging element having a second external diameter. The first diameter and the second diameter may be selected to permit the clot engaging element to be rotated within the tubular clot capture element. Further still, a clot removal device and method may employ a shaft and a clot engagement element on an end of the shaft, both configured for deployment in a blood vessel. The clot removal device may also include a stabilizer configured to at least partially surround the shaft and to maintain a portion of the shaft in a non-contacting relationship with the blood vessel wall.

Description

Grumeleuse scavenge unit and method
Technical field
Current disclosed embodiment relates generally to the apparatus and method for the treatment of the obturator in vascular system.More particularly, current disclosed embodiment relates in particular to for example, apparatus and method for remove the grumeleuse (embolus and thrombosis) of finding in blood vessel.
Background technology
Blood clot (for example embolus and thrombosis) is the example of the tamper that possible form in the blood vessel of mammal.People's endovascular grumeleuse may become more dangerous in the time of its restriction blood flow, thus people is placed under the medical science wound risk occurring such as apoplexy or heart attack.Therefore, may need to remove residing in endovascular grumeleuse.
Use multiple device and operation that grumeleuse is removed from blood vessel.For example, the conduit on its end far away with sacculus can be inserted in blood vessel and through grumeleuse, afterwards by inflation.Then sacculus can be withdrawn to grumeleuse is removed from blood vessel.
Another example of grumeleuse scavenge unit is the conduit that contains spiral type sections in its distal portion.This conduit with spiral type sections can be transported to endovascular grumeleuse position, then can use in spiral type sections incision grumeleuse.Therefore, this spiral type sections can by grumeleuse from catching the inside of grumeleuse before blood vessel is withdrawn from.
The risk that grumeleuse scavenge unit exists is that a clotting piece may break in reset procedure, passes through vascular system and causes trauma injuries.Its generation may be due to a variety of causes.For example, if grumeleuse scavenge unit just passed grumeleuse before launching, launch in advance behavior meeting and destroy grumeleuse and cause clot disruption.In addition, within the scope of the far-end not relating to, the risk of expanding unit increases.Need to have such apparatus and method, they can allow grumeleuse to remove from blood vessel, and a part that simultaneously reduces grumeleuse or grumeleuse may be ejected and patient be caused to the risk of further danger in reset procedure.
Summary of the invention
Embodiments of the present invention provide the apparatus and method for remove grumeleuse from blood vessel.
A first aspect of the present invention provides a kind of grumeleuse scavenge unit, and this device comprises: expandable grumeleuse joint element; Expandable grumeleuse capture element; And surround and compress the sheath of described grumeleuse capture element and described grumeleuse joint element, described sheath can remove, to make thus described grumeleuse capture element expand in the blood vessel of the described sheath of configuration, and described grumeleuse joint element can be expanded in described grumeleuse capture element.
In some embodiments, described grumeleuse capture element is surrounded described grumeleuse joint element, and/or described grumeleuse capture element comprises network structure, and/or described in the Length Ratio of described grumeleuse capture element, the length of grumeleuse joint element is long, and/or described grumeleuse capture element is sized to and makes under deployed condition this grumeleuse capture element engage blood vessel wall, and wherein said grumeleuse joint element is sized to this grumeleuse joint element under deployed condition can be moved in described grumeleuse capture element.
In some embodiments, described joint element is coil, and/or described joint element is sized to and can moves in described grumeleuse capture element after described sheath removes, and/or described grumeleuse joint element is sized to and can after described sheath removes, in described grumeleuse capture element, rotates.
Described grumeleuse capture element and described grumeleuse joint element can be constructed such that in use, and described grumeleuse joint element is between described grumeleuse capture element and grumeleuse.
Described device may further include the locking mechanism for described grumeleuse joint element being locked in to described grumeleuse capture element.
A second aspect of the present invention provides a kind of method of removing grumeleuse from blood vessel, the method comprises the steps: grumeleuse scavenge unit to be configured in the grumeleuse position in blood vessel, and this grumeleuse scavenge unit comprises expandable grumeleuse joint element, expandable grumeleuse capture element and encirclement and compresses the sheath of described grumeleuse capture element and described grumeleuse joint element; And described sheath is removed from described grumeleuse capture element and described grumeleuse joint element, described grumeleuse capture element is expanded in blood vessel, and described grumeleuse joint element expand in described grumeleuse capture element.
Method according to a second aspect of the invention can be carried out with any one embodiment according to the device of above disclosed first aspect.
In some embodiments, described grumeleuse joint element moves after described sheath removes in described grumeleuse capture element, and/or described grumeleuse joint element rotates after described sheath removes in described grumeleuse capture element.
In some embodiments, the method also comprises that described grumeleuse joint element is locked in the step in described grumeleuse capture element by use locking mechanism
In some embodiments, described grumeleuse capture element engages blood vessel wall under deployed condition, and wherein said grumeleuse joint element moves under deployed condition in described grumeleuse capture element.
A third aspect of the present invention provides a kind of grumeleuse scavenge unit, this device comprises: tubulose grumeleuse capture element, wherein this grumeleuse capture element is configured for and is configured in blood vessel to surround grumeleuse, in this grumeleuse capture element, there is opening, this opening is configured to receive and guiding grumeleuse joint element, described grumeleuse capture element is formed at radial contraction while retraction, thereby when described grumeleuse capture element is surrounded while retracting on grumeleuse the longitudinal direction at blood vessel, described grumeleuse capture element is formed at and on described grumeleuse, applies radially inner compression stress.
In some embodiments, described grumeleuse capture element is taked cancellated form, such as net.This net can weave, and/or described net comprises multiple halved belts, and wherein can relative to each other move in these multiple halved belts, and/or described net comprising many lines, close end and distal portion, and the thread end that do not open wide of wherein said close end and described distal portion.
In some embodiments, described grumeleuse joint element comprises coil and the axle that is connected to this coil.
In some embodiments, further comprise Control Shaft according to the device of third aspect present invention, wherein said grumeleuse capture element comprises close end and distal portion, and wherein said Control Shaft extends from the described close end of described grumeleuse capture element.
In some embodiments, described Control Shaft and described grumeleuse capture element are constructed such that, when proper described Control Shaft is retracted on the longitudinal direction of blood vessel, described grumeleuse capture element is retracted on the longitudinal direction of blood vessel.
In some embodiments, described grumeleuse capture element is constructed such that proper while retracting on the longitudinal direction of blood vessel, and described grumeleuse capture element applies longitudinal shear power on grumeleuse.
A fourth aspect of the present invention provides a kind of method of removing grumeleuse from blood vessel, and the method comprises the steps: tubulose grumeleuse capture element to be configured in blood vessel, has opening in described grumeleuse capture element, and this opening receives and guide grumeleuse joint element; Utilize described grumeleuse capture element to surround grumeleuse; And the described grumeleuse capture element of retracting on the longitudinal direction of blood vessel, make described grumeleuse capture element radial contraction, thereby on grumeleuse, apply radially inner compression stress.
In some embodiments, can carry out with device according to a third aspect of the invention we according to the method for fourth aspect.
In some embodiments, described grumeleuse capture element is by means of retracting from the extended Control Shaft of described grumeleuse capture element.
In some embodiments, the described grumeleuse capture element of retracting on the longitudinal direction of blood vessel is included in and on grumeleuse, applies longitudinal shear power.
A fifth aspect of the present invention provides a kind of grumeleuse scavenge unit, and this device comprises: the tubulose grumeleuse capture element with the first internal diameter; And thering is the grumeleuse joint element of the second external diameter, wherein said the first internal diameter and described the second external diameter are selected to and allow described grumeleuse joint element to rotate in described tubulose grumeleuse capture element.
In some embodiments, described tubulose grumeleuse capture element comprises network structure.
In some embodiments, described grumeleuse joint element comprises coil.
In the time that described tubulose grumeleuse capture element comprises that network structure and described grumeleuse joint element comprise coil, described coil can be configured to the outside rotation around grumeleuse, and described network structure can be configured to hold described coil and grumeleuse.
In some embodiments, described the first internal diameter is selected such that with described the second external diameter the exterior surface area of described grumeleuse joint element contacts the inner surface area of described tubulose grumeleuse capture element, and/or described the first internal diameter and described the second external diameter be selected to and allow the longitudinally motion in described tubulose grumeleuse capture element of described grumeleuse joint element, and/or described the first internal diameter and described the second external diameter are selected to and allow described grumeleuse joint element to expand in described tubulose grumeleuse capture element.
In some embodiments, also comprise described grumeleuse joint element is locked in to the locking mechanism in described tubulose grumeleuse capture element according to the device of the 5th embodiment of the present invention.
In some embodiments, also comprise according to the device of the 5th embodiment of the present invention: the first axle, this first axle extends from the close end of described tubulose grumeleuse capture element; With the second axle, this second axle extends from the close end of described grumeleuse joint element, and wherein said the second axle is formed at rotation in described the first axle.
A sixth aspect of the present invention provides a kind of method of removing grumeleuse from blood vessel, and the method comprises the steps: the tubulose grumeleuse capture element with the first diameter to be delivered to grumeleuse position; The grumeleuse joint element with the second external diameter is delivered to described grumeleuse position, and wherein said the first diameter and described the second external diameter are selected such that described grumeleuse joint element rotates in described tubulose grumeleuse capture element.
In some embodiments, can carry out by device according to a fifth aspect of the invention according to the method for sixth aspect present invention.
In some embodiments, locking mechanism is locked in described grumeleuse joint element in described tubulose grumeleuse capture element.
In some embodiments, method according to a sixth aspect of the invention may further include and makes the longitudinally motion in tubulose grumeleuse capture element of described grumeleuse joint element.
In some embodiments, method according to a sixth aspect of the invention may further include described grumeleuse joint element is expanded in described tubulose grumeleuse capture element.
In some embodiments, the first axle extends from the close end of described tubulose grumeleuse capture element, and the second axle extends from the close end of described grumeleuse joint element, and wherein the method is also included in described the second axle of rotation in described the first axle.
A seventh aspect of the present invention provides a kind of grumeleuse scavenge unit, and this device comprises: axle; Be positioned at the grumeleuse joint element on the end of described axle, this grumeleuse joint element and described axle are configured for and are configured in blood vessel; And regulator, this regulator is configured to surround at least in part described axle and a part for described axle is maintained in blood vessel wall and is non-contacting relation.
In some embodiments, described grumeleuse joint element is coil.Described coil can comprise multiple pitch of the laps of the spacing with substantial constant, and/or described coil can comprise multiple pitch of the laps of the radius with substantial constant.
In some embodiments, described regulator is formed in blood vessel described coil is maintained to roughly axial orientation.
In some embodiments, may further include grumeleuse capture element according to the device of the 7th aspect.Described regulator can be connected to described grumeleuse capture element, and/or described grumeleuse capture element is netted pipe, and wherein said regulator comprises the opening of the end that is arranged in described netted pipe, and/or described regulator comprises a part for the Control Shaft extending from the close end of described grumeleuse capture element.
A eighth aspect of the present invention provides a kind of grumeleuse scavenge unit, and this device comprises: axle; Be positioned at the grumeleuse joint element on the end of described axle, described grumeleuse joint element comprises rotatable coil, and wherein said coil extends from described axle, and wherein said axle and described coil are configured for and are configured in blood vessel; And regulator, this regulator comprises the opening passing for described axle, described regulator is formed at the substantial middle that in the rotary course of described coil, described axle is maintained to blood vessel.
In some embodiments, described regulator comprises the pipe with tapered ends, and wherein said opening is arranged in described tapered ends.Described pipe can be made up of network structure.Radial contraction while retracting on the longitudinal direction of blood vessel that described network structure can be formed at described pipe.
A ninth aspect of the present invention provides that a kind of the method comprises the steps: grumeleuse joint element to be configured in blood vessel for removing the method for grumeleuse from blood vessel, and described grumeleuse joint element is positioned on the end of axle; And in the mode of surrounding at least in part described axle, regulator is configured in blood vessel, so that a part for described axle is maintained in the wall of described blood vessel and is non-contacting relation.
In some embodiments aspect the 9th, described method also comprises described regulator is positioned to the position adjacent with described grumeleuse joint element, and wherein said regulator is constructed such that described grumeleuse joint element centering substantially in blood vessel.
Method according to a ninth aspect of the invention can be carried out with device according to an eighth aspect of the invention.
In some embodiments, described regulator maintains described coil on the roughly axial orientation of described blood vessel.
In some embodiments, method according to a ninth aspect of the invention may further include grumeleuse capture element is configured in to the step in blood vessel, and wherein said regulator is connected to described grumeleuse capture element.
The additional aspect of the disclosure will partly be set forth in explanation subsequently, and will partly easily determine from this explanation, or can know by the practice of the disclosure.
Should be appreciated that, above-mentioned general description and following detailed description in detail are only all exemplary and explanat, and are not that the present invention for required protection is limited.
The accompanying drawing that is combined in this description and be configured to a part for this description shows described disclosed some embodiments, and for described disclosed principle is described together with this description.
Brief description of the drawings
Figure 1A is the cutaway view for the medical treatment device from blood vessel removing grumeleuse according to the embodiment of the disclosure.
Figure 1B and Fig. 1 C are the cutaway views of the medical treatment device of the Figure 1A in expanded configuration.
Fig. 2 is the grumeleuse capture element of medical treatment device and the axonometric chart of grumeleuse joint element of Figure 1A.
Fig. 3 A and Fig. 3 B be respectively in contracted configurations and expanded configuration according to the axonometric chart of the grumeleuse capture element of the second embodiment of the disclosure.
Fig. 4 A and Fig. 4 B are respectively according to the axonometric chart of the grumeleuse capture element of the third and fourth embodiment of the disclosure.
Fig. 5 is for the axonometric chart with the traditional locking mechanism using together with the medical treatment device of Figure 1A.
Fig. 6 A and Fig. 6 B are the cutaway views of body part, show the step that uses the medical treatment device of Figure 1A removes grumeleuse method from this body part.
Fig. 7 A and Fig. 7 B are the cutaway views of the body part of Fig. 6 A and Fig. 6 B, show the motion of grumeleuse joint element the process of the method that uses the medical treatment device of Figure 1A that grumeleuse is removed from this body part.
Fig. 7 C and Fig. 7 D are the cutaway views of the body part of Fig. 6 A and Fig. 6 B, show the step that uses the medical treatment device of Figure 1A that grumeleuse is removed from this body part.
Fig. 8 is the cutaway view of the body part of Fig. 6 A and Fig. 6 B, shows the process of the method that uses the medical treatment device of Figure 1A that grumeleuse is removed from this body part and acts on the power on grumeleuse.
Detailed description of the invention
To be described in detail to current disclosed illustrative embodiments now the example of the disclosure shown in the drawings.As possible, in whole accompanying drawings, will use identical Reference numeral to represent same or analogous parts.
Current disclosed embodiment relates generally to medical treatment device and the method for the treatment of the obturator in health.More particularly, current disclosed embodiment relates to the apparatus and method for remove grumeleuse (including but not limited to embolus and thrombosis) from blood vessel.But, should be emphasized that, current disclosed embodiment also can be applied in other medical operatings of expecting to remove tamper or foreign body.
According to the embodiment of the disclosure, can provide a kind of grumeleuse scavenge unit that comprises expandable grumeleuse joint element.Expandable grumeleuse joint element can be any structure that can clamp, catch, limit or keep and/or fetch blood clot or other obturators after being disposed in blood vessel.
Figure 1A shows an example about the grumeleuse joint element 102 of exemplary grumeleuse scavenge unit 100.For the object of the disclosure, " near-end " refers to the end that in use more approaches device operator, and " far-end " refers to the in use farther end of distance means operator.
As shown in Figure 1B, in one embodiment, grumeleuse joint element 102 can comprise the coil with one or more pitch of the laps 108.Pitch of the laps 108 can be angled with respect to the longitudinal axis 1006 of blood vessel 1002 (Fig. 7 A).The angular range of pitch of the laps 108 can, from approximate 0 degree to being similar to 180 degree, more preferably, be spent to approximate 180 from approximate 90 degree.
Multiple pitch of the laps 108 can further form helical configuration, and multiple pitch of the laps 108 are shared the pitch P of substantial constant and/or the radius R of substantial constant thus, as shown in the reference line in Fig. 7 A.Thereby in rotary course, the adjacent turn with same radius and pitch will be followed substantially the same rotate path.Alternatively, described one or more pitch of the laps 108 can comprise the pitch of variation and/or the radius of variation.Described one or more pitch of the laps 108 can have any shape and/or structure, thereby they can be configured to around residing in the rotation of endovascular grumeleuse, with catch grumeleuse periphery at least a portion and grumeleuse is separated to (Fig. 6 B) from blood vessel.For example, described one or more pitch of the laps 108 can be wound around with any suitable shape (including but not limited to circle and ellipse).Described one or more pitch of the laps 108 can also be continuous material block.This continuous material block can have any suitable shape of cross section, includes but not limited to any other shape that circle, ellipse, polygon maybe can be wound.
It can be substantially smooth or circular anti-wound bottom grumeleuse contact surface that described one or more pitch of the laps 108 may further include.When the bottom grumeleuse contact surface of one or more pitch of the laps 108 can alleviate contact, grumeleuse 1000 is broken into the trend of polylith.In addition, the bottom grumeleuse contact surface of described one or more pitch of the laps 108 can have texture to strengthen firmly grasping of grumeleuse 1100.The outer surface of cupular part of described one or more pitch of the laps 108 can be also anti-wound surface.The anti-wound outer surface of cupular part of described one or more pitch of the laps 108 can alleviate the damage at the tissue of grumeleuse position contact to described one or more pitch of the laps 108.Pitch of the laps 108 can also comprise the coating in top surface and/or the lower surface that is positioned at them.This coating can include but not limited to lubricant and/or anesthetis.
Grumeleuse joint element 102 can further be configured for the spring member of self inflation and retraction.Expanding and retract can be at longitudinal direction and/or in the radial direction.Thereby grumeleuse joint element 102 can comprise contracted configurations (Figure 1A) and expanded configuration (Figure 1B).Contracted configurations can be kept in the time that sheath 118 surrounds the outer surface of grumeleuse joint element 102 substantially.In the time that sheath 118 is removed from least a portion of the outer surface of grumeleuse joint element 102, can realize expanded configuration (sheath 118 will be discussed in further detail) below.
Grumeleuse joint element 102 can be configured to be expanded to the internal diameter (Fig. 7 A) that is approximately blood vessel 1002.Being expanded to the internal diameter that is approximately blood vessel 1002 may (but and not necessarily) cause grumeleuse joint element 102 to apply power on the wall 1004 of blood vessel 1002.If apply power in blood vessel wall 1004, this power can cause grumeleuse 1000 to separate from the wall 1004 of blood vessel 1002.The separation causing may be useful, and this is that grumeleuse 1000 may all reside in blood vessel 1002 because in many cases.Thereby, grumeleuse 1000 is separated to reduce from the wall 1004 of blood vessel grumeleuse 1000 is further removed to the amount of required power from blood vessel 1002, and alleviate the process of removing from blood vessel 1002 grumeleuse 1000 and be broken into the trend of multiple fragments.
Axle 116 can extend from the close end of grumeleuse joint element 102.Axle 116 can be the slender member that is configured to rotation and the lengthwise movement of controlling grumeleuse joint element 102.For example, as shown in Figure 7 A, axle 116 can cause grumeleuse joint element 102 to move upward in the side of arrow 1010 ' by the motion in the direction shown in arrow 1010.In addition, the rotation of axle 116 in the direction of arrow 1012 can cause grumeleuse joint element 102 to rotate up in the side of arrow 1012 '.
Axle 116 can have any shape and/or structure, as long as can be configured to make grumeleuse joint element 102 rotate and advance on axle 116.In addition, axle 116 can have any suitable shape of cross section, as long as axle 116 can be configured to rotation (Fig. 7 A).
Although embodiment described above provides as an example of the grumeleuse joint element 102 of winding arrangement using implication widely, but grumeleuse joint element can have any shape and/or structure, as long as this grumeleuse joint element can be caught grumeleuse and grumeleuse is removed from blood vessel.In addition, grumeleuse joint element can have any size, thereby can be through the inner chamber of blood vessel.
Grumeleuse joint element can form with any suitable biocompatible material of the inner chamber through blood vessel by having enough flexibilities and/or rigidity.Biocompatible material can include but not limited to the metal alloy of synthetic plastic, rustless steel, ePTFE, PTFE, Metal polymer composite and nickel, titanium, NiTi, copper cobalt, chromium and steel.
In the embodiment widely of the disclosure, grumeleuse joint element can comprise any structure or the mechanism that can engage with grumeleuse or other obturators.For example, grumeleuse joint element can comprise one or more hooks, tweezers, inflatable cage, balloon-expandable or heat or chemical mechanism for causing frame for movement to be connected with grumeleuse or obturator.
According at least some embodiments of the disclosure, can provide a kind of expandable grumeleuse capture element.Expandable grumeleuse capture element can be for catching any structure of the grumeleuse having been engaged by grumeleuse joint element after being disposed in blood vessel.
According to an illustrative embodiment of the invention, figure 1 illustrates exemplary grumeleuse capture element 104.Grumeleuse capture element 104 can move grumeleuse joint element 102 after can being formed at and being disposed in blood vessel in this grumeleuse capture element 104.For example, as will be described in more detail after a while, after sheath 118 removes, grumeleuse joint element 102 can be configured in the interior rotation of grumeleuse capture element 104, expansion and/or longitudinal sliding motion.
As shown in Fig. 1 C, grumeleuse capture element 104 can include but not limited to have the conduit of close end 104a and distal portion 104b.Close end 104a and distal portion 104b can include the opening 112 being positioned at wherein.The opening 112 that is arranged in close end 104a and distal portion 104b place can be communicated with (Figure 1A) with the central lumen of grumeleuse capture element 104 110.The miscellaneous part that central lumen 110 in grumeleuse capture element 104 can allow to insert grumeleuse joint element 102 and may contribute to medical operating, includes but not limited to optional seal wire 120, vacuum source, illumination and/or imaging device and for catching the instrument of grumeleuse.
Grumeleuse capture element 104 can further be configured to expand and shrink.Thereby grumeleuse capture element 104 can be configured to response and change between contracted configurations (Figure 1A) and expanded configuration (Figure 1B) in spring mode with respect to the motion of sheath 118 around.Be similar to grumeleuse joint element 102, grumeleuse capture element 104 can be configured to be expanded to the size substantially the same with the internal diameter of the blood vessel 1002 at grumeleuse position.Grumeleuse capture element 104 expand into the internal diameter of blood vessel 1002 at grumeleuse position and the power that applies in blood vessel wall 1004 can help grumeleuse 1000 to separate from the wall 1004 of blood vessel 1002.This separation can cause removes required power minimizing by grumeleuse 1000 from blood vessel 1002.This separation can also contribute to alleviate the process that grumeleuse 1000 is removed from blood vessel 1002 grumeleuse 1000 and be broken into the trend of polylith.
Grumeleuse capture element 104 can have any shape and/or structure, makes it can pass the inner chamber of blood vessel.In one embodiment, grumeleuse capture element 104 can be the hollow pipe with constant diameter.Alternatively, grumeleuse capture element 104 can have the diameter along its length variations.For example, as shown in Figure 2, grumeleuse capture element 104 can have the diameter at close end 104a place convergent, thereby close end 104 can be configured to be connected to the distal portion (Control Shaft 114 will be discussed in further detail) of Control Shaft 114 below.
Grumeleuse capture element 104 can form with any known suitable biocompatible material of the inner chamber through blood vessel by having enough flexibilities and/or rigidity.The biocompatible material of grumeleuse capture element 104 may further include the characteristic that can make grumeleuse capture element 104 expand and to shrink in mode previously discussed.Thereby biocompatible material can include but not limited to synthetic plastic, silicone elastomer, thermoplastic elastomer (TPE), NiTi, rustless steel, ePTFE, PTFE, polyimides, polyamide, HDPE, polypropylene, polrvinyl chloride, LDPE, Metal polymer composite and metal alloy.
Grumeleuse capture element 104 can comprise the combination of single creature compatible material or multiple biocompatible material.In one embodiment, grumeleuse capture element 104 can comprise various biocompatible materials, thereby the type of biocompatible material and characteristic can change the position in grumeleuse capture element 104 according to biocompatible material.For example, the distal portion 104b of grumeleuse capture element 104 can comprise the material with spring characteristic.This biocompatible material can include but not limited to polyurethane, Low Density Polyethylene, polrvinyl chloride, Nitinol and THV.
May expect, make the close end 104a of grumeleuse capture element 104 there is the biocompatible material firmer than distal portion 104b.The biocompatible material of the close end 104a of grumeleuse capture element 104 can have any suitable rigidity, as long as grumeleuse capture element 104 can be configured to the inner chamber through blood vessel.Thereby the biocompatible material of the close end 104a of grumeleuse capture element 104 can include but not limited to blend or the mixture of polyimides, polyamide, high density polyethylene (HDPE), polypropylene, polrvinyl chloride, PTFE, polysulfones, co-polymer and above-mentioned material.
Grumeleuse capture element 104 can be the integrative-structure being formed by continuous material block.Alternatively, as shown in Figure 2, grumeleuse capture element 104 can comprise multiple parts 106.In one embodiment, for example, described multiple parts 106 can comprise mutual winding and form cancellated multiple braid over braid (Fig. 2).Described multiple braid over braid 106 can be connected to each other by any any means known.Alternatively, network structure can be taked the form of net, and described multiple braid over braid 106 can not connect intersected with each otherly, and described multiple braid over braid 106 can be configured to relative to each other move thus.In addition, described multiple braid over braid 106 can comprise many lines.Described line can intersect also bending and form network structure, thereby makes the close end 104a of grumeleuse capture element 104 and distal portion 104b can there is no unlimited thread end (Fig. 2).Do not have open end can reduce the wound to blood vessel.In other embodiments, can use free open end.In some embodiments in these embodiments, it can be maybe that other forms of physical arrangement is so that the wound minimum to blood vessel that open end can curve inwardly slightly.
When adopt network structure in grumeleuse capture element 104 time, can construct net in the mode that is similar to Chinese fingerstall (Chinese finger trap), thereby make longitudinal withdrawal force cause this tubular structure radial contraction.
Thereby, no matter other structures that may adopt how, an embodiment of the disclosure can comprise tubulose grumeleuse capture element simply, wherein this grumeleuse capture element is configured for and is configured in blood vessel to surround grumeleuse, in this grumeleuse capture element, there is opening, this opening is configured for and receives and guide grumeleuse joint element, described grumeleuse capture element is formed at radial contraction while retraction, thereby in the time retracting on grumeleuse capture element encirclement grumeleuse the longitudinal direction at blood vessel, described grumeleuse capture element is formed at and on grumeleuse, applies radially inner compression stress.
Thereby, for example, an embodiment of the disclosure may simply be the structure of the capture element 104 shown in Fig. 2, and this capture element has the tubular form being formed by net 106, and this tubular form has at close end 104a place for receiving and the opening 112 of leading axle 116.Due to its network structure, therefore, in the time retracting, capture element 104 is radially inwardly shunk.
This network structure can be that net or its can weave.Itself can comprise multiple halved belts described net, and these halved belts can relative to each other be moved.Described net can comprise many lines, wherein one or more thread end not opening wide in close end and the distal portion of capture element (referring to the distal portion of the capture element 104 in Fig. 2 for example, the free end of the line wherein not exposing).
Fig. 3 A and Fig. 3 B and 4A and Fig. 4 B show cancellated alternative arrangement, and this alternative arrangement can comprise any suitable self-expanding structure.For example, suitable self-expanding structure can include but not limited to circular coil, flat rubber belting coil, multiple inflatable ring (Fig. 3 A and Fig. 3 B) and/or open up and stretch formula structure (Fig. 4 A and Fig. 4 B).Self-expanding structure for example can further be supported on, between multilayer material 306 (polymer), and this provides suitable structure can to grumeleuse capture element 104.
Grumeleuse capture element 104 may further include anti-wound outer surface, and this anti-wound outer surface can limit tissue injury in the time being disposed at grumeleuse position.Grumeleuse capture element 104 can also comprise the coating being positioned on its outer surface and/or inner surface.This coating can comprise anesthetis and/or lubricant, and it can help to configure grumeleuse capture element 104 and grumeleuse joint element 102 and/or can help the motion of grumeleuse joint element 102 in grumeleuse capture element 104.
As mentioned above, the close end 104a of grumeleuse capture element 104 can be connected to Control Shaft 114.(referring to Fig. 2) Control Shaft 114 can be configured for the slender member of grumeleuse capture element 104 being moved to contracted configurations.The slender member of Control Shaft 114 can be the hollow pipe with solid wall structure, braiding wall structure, winding wall structure, hypotube (hypo-tube) (part is removed so that the solid wall structure of deflection).This hollow pipe can have the opening being positioned on each end, thereby Control Shaft 114 can be communicated with the central lumen of grumeleuse capture element 104 110 (Fig. 1).Control Shaft 114 can pass through by permission instrument thus, and described instrument includes but not limited to seal wire 120 and the apparatus for engaging with grumeleuse 1000.Control Shaft 114 can further allow the axle 116 of grumeleuse joint element 102 to pass through, as example as shown in Figure 2.Alternatively, Control Shaft 114 can be solid construction, and axle 116 can be adjacent to location with axle 114, instead of extends through axle 114.
The diameter of axle 116 can be less than the diameter of Control Shaft 114, and this can allow grumeleuse joint element 102 to move along the longitudinal axis of grumeleuse capture element 104.Axle 116 can also comprise the outer surface that friction is minimum.For example, the outer surface of axle 116 can be smooth and/or can comprise lubricant coating, thereby axle 116 can relatively easily slide in Control Shaft 114.Axle 116 may further include the inner chamber being positioned at wherein.This inner chamber can be communicated with grumeleuse capture element 104.This inner chamber can also be communicated with the inner chamber 1008 in blood vessel 1002 in the time that grumeleuse scavenge unit 100 is transported to grumeleuse position.Thereby this inner chamber can allow will remove at grumeleuse useful in operation process instrument to insert, described instrument includes but not limited to seal wire 120, aspirator, illuminator, imaging device and/or for catching the suitable instrument of grumeleuse.
Control Shaft 114 can comprise and be sized to the diameter that is suitable for receiving axes 116, so as to allow the motion of grumeleuse joint element 102 by axle 116 and the interior movement of grumeleuse capture element 104.The length of axle 116 can be longer than the length of Control Shaft 114 (Fig. 2), makes Control Shaft 114 can surround at least in part axle 116, and this can allow device operator control the longitudinal of grumeleuse joint element 102 and rotatablely move.Control Shaft 114 can further be configured to a part for the axle of grumeleuse joint element 102 116 to be maintained in blood vessel wall 1004 and to be non-contacting relation, and can be configured to grumeleuse joint element 102 to maintain desired locations with respect to the grumeleuse 1000 at grumeleuse position.Thereby Control Shaft 114 can be used as the regulator of grumeleuse joint element 102 in the time that grumeleuse joint element 102 is positioned at grumeleuse capture element 104.For example, the diameter of Control Shaft 114 can be greatly to being enough to allow axle 116 carry out longitudinally and rotatablely move, but littlely prevent axle 116 and prevent that thus grumeleuse joint element 102 from departing from the precalculated position with respect to grumeleuse 1000 substantially to being enough to.Therefore, in one embodiment, the second axle (axle 116) can rotate and/or be mobile in the first axle (Control Shaft 114).Thereby a function of Control Shaft 114 can be to make axle 116 centering in blood vessel, thereby in the time that joint element 102 rotates, this rotation occurs substantially on the longitudinal direction of blood vessel.According in the embodiment of the disclosure, for example, by axle 116 is maintained and is positioned at middle position in blood vessel, grumeleuse joint element 102 also can be maintained on the roughly axial orientation of blood vessel, and this can reduce the risk that blood vessel is caused damage in the time that grumeleuse joint element 102 rotates.
In the situation that there is no Control Shaft 114, or except Control Shaft 114, can axle 116 unshowned distance piece of centering in blood vessel be realized to joint element endovascular centering due to the convergent of capture element 104 or by using.In this respect, another embodiment of the disclosure can comprise grumeleuse scavenge unit, and this grumeleuse scavenge unit has: axle; Be positioned at the grumeleuse joint element on the end of described axle, this grumeleuse joint element and described axle are configured for and are configured in blood vessel; And regulator, described regulator is configured to surround at least in part described axle and is configured to a part for described axle is maintained in described blood vessel wall and is non-contacting relation.
In Fig. 2, for example, the centering interconnection by Control Shaft 114 with capture element 104, axle 116 is maintained in blood vessel wall and is non-contacting relation.Thereby in the time that axle 116 enters the inner chamber being limited by capture element 104, it is biased in the direction towards vasotropic central authorities.This contributes to maintain as follows joint element then, and, in the time of this joint element rotation, it tends to rotate on the longitudinal direction of blood vessel, instead of extends substantially transversely to this longitudinal direction rotation.This is only an example of stabilizer structure.It will also be appreciated that the axle that keeps joint element is away from any structure of blood vessel wall, these structures also contain in this embodiment.
Control Shaft 114 also can be configured to grumeleuse capture element 104 to be converted to from expanded configuration the structure of at least part of contraction.For example, the motion of Control Shaft 114 in the direction shown in the arrow 115 by Fig. 2 can cause to the close end 104a of grumeleuse joint element 104 and apply power.The power applying to the close end 104a of grumeleuse capture element 104 can also be positioned at by the direction shown in arrow 115, and this can cause grumeleuse capture element 104 to be shunk thus.
In retraction process, grumeleuse capture element 104 can be shunk, thereby on grumeleuse 1000 and/or grumeleuse joint element 102, applies power 1016,1018 (Fig. 8) in the time that grumeleuse 1000 and/or grumeleuse joint element 102 are positioned at the central lumen 110 of grumeleuse capture element.Power 1016,1018 can remain on grumeleuse 1000 in the central lumen 110 of grumeleuse capture element 104 the process that grumeleuse 1000 is removed from blood vessel 1002, and can alleviate grumeleuse 1000 and be broken into the trend of polylith.Then, the in the situation that of in grumeleuse remains on capture element and joint element individually, grumeleuse can be taken out from blood vessel, as shown in Fig. 7 A and 7B.Alternatively, for little, to being enough to be engaged in the grumeleuse in sheath 118, grumeleuse can be forgotten about it in sheath 118 before removing from blood vessel, as shown in Fig. 7 C and 7D.Like this, sheath 118 can apply further retentivity on grumeleuse.
According at least some embodiments, such sheath can be set, this sheath surrounds and compresses capture element and joint element.This sheath can be can remove to make thus capture element to expand in the blood vessel of configuration sheath, and described joint element can be expanded in capture element.Sheath can be can keep in grumeleuse joint element and grumeleuse capture element one or more simultaneously fully deflection to configure one or more any structure in these elements in blood vessel.
According at least some illustrative embodiments of the disclosure, example jacket 118 is shown in Fig. 1.Grumeleuse joint element 102 and grumeleuse capture element 104 can be transported to grumeleuse position in sheath 118.Sheath 118 can be the hollow tubular structure with central lumen, and described central lumen is configured to surround grumeleuse joint element 102 and grumeleuse capture element 104 (Figure 1A).Sheath 118 can further be formed at grumeleuse joint element 102 and grumeleuse capture element 104 is protected grumeleuse joint element 102 and grumeleuse capture element 104 in the time that the transport path that arrives grumeleuse position advances.Thereby, sheath 118 can be made up of any suitable biocompatible material, and can there is any suitable shape and/or structure, as long as sheath 118 can be configured to through patient's vascular system simultaneously being transported to grumeleuse position and in the time that grumeleuse position removes, grumeleuse joint element 102 and grumeleuse capture element 104 being remained on their corresponding contracted configurations.In addition, in the time grumeleuse joint element 102 and grumeleuse capture element 104 being removed from grumeleuse position, sheath can also be configured to grumeleuse to keep in the central in inner chamber (Fig. 7 D).
In addition, sheath 118 can be configured to allow to control the expansion of grumeleuse capture element 104 and grumeleuse joint element 102.For example, as previously discussed, grumeleuse capture element 104 and grumeleuse joint element 102 can be formed at and remove the rear expansion of sheath 118.Sheath 118 can be retracted in the direction of distal portion 104b that deviates from grumeleuse capture element 104.Thereby sheath 118 can remove with the speed of speed of the expansion that can control grumeleuse capture element 104 and grumeleuse joint element.In addition, sheath 118 can be retracted and can be controlled the distance (Figure 1B) of the amount that grumeleuse capture element 104 and grumeleuse joint element 102 can expose and expand.Alternatively, it is substantially static that sheath 118 can be kept, and grumeleuse capture element 104 and grumeleuse joint element 102 can advance, thereby cause these elements to expand.
According to another embodiment of the disclosure, a kind of grumeleuse joint element that has the tubulose grumeleuse capture element of the first internal diameter and have the second external diameter can be provided, and wherein said the first diameter and described Second bobbin diameter are selected to and allow described grumeleuse joint element to rotate in described tubulose grumeleuse capture element.
Only for instance, as shown in Fig. 2 and other accompanying drawings, the internal diameter of grumeleuse capture element 104 is sized to is enough to make grumeleuse joint element 102 to rotate therein.According to final commercial designs, this can provide and utilize joint element 102 grumeleuse to be drawn in to the freedom in capture element 104 around grumeleuse simultaneously to operator.Or it can provide the ability of rotating grumeleuse in the time that grumeleuse is positioned at capture element 104 to operator.Like this, element 102,104 is sized to the inner surface area that can make the exterior surface area of grumeleuse joint element 102 can contact grumeleuse capture element 104.
In the operating process of grumeleuse scavenge unit 100, device operator can find that this device is preventing that grumeleuse joint element 102 is with respect to more useful aspect the motion of grumeleuse capture element 104.For example, in the process that grumeleuse scavenge unit 100 is transported to grumeleuse position and/or the process that grumeleuse 1000 is removed from patient, this may expect.Correspondingly, Fig. 5 shows locking mechanism 150, and this locking mechanism 150 can use together with grumeleuse scavenge unit 100, optionally the axle of grumeleuse joint element 102 116 is locked in to fixed position with respect to the Control Shaft 114 of grumeleuse capture element 104.In the time that locking mechanism 150 rotates in one direction, can lock, and in the time that locking mechanism rotates in the opposite direction, can discharge.Locking mechanism can be any suitable device that optionally prevents the relative motion between grumeleuse joint element and grumeleuse capture element.The example of locking mechanism can include but not limited to snap lock, spin locking and interference engagement.For example, in one embodiment, locking mechanism can be torquer 150.Can control the relative motion between sheath 118 and capture element 104 with similar or different locking mechanisms.
Grumeleuse scavenge unit 100 can also comprise the parts that can allow device operator to know the position of grumeleuse scavenge unit 100 in the time that it is advanced to grumeleuse position.Location component can include but not limited to radiopaque labelling, sensor and/or imaging device.In one embodiment, for example, the distal portion 104b of grumeleuse capture element 104 can comprise radiopaque labelling (not shown).
Forward now Fig. 6 A and Fig. 6 B, Fig. 7 A to Fig. 7 D and Fig. 8 to, show the process that uses the grumeleuse scavenge unit 100 shown in Figure 1A to remove grumeleuse from blood vessel.Grumeleuse scavenge unit 100 can be transported to the grumeleuse position in blood vessel 1002.The conveying of grumeleuse scavenge unit 100 can be included in patient's vascular system sheath 118 (it can surround grumeleuse joint element 102 and grumeleuse capture element 104 substantially) is sent to the position that approaches grumeleuse 1000.Device operator can insert grumeleuse scavenge unit 100 via seal wire 120, to guarantee that grumeleuse scavenge unit 100 advances to grumeleuse position along correct path.In the process of carrying in sheath 118, grumeleuse joint element 102 can be surrounded by grumeleuse capture element 104 substantially, as shown in Figure 1A.Alternatively, grumeleuse joint element 102 can be positioned at the outside of grumeleuse capture element 104, and can after the time point after a while of this process is being caught grumeleuse 1000, move in grumeleuse capture element 104.
As previously mentioned, device operator can be by means of sensor, radiopaque labelling and/or the position of imaging device monitoring grumeleuse scavenge unit 100 in the time that it approaches grumeleuse position.Once grumeleuse scavenge unit 100 has arrived grumeleuse position, installing operator can remove seal wire 120 from grumeleuse scavenge unit 100.Device operator can retract sheath 118 (or joint element is advanced) fully, thereby joint element 102 can be rotated.Alternatively, sheath 118 entirety can be removed.By sheath 118 from grumeleuse joint element 102 after separatings, grumeleuse joint element 102 then can expanded radially and can for example, the interior motion of grumeleuse capture element 104 (longitudinally and rotatablely move).Grumeleuse joint element 102 and grumeleuse capture element 104 can be with the self-expandings of spring mode.Grumeleuse capture element 104 can be expanded to the approx. dimension of the internal diameter of blood vessel 1002.As previously mentioned, the expansion of grumeleuse capture element 104 can make grumeleuse 1000 start to separate from blood vessel wall 1004.
Device operator can move the axle 116 of grumeleuse joint element 102 in the direction of arrow 1010 towards grumeleuse 1000, and in the direction of arrow 1012 turning cylinder 116, this can cause grumeleuse joint element 102 to engage with grumeleuse 1000.The lengthwise movement of axle 116 can cause grumeleuse joint element 102 lengthwise movement in the direction of arrow 1010 ', and rotatablely moving of axle 116 can cause grumeleuse joint element 102 to rotatablely move in the direction of arrow 1012 '.Grumeleuse joint element 102 can move towards grumeleuse 1000 along the longitudinal axis of blood vessel 1006.In the time that the distal end of grumeleuse joint element 102 arrives grumeleuse 1000, when axle 116 longitudinally and rotatablely move and can cause grumeleuse joint element 102 around grumeleuse 1000.If the pitch of the laps 108 of grumeleuse capture element 102 has the radius of pitch and the substantial constant of substantial constant, in the time that capture element 102 is wound around, pitch of the laps will advance along single path, thus the wound minimum to grumeleuse, and make thus the least risk of clot disruption.Because grumeleuse joint element 102 is around grumeleuse 1000, therefore grumeleuse joint element 102 can be between grumeleuse 1000 and grumeleuse capture element.In some usage examples, the rotation of grumeleuse joint element 102 can cause Archimedian screw effect, thereby grumeleuse is further moved in joint element 102, and without the joint element that advances significantly.The degree of Archimedes's effect with and fundamentally whether occur to change according to the specific nature of grumeleuse and with the contiguity of blood vessel wall 1004.
Can make grumeleuse joint element 102 that after-expansion occurs by grumeleuse joint element 102 around grumeleuse 100.As previously discussed, the expanded radially of grumeleuse joint element 102 can cause the outer surface of this grumeleuse joint element 102 to apply power on the wall 1004 of blood vessel 1002, and this can further help grumeleuse 1000 to separate with blood vessel wall 1004.This separation can help to reduce removes required power by grumeleuse 1000 from blood vessel 1002.This separation can also help to alleviate the process that grumeleuse is removed from blood vessel 1002 grumeleuse 1000 and be broken into the trend of polylith.
Device operator can utilize grumeleuse engagement device around grumeleuse 1000, thereby device operator can move grumeleuse joint element 102 in grumeleuse capture element 104 to together with grumeleuse 1000.Thereby, device operator can be in the direction of arrow 1014 shifting axle 116, thereby make by grumeleuse joint element 102 around grumeleuse 1000 can be pulled in the central lumen 110 of grumeleuse capture element 104 by opening 112.
Because device operator moves grumeleuse 1000 and grumeleuse joint element 102 in the central lumen 110 of grumeleuse capture element 114 in the direction of arrow 1014, so device operator also can pull the Control Shaft 114 of grumeleuse capture element 104 in the direction of arrow 115.This pulling can cause grumeleuse capture element 104 to apply radial contraction power 1016 and longitudinal shear power 1018 to grumeleuse 1000 and grumeleuse joint element 102.These power that apply can aid-device operator maintain grumeleuse 1000 in grumeleuse capture element 104 and grumeleuse 1000 is removed from blood vessel 1002, and can not make grumeleuse 1000 be fragmented into polylith.And if grumeleuse portion is cracked, capture element 104 can prevent that fragment from becoming freely in blood flow.
As shown in Fig. 7 D, pull simultaneously grumeleuse capture element 104 and by grumeleuse joint element 102 around grumeleuse 1000 can cause in the direction of arrow 1020, above-mentioned parts being withdrawn in sheath 118.Grumeleuse joint element 102 and grumeleuse capture element 104 are withdrawn in sheath 118 and can cause grumeleuse joint element 102 and grumeleuse capture element 104 to change contracted configurations (Fig. 7 D) into from expanded configuration (Fig. 7 C).So device operator can remove grumeleuse scavenge unit 100 along the longitudinal axis of blood vessel 1,002 1006 from patient's vascular system.
Alternatively, can be not by capture element and joint element being withdrawn in sheath and grumeleuse is removed from vascular system.On the contrary, because grumeleuse may be trapped in capture element, the radial force therefore applying in the time retracting can enough be compressed in grumeleuse in capture element, thereby can this structure be regained with the form substantially expanding.
If desired, device operator can change the method for removing grumeleuse 1000 from blood vessel 1002.For example, at location grumeleuse joint element 102, with before around grumeleuse 1000, device operator can be through the central lumen insertion instrument of grumeleuse capture element 104, and this apparatus may be necessary for removing grumeleuse position.In addition, the removing of grumeleuse 1000 can be accompanied by by realizing for the suitable tools of grumeleuse 1000 being caught and/or maintained grumeleuse capture element 104.For example, device operator can adopt aspirator at the close end place of grumeleuse scavenge unit 100.This aspirator can further help grumeleuse 1000 to move in grumeleuse capture element 104 and at grumeleuse 1000 and kept grumeleuse 104 to be positioned at grumeleuse capture element 104 in the time that patient's vascular system pulls out.
According to another embodiment of the disclosure, the method for removing grumeleuse from blood vessel can comprise: blood vessel, configure tubulose grumeleuse capture element, in this grumeleuse capture element, have opening, this opening receives and guide grumeleuse joint element; Utilize grumeleuse capture element to surround grumeleuse; And along the longitudinal direction of blood vessel, grumeleuse capture element is retracted, make grumeleuse capture element radial contraction, thereby on grumeleuse, apply the power of radially inwardly compressing.Described disclosed this embodiment can utilize any one grumeleuse capture element described above to put into practice, and comprises grumeleuse capture element 104.
According to another embodiment of the disclosure, the method for removing grumeleuse from blood vessel can comprise: the tubulose grumeleuse capture element with the first diameter is transported to grumeleuse position; And the grumeleuse joint element with the second external diameter is transported to grumeleuse position, wherein said the first diameter and described Second bobbin diameter are selected such that described grumeleuse joint element rotates in described tubulose grumeleuse capture element.In conjunction with as described in Fig. 2, for example, be transported to grumeleuse position when grumeleuse capture element 104 as above, when grumeleuse joint element 102 is transported to grumeleuse position, and the diameter of these two elements is while allowing joint element to rotate in capture element, can realize this method.
Although capture element and joint element can together be for example configured in same sheath, inevitable requirement is not like this under its broad sense for the disclosure.For example, can first carry joint element, and can carry subsequently capture element.In addition, joint element is sized to the inwall that can contact capture element when rotated, or joint element be sized to can avoid contact.
According to another embodiment of the disclosure, can comprise for the method for removing grumeleuse from blood vessel: configure grumeleuse joint element at blood vessel, this grumeleuse joint element is positioned at the end of axle; Utilize the described axle of at least part of low encirclement in regulator, so that a part for described axle is maintained in blood vessel wall and is non-contacting relation.The situation that the method can be utilized or can not utilize grumeleuse capture element (such as structure 104) and the not consider any concrete stabilizer structure practice of getting off.As previously mentioned, according to design alternative, some embodiments of the disclosure can be benefited from the rotation of joint element 102 in the time that joint element is centered in blood vessel.The pressure minimum that this can make to be applied in blood vessel wall makes the motion of joint element 102 on the longitudinal direction of blood vessel maximize, to surround grumeleuse simultaneously.For example, for example, by the stable axle (axle 116) that makes joint element (102) rotation towards vasotropic center, can make lengthwise movement maximize.Thereby, can utilize any structure surround axle 116 and realize stable, described structure by axle 116 maintain substantially the intersection point that approaches axle 116 and pitch of the laps 108 position and near the center of blood vessel.
By considering description and the practice of invention disclosed herein, other embodiments of the disclosure will be apparent to those skilled in the art.It is exemplary that description and example should be regarded as merely, and true scope is represented by appended claim.

Claims (80)

1. a grumeleuse scavenge unit, this device comprises:
Expandable grumeleuse joint element;
Expandable grumeleuse capture element; And
Surround and compress the sheath of described grumeleuse capture element and described grumeleuse joint element, described sheath can remove, to make thus described grumeleuse capture element expand in the blood vessel of the described sheath of configuration, and described grumeleuse joint element can be expanded in described grumeleuse capture element.
2. device according to claim 1, wherein, described grumeleuse capture element is surrounded described grumeleuse joint element.
3. device according to claim 1, wherein, described grumeleuse joint element is coil.
4. device according to claim 1, wherein, described grumeleuse capture element comprises network structure.
5. device according to claim 1, wherein, described grumeleuse joint element is sized to after described sheath removes and can in described grumeleuse capture element, moves.
6. device according to claim 1, wherein, described grumeleuse joint element is sized to after described sheath removes and can in described grumeleuse capture element, rotates.
7. device according to claim 1, wherein, the length of grumeleuse joint element is long described in the Length Ratio of described grumeleuse capture element.
8. device according to claim 1, this device also comprises for described grumeleuse joint element is locked in to the locking mechanism in described grumeleuse capture element.
9. device according to claim 1, wherein, described grumeleuse capture element is sized to and makes under deployed condition this grumeleuse capture element engage blood vessel wall, and wherein said grumeleuse joint element is sized to this grumeleuse joint element under deployed condition can be moved in described grumeleuse capture element.
10. device according to claim 1, wherein, described grumeleuse capture element and described grumeleuse joint element be constructed such that in use, described grumeleuse joint element is between described grumeleuse capture element and grumeleuse.
Remove the method for grumeleuse from blood vessel for 11. 1 kinds, the method comprises the steps:
Grumeleuse scavenge unit is configured in to the grumeleuse position in blood vessel, and this grumeleuse scavenge unit comprises expandable grumeleuse joint element, expandable grumeleuse capture element and encirclement and compresses the sheath of described grumeleuse capture element and described grumeleuse joint element; And
Described sheath is removed from described grumeleuse capture element and described grumeleuse joint element, described grumeleuse capture element is expanded in described blood vessel, and described grumeleuse joint element expands in described grumeleuse capture element.
12. methods according to claim 11, wherein, described grumeleuse capture element is surrounded described grumeleuse joint element.
13. methods according to claim 11, wherein, described grumeleuse joint element is coil.
14. methods according to claim 11, wherein, described grumeleuse capture element comprises network structure.
15. methods according to claim 11, wherein, described grumeleuse joint element moves after described sheath removes in described grumeleuse capture element.
16. methods according to claim 11, wherein, described grumeleuse joint element rotates after described sheath removes in described grumeleuse capture element.
17. methods according to claim 11, wherein, the length of grumeleuse joint element is long described in the Length Ratio of described grumeleuse capture element.
18. methods according to claim 11, the method also comprises that described grumeleuse joint element is locked in the step in described grumeleuse capture element by use locking mechanism.
19. methods according to claim 11, wherein, described grumeleuse capture element engages blood vessel wall under deployed condition, and wherein said grumeleuse joint element moves under deployed condition in described grumeleuse capture element.
20. methods according to claim 11, wherein, in the time that described grumeleuse capture element and described grumeleuse joint element are used, described grumeleuse joint element is between described grumeleuse capture element and grumeleuse.
21. 1 kinds of grumeleuse scavenge units, this device comprises:
Tubulose grumeleuse capture element, wherein this grumeleuse capture element is configured for and is configured in blood vessel to surround grumeleuse, in this grumeleuse capture element, there is opening, this opening is configured to receive and guides grumeleuse joint element, described grumeleuse capture element is formed at radial contraction while retraction, thereby when described grumeleuse capture element is surrounded while retracting on described grumeleuse the longitudinal direction at described blood vessel, described grumeleuse capture element is formed at and on described grumeleuse, applies radially inner compression stress.
22. devices according to claim 21, wherein, described grumeleuse capture element is taked cancellated form.
23. devices according to claim 22, wherein, described network structure is net.
24. devices according to claim 23, wherein, described net weaves.
25. devices according to claim 23, wherein, described net comprises multiple halved belts, and wherein these multiple halved belts can relative to each other move.
26. devices according to claim 23, wherein, described net comprises many lines, close end and distal portion, and the thread end that do not open wide of wherein said close end and described distal portion.
27. devices according to claim 21, wherein, described grumeleuse joint element comprises coil and is connected to the axle of this coil.
28. devices according to claim 21, this device also comprises Control Shaft, wherein said grumeleuse capture element comprises close end and distal portion, and wherein said Control Shaft extends from the described close end of described grumeleuse capture element.
29. devices according to claim 28, wherein, described Control Shaft and described grumeleuse capture element are constructed such that, when proper described Control Shaft is retracted on the longitudinal direction of described blood vessel, described grumeleuse capture element is retracted on the longitudinal direction of described blood vessel.
30. devices according to claim 21, wherein, described grumeleuse capture element is constructed such that proper while retracting on the longitudinal direction of described blood vessel, described grumeleuse capture element applies longitudinal shear power on described grumeleuse.
Remove the method for grumeleuse from blood vessel for 31. 1 kinds, the method comprises the steps:
Tubulose grumeleuse capture element is configured in blood vessel, in described grumeleuse capture element, has opening, this opening receives and guides grumeleuse joint element;
Utilize described grumeleuse capture element to surround grumeleuse; And
The described grumeleuse capture element of retracting on the longitudinal direction of described blood vessel, makes described grumeleuse capture element radial contraction, thereby on described grumeleuse, applies radially inner compression stress.
32. methods according to claim 31, wherein, described grumeleuse capture element is taked cancellated form.
33. methods according to claim 32, wherein, described network structure is taked the form of net.
34. methods according to claim 33, wherein, described net weaves.
35. methods according to claim 33, wherein, described net comprises multiple halved belts, and wherein these multiple halved belts can relative to each other move.
36. methods according to claim 33, wherein, described net comprises many lines, close end and distal portion, and the thread end that do not open wide of wherein said close end and described distal portion.
37. methods according to claim 31, wherein, described grumeleuse joint element comprises coil and is connected to the axle of this coil.
38. methods according to claim 31, wherein, described grumeleuse capture element comprises close end and distal portion, and wherein Control Shaft extends from the described close end of described grumeleuse capture element.
39. according to the method described in claim 38, and wherein, described grumeleuse capture element is by means of retracting from the extended Control Shaft of described grumeleuse capture element.
40. methods according to claim 31, wherein, the described grumeleuse capture element of retracting on the longitudinal direction of described blood vessel is included in and on described grumeleuse, applies longitudinal shear power.
41. 1 kinds of grumeleuse scavenge units, this device comprises:
There is the tubulose grumeleuse capture element of the first internal diameter; And
Have the grumeleuse joint element of the second external diameter, wherein said the first internal diameter and described the second external diameter are selected to and allow described grumeleuse joint element to rotate in described tubulose grumeleuse capture element.
42. according to the device described in claim 41, and wherein, described tubulose grumeleuse capture element comprises network structure.
43. according to the device described in claim 41, and wherein, described grumeleuse joint element comprises coil.
44. according to the device described in claim 41, wherein, described tubulose grumeleuse capture element comprises that network structure and described grumeleuse joint element comprise coil, and wherein said coil is configured to the outside rotation around grumeleuse, and described network structure is configured to hold described coil and grumeleuse.
45. according to the device described in claim 41, and wherein, described the first internal diameter is selected such that with described the second external diameter the exterior surface area of described grumeleuse joint element contacts the inner surface area of described tubulose grumeleuse capture element.
46. according to the device described in claim 41, and this device also comprises described grumeleuse joint element is locked in to the locking mechanism in described tubulose grumeleuse capture element.
47. according to the device described in claim 41, and wherein, described the first internal diameter and described the second external diameter are selected to and allow the longitudinally motion in described tubulose grumeleuse capture element of described grumeleuse joint element.
48. according to the device described in claim 41, and wherein, described the first internal diameter and described the second external diameter are selected to and allow described grumeleuse joint element to expand in described tubulose grumeleuse capture element.
49. according to the device described in claim 41, and this device also comprises: the first axle, and this first axle extends from the close end of described tubulose grumeleuse capture element; With the second axle, this second axle extends from the close end of described grumeleuse joint element, and wherein said the second axle is formed at rotation in described the first axle.
Remove the method for grumeleuse from blood vessel for 50. 1 kinds, the method comprises the steps:
The tubulose grumeleuse capture element with the first diameter is delivered to grumeleuse position;
The grumeleuse joint element with the second external diameter is delivered to described grumeleuse position, and wherein said the first diameter and described the second external diameter are selected such that described grumeleuse joint element rotates in described tubulose grumeleuse capture element.
51. according to the method described in claim 50, and wherein, described tubulose grumeleuse capture element comprises network structure.
52. according to the method described in claim 50, and wherein, described grumeleuse joint element comprises coil.
53. according to the method described in claim 50, wherein, described tubulose grumeleuse capture element comprises that network structure and described grumeleuse joint element comprise coil, and wherein the method also comprises the described coil of rotation around the outside rotation of grumeleuse, and at least a portion of described coil and grumeleuse is contained in described network structure.
54. according to the method described in claim 50, and wherein, described the first diameter is selected such that with described the second external diameter the exterior surface area of described grumeleuse joint element contacts the inner surface area of described tubulose grumeleuse capture element.
55. according to the method described in claim 50, and wherein, locking mechanism is locked in described grumeleuse joint element in described tubulose grumeleuse capture element.
56. according to the method described in claim 50, and the method also comprises makes the longitudinally motion in described tubulose grumeleuse capture element of described grumeleuse joint element.
57. according to the method described in claim 50, wherein, the first axle extends from the close end of described tubulose grumeleuse capture element, and the second axle extends from the close end of described grumeleuse joint element, and wherein the method is also included in described the second axle of rotation in described the first axle.
58. 1 kinds of grumeleuse scavenge units, this device comprises:
Axle;
Be positioned at the grumeleuse joint element on the end of described axle, this grumeleuse joint element and described axle are configured for and are configured in blood vessel; And
Regulator, this regulator is configured to surround at least in part described axle and a part for described axle is maintained in blood vessel wall and is non-contacting relation.
59. according to the device described in claim 58, and wherein, described grumeleuse joint element is coil.
60. according to the device described in claim 58, and wherein, described coil comprises multiple pitch of the laps of the pitch with substantial constant.
61. according to the device described in claim 58, and wherein, described coil comprises multiple pitch of the laps of the radius with substantial constant.
62. according to the device described in claim 58, and wherein, described regulator is formed in blood vessel described coil is maintained to roughly axial orientation.
63. according to the device described in claim 57, and this device also comprises grumeleuse capture element, and wherein said regulator is connected to described grumeleuse capture element.
64. according to the device described in claim 63, and wherein, described grumeleuse capture element is netted pipe, and wherein said regulator comprises the opening of the end that is arranged in described netted pipe.
65. according to the device described in claim 63, and wherein, described regulator comprises a part for the Control Shaft extending from the close end of described grumeleuse capture element.
66. 1 kinds of grumeleuse scavenge units, this device comprises:
Axle;
Be positioned at the grumeleuse joint element on the end of described axle, described grumeleuse joint element comprises rotatable coil, and wherein said coil extends from described axle, and wherein said axle and described coil are configured for and are configured in blood vessel; And
Regulator, this regulator comprises the opening passing for described axle, described regulator is formed at the substantial middle that in the rotary course of described coil, described axle is maintained to described blood vessel.
67. according to the device described in claim 66, and wherein, described regulator comprises the pipe with tapered ends, and wherein said opening is arranged in described tapered ends.
68. according to the device described in claim 67, and wherein, described pipe is made up of network structure.
69. according to the device described in claim 68, wherein, and radial contraction while retracting on the longitudinal direction of described blood vessel that described network structure is formed at described pipe.
70. 1 kinds for removing the method for grumeleuse from blood vessel, and the method comprises the steps:
Grumeleuse joint element is configured in blood vessel, and described grumeleuse joint element is positioned on the end of axle; And
In the mode of surrounding at least in part described axle, regulator is configured in described blood vessel, so that a part for described axle is maintained in the wall of described blood vessel and is non-contacting relation.
71. according to the method described in claim 70, and the method also comprises described regulator is positioned to the position adjacent with described grumeleuse joint element, and wherein said regulator is constructed such that described grumeleuse joint element centering substantially in described blood vessel.
72. according to the method described in claim 71, and the method is also included in described grumeleuse joint element by described regulator and the step of substantially rotating described grumeleuse joint element around grumeleuse in the situation of centering.
73. according to the method described in claim 70, and wherein, described grumeleuse joint element is coil.
74. according to the method described in claim 73, and wherein, described coil comprises multiple pitch of the laps of the pitch with substantial constant.
75. according to the method described in claim 73, and wherein, described coil comprises multiple pitch of the laps of the radius with substantial constant.
76. according to the method described in claim 73, and wherein, described regulator maintains described coil on the roughly axial orientation of described blood vessel.
77. according to the method described in claim 70, and the method also comprises grumeleuse capture element is configured in to the step in described blood vessel, and wherein said regulator is connected to described grumeleuse capture element.
78. according to the method described in claim 70, and wherein, described grumeleuse capture element is netted pipe, and wherein said regulator comprises the opening of the end that is arranged in described netted pipe.
79. according to the method described in claim 78, and wherein, described regulator comprises the Control Shaft extending from the close end of described grumeleuse capture element.
80. according to the method described in claim 50, and the method also comprises expands described grumeleuse joint element in described tubulose grumeleuse capture element.
CN201280063095.0A 2011-10-24 2012-10-23 Clot removal devices and methods Pending CN104159525A (en)

Applications Claiming Priority (9)

Application Number Priority Date Filing Date Title
US13/279,880 US9005237B2 (en) 2008-08-29 2011-10-24 Device and method for clot capture
US13/279,870 US8758364B2 (en) 2008-08-29 2011-10-24 Device and method for clot engagement and capture
US13/279,898 US9034008B2 (en) 2008-08-29 2011-10-24 Device and method involving stabilization during clot removal
US13/279,891 2011-10-24
US13/279,898 2011-10-24
US13/279,870 2011-10-24
US13/279,880 2011-10-24
US13/279,891 US8864792B2 (en) 2008-08-29 2011-10-24 Device and method for clot engagement
PCT/IB2012/003053 WO2013072777A2 (en) 2011-10-24 2012-10-23 Clot removal devices and methods

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JP (1) JP2015505250A (en)
KR (1) KR20140098749A (en)
CN (1) CN104159525A (en)
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HK (1) HK1201708A1 (en)
IL (2) IL232252B (en)
WO (1) WO2013072777A2 (en)

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