WO1998044982A1 - Percutaneous aspiration catheter system - Google Patents
Percutaneous aspiration catheter system Download PDFInfo
- Publication number
- WO1998044982A1 WO1998044982A1 PCT/US1998/005411 US9805411W WO9844982A1 WO 1998044982 A1 WO1998044982 A1 WO 1998044982A1 US 9805411 W US9805411 W US 9805411W WO 9844982 A1 WO9844982 A1 WO 9844982A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- catheter
- lumen
- distal end
- percutaneous aspiration
- distal
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
- A61M25/0026—Multi-lumen catheters with stationary elements
- A61M25/0029—Multi-lumen catheters with stationary elements characterized by features relating to least one lumen located at the middle part of the catheter, e.g. slots, flaps, valves, cuffs, apertures, notches, grooves or rapid exchange ports
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0082—Catheter tip comprising a tool
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements 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
- A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements 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
- A61B2017/22038—Implements 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
- A61B2017/22039—Implements 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 eccentric
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M2025/0183—Rapid exchange or monorail catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
- A61M25/0026—Multi-lumen catheters with stationary elements
- A61M25/0032—Multi-lumen catheters with stationary elements characterized by at least one unconventionally shaped lumen, e.g. polygons, ellipsoids, wedges or shapes comprising concave and convex parts
Definitions
- This invention relates to a device used to break up and extract blood clots or
- this invention relates to a
- coronary artery comprising an improved percutaneous aspiration thrombectomy catheter
- a thrombus is nature's way of stemming the loss of blood from its
- fibrinogen molecules into a polymeric structure of fibrin.
- the individual strands which entraps red blood cells.
- the individual strands are approximately 0.2
- Coronary artery bypass graft (CABG) surgery is a surgical method for bypassing
- Streptokinase is an enzyme which is able in time to
- thrombus fragments (emboli) which can lead to blockage of small diameter branches.
- the device is characterized by small catheter tip size and thus is unable to exert significant total force on clot masses. Also, a
- the present invention provides for an improved system for removing thrombus
- a catheter having proximal and distal ends, designed to be advanced through a
- hemostasis valve and guide catheter and over a guide wire for placement of its
- the catheter having at least one lumen passing from
- the catheter having a guide wire retaining means, which retains the guide wire
- the distal tip of the catheter is angled back from the guide wire retaining
- suction means in fluid communication with the proximal end of the catheter
- the catheter and method of use is disclosed.
- the catheter has barbs located near the distal end
- the barbs may be attached to the catheter or integrally formed with a radio opaque
- the ring may have a reverse bend which
- the barbs provide a channel to retain a guide wire.
- the barbs provide safety in that any particles
- the barbs further provide a means of removing
- FIG. 1 is a schematic representation of a bifurcated blood vessel having a blunt tip catheter and guidewire inserted at the point of bifurcation
- Fig. 2 is a schematic representation of a bifurcated blood vessel having a catheter with an
- Fig, 3(a) is a schematic representation of a bifurcated blood vessel having a
- Fig, 3(b) is a schematic representation of a bifurcated blood vessel having a
- Fig, 4 is a schematic representation of a preferred embodiment of percutaneous
- Fig, 5(a) is a schematic representation of a preferred embodiment of a .
- Fig, 5(b) is a cross-section of the percutaneous aspiration thrombectomy catheter
- Fig. 5(c) is another cross-section of the percutaneous aspiration thrombectomy
- Fig, 6(a) is a schematic representation of the tip design of a single lumen
- percutaneous aspiration thrombectomy catheter showing a variation wherein the distal tip is punched to provide a hole through which the guidewire is inserted;
- Fig, 6(b) is a plan view of a schematic representation of the distal tip depicted in
- Fig, 6(c) is a side view of the distal tip depicted in Fig, 6(a) prior to the formation of
- Fig. 6(d) is an end view of the distal tip depicted in Fig. 6(c);
- Fig. 7(a) is a cross-sectional representation of a single lumen design of a necked
- Fig. 7(b) is a longitudinal cross-section of the single lumen design for a necked
- Fig. 7(c) is a side view of the single lumen design for necked down distal. tip for the
- Fig. 7(d) is a distal end view of the embodiment shown in Fig. 7(c);
- Fig. 8 is a cross-sectional representation of a single lumen off-set tip design for
- distal guidewire exit hole and a thrombus entry port located in the off-set section of the distal tip
- Fig. 9(a) is a schematic representation of the tip design of a preferred
- present invention with a two lumen configuration and a barb with two points attached to the catheter tip with the barb points oriented distally;
- Fig. 9(b) is a plan view of the barb depicted in Fig. 9(a);
- Fig. 10(a) is a schematic representation of the tip design of a preferred
- present invention with a two lumen configuration and a cutting-blade attached to the
- Fig. 10(b) is a plane view of the blade depicted in Fig. 10(a);
- Fig. 10(c) is an end view of the distal tip depicted in Fig. 10(a);
- Fig. 11(a) is a schematic representation of the tip design of a preferred
- present invention with a two lumen configuration and an expandable balloon attached to
- Fig. 11(b) is a cross-sectional representation of the distal tip depicted in Fig.
- Fig. 12(a) is a partially cross-sectioned side view of another embodiment of the
- Fig. 12(b) is an end view of the embodiment of Fig. 12(a).
- Fig. 13 is a partially cross-sectioned side view of another embodiment of the
- Fig. 14 (a) is a partially cross-sectioned side view of further embodiment of the
- Fig. 14(b) is an end view of the embodiment of Fig. 14(a).
- a catheter having proximal and distal ends, designed to be advanced through a
- hemostasis valve and guide catheter and over a guidewire for placement of its distal end
- the catheter having at least one lumen passing from the proximal to the
- suction means in communication with the proximal end of the catheter for providing
- the lumen terminates in the angled tip at the distal end, the angled tip improving the
- blunt tip tended to advance straight and would catch at the bifurcation.
- Adding an angled tip to the catheter helped in negotiating the bend if the tip was on the inner radius of the curvature. If it was on the outside, it increased the tendency to snag at the
- Vacuum is provided using a small diaphragm pump which maintains a steady
- the angled tip provided for in the present invention provides a greater cross-
- an exit point for the guidewire allows the guidewire to continue outside of
- dilatation balloon may be incorporated integral to thrombectomy catheter at or near the
- a bottle or bag may be provided between suction means and the catheter for
- a filter for removing blood and thrombus as it is removed by the suction means. Further, a filter
- the filter provides a convenient way to visualize the amount of clot removed and
- a guidewire retaining means may be provided, comprising a second lumen
- means comprises a second lumen has both advantages and disadvantages.
- Advantages include:
- a "partial rapid exchange" design can be accomplished using a long guidewire lumen
- the cardiologist user can load the catheter over the short rapid exchange
- the guidewire extends distally out of the catheter and
- thrombectomy catheter can be used with any standard length guidewire.
- the main disadvantage of the two lumen design is that a slightly larger diameter
- the proximal end of the second guidewire lumen may be provided with a slit for
- the device of the present invention may be any device of the present invention.
- the end of the catheter can be necked down for a distance before the guidewire
- the catheter protects the delicate guidewire tip while advancing across the hemostasis
- the distal end of the catheter may be offset from the catheter center line,
- the catheter yet maintains longitudinal flexibility for placement of the catheter within
- the suction means may be attached to the catheter with tubing, the size and length of
- tubing being selected to reduce the flow of blood due to friction flow losses
- a valve may be located between the catheter and suction means to shut off or
- the collection bottle may be provided with a window, or clear portion, through
- clot filter may be provided, through which saline or other washing solutions maybe
- the percutaneous aspiration catheter has a relatively large cross-section.
- the catheter across restrictions in a blood vessel the distal portion may be coated with a
- lubricious or low friction coating such as polyvinylpyrrolidone hydrogel.
- antithrombotic material such as heparin may be incorporated into the hydrogel
- the internal flow cross-section of the catheter and connecting tubing may be any suitable internal flow cross-section of the catheter and connecting tubing.
- thrombus filter provided with a progressively increasing area to the thrombus filter to prevent thrombus
- tubing to prevent thrombus from snagging and catching at any corners or rough edges
- FIG. 1 schematic representation of a bifurcated blood vessel 10 is depicted wherein a blunt tip catheter 12 and guidewire 14 are inserted at the point of
- Fig. 2 is a
- catheter 16 and guidewire 14 shown inserted at the point of bifurcation and also
- Fig. 3(b) is a
- catheter 18 in an alternative orientation and an inserted constrained guidewire 14 at the
- Fig. 4 comprises a schematic representation of a preferred arrangement of a
- a constrained angled tip catheter 18 has a guidewire 14 passing through the
- catheter 20 which in turn is contained within a hemostasis valve 22 through which the
- catheter guidewire exits at the proximal end 24. Proximal to the exit of the catheter
- guidewire from the hemostasis valve is a guidewire exit port 26.
- catheter is provided with a transitional connecting means 28 which is provided with an
- auxiliary Luer port 30 The proximal end of the transitional connecting means is attached
- a connecting tubing 32 which passes through a clamp 34 before entering a collection bottle 36, which is provided with a filter means 38 to separate thrombus from
- hydrophobic barrier filter 42 prior to entering the suction end of a suction means 44.
- Fig. 5(a) represents a preferred embodiment of a percutaneous aspiration
- thrombectomy catheter system according to the present invention, where a two lumen
- transitional connection means 28 having an auxiliary Luer port 30, the proximal end of
- connection means 28 is provided with connecting tubing 32.
- FIG. 5 A cross-sectional of the proximal portion of the catheter 18 is depicted in Fig. 5
- Fig. 6(a) is a schematic representation of the tip design for a single lumen
- thrombus entry opening 52 located in the angled portion of the distal end 54.
- bent up position of the distal tip is provided with a guidewire opening 56 through which
- FIG. 6(b) a top plan view of a schematic representation of the distal end of the guidewire 14
- catheter 18 shows the angled portion of the distal end 54, the thrombus entry opening
- catheter 18 is sufficiently flexible that
- the distal tip 50 will He flat prior to insertion of guidewire 14. However, if catheter 18 is
- the distal tip 50 will be bent upward as in Fig. 6 (a), without
- Fig. 6 (d) is an end, distal view of the distal tip according to Fig. 6(c) showing
- catheter 18 is shown which depicts a necked down distal tip 58 and the guidewire 14
- Fig. 7 (c) is a lateral view of the single lumen design of the percutaneous
- Fig. 5(a) is depicted showing the catheter 18 guidewire 14 thrombus entry hole 52 and
- the distal tip having a skewed orientation 60.
- proximally extending section 62 which has one or more, preferably two, pointed
- Pointed members 63 to engage thrombus. Pointed members 63 extend slightly into opening 65,
- FIG. 10(a) to 10(c) Another arrangement is shown in Figs. 10(a) to 10(c), where a cutting blade 70 is
- blade holder 72 is fixedly concentric to extended
- blade 70 The purpose of blade 70 is to bisect large thrombi that might enter
- Barb 60, blade 70, and blade holder 72 are preferably fashioned from rigid
- materials include suitably rigid polymers and co-polymers and
- FIGs. 11(a) and 11(b) has a dilatation balloon 80
- catheter 82 comprises three lumens,
- Balloon 80 is in fluid communication with inflation lumen 88 by means of any conventional
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- the balloon can, be any material that is within the skill of any art skilled person.
- FIGS 12-14 depict several alternative embodiments of the percutaneous
- each of these embodiments have barbs which are
- Barbs provide the added advantage of
- the flared distal end has the advantage of providing a larger diameter capture opening.
- the flared distal end also allows room for the placement of barbs within the tip without restricting the
- Another embodiment has an angled tip, where the angled tip provides a less
- the fixed guide wire tip at the distal end of the catheter is disclosed (See Fig. 13).
- these embodiments may have a straight tip, an angled tip, or a flared tip. All materials,
- Figure 12a depicts an embodiment of the percutaneous aspiration catheter
- barbs 110 are positioned within the distal portion of catheter 18 and oriented such that
- Barbs 110 may be made separately
- Barbs 110 are attached to the interior of catheter 18 or integrally formed in a ring 115. Barbs 110
- ring 115 may be machined into ring 115 by milling or laser cutting and are preferably formed by
- barbs 110 be as sharp as
- Ring 115 may further be bent into a noncircular
- Ring 115 may be made of any medical grade metal, and is preferably a radio-
- opaque alloy such as a platinum-iridium alloy consisting of 90% platinum and 10%
- ring 115 may also serve as a marker band facilitating
- Ring 115 may be mounted near the distal opening of catheter
- ring 115 is adhesively bonded to the interior of catheter 18. Adhesives
- Catheter 18 may be used with a guide wire 14, without a guide wire, or in a fixed
- Catheter 18 may have a single layer or plurality of layers. In a
- catheter 18 may be made from three layers where the inner layer is
- the intermediate layer is a
- braid of metal or plastic filaments with a wall thickness of about .002 inches.
- the outer layer is a thermoplastic such as
- the flared tip may be as large as .052
- Figure 13 shows another embodiment of the percutaneous aspiration catheter where the distal end of catheter 18 is larger in diameter than the body of catheter 18.
- This flared portion 125 provides a larger working area for the suction end of catheter 18. Flared portion 125 preferably is formed by stretching the distal portion of catheter 18
- a separate flared portion 125 may be constructed and
- Figure 13 also shows a fixed guide wire tip 120 which is mounted inside the
- Guide wire tip 120 has a
- Guide wire tip 120 may fit into a reverse
- Guide wire 120 is adhesively
- Guide wire tip 120 provides guidance for catheter 18 and is
- guide wire tip 18 is bonded to catheter 18 near the distal end but does not extend proximally of the bond, guide wire tip
- catheter 18 where the guide wire 14 or the fixed guide wire tip 120 is preferably
- an angled tip provides better advancement around corners and
- Figure 12a depicts the distal opening of catheter 18 having
- Figure 14a shows yet another embodiment of the percutaneous
- barbed embodiments of the percutaneous aspiration catheter have several
- embolus that is drawn into catheter 18 can not float out of the end of catheter 18.
- barbs 110 may be particularly useful in removing particles which are larger
- thrombus may be drawn into the end of catheter 18 and caught by barbs 110.
Abstract
This invention is a percutaneous aspiration catheter (18) for removing thrombus or other emboli from blood vessels (10), and a method of extracting embolus pieces larger than the diameter of the catheter (18). The percutaneous aspiration catheter has barbs (60) positioned near its end to trap material within the catheter.
Description
PERCUTANEOUS ASPIRATION CATHETER SYSTEM
CROSS REFERENCE TO RELATED APPLICATIONS
This application is a continuation in part of U.S. Patent Application, Serial No.
08/449,203 filed on May 24, 1995 and entitled PERCUTANEOUS ASPIRATION
THROMBECTOMY CATHETER SYSTEM, the entire disclosure of which is hereby
incorporated by reference.
FIELD OF THE INVENTION
This invention relates to a device used to break up and extract blood clots or
thrombi which form within blood vessels. More particularly, this invention relates to a
device adapted to break up and extract clots or thrombi which may form within a
coronary artery comprising an improved percutaneous aspiration thrombectomy catheter
system.
BACKGROUND OF THE INVENTION
Approximately 1.2 million Americans suffer heart attacks each year. A large
percentage of the heart attacks are caused by blood clots or thrombi which form within
the coronary arteries. A thrombus is nature's way of stemming the loss of blood from its
pipeline system by corking off an opening into the vascular tree. The biochemical
process which results in thrombus formation is not fully understood. However, in
simple terms, injury to the vascular wall releases chemicals which lead to conversion of
soluble, circulating fibrinogen molecules into a polymeric structure of fibrin. The fibrin
structure is insoluble and arranges itself into a three dimensional network of meshed
strands which entraps red blood cells. The individual strands are approximately 0.2
NOT FURNISHED UPON FILING
collateral blood vessels and flow which can provide the necessary oxygen.
Coronary artery bypass graft (CABG) surgery is a surgical method for bypassing
coronary arteries which, because of narrowing or obstruction, are unable to supply
adequate oxygen to heart muscle. In recent years, direct administration of chemical
lysing agents into the coronary arteries has shown to be of some benefit to patients who
have thrombosed coronary arteries. In this procedure, a catheter is placed immediately in
front of the blockage and a drip of streptokinase is positioned to be directed at the
upstream side of the thrombus. Streptokinase is an enzyme which is able in time to
dissolve the fibrin molecule. This procedure can take several hours and is not always
successful in breaking up the thrombus. Furthermore, it can lead to downstream
thrombus fragments (emboli) which can lead to blockage of small diameter branches.
Auth, U.S. Patent No. 4,646,736, discloses a thrombectomy device that permits rapid
removal of an obstructive thrombus. However, the device is characterized by small catheter tip size and thus is unable to exert significant total force on clot masses. Also, a
clot which is not in good position of purchase on a vessel wall in the "line of fire" of the
rotating wire is not fϊbrinectomized. This is especially true of clots floating free in the-
blood stream, since it is virtually impossible to revolve within these clots in the
absence of a constraint such as fingers.
Further disadvantages to this thrombectomy device include the difficulty of
keeping the clot in the space above the wire during all degrees of rotation as the wire is
moved sideways during rotation, which is sometimes necessary to sweep the arterial
lumen. In fact, sweeping out an entire arterial lumen with a rotating wire is virtually
impossible in all but the smallest, i.e., less than 1.5 mm diameter, arteries. An additional
and serious possible disadvantage is that fragments of the clot may be embolized
downstream.
Therefore, there has been a definite need for a thrombectomy device that can be
more effective in sweeping arteries, in removing emboli that are free floating
or not perfectly positioned, and in minimizing fragmentation of clots.
These and other objects of the invention will become apparent from the following
discussion of the invention
SUMMARY OF THE INVENTION
The present invention provides for an improved system for removing thrombus
from blood vessels which includes the following components:
a catheter having proximal and distal ends, designed to be advanced through a
hemostasis valve and guide catheter and over a guide wire for placement of its
distal end at the thrombus, the catheter having at least one lumen passing from
the proximal to the distal end;
the catheter having a guide wire retaining means, which retains the guide wire
within the catheter in a peripheral or non-centered part of the catheter cross-
section. The distal tip of the catheter is angled back from the guide wire retaining
means to allow the catheter to easily follow the guide wire around tight bends and
across restrictions;
suction means in fluid communication with the proximal end of the catheter
for providing vacuum down the catheter lumen to the distal tip, for drawing
thrombus into the lumen; and
the lumen terminating in and angled tip at the distal end of the catheter, the
angled tip improving the removal of thrombus adhering to the vessel wall and
reducing clogging of the hole with thrombus.
In another embodiment of the present invention, an improved thrombectomy
catheter and method of use is disclosed. The catheter has barbs located near the distal
end. The barbs may be attached to the catheter or integrally formed with a radio opaque
ring and thereby also serve as a marker band. The ring may have a reverse bend which
provides a channel to retain a guide wire. The barbs provide safety in that any particles
entering the catheter can not float out. The barbs further provide a means of removing
pieces of thrombus which are larger than the diameter of the catheter and which may be
too hard to deform or break apart and be drawn through the catheter.
BRIEF DESCRIPTION OF THE DRAWINGS Fig. 1 is a schematic representation of a bifurcated blood vessel having a blunt tip catheter and guidewire inserted at the point of bifurcation; Fig. 2 is a schematic representation of a bifurcated blood vessel having a catheter with an
unconstrained angled tip and guidewire inserted therein at the point of
bifurcation;
Fig, 3(a) is a schematic representation of a bifurcated blood vessel having a
constrained angled tip catheter and guidewire inserted at the point of bifurcation with the
angled tip of the catheter in one orientation;
Fig, 3(b) is a schematic representation of a bifurcated blood vessel having a
constrained angled tip catheter and guidewire inserted at the point of bifurcation with the
angled tip of the catheter in another orientation;
Fig, 4 is a schematic representation of a preferred embodiment of percutaneous
aspiration thrombectomy catheter system, according to the present invention;
Fig, 5(a) is a schematic representation of a preferred embodiment of a ,
percutaneous aspiration thrombectomy catheter system according to the present
invention with a two lumen configuration;
Fig, 5(b) is a cross-section of the percutaneous aspiration thrombectomy catheter
depicted in Fig. 5(a);
Fig. 5(c) is another cross-section of the percutaneous aspiration thrombectomy
catheter depicted in Fig. 5(a);
Fig, 6(a) is a schematic representation of the tip design of a single lumen
percutaneous aspiration thrombectomy catheter according to the present invention showing a variation wherein the distal tip is punched to provide a hole through which the guidewire is inserted;
Fig, 6(b) is a plan view of a schematic representation of the distal tip depicted in
Fig. 6(a);
Fig, 6(c) is a side view of the distal tip depicted in Fig, 6(a) prior to the formation of
the bent tip;
Fig. 6(d) is an end view of the distal tip depicted in Fig. 6(c);
Fig. 7(a) is a cross-sectional representation of a single lumen design of a necked
down distal tip for a percutaneous aspiration thrombectomy catheter depicted in Fig. 5(a)
showing the location of the proximal entry of the guidewire at the distal exit point of the
guidewire;
Fig. 7(b) is a longitudinal cross-section of the single lumen design for a necked
down distal tip for the percutaneous aspiration thrombectomy catheter shown in Fig.
7(a) without the insertion of the guidewire;
Fig. 7(c) is a side view of the single lumen design for necked down distal. tip for the
percutaneous aspiration thrombectomy catheter shown in Fig. 7(a) without the insertion
of the guidewire;
Fig. 7(d) is a distal end view of the embodiment shown in Fig. 7(c);
Fig. 8 is a cross-sectional representation of a single lumen off-set tip design for
the percutaneous aspiration thrombectomy catheter according to Fig. 5(a) showing a
distal guidewire exit hole and a thrombus entry port located in the off-set section of the distal tip;
Fig. 9(a) is a schematic representation of the tip design of a preferred
embodiment of a percutaneous aspiration thrombectomy catheter system according to the
present invention with a two lumen configuration and a barb with two points attached to the catheter tip with the barb points oriented distally;
Fig. 9(b) is a plan view of the barb depicted in Fig. 9(a);
Fig. 10(a) is a schematic representation of the tip design of a preferred
embodiment of a percutaneous aspiration thrombectomy catheter system according to the
present invention with a two lumen configuration and a cutting-blade attached to the
catheter tip with the blade bisecting the thrombus aspiration lumen;
Fig. 10(b) is a plane view of the blade depicted in Fig. 10(a);
Fig. 10(c) is an end view of the distal tip depicted in Fig. 10(a);
Fig. 11(a) is a schematic representation of the tip design of a preferred
embodiment of a percutaneous aspiration thrombectomy catheter system according to the
present invention with a two lumen configuration and an expandable balloon attached to
the catheter tip-near to the distal end; and
Fig. 11(b) is a cross-sectional representation of the distal tip depicted in Fig.
11(a).
Fig. 12(a) is a partially cross-sectioned side view of another embodiment of the
percutaneous aspiration thrombectomy catheter system.
Fig. 12(b) is an end view of the embodiment of Fig. 12(a).
Fig. 13 is a partially cross-sectioned side view of another embodiment of the
percutaneous aspiration thrombectomy catheter system.
Fig. 14 (a) is a partially cross-sectioned side view of further embodiment of the
percutaneous aspiration thrombectomy catheter system.
Fig. 14(b) is an end view of the embodiment of Fig. 14(a).
DETAILED DESCRIPTION OF THE INVENTION
According to the invention, a system for removing thrombus from blood vessels
comprises a catheter having proximal and distal ends, designed to be advanced through a
hemostasis valve and guide catheter and over a guidewire for placement of its distal end
at the thrombus, the catheter having at least one lumen passing from the proximal to the
distal end, and a guidewire retaining means, which retains the guidewire within the
catheter in a peripheral or non centered part of the catheter cross section. The distal tip
of the catheter is angled back from the guidewire retaining means to allow the catheter to
follow the guidewire around tight bends and across restrictions easily. Also, there is
suction means in communication with the proximal end of the catheter for providing
vacuum down the catheter lumen to the distal tip, for drawing thrombus into the lumen,
and the lumen terminates in the angled tip at the distal end, the angled tip improving the
removal of thrombus adhering to the vessel wall and reducing clogging of the hole with
thrombus.
Various prior art references on thrombectomy aspiration catheters address the use
of plain, single lumen catheters with a blunt tip over a conventional guidewire. In some
cases the catheters taught there may have side holes (such as, for example, drug infusion
catheters). In-vitro testing has established that single lumen, round bore catheters need
to be at least 0.042" i.d. to effectively remove a thrombus with a 0.009" guidewire down
the middle. When such catheters were placed in a "heart model", it was found that it was
sometimes very difficult to maneuver such a catheter over the wire at a bifurcation. The
blunt tip tended to advance straight and would catch at the bifurcation. Adding an angled tip to the catheter helped in negotiating the bend if the tip was on the inner radius of the curvature. If it was on the outside, it increased the tendency to snag at the
bifurcation. As will be seen, adding a means to capture the guidewire on one side of the
catheter and tapering from that point made it possible to always negotiate a right bend or
bifurcation.
Vacuum is provided using a small diaphragm pump which maintains a steady
vacuum of about 550 millimeters of Mercury vacuum. The use of a pump makes it easy
to advance the catheter tip through the thrombus with a steady vacuum level. Most of
the previous clinical use of thrombectomy catheters used suction applied with a syringe,
It has been found that it is difficult to advance the catheter while maintaining steady
vacuum with the syringe.
The angled tip provided for in the present invention provides a greater cross-
sectional area for the thrombus to enter the catheter, increasing the total force (Force =
Pressure X Area) which is applied to the thrombus, increasing the amount and rate of
thrombus removal and reducing the tendency to clog.
Various additional features are contemplated and may be optionally incorporated
into the device of the present invention to improve its overall efficiency and workability.
For example, an exit point for the guidewire allows the guidewire to continue outside of
the catheter in the proximal section, allowing the catheter and guidewire to
separately pass through the hemostasis valve.
It has been found that optimal tracking of the relatively large bore thrombectomy catheter over the small guidewire works best if the wire is held at the outer wall of the catheter tip and the tip is angled back from that point. However, to simplify sealing
around the guidewire it is generally easiest if the guidewire and catheter are passed
through the hemostasis valve separately. This eliminates the need for a separate seal
around the guidewire at the proximal end of the catheter. This is advantageous, as was
shown when an embodiment of the present invention was tested with a seal at the
proximal end of the catheter through which a guidewire was passed. To advance the
catheter over the guidewire with the vacuum on, the guidewire seal had to be loosened.
Air was immediately pulled through the seal and into the catheter and rapidly filled
- li ¬
the blood collection bottle. Also, there was a lower level of vacuum in the inner lumen at
the catheter tip. The presence of air in the catheter can also be a problem if it is desired to
infuse medicants through the catheter.
Since coronary thrombi are often initiated by a lesion on the vessel wall, it is sometimes
advantageous to dilatate the lesion with a balloon catheter, thereby reducing the
constriction and reducing the chances for another thrombotic event. Many examples of
these devices are known to the art. To facilitate this dilatation procedure, an expandable
dilatation balloon may be incorporated integral to thrombectomy catheter at or near the
distal tip. This allows the operator to easily dilatate the lesion before or after aspirating
the thrombus utilizing a single device.
A situation occasionally occurs when a large, very firm thrombus is aspirated into
a catheter tip but is not fragmented and withdrawn down the catheter. In this situation,
there is a need to positively retain the thrombus within the catheter tip. To accomplish
this a barb incorporating one or more-points can be placed within the catheter lumen at
the distal tip. By orienting the points proximally, the thrombus is effectively retained and
prevented from escaping.
Another way to handle this situation is to place a blade within the distal tip of the
catheter lumen with the sharp edge facing distally. The blade cuts the large thrombus
and allows the pieces to more easily pass through the catheter lumen.
A bottle or bag may be provided between suction means and the catheter for
collecting blood and thrombus as it is removed by the suction means. Further, a filter
may be provided between the suction means and the catheter to separate the solid
thrombus from the liquid blood, said filter preferably being located-within the collecting
bottle. The filter provides a convenient way to visualize the amount of clot removed and
makes it easy to take a sample for analysis.
A guidewire retaining means may be provided, comprising a second lumen
extending proximally from the distal end of the catheter, terminating prior to the point
where the catheter passes through the hemostasis valve.
A variation of the device of the present invention wherein the guidewire retaining
means comprises a second lumen has both advantages and disadvantages. Advantages include:
no holes penetrating through the main aspiration lumen to reduce vacuum
to the tip and suck additional blood through; and
slight ease in loading the catheter on the guide wire.
A "partial rapid exchange" design can be accomplished using a long guidewire lumen
with a slit from the proximal end, extending to several inches (less than 10 cm) from the
distal end. The cardiologist user can load the catheter over the short rapid exchange
length guidewire and insert both the wire and catheter through the guide sheath to the
coronary arteries. At that point, the guidewire extends distally out of the catheter and
through the thrombus. The catheter is then advanced. To remove the catheter, it is
withdrawn over the wire to the point where the guidewire lumen is exposed and then the
catheter is peeled off of the guidewire as it is withdrawn to the end of the slit. The last
two inches are then pulled off. At this point another rapid exchange catheter can be
advanced over the guidewire but not another thrombectomy catheter. Of course, the
thrombectomy catheter can be used with any standard length guidewire.
The main disadvantage of the two lumen design is that a slightly larger diameter
is required due to the presence of the added internal wall.
The proximal end of the second guidewire lumen may be provided with a slit for
a portion of its length from the proximal end toward the distal end to allow for the
peeling of the catheter from the guidewire, as the catheter is removed from the
vasculature over the guidewire. Also, the device of the present invention may be
configured as a single lumen catheter where the guidewire retaining means is
comprised of two holes in the lumen, one at the distal end and one intermediate between
the distal and proximal ends allowing the guidewire and catheter to pass separately
through the hemostasis valve.
This latter design is the simplest to manufacture but it has some functional
problems as described above for the double lumen configuration.
The end of the catheter can be necked down for a distance before the guidewire
exit hole at the distal end of the catheter. The reason for this necking down is that it
allows the guidewire to be retracted into the catheter without losing placement in the
guidewire hole. This technique is often used when the cardiologist is initially inserting
the guidewire and catheter through the hemostasis valve. Retracting the guidewire into
the catheter protects the delicate guidewire tip while advancing across the hemostasis
valve which can damage the tip if exposed.
The distal end of the catheter may be offset from the catheter center line,
improving the removal of thrombus adhering to the vessel wall when the catheter is
rotated around the guidewire. This is an improvement which may be incorporated into a
catheter intended for use in larger vessels. Reinforcing the wall of the catheter with
metal or plastic braid substantially increases the torsional strength and kink resistance of
the catheter yet maintains longitudinal flexibility for placement of the catheter within
tortuous vessels.
The suction means may be attached to the catheter with tubing, the size and length of
said tubing being selected to reduce the flow of blood due to friction flow losses,
reducing blood removal from the patient without becoming clogged from aspirated
thrombus particles. This concept was demonstrated, by using a 1/8" i.d. tube, 10 feet
long, connecting the vacuum pump to a catheter, to aspirate 125 cc of blood while
removing a typical thrombus. By reducing the tubing diameter to 1/16" i.d., the amount
of blood aspirated was reduced to approximately 50 cc with no loss of efficacy. There is
an obvious benefit to minimizing the amount of blood lost by the patient.
A valve may be located between the catheter and suction means to shut off or
regulate the vacuum level dehvered to the catheter. This represents a convenient way for the cardiologist to regulate vacuum without having to have someone turn the pump on and off.
The collection bottle may be provided with a window, or clear portion, through
which any clot collected in the filter may be visualized. An access port located above the
clot filter may be provided, through which saline or other washing solutions maybe
directed onto the thrombus to improve visualization and aid in discernment of clot
fragments.
A push-pull transport system as described in U.S. Patent No. 4,561,807,
incorporated herein by reference, may be incorporated into the suction means.
The surfaces of all components in blood contact may be coated with an antithrombogenic
material such as heparin complex, hirudin or other clot-inhibiting chemical. The purpose
of such a coating is to ensure that the collected clot came from the treated blood vessel
and was not formed from the liquid blood.
In comparison to some types of therapeutic catheters, such as balloon dilatation
catheters, the percutaneous aspiration catheter has a relatively large cross-section.
This is required to prevent occlusion by the aspirated thrombus. To assist in negotiating
the catheter across restrictions in a blood vessel the distal portion may be coated with a
lubricious or low friction coating such as polyvinylpyrrolidone hydrogel. Use of such a
catheter in the coronary arteries of animal subjects has reduced the difficulty in
penetrating a thrombus. One advantage of using a hydrogel coating for this purpose is
that antithrombotic material such as heparin may be incorporated into the hydrogel
coating, providing both benefits with one coating application. The low friction-coating
may also be placed on the inside of the catheter lumen to reduce the possibility
of the thrombus sticking within it.
The internal flow cross-section of the catheter and connecting tubing may be
provided with a progressively increasing area to the thrombus filter to prevent thrombus
from plugging at any point.
Smooth surfaces and joints may be provided in the catheter and connecting
tubing to prevent thrombus from snagging and catching at any corners or rough edges,
preventing them from reaching the thrombus filter.
The invention can perhaps be better understood by making reference to the drawings,
with reference to Fig. 1, schematic representation of a bifurcated blood vessel 10 is
depicted wherein a blunt tip catheter 12 and guidewire 14 are inserted at the point of
bifurcation showing the catheter lodged at the point of bifurcation. Fig. 2 is a
schematic representation of bifurcated blood vessel 10 and an unconstrained angled tip-
catheter 16 and guidewire 14, shown inserted at the point of bifurcation and also
showing the catheter lodged at the point of bifurcation.
With reference to Fig. 3(a), constrained angle tip catheter 18 and guidewire 14
are inserted into bifurcated blood vessel 10. This shows the smooth passage of the
constrained angled tip catheter/guidewire through the point of bifurcation. Fig. 3(b) is a
schematic representation of a bifurcated blood vessel 10 having a constrained angled tip
catheter 18 in an alternative orientation and an inserted constrained guidewire 14 at the
point of bifurcation. Also shown is the smooth transition of the catheter guidewire
through the point of bifurcation.
Fig. 4 comprises a schematic representation of a preferred arrangement of a
complete percutaneous aspiration thrombectomy catheter system according to the present
invention. A constrained angled tip catheter 18 has a guidewire 14 passing through the
constrained distal tip of said catheter guidewire arrangement passing through guide
catheter 20, which in turn is contained within a hemostasis valve 22 through which the
catheter guidewire exits at the proximal end 24. Proximal to the exit of the catheter
guidewire from the hemostasis valve is a guidewire exit port 26. The proximal end of the
catheter is provided with a transitional connecting means 28 which is provided with an
auxiliary Luer port 30. The proximal end of the transitional connecting means is attached
to a connecting tubing 32 which passes through a clamp 34 before entering a
collection bottle 36, which is provided with a filter means 38 to separate thrombus from
blood which has been aspirated from a patient's artery. The outlet port of the collection
bottle is provided with additional connecting tubing 40 which passes through a
hydrophobic barrier filter 42 prior to entering the suction end of a suction means 44.
Fig. 5(a) represents a preferred embodiment of a percutaneous aspiration
thrombectomy catheter system according to the present invention, where a two lumen
configuration is depicted showing the catheter 18 having a guidewire 14 passing through
a separate guidewire lumen 42 which is formed as part of the catheter 18. The proximal
end of the catheter passes through a hemostasis valve 22 and subsequently enters a
transitional connection means 28 having an auxiliary Luer port 30, the proximal end of
which connection means 28 is provided with connecting tubing 32.
A cross-sectional of the proximal portion of the catheter 18 is depicted in Fig. 5
(b) showing the internal guidewire lumen 46, which in this section of the catheter is
provided with a slit 48 for easy removal of the guidewire.
The cross-section of the distal portion of the catheter 18 is depicted in Fig. 5(c)
showing the internal guidewire lumen 46, which in this section of the catheter is not
provided with a slit.
Fig. 6(a) is a schematic representation of the tip design for a single lumen
percutaneous aspiration thrombectomy catheter system according to the present
invention, showing the distal end of the catheter 18 having a bent upward distal tip 50
and a thrombus entry opening 52 located in the angled portion of the distal end 54. The
bent up position of the distal tip is provided with a guidewire opening 56 through which
the guidewire 14 passes.
In Fig. 6(b) a top plan view of a schematic representation of the distal end of the
catheter 18 shows the angled portion of the distal end 54, the thrombus entry opening
52, and the guidewire entry opening 56.
With reference to. Fig. 6(c) a lateral partly cross-sectional view of the distal-tip of
the catheter 18 of Fig. 6(b) is depicted showing the angle orientation of the angled distal
tip 50 and the location of the guidewire entry opening 56 prior to the formation of the
bent tip in the upward position. The material of catheter 18 is sufficiently flexible that
the distal tip 50 will He flat prior to insertion of guidewire 14. However, if catheter 18 is
made of more rigid material, the distal tip 50 will be bent upward as in Fig. 6 (a), without
guidewire 14 present.
Fig. 6 (d) is an end, distal view of the distal tip according to Fig. 6(c) showing
the catheter 18 and the location of the guidewire entry opening 56 prior to the tip being
bent upward.
With reference to Fig. 7 (a) a cross-sectional representation of a single lumen
catheter 18 is shown which depicts a necked down distal tip 58 and the guidewire 14
passing through the distal end of said necked down distal tip and exiting through the
proximal guidewire exit opening 26.
With reference to Fig. 7 (b) a longitudinal cross-section of the single lumen
design of the percutaneous aspiration thrombectomy catheter system according to the
present invention is shown depicting the catheter 18 the necked down distal tip 58 of the
catheter, and the thrombus entry opening 52.
Fig. 7 (c) is a lateral view of the single lumen design of the percutaneous
aspiration thrombectomy catheter system and the necked down distal tip 58, while Fig.
7(d) is a distal end view.
With reference to Fig. 8 a cross-sectional representation of a single lumen off-set
tip design for the percutaneous aspiration thrombectomy catheter system according to
Fig. 5(a) is depicted showing the catheter 18 guidewire 14 thrombus entry hole 52 and
the distal tip having a skewed orientation 60.
The embodiments of the invention shown in Figs. 9(a) to 11(b) represent
variations of the embodiment depicted in Figs. 5(a) to 5(c). In Fig. 9(a) catheter 18
comprises extended guidewire lumen 58, fixed concentric to which is barb 60. Barb 60
has a proximally extending section 62, which has one or more, preferably two, pointed
members 63 to engage thrombus. Pointed members 63 extend slightly into opening 65,
sufficient to be effective to retain thrombus as desired but not to block opening-65.
Another arrangement is shown in Figs. 10(a) to 10(c), where a cutting blade 70 is
positioned on blade holder 72 blade holder 72 is fixedly concentric to extended
guidewire lumen 58. The purpose of blade 70 is to bisect large thrombi that might enter
opening 65.
Barb 60, blade 70, and blade holder 72 are preferably fashioned from rigid
materials. Useful such materials include suitably rigid polymers and co-polymers and
medically acceptable metals.
The embodiment shown in Figs. 11(a) and 11(b) has a dilatation balloon 80
concentrically positioned around catheter 82. Catheter 82 comprises three lumens,
namely, suction lumen 84, guidewire lumen 86, and inflation lumen 88. Balloon 80 is in
fluid communication with inflation lumen 88 by means of any conventional
configuration or arrangement, such as one or more inflation port 90.
Manufacture of the catheters herein, including the catheter of Figs. 11(a) and
11 (b), is within the skill of any art skilled person. For example, the balloon can, be
manufactured and/or attached in conventional manner.
Figures 12-14 depict several alternative embodiments of the percutaneous
aspiration catheter. In general, each of these embodiments have barbs which are
mounted inside a catheter near the distal end. Barbs provide the added advantage of
trapping material within the catheter. Barbs also prevent pieces of thrombus from
floating out of the catheter and further provide an apparatus for removing emboli which
are larger than the distal end of the catheter. Variations on these embodiments include
an embodiment with a flared distal end to the catheter (See Fig. 13). The flared distal
end has the advantage of providing a larger diameter capture opening. The flared distal end also allows room for the placement of barbs within the tip without restricting the
removal of particles. Any particles that are small enough to pass through the catheter
lumen will not be impeded by the barbs.
Another embodiment has an angled tip, where the angled tip provides a less
traumatic tip and also creates a larger cross-sectional area to the distal opening of the
catheter (See Fig.s 12a and 14a). Another embodiment is disclosed that may be used
over a guide wire (See Fig.s 12a and 14a). Finally, an embodiment with a fixed guide
wire tip at the distal end of the catheter is disclosed (See Fig. 13). The fixed guide wire
tip provides some of the advantages of a guide wire while also providing a maximum
cross-sectional open lumen for thrombus removal. It is possible to make any of these
embodiments in a fixed wire, over the wire, or no wire configuration. Further, any of
these embodiments may have a straight tip, an angled tip, or a flared tip. All materials,
dimensions, processes of manufacture, features, and advantages previously described
may also apply to the following embodiments except as described hereafter.
Figure 12a depicts an embodiment of the percutaneous aspiration catheter where
barbs 110 are positioned within the distal portion of catheter 18 and oriented such that
the sharp part of the barb 110 is pointed proximally. Barbs 110 may be made separately
and attached to the interior of catheter 18 or integrally formed in a ring 115. Barbs 110
may be machined into ring 115 by milling or laser cutting and are preferably formed by
electrical-discharge machining. It is very important that barbs 110 be as sharp as
possible. Therefore post polishing or sharpening of barbs 110 may be preferred after
barbs 110 are machined into ring 115. Ring 115 may further be bent into a noncircular
shape, as shown in Figure 12b, where a reverse bend 118 in the circumference of ring 115 may act as a guide wire retainer. Reverse bend 118 retains guide wire 14 near the
edge of the interior of catheter 18 and therefore provides the maximum continuous cross-
sectional area for thrombus to travel through catheter 18.
Ring 115 may be made of any medical grade metal, and is preferably a radio-
opaque alloy, such as a platinum-iridium alloy consisting of 90% platinum and 10%
iridium. As a radio opaque alloy, ring 115 may also serve as a marker band facilitating
radiographic visualization. Ring 115 may be mounted near the distal opening of catheter
18. Preferably ring 115 is adhesively bonded to the interior of catheter 18. Adhesives
that may be used include cyanoacrylates and epoxies.
Catheter 18 may be used with a guide wire 14, without a guide wire, or in a fixed
wire configuration. Catheter 18 may have a single layer or plurality of layers. In a
preferred embodiment catheter 18 may be made from three layers where the inner layer is
made of PTFE and has a wall thickness of about .003 inches. The intermediate layer is a
braid of metal or plastic filaments with a wall thickness of about .002 inches. The braid
may have a continuous or variable pick count. The outer layer is a thermoplastic such as
polyurethane with a wall thickness of about .002 inches. When using catheters 18 with
as larger as an outside diameter of .039 inches, the flared tip may be as large as .052
inches allowing barbs 110 to be bent inward .0065 inches without restricting the size of
particles that may be drawn into catheter 18.
Figure 13 shows another embodiment of the percutaneous aspiration catheter where the distal end of catheter 18 is larger in diameter than the body of catheter 18.
This flared portion 125 provides a larger working area for the suction end of catheter 18. Flared portion 125 preferably is formed by stretching the distal portion of catheter 18
over a hot mandrel. However, in embodiments where a layer of braid is incorporated
into the construction of catheter 18, a separate flared portion 125 may be constructed and
adhesively attached to the distal end of catheter 18.
Figure 13 also shows a fixed guide wire tip 120 which is mounted inside the
distal end of catheter 18 and extends out of the distal end. Guide wire tip 120 has a
spring tip 14, as is commonly known in the art. Guide wire tip 120 may fit into a reverse
bend 118 as in the embodiment shown in Figure 12b. Guide wire 120 is adhesively
bonded to catheter 18. Guide wire tip 120 provides guidance for catheter 18 and is
helpful in negotiating the tortuous vasculature. Since guide wire tip 18 is bonded to
catheter 18 near the distal end but does not extend proximally of the bond, guide wire tip
18 does not block most of the fluid path within catheter 18. This guide wire tip
configuration provides the ability to negotiate tortuous vessels and still have the high
suction capability of embodiments of the percutaneous aspiration catheter that do not
have a wire.
Both of the embodiments of Figures 12a and 13 show an angled distal end of
catheter 18 where the guide wire 14 or the fixed guide wire tip 120 is preferably
positioned to correspond to the distal-most portion of the angled end of catheter 18. As
previously described, an angled tip provides better advancement around corners and
through bifurcated vessels. Figure 12a depicts the distal opening of catheter 18 having
an angle θ with respect to a line parallel to the axis of catheter 18. The distal opening
therefore must also be oriented at an angle θ with respect to the axis of catheter 18 and
must be from 0-90°. Figure 14a shows yet another embodiment of the percutaneous
aspiration catheter where the distal end of catheter 18 is flat and Figure 14b depicts a
side view of the embodiment of Figure 14a.
In use, barbed embodiments of the percutaneous aspiration catheter have several
added benefits. During normal aspiration barbs 110 provide a safety mechanism where
embolus that is drawn into catheter 18 can not float out of the end of catheter 18. In
addition, barbs 110 may be particularly useful in removing particles which are larger
than the diameter of catheter 18. In cases like these a portion of a large piece of
thrombus may be drawn into the end of catheter 18 and caught by barbs 110. Even
though the piece of thrombi is too large to flow through catheter 18 it can then be
removed from the body by removing catheter 18.
It will be further apparent to one skilled in this art that the improvements
provided for in the present invention, while described with relation to certain specific
physical embodiments also lend themselves to being applied in other physical
arrangements not specifically provided for herein, which are nonetheless within the spirit
and scope of the invention taught here.
Claims
1. A percutaneous aspiration catheter comprising:
a catheter having a proximal end, a distal end, and a lumen therethrough;
and
a plurality of barbs mounted within the distal end of the catheter lumen.
2. The percutaneous aspiration catheter of claim 1 wherein the barbs are integrally
formed with a ring, the ring mounted within the lumen of the catheter near the distal
end.
3. The percutaneous aspiration catheter of claim 2 wherein the ring is made of a radio
opaque material.
4. The percutaneous aspiration catheter of claim 2 wherein the ring describes a
substantially circular shape with a reverse bend suitable for forming a channel to act
as a guide wire retainer.
5. The percutaneous aspiration catheter system of claim 1 wherein portions of the
catheter are coated with an anti-thrombogenic coating.
6. The percutaneous aspiration catheter system of claim 1 wherein the distal end of the
catheter is coated with a lubricious coating.
7. The percutaneous aspiration catheter of claim 1 further comprising:
a guide wire lumen within the catheter lumen.
8. The percutaneous aspiration catheter system of claim 7 wherein a proximal end of the
guide wire lumen is provided with a slit for a portion of the length of the guide wire
lumen from a proximal end of the guide wire lumen toward a distal end of the guide
wire lumen, the slit allowing for the peeling of the catheter from a guide wire therein.
9. The percutaneous aspiration catheter of claim 1 further comprising:
a wire tip attached to an internal surface of the catheter lumen and
extending beyond the distal end of the catheter.
10. A percutaneous aspiration catheter which comprises:
an elongate tube having a lumen therethrough;
a plurality of barbs positioned within a distal end of the lumen;
a first proximal lumen diameter;
a second distal lumen diameter; and
a transition zone between the first diameter and the second diameter.
11. The percutaneous aspiration catheter system of claim 10 wherein the second diameter
is greater than the first diameter.
12. A percutaneous aspiration catheter which comprises:
an elongate catheter having a lumen therethrough;
a plurality of barbs positioned within a distal end of the lumen; and
a distal opening, the opening located at the distal end of the catheter and
oriented at an angle of less than 90┬░ with respect to an axis of the catheter lumen.
13. An embolectomy method comprising:
providing a catheter having an elongate body, a lumen therethrough, a
distal opening, and barbs mounted within the lumen near the distal opening;
advancing the catheter through the vasculature until the distal opening is
adjacent a site to be treated; and
providing suction at a proximal opening of the catheter.
14. The embolectomy method of claim 13 further comprising;
catching material larger than the diameter of the lumen in the barbs; and
removing the catheter from the vasculature while the material remains
caught in the barbs.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/822,364 | 1997-03-20 | ||
US08/822,364 US5938645A (en) | 1995-05-24 | 1997-03-20 | Percutaneous aspiration catheter system |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1998044982A1 true WO1998044982A1 (en) | 1998-10-15 |
Family
ID=25235820
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1998/005411 WO1998044982A1 (en) | 1997-03-20 | 1998-03-19 | Percutaneous aspiration catheter system |
Country Status (2)
Country | Link |
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US (1) | US5938645A (en) |
WO (1) | WO1998044982A1 (en) |
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US5911734A (en) | 1997-05-08 | 1999-06-15 | Embol-X, Inc. | Percutaneous catheter and guidewire having filter and medical device deployment capabilities |
US6066149A (en) | 1997-09-30 | 2000-05-23 | Target Therapeutics, Inc. | Mechanical clot treatment device with distal filter |
US6482217B1 (en) | 1998-04-10 | 2002-11-19 | Endicor Medical, Inc. | Neuro thrombectomy catheter |
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US6171327B1 (en) | 1999-02-24 | 2001-01-09 | Scimed Life Systems, Inc. | Intravascular filter and method |
US6231551B1 (en) * | 1999-03-01 | 2001-05-15 | Coaxia, Inc. | Partial aortic occlusion devices and methods for cerebral perfusion augmentation |
US6682505B2 (en) | 1999-03-12 | 2004-01-27 | Arteria Medical Science, Inc. | Catheter for removing emboli from saphenous vein grafts and native coronary arteries |
US6146370A (en) * | 1999-04-07 | 2000-11-14 | Coaxia, Inc. | Devices and methods for preventing distal embolization from the internal carotid artery using flow reversal by partial occlusion of the external carotid artery |
US6648854B1 (en) * | 1999-05-14 | 2003-11-18 | Scimed Life Systems, Inc. | Single lumen balloon-tipped micro catheter with reinforced shaft |
WO2000069350A1 (en) * | 1999-05-19 | 2000-11-23 | Innerdyne, Inc. | System and method for establishing vascular access |
US6692462B2 (en) | 1999-05-19 | 2004-02-17 | Mackenzie Andrew J. | System and method for establishing vascular access |
AU5298000A (en) | 1999-05-26 | 2000-12-12 | Scimed Life Systems, Inc. | A suction device for an endoscope |
US20030150821A1 (en) | 1999-07-16 | 2003-08-14 | Bates Mark C. | Emboli filtration system and methods of use |
US6530939B1 (en) | 1999-07-30 | 2003-03-11 | Incept, Llc | Vascular device having articulation region and methods of use |
US6616679B1 (en) | 1999-07-30 | 2003-09-09 | Incept, Llc | Rapid exchange vascular device for emboli and thrombus removal and methods of use |
US6589263B1 (en) | 1999-07-30 | 2003-07-08 | Incept Llc | Vascular device having one or more articulation regions and methods of use |
US6544279B1 (en) | 2000-08-09 | 2003-04-08 | Incept, Llc | Vascular device for emboli, thrombus and foreign body removal and methods of use |
US6620182B1 (en) | 1999-07-30 | 2003-09-16 | Incept Llc | Vascular filter having articulation region and methods of use in the ascending aorta |
US6371970B1 (en) | 1999-07-30 | 2002-04-16 | Incept Llc | Vascular filter having articulation region and methods of use in the ascending aorta |
US6142987A (en) | 1999-08-03 | 2000-11-07 | Scimed Life Systems, Inc. | Guided filter with support wire and methods of use |
US6168579B1 (en) | 1999-08-04 | 2001-01-02 | Scimed Life Systems, Inc. | Filter flush system and methods of use |
US6235044B1 (en) | 1999-08-04 | 2001-05-22 | Scimed Life Systems, Inc. | Percutaneous catheter and guidewire for filtering during ablation of mycardial or vascular tissue |
US6299622B1 (en) | 1999-08-19 | 2001-10-09 | Fox Hollow Technologies, Inc. | Atherectomy catheter with aligned imager |
US8328829B2 (en) | 1999-08-19 | 2012-12-11 | Covidien Lp | High capacity debulking catheter with razor edge cutting window |
US7708749B2 (en) | 2000-12-20 | 2010-05-04 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
US7713279B2 (en) | 2000-12-20 | 2010-05-11 | Fox Hollow Technologies, Inc. | Method and devices for cutting tissue |
US7022100B1 (en) | 1999-09-03 | 2006-04-04 | A-Med Systems, Inc. | Guidable intravascular blood pump and related methods |
US6371971B1 (en) | 1999-11-15 | 2002-04-16 | Scimed Life Systems, Inc. | Guidewire filter and methods of use |
EP1241993B1 (en) * | 1999-12-22 | 2007-03-28 | Boston Scientific Limited | Endoluminal occlusion-irrigation catheter |
US6719717B1 (en) * | 2000-03-17 | 2004-04-13 | Advanced Research & Technology Institute, Inc. | Thrombectomy treatment system and method |
CA2410971C (en) | 2000-05-31 | 2007-12-18 | Brian K. Courtney | Embolization protection system for vascular procedures |
US8435225B2 (en) * | 2000-06-02 | 2013-05-07 | Fox Hollow Technologies, Inc. | Embolization protection system for vascular procedures |
US6776770B1 (en) | 2000-09-07 | 2004-08-17 | Advanced Research & Technology Institute | Thromboaspiration valve-filter device and methods |
US6712797B1 (en) * | 2000-09-19 | 2004-03-30 | Board Of Supervisors Of Louisiana State University And Agricultural And Mechanical College | Blood return catheter |
US6616681B2 (en) | 2000-10-05 | 2003-09-09 | Scimed Life Systems, Inc. | Filter delivery and retrieval device |
ATE499054T1 (en) | 2000-12-20 | 2011-03-15 | Fox Hollow Technologies Inc | REDUCTION CATHETER |
US20020095129A1 (en) * | 2000-12-21 | 2002-07-18 | Friderich S. Scott | Body fluid sealing gaskets for personal care products |
US6663651B2 (en) | 2001-01-16 | 2003-12-16 | Incept Llc | Systems and methods for vascular filter retrieval |
US6689151B2 (en) | 2001-01-25 | 2004-02-10 | Scimed Life Systems, Inc. | Variable wall thickness for delivery sheath housing |
US6840950B2 (en) | 2001-02-20 | 2005-01-11 | Scimed Life Systems, Inc. | Low profile emboli capture device |
US6887227B1 (en) | 2001-02-23 | 2005-05-03 | Coaxia, Inc. | Devices and methods for preventing distal embolization from the vertebrobasilar artery using flow reversal |
US6595980B1 (en) | 2001-02-23 | 2003-07-22 | Coaxia, Inc. | Devices and methods for preventing distal embolization using flow reversal by occlusion of the brachiocephalic artery |
US6537295B2 (en) | 2001-03-06 | 2003-03-25 | Scimed Life Systems, Inc. | Wire and lock mechanism |
US6676691B1 (en) * | 2001-03-28 | 2004-01-13 | Ayman A. Hosny | Stent delivery system |
US6830579B2 (en) * | 2001-05-01 | 2004-12-14 | Coaxia, Inc. | Devices and methods for preventing distal embolization using flow reversal and perfusion augmentation within the cerebral vasculature |
EP1270038A1 (en) * | 2001-06-19 | 2003-01-02 | N.G.C. Medical S.p.A. | Two-lumen suction catheter for distal protection in a percutaneous intervention |
WO2003007797A2 (en) * | 2001-07-17 | 2003-01-30 | Kerberos Proximal Solutions | Fluid exchange system for controlled and localized irrigation and aspiration |
US20030023263A1 (en) | 2001-07-24 | 2003-01-30 | Incept Llc | Apparatus and methods for aspirating emboli |
US6533800B1 (en) | 2001-07-25 | 2003-03-18 | Coaxia, Inc. | Devices and methods for preventing distal embolization using flow reversal in arteries having collateral blood flow |
US20030023261A1 (en) | 2001-07-30 | 2003-01-30 | Scimed Life Systems Inc. | Chronic total occlusion device with variable stiffness shaft |
US20030050660A1 (en) * | 2001-09-07 | 2003-03-13 | Scimed Life Systems, Inc. | Eccentric catheter shaft |
US6755847B2 (en) | 2001-10-05 | 2004-06-29 | Scimed Life Systems, Inc. | Emboli capturing device and method of manufacture therefor |
JP4350515B2 (en) | 2001-11-09 | 2009-10-21 | ルビコン・メデイカル・インコーポレイテツド | Stent delivery device |
US20030171765A1 (en) * | 2002-03-05 | 2003-09-11 | Scimed Life Systems, Inc. | Catheter for treating vulnerable plaque |
WO2003075793A1 (en) | 2002-03-06 | 2003-09-18 | Boston Scientific Limited | Medical retrieval device |
US20030199917A1 (en) * | 2002-04-22 | 2003-10-23 | Knudson Mark B. | Thrombus treatment with emboli management |
US20040082859A1 (en) | 2002-07-01 | 2004-04-29 | Alan Schaer | Method and apparatus employing ultrasound energy to treat body sphincters |
US7309334B2 (en) | 2002-07-23 | 2007-12-18 | Von Hoffmann Gerard | Intracranial aspiration catheter |
US8425549B2 (en) * | 2002-07-23 | 2013-04-23 | Reverse Medical Corporation | Systems and methods for removing obstructive matter from body lumens and treating vascular defects |
US20040019358A1 (en) * | 2002-07-25 | 2004-01-29 | Scimed Life Systems, Inc. | Medical device |
US7303575B2 (en) * | 2002-08-01 | 2007-12-04 | Lumen Biomedical, Inc. | Embolism protection devices |
US8468678B2 (en) | 2002-10-02 | 2013-06-25 | Boston Scientific Scimed, Inc. | Expandable retrieval device |
US7998163B2 (en) | 2002-10-03 | 2011-08-16 | Boston Scientific Scimed, Inc. | Expandable retrieval device |
DE10258708A1 (en) * | 2002-12-12 | 2004-07-08 | Simag GmbH Systeme und Instrumente für die Magnetresonanztomographie | vessel filter |
EP1435253B1 (en) | 2002-12-31 | 2007-01-17 | Abbott Laboratories Vascular Enterprises Limited | Catheter having a more flexible part between shaft and tip and method of manufacturing thereof |
JP4409179B2 (en) * | 2003-01-22 | 2010-02-03 | ニプロ株式会社 | Thrombus aspiration catheter with improved suction and crossability |
US8246640B2 (en) | 2003-04-22 | 2012-08-21 | Tyco Healthcare Group Lp | Methods and devices for cutting tissue at a vascular location |
US7780611B2 (en) | 2003-05-01 | 2010-08-24 | Boston Scientific Scimed, Inc. | Medical instrument with controlled torque transmission |
US7879062B2 (en) * | 2003-07-22 | 2011-02-01 | Lumen Biomedical, Inc. | Fiber based embolism protection device |
US8048042B2 (en) * | 2003-07-22 | 2011-11-01 | Medtronic Vascular, Inc. | Medical articles incorporating surface capillary fiber |
US8535344B2 (en) | 2003-09-12 | 2013-09-17 | Rubicon Medical, Inc. | Methods, systems, and devices for providing embolic protection and removing embolic material |
US7479150B2 (en) * | 2003-09-19 | 2009-01-20 | Tyco Healthcare Group Lp | Trocar insertion apparatus |
US7651514B2 (en) | 2003-12-11 | 2010-01-26 | Boston Scientific Scimed, Inc. | Nose rider improvement for filter exchange and methods of use |
ATE484308T1 (en) * | 2004-02-18 | 2010-10-15 | Koninkl Philips Electronics Nv | CATHETER SYSTEM WITH ACTIVE POSITION MARKERS |
US8092483B2 (en) * | 2004-03-06 | 2012-01-10 | Medtronic, Inc. | Steerable device having a corewire within a tube and combination with a functional medical component |
US7988705B2 (en) * | 2004-03-06 | 2011-08-02 | Lumen Biomedical, Inc. | Steerable device having a corewire within a tube and combination with a functional medical component |
US8409237B2 (en) * | 2004-05-27 | 2013-04-02 | Medtronic, Inc. | Emboli filter export system |
US7794448B2 (en) * | 2004-05-27 | 2010-09-14 | Abbott Laboratories | Multiple lumen catheter and method of making same |
US7785439B2 (en) | 2004-09-29 | 2010-08-31 | Abbott Laboratories Vascular Enterprises Limited | Method for connecting a catheter balloon with a catheter shaft of a balloon catheter |
US8241315B2 (en) | 2004-06-24 | 2012-08-14 | Boston Scientific Scimed, Inc. | Apparatus and method for treating occluded vasculature |
US7976516B2 (en) * | 2004-06-25 | 2011-07-12 | Lumen Biomedical, Inc. | Medical device having mechanically interlocked segments |
US7794472B2 (en) | 2004-08-11 | 2010-09-14 | Boston Scientific Scimed, Inc. | Single wire intravascular filter |
US20060047301A1 (en) * | 2004-09-02 | 2006-03-02 | Ogle Matthew F | Emboli removal system with oxygenated flow |
US20060058837A1 (en) * | 2004-09-10 | 2006-03-16 | Arani Bose | System and method for treating ischemic stroke |
US9655633B2 (en) | 2004-09-10 | 2017-05-23 | Penumbra, Inc. | System and method for treating ischemic stroke |
US7931659B2 (en) * | 2004-09-10 | 2011-04-26 | Penumbra, Inc. | System and method for treating ischemic stroke |
JP2006087643A (en) * | 2004-09-24 | 2006-04-06 | Terumo Corp | Apparatus for sucking foreign substance from blood vessel |
US7621904B2 (en) | 2004-10-21 | 2009-11-24 | Boston Scientific Scimed, Inc. | Catheter with a pre-shaped distal tip |
US8038696B2 (en) | 2004-12-06 | 2011-10-18 | Boston Scientific Scimed, Inc. | Sheath for use with an embolic protection filter |
US20080125726A1 (en) * | 2004-12-07 | 2008-05-29 | Satoru Mori | Thrombus Suction Catheter With Excellent Crossability |
US8480629B2 (en) | 2005-01-28 | 2013-07-09 | Boston Scientific Scimed, Inc. | Universal utility board for use with medical devices and methods of use |
KR20090123018A (en) * | 2005-02-08 | 2009-12-01 | 노키아 코포레이션 | Harq failure indication over iub-interface |
US20060276774A1 (en) * | 2005-06-01 | 2006-12-07 | Satoru Mori | Thrombus suction catheter |
US20070060935A1 (en) * | 2005-07-11 | 2007-03-15 | Schwardt Jeffrey D | Apparatus and methods of tissue removal within a spine |
US20080172066A9 (en) * | 2005-07-29 | 2008-07-17 | Galdonik Jason A | Embolectomy procedures with a device comprising a polymer and devices with polymer matrices and supports |
US8021351B2 (en) * | 2005-08-18 | 2011-09-20 | Medtronic Vascular, Inc. | Tracking aspiration catheter |
US7938820B2 (en) * | 2005-08-18 | 2011-05-10 | Lumen Biomedical, Inc. | Thrombectomy catheter |
US20070060888A1 (en) * | 2005-09-06 | 2007-03-15 | Kerberos Proximal Solutions, Inc. | Methods and apparatus for assisted aspiration |
US7608063B2 (en) * | 2006-02-23 | 2009-10-27 | Medrad, Inc. | Dual lumen aspiration catheter system |
JP4504941B2 (en) * | 2006-04-25 | 2010-07-14 | テルモ株式会社 | Thrombus aspiration catheter |
US20070276419A1 (en) | 2006-05-26 | 2007-11-29 | Fox Hollow Technologies, Inc. | Methods and devices for rotating an active element and an energy emitter on a catheter |
US7793468B2 (en) * | 2006-09-14 | 2010-09-14 | Howard Dysle | Blind with easy access features |
WO2008097993A2 (en) | 2007-02-05 | 2008-08-14 | Boston Scientific Limited | Thrombectomy apparatus and method |
EP4088770A1 (en) | 2007-07-18 | 2022-11-16 | Silk Road Medical, Inc. | Methods and systems for establishing retrograde carotid arterial blood flow |
US8858490B2 (en) | 2007-07-18 | 2014-10-14 | Silk Road Medical, Inc. | Systems and methods for treating a carotid artery |
US8795326B2 (en) | 2007-10-05 | 2014-08-05 | Covidien Lp | Expanding seal anchor for single incision surgery |
US8784654B2 (en) * | 2007-11-14 | 2014-07-22 | Bayer Medical Care, Inc. | Methods and systems for biological sample collection and analysis |
JP2011510796A (en) | 2008-02-05 | 2011-04-07 | シルク・ロード・メディカル・インコーポレイテッド | Intervention catheter system and method |
US8784440B2 (en) | 2008-02-25 | 2014-07-22 | Covidien Lp | Methods and devices for cutting tissue |
US20090270892A1 (en) * | 2008-04-25 | 2009-10-29 | Greg Arcenio | Steerable medical device for tissue disruption |
US20090270862A1 (en) * | 2008-04-25 | 2009-10-29 | Greg Arcenio | Medical device with one-way rotary drive mechanism |
US20090270893A1 (en) * | 2008-04-25 | 2009-10-29 | Greg Arcenio | Medical device for tissue disruption with serrated expandable portion |
US8070694B2 (en) * | 2008-07-14 | 2011-12-06 | Medtronic Vascular, Inc. | Fiber based medical devices and aspiration catheters |
CN102119003B (en) * | 2008-08-13 | 2015-07-08 | A·德尔柯索 | Occlusion device for vascular surgery |
US8882751B2 (en) * | 2008-09-09 | 2014-11-11 | Cook Medical Technologies Llc | Wire guided thrombectomy device |
KR101645754B1 (en) | 2008-10-13 | 2016-08-04 | 코비디엔 엘피 | Devices and methods for manipulating a catheter shaft |
US9510854B2 (en) | 2008-10-13 | 2016-12-06 | Boston Scientific Scimed, Inc. | Thrombectomy catheter with control box having pressure/vacuum valve for synchronous aspiration and fluid irrigation |
US8444669B2 (en) | 2008-12-15 | 2013-05-21 | Boston Scientific Scimed, Inc. | Embolic filter delivery system and method |
WO2010075445A1 (en) | 2008-12-23 | 2010-07-01 | Silk Road Medical, Inc. | Methods and systems for treatment of acute ischemic stroke |
US20100204672A1 (en) * | 2009-02-12 | 2010-08-12 | Penumra, Inc. | System and method for treating ischemic stroke |
CN102625673B (en) | 2009-04-29 | 2014-12-24 | 泰科保健集团有限合伙公司 | Methods and devices for cutting and abrading tissue |
AU2010248909B2 (en) | 2009-05-14 | 2013-03-21 | Covidien Lp | Easily cleaned atherectomy catheters and methods of use |
CN102596320B (en) | 2009-10-30 | 2016-09-07 | 瑞蔻医药有限公司 | Method and apparatus by percutaneous ultrasound ripple Renal denervation treatment hypertension |
AU2010326063B2 (en) | 2009-12-02 | 2013-07-04 | Covidien Lp | Methods and devices for cutting tissue |
JP5511107B2 (en) | 2009-12-11 | 2014-06-04 | コヴィディエン リミテッド パートナーシップ | Substance removal device and method with improved substance capture efficiency |
CN102858400B (en) | 2010-01-20 | 2015-07-08 | 亭阁医疗创新公司 | Systems and methods for removal of intravascular leads |
WO2011130256A2 (en) | 2010-04-13 | 2011-10-20 | Lumen Biomedical, Inc. | Embolectomy devices and methods for treatment of acute ischemic stroke condition |
US8764779B2 (en) | 2010-05-13 | 2014-07-01 | Rex Medical, L.P. | Rotational thrombectomy wire |
US8663259B2 (en) | 2010-05-13 | 2014-03-04 | Rex Medical L.P. | Rotational thrombectomy wire |
US9023070B2 (en) | 2010-05-13 | 2015-05-05 | Rex Medical, L.P. | Rotational thrombectomy wire coupler |
US9795406B2 (en) | 2010-05-13 | 2017-10-24 | Rex Medical, L.P. | Rotational thrombectomy wire |
US9119662B2 (en) | 2010-06-14 | 2015-09-01 | Covidien Lp | Material removal device and method of use |
US20120071838A1 (en) * | 2010-09-22 | 2012-03-22 | Control Medical Technology, Llc | Rapid exchange aspiration catheters with lumens configured for optimized flow |
CA2815186C (en) | 2010-10-28 | 2015-12-29 | Covidien Lp | Material removal device and method of use |
AU2011326420B2 (en) | 2010-11-11 | 2014-11-27 | Covidien Lp | Flexible debulking catheters with imaging and methods of use and manufacture |
US8821478B2 (en) | 2011-03-04 | 2014-09-02 | Boston Scientific Scimed, Inc. | Catheter with variable stiffness |
US10779855B2 (en) | 2011-08-05 | 2020-09-22 | Route 92 Medical, Inc. | Methods and systems for treatment of acute ischemic stroke |
EP4101399A1 (en) * | 2011-08-05 | 2022-12-14 | Route 92 Medical, Inc. | System for treatment of acute ischemic stroke |
US8992717B2 (en) | 2011-09-01 | 2015-03-31 | Covidien Lp | Catheter with helical drive shaft and methods of manufacture |
JP2013180156A (en) * | 2012-03-05 | 2013-09-12 | Sumitomo Bakelite Co Ltd | Medical equipment |
US9579157B2 (en) | 2012-09-13 | 2017-02-28 | Covidien Lp | Cleaning device for medical instrument and method of use |
CA2891061C (en) | 2012-11-08 | 2018-05-01 | Covidien Lp | Tissue-removing catheter including operational control mechanism |
US9943329B2 (en) | 2012-11-08 | 2018-04-17 | Covidien Lp | Tissue-removing catheter with rotatable cutter |
EP3799931A1 (en) * | 2013-03-14 | 2021-04-07 | ReCor Medical, Inc. | Ultrasound-based neuromodulation system |
WO2014159273A1 (en) | 2013-03-14 | 2014-10-02 | Recor Medical, Inc. | Methods of plating or coating ultrasound transducers |
WO2014204860A1 (en) | 2013-06-18 | 2014-12-24 | Slik Road Medical, Inc. | Methods and systems for tretment of acute ischemic stroke |
US9265512B2 (en) | 2013-12-23 | 2016-02-23 | Silk Road Medical, Inc. | Transcarotid neurovascular catheter |
US9456843B2 (en) | 2014-02-03 | 2016-10-04 | Covidien Lp | Tissue-removing catheter including angular displacement sensor |
US9526519B2 (en) | 2014-02-03 | 2016-12-27 | Covidien Lp | Tissue-removing catheter with improved angular tissue-removing positioning within body lumen |
US10285720B2 (en) | 2014-03-11 | 2019-05-14 | Neuravi Limited | Clot retrieval system for removing occlusive clot from a blood vessel |
US9820761B2 (en) | 2014-03-21 | 2017-11-21 | Route 92 Medical, Inc. | Rapid aspiration thrombectomy system and method |
US9241699B1 (en) | 2014-09-04 | 2016-01-26 | Silk Road Medical, Inc. | Methods and devices for transcarotid access |
US9433427B2 (en) | 2014-04-08 | 2016-09-06 | Incuvate, Llc | Systems and methods for management of thrombosis |
US9883877B2 (en) | 2014-05-19 | 2018-02-06 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
US10441301B2 (en) | 2014-06-13 | 2019-10-15 | Neuravi Limited | Devices and methods for removal of acute blockages from blood vessels |
WO2015200702A1 (en) | 2014-06-27 | 2015-12-30 | Covidien Lp | Cleaning device for catheter and catheter including the same |
US10265086B2 (en) | 2014-06-30 | 2019-04-23 | Neuravi Limited | System for removing a clot from a blood vessel |
US11027104B2 (en) | 2014-09-04 | 2021-06-08 | Silk Road Medical, Inc. | Methods and devices for transcarotid access |
US11065019B1 (en) | 2015-02-04 | 2021-07-20 | Route 92 Medical, Inc. | Aspiration catheter systems and methods of use |
WO2016126974A1 (en) | 2015-02-04 | 2016-08-11 | Route 92 Medical, Inc. | Rapid aspiration thrombectomy system and method |
US10426497B2 (en) | 2015-07-24 | 2019-10-01 | Route 92 Medical, Inc. | Anchoring delivery system and methods |
US10314667B2 (en) | 2015-03-25 | 2019-06-11 | Covidien Lp | Cleaning device for cleaning medical instrument |
US10292721B2 (en) | 2015-07-20 | 2019-05-21 | Covidien Lp | Tissue-removing catheter including movable distal tip |
EP3344184A4 (en) | 2015-09-01 | 2019-05-15 | Mivi Neuroscience, Inc. | Thrombectomy devices and treatment of acute ischemic stroke with thrombus engagement |
US10561440B2 (en) | 2015-09-03 | 2020-02-18 | Vesatek, Llc | Systems and methods for manipulating medical devices |
US10314664B2 (en) | 2015-10-07 | 2019-06-11 | Covidien Lp | Tissue-removing catheter and tissue-removing element with depth stop |
US20170100142A1 (en) | 2015-10-09 | 2017-04-13 | Incuvate, Llc | Systems and methods for management of thrombosis |
US10716915B2 (en) | 2015-11-23 | 2020-07-21 | Mivi Neuroscience, Inc. | Catheter systems for applying effective suction in remote vessels and thrombectomy procedures facilitated by catheter systems |
US10226263B2 (en) | 2015-12-23 | 2019-03-12 | Incuvate, Llc | Aspiration monitoring system and method |
US10492805B2 (en) | 2016-04-06 | 2019-12-03 | Walk Vascular, Llc | Systems and methods for thrombolysis and delivery of an agent |
AU2017312421A1 (en) | 2016-08-17 | 2019-03-07 | Neuravi Limited | A clot retrieval system for removing occlusive clot from a blood vessel |
US11121502B2 (en) | 2016-09-23 | 2021-09-14 | Apple Inc. | Magnetic connectors |
CN107871943A (en) * | 2016-09-23 | 2018-04-03 | 苹果公司 | Magnetic force RF connectors |
US11229445B2 (en) | 2016-10-06 | 2022-01-25 | Mivi Neuroscience, Inc. | Hydraulic displacement and removal of thrombus clots, and catheters for performing hydraulic displacement |
US20180146842A1 (en) * | 2016-11-28 | 2018-05-31 | United States Endoscopy Group, Inc. | Bolus removal device |
CN110392591B (en) | 2017-01-10 | 2022-06-03 | 92号医疗公司 | Aspiration catheter system and method of use |
US10478535B2 (en) | 2017-05-24 | 2019-11-19 | Mivi Neuroscience, Inc. | Suction catheter systems for applying effective aspiration in remote vessels, especially cerebral arteries |
US11234723B2 (en) | 2017-12-20 | 2022-02-01 | Mivi Neuroscience, Inc. | Suction catheter systems for applying effective aspiration in remote vessels, especially cerebral arteries |
US11395665B2 (en) | 2018-05-01 | 2022-07-26 | Incept, Llc | Devices and methods for removing obstructive material, from an intravascular site |
AU2019262972A1 (en) | 2018-05-01 | 2020-10-15 | Incept, Llc | Devices and methods for removing obstructive material from an intravascular site |
US11129702B2 (en) | 2018-05-09 | 2021-09-28 | Boston Scientific Scimed, Inc. | Pedal access embolic filtering sheath |
CN115999019A (en) | 2018-05-17 | 2023-04-25 | 92号医疗公司 | Aspiration catheter system and method of use |
US11471582B2 (en) | 2018-07-06 | 2022-10-18 | Incept, Llc | Vacuum transfer tool for extendable catheter |
US11678905B2 (en) | 2018-07-19 | 2023-06-20 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
JP2020142074A (en) | 2019-03-04 | 2020-09-10 | ニューラヴィ・リミテッド | Actuated clot retrieval catheter |
EP3791815A1 (en) | 2019-09-11 | 2021-03-17 | Neuravi Limited | Expandable mouth catheter |
US11839725B2 (en) | 2019-11-27 | 2023-12-12 | Neuravi Limited | Clot retrieval device with outer sheath and inner catheter |
US11779364B2 (en) | 2019-11-27 | 2023-10-10 | Neuravi Limited | Actuated expandable mouth thrombectomy catheter |
US11259821B2 (en) | 2019-12-18 | 2022-03-01 | Imperative Care, Inc. | Aspiration system with accelerated response |
CA3162704A1 (en) | 2019-12-18 | 2021-06-24 | Imperative Care, Inc. | Methods and systems for treating venous thromboembolic disease |
US11633272B2 (en) | 2019-12-18 | 2023-04-25 | Imperative Care, Inc. | Manually rotatable thrombus engagement tool |
US20210260345A1 (en) * | 2020-02-24 | 2021-08-26 | Becton, Dickinson And Company | Tubular instrument to reduce vein trauma and related devices and methods |
US11944327B2 (en) | 2020-03-05 | 2024-04-02 | Neuravi Limited | Expandable mouth aspirating clot retrieval catheter |
US11633198B2 (en) | 2020-03-05 | 2023-04-25 | Neuravi Limited | Catheter proximal joint |
EP4117762A1 (en) | 2020-03-10 | 2023-01-18 | Imperative Care, Inc. | Enhanced flexibility neurovascular catheter |
US11883043B2 (en) | 2020-03-31 | 2024-01-30 | DePuy Synthes Products, Inc. | Catheter funnel extension |
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Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4729763A (en) * | 1986-06-06 | 1988-03-08 | Henrie Rodney A | Catheter for removing occlusive material |
US4894051A (en) * | 1984-05-14 | 1990-01-16 | Surgical Systems & Instruments, Inc. | Atherectomy system with a biasing sleeve and method of using the same |
US5234403A (en) * | 1990-05-25 | 1993-08-10 | Sumitomo Bakelite Co., Ltd. | Blood collecting apparatus |
US5346469A (en) * | 1992-10-07 | 1994-09-13 | Sumitomo Bakelite Company Limited | Handpiece for surgical operation |
US5395332A (en) * | 1990-08-28 | 1995-03-07 | Scimed Life Systems, Inc. | Intravascualr catheter with distal tip guide wire lumen |
US5419774A (en) * | 1993-07-13 | 1995-05-30 | Scimed Life Systems, Inc. | Thrombus extraction device |
US5451233A (en) * | 1986-04-15 | 1995-09-19 | Yock; Paul G. | Angioplasty apparatus facilitating rapid exchanges |
US5527292A (en) * | 1990-10-29 | 1996-06-18 | Scimed Life Systems, Inc. | Intravascular device for coronary heart treatment |
Family Cites Families (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE3235974A1 (en) * | 1981-11-24 | 1983-06-01 | Volkmar Dipl.-Ing. Merkel (FH), 8520 Erlangen | DEVICE FOR REMOVAL OR FOR THE EXPANSION OF CONSTRAINTS IN BODY LIQUID LEADING VESSELS |
US4646736A (en) * | 1984-09-10 | 1987-03-03 | E. R. Squibb & Sons, Inc. | Transluminal thrombectomy apparatus |
US4950257A (en) * | 1988-09-15 | 1990-08-21 | Mallinckrodt, Inc. | Catheter introducer with flexible tip |
JPH0751062Y2 (en) * | 1989-01-13 | 1995-11-22 | 晴夫 高瀬 | Suction tube for removing biological tissue |
US5034005A (en) * | 1990-07-09 | 1991-07-23 | Appling William M | Radiopaque marker |
CA2048120A1 (en) * | 1990-08-06 | 1992-02-07 | William J. Drasler | Thrombectomy method and device |
US5346569A (en) * | 1993-05-17 | 1994-09-13 | Monsanto Company | Process for deairing an interface region |
US5370653A (en) * | 1993-07-22 | 1994-12-06 | Micro Therapeutics, Inc. | Thrombectomy method and apparatus |
US5476450A (en) * | 1993-11-04 | 1995-12-19 | Ruggio; Joseph M. | Apparatus and method for aspirating intravascular, pulmonary and cardiac obstructions |
-
1997
- 1997-03-20 US US08/822,364 patent/US5938645A/en not_active Expired - Lifetime
-
1998
- 1998-03-19 WO PCT/US1998/005411 patent/WO1998044982A1/en active Application Filing
Patent Citations (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4894051A (en) * | 1984-05-14 | 1990-01-16 | Surgical Systems & Instruments, Inc. | Atherectomy system with a biasing sleeve and method of using the same |
US5451233A (en) * | 1986-04-15 | 1995-09-19 | Yock; Paul G. | Angioplasty apparatus facilitating rapid exchanges |
US4729763A (en) * | 1986-06-06 | 1988-03-08 | Henrie Rodney A | Catheter for removing occlusive material |
US5234403A (en) * | 1990-05-25 | 1993-08-10 | Sumitomo Bakelite Co., Ltd. | Blood collecting apparatus |
US5395332A (en) * | 1990-08-28 | 1995-03-07 | Scimed Life Systems, Inc. | Intravascualr catheter with distal tip guide wire lumen |
US5527292A (en) * | 1990-10-29 | 1996-06-18 | Scimed Life Systems, Inc. | Intravascular device for coronary heart treatment |
US5346469A (en) * | 1992-10-07 | 1994-09-13 | Sumitomo Bakelite Company Limited | Handpiece for surgical operation |
US5419774A (en) * | 1993-07-13 | 1995-05-30 | Scimed Life Systems, Inc. | Thrombus extraction device |
Cited By (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6152909A (en) * | 1996-05-20 | 2000-11-28 | Percusurge, Inc. | Aspiration system and method |
US6135991A (en) * | 1997-03-06 | 2000-10-24 | Percusurge, Inc. | Aspiration method |
US6454741B1 (en) | 1997-03-06 | 2002-09-24 | Medtronic Percusurge, Inc. | Aspiration method |
US6652480B1 (en) | 1997-03-06 | 2003-11-25 | Medtronic Ave., Inc. | Methods for reducing distal embolization |
US6849068B1 (en) | 1997-03-06 | 2005-02-01 | Medtronic Ave, Inc. | Aspiration catheter |
WO2006120464A3 (en) * | 2005-05-11 | 2007-04-19 | Univ Wolverhampton | Biomechanical probe |
EP3174471A4 (en) * | 2014-07-28 | 2018-04-11 | Wan, Shaw, P. | Suction evacuation device |
EP3760143A1 (en) * | 2014-07-28 | 2021-01-06 | Wan, Shaw, P. | Suction evacuation device |
WO2018043281A1 (en) * | 2016-08-29 | 2018-03-08 | テルモ株式会社 | Suction system and treatment method |
WO2018043279A1 (en) * | 2016-08-29 | 2018-03-08 | テルモ株式会社 | Suction catheter, suction system, and treatment method |
US11065020B2 (en) | 2016-08-29 | 2021-07-20 | Terumo Kabushiki Kaisha | Suction catheter, suction system, and treatment method |
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