CA2063741A1 - Distal atherectomy catheter - Google Patents
Distal atherectomy catheterInfo
- Publication number
- CA2063741A1 CA2063741A1 CA002063741A CA2063741A CA2063741A1 CA 2063741 A1 CA2063741 A1 CA 2063741A1 CA 002063741 A CA002063741 A CA 002063741A CA 2063741 A CA2063741 A CA 2063741A CA 2063741 A1 CA2063741 A1 CA 2063741A1
- Authority
- CA
- Canada
- Prior art keywords
- cutting
- housing
- head assembly
- cutter
- catheter
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
-
- 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
-
- 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
- A61B2017/22042—Details of the tip of the guide wire
- A61B2017/22044—Details of the tip of the guide wire with a pointed tip
-
- 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
- A61B2017/22051—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 an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22065—Functions of balloons
- A61B2017/22071—Steering
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320004—Surgical cutting instruments abrasive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
- A61B2090/08021—Prevention of accidental cutting or pricking of the patient or his organs
-
- 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
Abstract
This disclosure sets out a catheter (10) for bodily insertion.
The catheter tip supports an elongate hollow housing (14) with a window (82) for occlusive material cutting, a cutter head (86) on the interior rotates, driven by a drive wire (46) in the hollow catheter tube. In addition, the cutter head (86) reciprocates or oscillates to cut on its back edge, the edge trimming material entering through the window (82). The window and optional slots admit the unwanted material and enable trimming for a vacuum removal through the catheter tube. The window (82) is urged into contact by a pair of flexed wires (98), the wires moving the housing into operative contact.
The catheter tip supports an elongate hollow housing (14) with a window (82) for occlusive material cutting, a cutter head (86) on the interior rotates, driven by a drive wire (46) in the hollow catheter tube. In addition, the cutter head (86) reciprocates or oscillates to cut on its back edge, the edge trimming material entering through the window (82). The window and optional slots admit the unwanted material and enable trimming for a vacuum removal through the catheter tube. The window (82) is urged into contact by a pair of flexed wires (98), the wires moving the housing into operative contact.
Description
wo gl/01114 2 ~ ~ ~ 7 ~ ~ pcr/usso/o42l~
IMPROVED DISTAL ATHERECTOMY CATHETER
RELATED APPLICATIC)NS
This application is a Continuation-In-Part of Patent Application Serial No. 071312,737 filed February 17, 1989.
The present invention is directed to an atherectomy ca~heter, particularly, a distal atherectomy catheter for use in the distal and coronary arteries where small vessel size and tortuosity present numerous problems of access.
Many technological advancements have been made in recent years for treatment of coronary disease. Surgical bypass techniques, such as coronary artery bypass graft surgery, are routinely performed and are highly suc essful While the risks of bypass surgery have been minimized 2 O through technological advancements, opening of the chest cavity is still required. This requires special surgical slcills and equipment which are not readily available in many areas. For many patients, a bypass operation may not be indicated and therefore various surgical techniques have been devised to 2 5 treat occlusive coronary artery diseases of such patients. For example, various prior art devices have been developed for removing and/or compressing atherosclerotic plaque, t hromboses, stenosis, occlusion9 clots, embolic material, etc.
from veins, ar~eries and the like.
IMPROVED DISTAL ATHERECTOMY CATHETER
RELATED APPLICATIC)NS
This application is a Continuation-In-Part of Patent Application Serial No. 071312,737 filed February 17, 1989.
The present invention is directed to an atherectomy ca~heter, particularly, a distal atherectomy catheter for use in the distal and coronary arteries where small vessel size and tortuosity present numerous problems of access.
Many technological advancements have been made in recent years for treatment of coronary disease. Surgical bypass techniques, such as coronary artery bypass graft surgery, are routinely performed and are highly suc essful While the risks of bypass surgery have been minimized 2 O through technological advancements, opening of the chest cavity is still required. This requires special surgical slcills and equipment which are not readily available in many areas. For many patients, a bypass operation may not be indicated and therefore various surgical techniques have been devised to 2 5 treat occlusive coronary artery diseases of such patients. For example, various prior art devices have been developed for removing and/or compressing atherosclerotic plaque, t hromboses, stenosis, occlusion9 clots, embolic material, etc.
from veins, ar~eries and the like.
3 0 ~ ~ One ~ such device is disclosed in applicant's co-pending application serial no. 07/312,737 filed February 17, 1989, which disclosure is incorporated by reference herein. In ': ' , . . .
~: : : ~ :
WO 91/~)1114 PC~/IJS90/04214 37~
applicant's co-pending applicalion, removal of occlusive material is accomplished by cooperative reciprocal action between an inner and outer catheter tube for excising occlusive material blocking the coronary vessel.
While the appara~us of app}icant's co-pending application has been successfully shown to remove occlusive material in laboratory tests, enhanced and more efficient remov~l ot occlusive material may be achieved with the improved apparatus described herein. One feature which is important to the acceptability of a distal atherectomy catheter by the medical community is the efficiency and speed wi~h which the lumen of an artery or the like may be unblocked to provide normal blood flow.
U.S. Patent No. 4,650,466 (Luther) discloses an angioplasty device comprising a woven tube of metal or plastic fibers and a retraction stylet that are attached at one end of the catheter tube for insertion into a Yein, artery, and the like for the removal of plaque and similar materials. One or more guide wires are attached to the woven tube for rotation and 2 0 manipulation inside the artery. The woven tube is placed within the artery and expanded to contact the interior, plaque coated, wall of the artery. Mavement of the expanded woven tube abrades the plaque from the arterial wall to form particles which are trapped within the woven tubes. The trapped 2 5 plaque particles are removed with the angioplasty device upon its removal from the artery of the patient.
Other prior art devices include catheters fi~ted with an inflatable balloon for compressing occlusive materials such as plaque against the vessel wall. U.S. Patent No. 4,273,128 3 0 (Lary) discloses a coronary cutting and dilating instrument for `
treatment of stenotic and occlusive coronary artery disease.
The device disclosed therein includes a cutting and dilating instrument having one or more radially extending knife blades . ,.
- .
:
.
wo st/01114 3 2 ~ ~ 3 7 ~ ~ PCI`/US90/0421~
at a forward end thereof for makin~ the coronary incision and an inflatable balloon for dilating the stenotic artery zone immediately after the incision.
Other angioplasty devices include a catheter having 5 a motor driven cutting head mounted at its distal end. The cutting head is connected to the drive motor via a flexible drive shaft extending through the catheter. Extremely high rotational cutting head speeds have been achieved, in the range of 50,000-300,000 rpm, by these motor driven cutter heads.
I 0 Various problems, however, have been associated wi~h the use of the balloon tipped catheters and high speed cutting heads.
The balloon catheter is expanded by injection of pressurized fluid into the balloon to expand it against the wall of the artery.
Some problems which have been reported include the vessel l S dissection, perforation, rupture, conversion of a stenosis to an occlusion, and embolization. Furthermore, angioplasty devices utilizing balloons do not remove the plaque from the arterial wall but simply compress the plaque against the wall of the vessel. Thus, the stenosis or occlusion frequently re~ccur 2 0 requiring further treatment.
Atherectomy devices utilizing a motor driven high speed cutting head include a number of disadvantages. Heat dissipation and vibration is a problem. The path of the occlusion in an artery is often a tortuous path and therefore the 2 5 lengthy flexible drive shaft connected to the cutter head must traverse a number of bends or curves. Consequently, as the flexible drive shaft rotates, it contacts the inner wall of the cathe~er resulting in localized heating and vibrations due to the frictional contact. This, of course, is very uncomfortable for the 3 0 patient and may result in spasm, wealcening or perforation of the vessel along the route of the catheter.
It is therefore one advantage of the present invention to provide an improved atherec~omy catheter having ' ,:
~: : : ~ :
WO 91/~)1114 PC~/IJS90/04214 37~
applicant's co-pending applicalion, removal of occlusive material is accomplished by cooperative reciprocal action between an inner and outer catheter tube for excising occlusive material blocking the coronary vessel.
While the appara~us of app}icant's co-pending application has been successfully shown to remove occlusive material in laboratory tests, enhanced and more efficient remov~l ot occlusive material may be achieved with the improved apparatus described herein. One feature which is important to the acceptability of a distal atherectomy catheter by the medical community is the efficiency and speed wi~h which the lumen of an artery or the like may be unblocked to provide normal blood flow.
U.S. Patent No. 4,650,466 (Luther) discloses an angioplasty device comprising a woven tube of metal or plastic fibers and a retraction stylet that are attached at one end of the catheter tube for insertion into a Yein, artery, and the like for the removal of plaque and similar materials. One or more guide wires are attached to the woven tube for rotation and 2 0 manipulation inside the artery. The woven tube is placed within the artery and expanded to contact the interior, plaque coated, wall of the artery. Mavement of the expanded woven tube abrades the plaque from the arterial wall to form particles which are trapped within the woven tubes. The trapped 2 5 plaque particles are removed with the angioplasty device upon its removal from the artery of the patient.
Other prior art devices include catheters fi~ted with an inflatable balloon for compressing occlusive materials such as plaque against the vessel wall. U.S. Patent No. 4,273,128 3 0 (Lary) discloses a coronary cutting and dilating instrument for `
treatment of stenotic and occlusive coronary artery disease.
The device disclosed therein includes a cutting and dilating instrument having one or more radially extending knife blades . ,.
- .
:
.
wo st/01114 3 2 ~ ~ 3 7 ~ ~ PCI`/US90/0421~
at a forward end thereof for makin~ the coronary incision and an inflatable balloon for dilating the stenotic artery zone immediately after the incision.
Other angioplasty devices include a catheter having 5 a motor driven cutting head mounted at its distal end. The cutting head is connected to the drive motor via a flexible drive shaft extending through the catheter. Extremely high rotational cutting head speeds have been achieved, in the range of 50,000-300,000 rpm, by these motor driven cutter heads.
I 0 Various problems, however, have been associated wi~h the use of the balloon tipped catheters and high speed cutting heads.
The balloon catheter is expanded by injection of pressurized fluid into the balloon to expand it against the wall of the artery.
Some problems which have been reported include the vessel l S dissection, perforation, rupture, conversion of a stenosis to an occlusion, and embolization. Furthermore, angioplasty devices utilizing balloons do not remove the plaque from the arterial wall but simply compress the plaque against the wall of the vessel. Thus, the stenosis or occlusion frequently re~ccur 2 0 requiring further treatment.
Atherectomy devices utilizing a motor driven high speed cutting head include a number of disadvantages. Heat dissipation and vibration is a problem. The path of the occlusion in an artery is often a tortuous path and therefore the 2 5 lengthy flexible drive shaft connected to the cutter head must traverse a number of bends or curves. Consequently, as the flexible drive shaft rotates, it contacts the inner wall of the cathe~er resulting in localized heating and vibrations due to the frictional contact. This, of course, is very uncomfortable for the 3 0 patient and may result in spasm, wealcening or perforation of the vessel along the route of the catheter.
It is therefore one advantage of the present invention to provide an improved atherec~omy catheter having ' ,:
4 P~/US90/04214 2~J3~ ~
a reciprocal rotary cutter head at the distal elld thereof rot:~ted at a relatively low speed in the range of 2,000 rpm to enhance patient comfort.
One notable feature of the invention to provide an 5 atherectomy catheter for traversing the small and tortuous vasculature of the heart while havin~ the ability to bore through a total obstruction and excise a hemispherical or circumferenti~l section frorn the lumen of the vessel and entrap the excised section within a containment housing.
It is yet another object of the invention to provide an atherectomy catheter for progressively opening the lumen of a vessel, entrapping and discharging the excised obstructiYe material into a containment housing or discharge passage of the catheter until the entire obstruction has been removed leaving 15 a smooth fissure and flap-free enlarged internal vessel diameter.
SUMMAKY OF THE INVENTION
A distal atherectomy cathe~er is disclosed for 2 0 removing obstructions, pla~que, stenosis, occlusions, or the like from an artery or coronary vessel~ The catheter comprises a flexible, hollow outer catheter tube housing a reciprocating, rotating or oscillating cutting element at its distal end. The cutting element is connected to a flexible drive shaft 2 5 concentrically located within the outer tube. An annular return passage is defined by the outer catheter tube about ~he flexible drive shaft providing a discharge passage communicating with an external vacuum means for collection of occlusiYe cuttings removed by the cutting element from the artery or coronary 3 0 vessel. A guide wire extends through the catheter tube and cutting element for guiding the catheter to the occluded site in a vessel. A deflection wire extends through the catheter and exits near its forward end. The exposed end of the deflection : ' ' ~ -wo 91/01114 - Pcr/usso/04214 5 2~3~ ~
wire is welded, soldered or otherwise secured to the forward or leading end of the catheter for deflecting the catheter against the inner wall of the coronary vessel. The drive cable is connected to an external drive motor.
S
BRIEF DESCRIPTION OF THE DRAWINGS . .
So that the manner in which the above recited ~
features, advantages and objects of the present invention are :
attained and can be understood in detail, a more particular 10 description of the invention, briefly summarized above, may be had by reference to the embodiments thereof which are illustrated in the appended drawings. ..
It is to be noted, however, that the appended drawings illustrate only typical embodiments of this inven~ion .:
1~ and are therefore not to be considered limiting of its scope, for the invention may admit to other equally effec~ive embodiments. .
Fig. 1 is a partial sectional view of the atherectomy catheter of the invention;
- 2 0 Fig. 2 is a sectional view of the invention taken ~:
along line 2-2 of Fig. l;
Fig. 3 is a partial sectional view of the CUttillg head of the invention;
Fig. 4 is a sectional view of the cutting head of the .;
invention taken along line 4-4 of Fig. 3;
Fig. S is a partial side view of the def:lection wire of the invention;
Fig. 6 is a partial side view of an alternate embodiment of the cutting head of the invention;
3 0 ~ Fig. 7 is a partial side view of another alternate embodiment of the cutting head of the invention;
Fig. 8 is a partial side view of yet another alternate embodimen~ of the cutting head of the invention; and .,;~
:, wo 91/01 1 l4 Pcr/usso/o42l4 ~ ~3 ~, 3~ r~
Fig. 9 is a partial side view of another embodiment of the cutting head of the invention.
DETAILED DESCRIPTION OF THE PE~EF`ERRED
5 EMBODIM3~NT
Referring first to Fig. 1, the distal alherectomy catheter of the inven~ion is generally identified by the reference numeral 10. The catheter 10 of the invention comprises a flexible outer catheter 12 which may be several 10 feet in length. A cutter element housing 1 4 is thre3dably mounted or otherwise secured to the distal or forward end o~
the catheter tube 12. The proximal end of the catheter tube 12 is connected to a hand-held drive motor assembly generally identified by the reference numeral 20.
The motor assembly 20 includes a motor 22, ba~tery or storage cell 24 and a charging coil 26 housed within a substantially cylindrical housing 28. The motor 22, battery 24 and charging coil 26 are securely retained within the housing 28 and are electrically connected to provide sufficien~
2 0 power to operate the catheter 10. A drive shaft 30 extends axially from the motor 22. The drive shaft 30 extends through and is supported by a brace 32 and a bushing 34 so that the drive shaft 30 rotates freely and shaft vibration is minimized.
A coupling 36 is supported on the end of the drive shaft 30 for 2 5 connection to a drive shaft extension 38. The drive shaft extension 38 is hexagonal or square in cross section and fixedly . secured to the coupling 36 by set screw 40. The driYe shaft extension 38 extends into and is received in an axial recess 42 of a drive wire coupling 44. The axial recess 42 is profiled to 3 0 the shape of the drive sh~ft extension 38 for establishing a rotary connection between the flexible drive wire 46 and ~he drive shaft 30 connected to the rotary drive motor 22.
~' .
wo 91/01114 Pcr/usso/o42l4 7 2~3~
The drive wire coupling 44 is substantially cylindrical in shape and is centrally located wi~hin the h~ndle housing 28. The axial recess 42 is of sufficient depth to permit the drive coupling 44 to be reciprocated along the length of the S drive shaft extension 38 for reciprocally manipulating the cutting element of the apparatus 10 while maintainillg rotary engagement of the drive wire 46 with the drive motor ~2. The drive wire coupling 44 is manually reciprocated by moving the slide knob 48 to and fro. A drive fork 50 connects the slide knob 48 to the drive wire coupling 44. The drive for~ 50, ~s best shown in Fig. 2, terminates in a pair of spaced arms ~2 which extend about and engage the drive wire coupling 4g within a circumferential groove defined by a pair of spaced circumferential flange members 54 extending about the body of the drive wire coupling 44. The flange members 54 are sufficiently spaced and of adequate height to loosely engage the drive fork 50 so that rotation of the drive wire coupling 44 is not impeded even when the drive wire coupling 44 is manually reciprocated along the drive shaft extension 2 0 The open end of the handle housing 28 is closed by a cap 56 which is threaded onto the exteriorly threaded end 58 of the housing 28. The point of connection is sealed by a gasket 60 which is slightly compressed when the cap 56 is fully threaded on the end ~ 8 of the housing 28 .
2 5 The cap ~6 includes an axial passage 62 extending therethrough, a portion of which is interiorly threaded for connection with a Y fitting 64 threaded thereon. An axial passage 66 of reduced diameter but in alignment with the axial passage 62 extends through the Y fitting 64. A passage 68 3 0 angularly branching from the axial passage 66 provides an outlet connection for a cannula 70 providing access to the axial passage 36. The proximal end of the catheter tube 1'~ is attached eo the Y fitting 64 by a catheter retainer cap 72 ~ , ' .
:
::
~ .. :.. . .,. . ~ . - -.. .. . . . . . ~ .. . . . ..
7 ~ 1 8 threadably connected to the externally threaded end 74 of the Y fitting 64.
Referring now to Fig. 2 an on/off switch 76 insures that the cutting element of the invention does not rotate while S the catheter is being inserted into a patient. In the off position the drive motor 22 is opened so that the driYe wire 46 is not rotated. A locater slide 78, to be described in grei~ter de~ai~
hereinafter is located on the housing 28 opposite the slide knob 48 .
Referring now to Fig. 3, the cutter head assembly of the invention is shown in greater detail. The cutter head assembly includes an outer tubular housing 14 threadably secured to the distal end of the catheter tube 12 at 80. A slot or port 82 is formed in the cutter housing 14 by removing a 15 portion of the sidewall of the housing 1 4 providing access to the interior of the housing 14. The slot 82 defines a "duck bill"
profile terminating at a point 84. The "duck bill" profile aides in grabbing the obstructive material to be excised. As the tissue or obstructive material enters 2he slot 82, it is pushed 2 0 against the poiIIt 84 and speared and held stationary for - removal by the cutter 86.
The cutter 86 is connected to the distal end of the flexible drive wire 46. The cutter 46 is substantially cylindrical in shape and partially hollow. A raised portion 88 2 5 interiorly located within the cutter 86 provides a connection point for the drive wire 46. The raised portion 88 does not totally obstruct the interior of the cutter 86 so that a passage is defined which permits a guide wire to be passed through the catheter 12, the cutter 86 and out a guide wire port 90 formed 30 in the forward tip of the cutter housing 14. The sloped portion or ramp 92 of the raised portion 88 enables the guide wire (not shown in the drawings) to conveniently pass through the cutter 86. ~ Likewise, the slope inner walls 94 of the forward tip of the - .
` ~ ~ ~ ' wo gl/01114 Pcr/usso/04214 9 2~3~1 housing 14 direct the guide wire so that it may be conveniently threaded through the port 90 The guide wire typically extends a short distance in advance of the housing 14 lo aid in guiding the catheter of the invention in traversing the tortuous 5 paths encountered in blood vessels, particularly the smaller blood vessels. The proximal end of the cutter 86 forms a serrated cutting edge 96 for removing occlusive material, such as plaque which coats the arterial wall. To aid the efficiency of the cutter 86, bowed wires 98 are provided to 10 force the cutter head against the interior arterial wall of an artery or blood vessel 100 as best shown in Fig. l. The bowed wires 98 are connected to the forward tip of the cutter housing 14 at 102 and extend exterior of the cutter housing 14 through an opening 104. The wires 98 are welded or braised to a 15 locater shaft 1 06 which extends the full length of the catheter 12 and is connected to the locator slide 78 which is manipulated baclc and forth to actuate the wires 98. Referring briefly to Fig. 5, it will be noted that the wires 98 are bent at 108 and crossed over each other. This permits the cutter head 2 0 assembly to be correctly positioned against the wall of the aTtery lO0. In operation, as the locater slide 78 is moved forward, the wires 98 extend into the artery 100 and spread outwardly slightly so that the cutter head assembly is centrally located between the spread wires 98 substantia}ly as shown in 25 Fig. 4. Rotation of the slide knob 78 in the clockwise direction will lock the locater wires 98 in the expanded position. If the catheter is to be rotated for further positioning, the wires 98 must be completely retracted flush with the cutter housing 14 so as to avoid any damage on contact of the wires 98 and the 3 0 vessel wall. The wires 98 decentrali~e the structure of Fig. 3 in the vessel.
Referring again to ~ig. 1, the opera~ion of the catheter 10 will be described . The cathe~er 10 is typicall~
. .
. .
.. , .. , . . . , ., . . . ., . . ... . . . . . . . :.
WO 91/011 14 PCT/US9()/04214 2 ~ o inserted through the femoral artery of the patient and is directed by the physician to the site of the obstruction. If a guide wire is required, the guide wire is inserted through the cannula 70, through the catheter 12 and out the port 90 of the 5 forward tip of the cutter housing 14. Once the cutter head assembly is properly positioned, the guide wire is removed and vacuum pump is connected to the cannula 70 for creating a vacuum within the cathe~er 12 for removal of severed or excised plaque or the like as it is severed by the cutter 86. A
10 seal 1 1 0 in the passage 66 of the Y fitting 64 seals off the return passage so that plaque and the like is directed to a collection vessel connected to the cannula 70.
To operate the catheter 10 the switch 76 is positioned in the on position. However, when the cutter 86 is 15 in the innermost position as shown in Fig. 3, it does not rotate because the electrical connection for providing power to the motor 28 is not yet complete. Referring to Fig. 1, ~he switch 48 is provided with a brass conductor StTip 112 which must engage the brass conductor 11 4 to complete the circuit and 2 0 provide electrical power to the drive shaft 30. As the slide 48 is slid backward toward the base of the handle 20, the contact between the conductor strip 112 and the brass conduc~or 1 14 is completed and the drive motor 22 is engaged resulting in rotation or oscillation of the drive wire 46 which is connected 2 5 ~o the drive wire coupling 44 by a set screw 116. In this manner, the cutter 86 is rotated or oscillated in the range of 2,000 to 10,000 rpm while it is pulled toward the rear end of the cutter housing 14. As material is severed by the cutter 86, it is removed by the vacuum suction so ~hat the severed 30 material does not interfere with the cutting action of the cutter 86.
~: ' , . :-1 1 2~3~ ~
ALTERNATE EMBODIMENTS
Fig. 6 is an embodiment 120 of the cutter head which includes a forward portion 122 which can extend out of, or in advance of, the cutter housing 124 and the cutter itself is 5 hollow having a more or less conical forward portion which is slotted so that it can cut into any obstruction ~hat is directly in advance. It can more or less bore through a !total obstruction.
The backside 126 of the blade still has the serrated cutting edge and it can operate in ihe same fashion as previously 10 described regarding the first embodiment 10.
Fig. 7 is a similar structure 13Q e~cept that the conical cutter head is not exposed but it is enclosed within the forward conical portion of the cutter housing. The cutter housing 132 is slotted and the cutter head 134 is also slotted 1~ and is hollow and may also be provided with some cutting burrs to basically cut or scrape the material as it extends through the slots 136 in the outer conical surface. Again, it also has the serrated at the back edge blade so that it will continue to perform a cutting function as it is reciprocated backwardly 2 0 and the drive shaft is optionally hollow to provide the return passage for any severed material captured within the hollow cutter head. A baffle 138 closes the cone portion of the cutter from the serrated end of the cutter. Hence, cuttings are entrapped in the cone and may be suctioned through the 2 5 hollow drive wire if desired.
Fig. 8 is a similar embodiment 140 except that the housing 142 and cutter head 144 are generally hollow and it may have a passage for a guide wire. The surface of the conical cutter element may be provided with diamond or tungslen 3 0 carbide burrs or may be a V-shaped knife having two cutting edges 146 located diametrically opposite one another for cutting any material entering $hrough the conic screen. The screen defines openings of specified size to enable material :
. . .
wo gl/01114 Pcr/uS90/04214 2~37~1 entry and subsequent cutting. This furnishes holes of the appropriate size to enable occlusive material cutting. As before, cuttings are flushed to the rear of the tool and vacuum removed .
Fig. 9 is another variation on essen~ially the same theme, except in this embodiment lS0, the subsiantial}y cylindrical shape of the cutter element lS2 is constructed ~dth either diagona] or horizontal cutting members l ~4 about the body of the cutting element. The diagonal or hori~ontal cutters 1 54 may be sharply honed to allow the cutter to be rotated or oscilla~ed against a particularly hard material such as calcific or boney material while in contact. In this version a grinding, grating or sanding action is achieved instead of cutting. Cutter reciprocation to and fro will cut or abrade the occlusive material. The back edge 1 56 is again serrated to cut rnaterial extending through the window 1~8 of the housing 160.
While the foregoing is directed to the prefelTed and illustrated embodiments, the scope is determined by the claims which follow.
~ O
WHAT IS CLAIMED IS:
. .
a reciprocal rotary cutter head at the distal elld thereof rot:~ted at a relatively low speed in the range of 2,000 rpm to enhance patient comfort.
One notable feature of the invention to provide an 5 atherectomy catheter for traversing the small and tortuous vasculature of the heart while havin~ the ability to bore through a total obstruction and excise a hemispherical or circumferenti~l section frorn the lumen of the vessel and entrap the excised section within a containment housing.
It is yet another object of the invention to provide an atherectomy catheter for progressively opening the lumen of a vessel, entrapping and discharging the excised obstructiYe material into a containment housing or discharge passage of the catheter until the entire obstruction has been removed leaving 15 a smooth fissure and flap-free enlarged internal vessel diameter.
SUMMAKY OF THE INVENTION
A distal atherectomy cathe~er is disclosed for 2 0 removing obstructions, pla~que, stenosis, occlusions, or the like from an artery or coronary vessel~ The catheter comprises a flexible, hollow outer catheter tube housing a reciprocating, rotating or oscillating cutting element at its distal end. The cutting element is connected to a flexible drive shaft 2 5 concentrically located within the outer tube. An annular return passage is defined by the outer catheter tube about ~he flexible drive shaft providing a discharge passage communicating with an external vacuum means for collection of occlusiYe cuttings removed by the cutting element from the artery or coronary 3 0 vessel. A guide wire extends through the catheter tube and cutting element for guiding the catheter to the occluded site in a vessel. A deflection wire extends through the catheter and exits near its forward end. The exposed end of the deflection : ' ' ~ -wo 91/01114 - Pcr/usso/04214 5 2~3~ ~
wire is welded, soldered or otherwise secured to the forward or leading end of the catheter for deflecting the catheter against the inner wall of the coronary vessel. The drive cable is connected to an external drive motor.
S
BRIEF DESCRIPTION OF THE DRAWINGS . .
So that the manner in which the above recited ~
features, advantages and objects of the present invention are :
attained and can be understood in detail, a more particular 10 description of the invention, briefly summarized above, may be had by reference to the embodiments thereof which are illustrated in the appended drawings. ..
It is to be noted, however, that the appended drawings illustrate only typical embodiments of this inven~ion .:
1~ and are therefore not to be considered limiting of its scope, for the invention may admit to other equally effec~ive embodiments. .
Fig. 1 is a partial sectional view of the atherectomy catheter of the invention;
- 2 0 Fig. 2 is a sectional view of the invention taken ~:
along line 2-2 of Fig. l;
Fig. 3 is a partial sectional view of the CUttillg head of the invention;
Fig. 4 is a sectional view of the cutting head of the .;
invention taken along line 4-4 of Fig. 3;
Fig. S is a partial side view of the def:lection wire of the invention;
Fig. 6 is a partial side view of an alternate embodiment of the cutting head of the invention;
3 0 ~ Fig. 7 is a partial side view of another alternate embodiment of the cutting head of the invention;
Fig. 8 is a partial side view of yet another alternate embodimen~ of the cutting head of the invention; and .,;~
:, wo 91/01 1 l4 Pcr/usso/o42l4 ~ ~3 ~, 3~ r~
Fig. 9 is a partial side view of another embodiment of the cutting head of the invention.
DETAILED DESCRIPTION OF THE PE~EF`ERRED
5 EMBODIM3~NT
Referring first to Fig. 1, the distal alherectomy catheter of the inven~ion is generally identified by the reference numeral 10. The catheter 10 of the invention comprises a flexible outer catheter 12 which may be several 10 feet in length. A cutter element housing 1 4 is thre3dably mounted or otherwise secured to the distal or forward end o~
the catheter tube 12. The proximal end of the catheter tube 12 is connected to a hand-held drive motor assembly generally identified by the reference numeral 20.
The motor assembly 20 includes a motor 22, ba~tery or storage cell 24 and a charging coil 26 housed within a substantially cylindrical housing 28. The motor 22, battery 24 and charging coil 26 are securely retained within the housing 28 and are electrically connected to provide sufficien~
2 0 power to operate the catheter 10. A drive shaft 30 extends axially from the motor 22. The drive shaft 30 extends through and is supported by a brace 32 and a bushing 34 so that the drive shaft 30 rotates freely and shaft vibration is minimized.
A coupling 36 is supported on the end of the drive shaft 30 for 2 5 connection to a drive shaft extension 38. The drive shaft extension 38 is hexagonal or square in cross section and fixedly . secured to the coupling 36 by set screw 40. The driYe shaft extension 38 extends into and is received in an axial recess 42 of a drive wire coupling 44. The axial recess 42 is profiled to 3 0 the shape of the drive sh~ft extension 38 for establishing a rotary connection between the flexible drive wire 46 and ~he drive shaft 30 connected to the rotary drive motor 22.
~' .
wo 91/01114 Pcr/usso/o42l4 7 2~3~
The drive wire coupling 44 is substantially cylindrical in shape and is centrally located wi~hin the h~ndle housing 28. The axial recess 42 is of sufficient depth to permit the drive coupling 44 to be reciprocated along the length of the S drive shaft extension 38 for reciprocally manipulating the cutting element of the apparatus 10 while maintainillg rotary engagement of the drive wire 46 with the drive motor ~2. The drive wire coupling 44 is manually reciprocated by moving the slide knob 48 to and fro. A drive fork 50 connects the slide knob 48 to the drive wire coupling 44. The drive for~ 50, ~s best shown in Fig. 2, terminates in a pair of spaced arms ~2 which extend about and engage the drive wire coupling 4g within a circumferential groove defined by a pair of spaced circumferential flange members 54 extending about the body of the drive wire coupling 44. The flange members 54 are sufficiently spaced and of adequate height to loosely engage the drive fork 50 so that rotation of the drive wire coupling 44 is not impeded even when the drive wire coupling 44 is manually reciprocated along the drive shaft extension 2 0 The open end of the handle housing 28 is closed by a cap 56 which is threaded onto the exteriorly threaded end 58 of the housing 28. The point of connection is sealed by a gasket 60 which is slightly compressed when the cap 56 is fully threaded on the end ~ 8 of the housing 28 .
2 5 The cap ~6 includes an axial passage 62 extending therethrough, a portion of which is interiorly threaded for connection with a Y fitting 64 threaded thereon. An axial passage 66 of reduced diameter but in alignment with the axial passage 62 extends through the Y fitting 64. A passage 68 3 0 angularly branching from the axial passage 66 provides an outlet connection for a cannula 70 providing access to the axial passage 36. The proximal end of the catheter tube 1'~ is attached eo the Y fitting 64 by a catheter retainer cap 72 ~ , ' .
:
::
~ .. :.. . .,. . ~ . - -.. .. . . . . . ~ .. . . . ..
7 ~ 1 8 threadably connected to the externally threaded end 74 of the Y fitting 64.
Referring now to Fig. 2 an on/off switch 76 insures that the cutting element of the invention does not rotate while S the catheter is being inserted into a patient. In the off position the drive motor 22 is opened so that the driYe wire 46 is not rotated. A locater slide 78, to be described in grei~ter de~ai~
hereinafter is located on the housing 28 opposite the slide knob 48 .
Referring now to Fig. 3, the cutter head assembly of the invention is shown in greater detail. The cutter head assembly includes an outer tubular housing 14 threadably secured to the distal end of the catheter tube 12 at 80. A slot or port 82 is formed in the cutter housing 14 by removing a 15 portion of the sidewall of the housing 1 4 providing access to the interior of the housing 14. The slot 82 defines a "duck bill"
profile terminating at a point 84. The "duck bill" profile aides in grabbing the obstructive material to be excised. As the tissue or obstructive material enters 2he slot 82, it is pushed 2 0 against the poiIIt 84 and speared and held stationary for - removal by the cutter 86.
The cutter 86 is connected to the distal end of the flexible drive wire 46. The cutter 46 is substantially cylindrical in shape and partially hollow. A raised portion 88 2 5 interiorly located within the cutter 86 provides a connection point for the drive wire 46. The raised portion 88 does not totally obstruct the interior of the cutter 86 so that a passage is defined which permits a guide wire to be passed through the catheter 12, the cutter 86 and out a guide wire port 90 formed 30 in the forward tip of the cutter housing 14. The sloped portion or ramp 92 of the raised portion 88 enables the guide wire (not shown in the drawings) to conveniently pass through the cutter 86. ~ Likewise, the slope inner walls 94 of the forward tip of the - .
` ~ ~ ~ ' wo gl/01114 Pcr/usso/04214 9 2~3~1 housing 14 direct the guide wire so that it may be conveniently threaded through the port 90 The guide wire typically extends a short distance in advance of the housing 14 lo aid in guiding the catheter of the invention in traversing the tortuous 5 paths encountered in blood vessels, particularly the smaller blood vessels. The proximal end of the cutter 86 forms a serrated cutting edge 96 for removing occlusive material, such as plaque which coats the arterial wall. To aid the efficiency of the cutter 86, bowed wires 98 are provided to 10 force the cutter head against the interior arterial wall of an artery or blood vessel 100 as best shown in Fig. l. The bowed wires 98 are connected to the forward tip of the cutter housing 14 at 102 and extend exterior of the cutter housing 14 through an opening 104. The wires 98 are welded or braised to a 15 locater shaft 1 06 which extends the full length of the catheter 12 and is connected to the locator slide 78 which is manipulated baclc and forth to actuate the wires 98. Referring briefly to Fig. 5, it will be noted that the wires 98 are bent at 108 and crossed over each other. This permits the cutter head 2 0 assembly to be correctly positioned against the wall of the aTtery lO0. In operation, as the locater slide 78 is moved forward, the wires 98 extend into the artery 100 and spread outwardly slightly so that the cutter head assembly is centrally located between the spread wires 98 substantia}ly as shown in 25 Fig. 4. Rotation of the slide knob 78 in the clockwise direction will lock the locater wires 98 in the expanded position. If the catheter is to be rotated for further positioning, the wires 98 must be completely retracted flush with the cutter housing 14 so as to avoid any damage on contact of the wires 98 and the 3 0 vessel wall. The wires 98 decentrali~e the structure of Fig. 3 in the vessel.
Referring again to ~ig. 1, the opera~ion of the catheter 10 will be described . The cathe~er 10 is typicall~
. .
. .
.. , .. , . . . , ., . . . ., . . ... . . . . . . . :.
WO 91/011 14 PCT/US9()/04214 2 ~ o inserted through the femoral artery of the patient and is directed by the physician to the site of the obstruction. If a guide wire is required, the guide wire is inserted through the cannula 70, through the catheter 12 and out the port 90 of the 5 forward tip of the cutter housing 14. Once the cutter head assembly is properly positioned, the guide wire is removed and vacuum pump is connected to the cannula 70 for creating a vacuum within the cathe~er 12 for removal of severed or excised plaque or the like as it is severed by the cutter 86. A
10 seal 1 1 0 in the passage 66 of the Y fitting 64 seals off the return passage so that plaque and the like is directed to a collection vessel connected to the cannula 70.
To operate the catheter 10 the switch 76 is positioned in the on position. However, when the cutter 86 is 15 in the innermost position as shown in Fig. 3, it does not rotate because the electrical connection for providing power to the motor 28 is not yet complete. Referring to Fig. 1, ~he switch 48 is provided with a brass conductor StTip 112 which must engage the brass conductor 11 4 to complete the circuit and 2 0 provide electrical power to the drive shaft 30. As the slide 48 is slid backward toward the base of the handle 20, the contact between the conductor strip 112 and the brass conduc~or 1 14 is completed and the drive motor 22 is engaged resulting in rotation or oscillation of the drive wire 46 which is connected 2 5 ~o the drive wire coupling 44 by a set screw 116. In this manner, the cutter 86 is rotated or oscillated in the range of 2,000 to 10,000 rpm while it is pulled toward the rear end of the cutter housing 14. As material is severed by the cutter 86, it is removed by the vacuum suction so ~hat the severed 30 material does not interfere with the cutting action of the cutter 86.
~: ' , . :-1 1 2~3~ ~
ALTERNATE EMBODIMENTS
Fig. 6 is an embodiment 120 of the cutter head which includes a forward portion 122 which can extend out of, or in advance of, the cutter housing 124 and the cutter itself is 5 hollow having a more or less conical forward portion which is slotted so that it can cut into any obstruction ~hat is directly in advance. It can more or less bore through a !total obstruction.
The backside 126 of the blade still has the serrated cutting edge and it can operate in ihe same fashion as previously 10 described regarding the first embodiment 10.
Fig. 7 is a similar structure 13Q e~cept that the conical cutter head is not exposed but it is enclosed within the forward conical portion of the cutter housing. The cutter housing 132 is slotted and the cutter head 134 is also slotted 1~ and is hollow and may also be provided with some cutting burrs to basically cut or scrape the material as it extends through the slots 136 in the outer conical surface. Again, it also has the serrated at the back edge blade so that it will continue to perform a cutting function as it is reciprocated backwardly 2 0 and the drive shaft is optionally hollow to provide the return passage for any severed material captured within the hollow cutter head. A baffle 138 closes the cone portion of the cutter from the serrated end of the cutter. Hence, cuttings are entrapped in the cone and may be suctioned through the 2 5 hollow drive wire if desired.
Fig. 8 is a similar embodiment 140 except that the housing 142 and cutter head 144 are generally hollow and it may have a passage for a guide wire. The surface of the conical cutter element may be provided with diamond or tungslen 3 0 carbide burrs or may be a V-shaped knife having two cutting edges 146 located diametrically opposite one another for cutting any material entering $hrough the conic screen. The screen defines openings of specified size to enable material :
. . .
wo gl/01114 Pcr/uS90/04214 2~37~1 entry and subsequent cutting. This furnishes holes of the appropriate size to enable occlusive material cutting. As before, cuttings are flushed to the rear of the tool and vacuum removed .
Fig. 9 is another variation on essen~ially the same theme, except in this embodiment lS0, the subsiantial}y cylindrical shape of the cutter element lS2 is constructed ~dth either diagona] or horizontal cutting members l ~4 about the body of the cutting element. The diagonal or hori~ontal cutters 1 54 may be sharply honed to allow the cutter to be rotated or oscilla~ed against a particularly hard material such as calcific or boney material while in contact. In this version a grinding, grating or sanding action is achieved instead of cutting. Cutter reciprocation to and fro will cut or abrade the occlusive material. The back edge 1 56 is again serrated to cut rnaterial extending through the window 1~8 of the housing 160.
While the foregoing is directed to the prefelTed and illustrated embodiments, the scope is determined by the claims which follow.
~ O
WHAT IS CLAIMED IS:
. .
Claims (20)
1. An atherectomy catheter for removal of occlusive material in a blood vessel, tract, or cavity comprising:
(a) an outer catheter tube;
(b) a cutter head assembly attached to the distal end of said outer catheter tube;
(c) flexible drive means extending through said catheter tube;
(d) a rotary cutter housed movably mounted within said cutter head assembly and connected to said flexible drive means;
(e) power means connected to the end of said catheter tube for rotating and reciprocating said cutter within said cutter head assembly for excising occlusive material blocking the vessel; and (f) means connected to said catheter tube means for evacuating the excised occlusive material from the vessel through said cutter head assembly and said catheter tube.
(a) an outer catheter tube;
(b) a cutter head assembly attached to the distal end of said outer catheter tube;
(c) flexible drive means extending through said catheter tube;
(d) a rotary cutter housed movably mounted within said cutter head assembly and connected to said flexible drive means;
(e) power means connected to the end of said catheter tube for rotating and reciprocating said cutter within said cutter head assembly for excising occlusive material blocking the vessel; and (f) means connected to said catheter tube means for evacuating the excised occlusive material from the vessel through said cutter head assembly and said catheter tube.
2. The catheter of claim 1 further including means cooperative with said cutter head assembly for moving a portion thereof laterally relative to the vessel, and wherein a portion of said cutter head assembly comprises an opening for receiving occlusive material therein for excising.
3. The catheter of claim 1 including means for engaging the vessel around said catheter to move said cutter head assembly against the vessel.
4. The catheter of claim 1 wherein said cutter head assembly has an elongate, generally cylindrical shape and has an opening means therein for admitting occlusive material during use, and wherein said cutter cuts occlusive materials into particles sufficiently small for evacuating through said catheter tube.
5. The catheter of claim 1 wherein said cutter head assembly comprises an elongate cylindrical housing, and including protruding resilient means for urging said housing laterally toward occlusive material.
6. The catheter of claim 5 wherein said resilient means comprises a pair of bendable wires protruding from said housing, said wires forming long bows having a curvature exposed for contact and having bow ends recessed from contact against the vessel.
7. The apparatus of claim 6 including a control line extending along said catheter tube to control extension of said wires.
8. The apparatus of claim 7 wherein said wires extend on one side of said housing and said housing has a cutting window diametrically opposite said wires for engaging occlusive material.
9. The apparatus of claim 8 wherein said cutter has a rearwardly facing cutting means to cut material in said window.
10. Apparatus for removal of unwanted or occlusive body material located in a vessel, cavity or other region of the body wherein entry is via an elongate catheter, comprising:
(a) an elongate hollow catheter tube;
(b) a cutting head assembly attached to an end of said catheter tube and comprising:
(1) an elongate housing defining said assembly;
(2) a window formed in said housing, said window being positioned to admit unwanted body material into said housing;
(c) a rotatable cutting means mounted in said housing and having a cutting edge for cutting unwanted body material;
(d) power connected to an end of said catheter tube;
(e) an elongate power drive means in said tube connected from said power means to said cutting means to rotate said cutting means;
(f) means positioning said cutting means in said housing for reciprocating movement to thereby enable cutting of the unwanted body material; and (g) means urging said cutting head assembly toward the unwanted body material causing the unwanted material to align adjacent said window for cutting by said cutting means.
(a) an elongate hollow catheter tube;
(b) a cutting head assembly attached to an end of said catheter tube and comprising:
(1) an elongate housing defining said assembly;
(2) a window formed in said housing, said window being positioned to admit unwanted body material into said housing;
(c) a rotatable cutting means mounted in said housing and having a cutting edge for cutting unwanted body material;
(d) power connected to an end of said catheter tube;
(e) an elongate power drive means in said tube connected from said power means to said cutting means to rotate said cutting means;
(f) means positioning said cutting means in said housing for reciprocating movement to thereby enable cutting of the unwanted body material; and (g) means urging said cutting head assembly toward the unwanted body material causing the unwanted material to align adjacent said window for cutting by said cutting means.
11. The apparatus of claim 10 wherein said rotatable cutting means includes a forwardly located cutting edge, and a rearwardly located cutting edge wherein said rearwardly located cutting edge engages the unwanted body material on retraction of said cutting means.
12. The apparatus of claim 10 wherein said window comprises a side opening window formed in an elongate cylindrical housing .
13. The apparatus of claim 10 wherein said window comprises a plurality of openings formed in a screen formed of wire and said window openings collectively permit unwanted body material to pass therethrough into the path of said cutting means.
14. The apparatus of claim 10 wherein said window comprises an opening on said housing, and said housing has a conic leading end portion with said window at least partially deployed over said conic portion.
15. The apparatus of claim 10 wherein said elongate housing is an elongate cylindrical hollow body, and said window encircles approximately one half the circumference thereof, and wherein said housing includes a forwardly located full circle portion of said housing and said window is to the rear thereof.
16. The apparatus of Claim 1 wherein said cutter head assembly is generally cylindrical in shape centered along and around an axis of rotation therethrough, and including means driven by said flexible drive means for rotating wherein said means comprises said cutter, and said head assembly includes a surrounding alignment surface for guiding said rotating cutter in reciprocating fashion forwardly and rearwardly thereof to form a cutting action.
17. The apparatus of Claim 1 wherein said cutter head assembly includes a side loaded laterally opening port thereinto for receiving occlusive material thereinto for cutting and removal.
18. The apparatus of Claim 1 wherein said cutter head assembly has a selected set of openings formed in the outer surface thereof wherein the outer surface is otherwise a solid member to enable occlusive material to extend thereinto for subsequent removal.
19. The apparatus of Claim 1 wherein said rotary cutter connects with and is rotated by said flexible drive means and said cutter includes at least one sharp edge moving in near proximity of said cutter head assembly to serve as a cutter for occlusive material.
20. The apparatus of Claim 1 including a motorized means for forming rotary motion imparted to a coupling means wherein said coupling means connects with said elongate flexible drive means and said drive means extends along and within said outer catheter tube to thereby impart rotative cutting action to said cutter head assembly, and said cutter head assembly is affixed to the end of said outer catheter tube with said flexible drive means extending therealong for rotative motion therein.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US383,606 | 1989-07-24 | ||
US07/383,606 US5087265A (en) | 1989-02-17 | 1989-07-24 | Distal atherectomy catheter |
Publications (1)
Publication Number | Publication Date |
---|---|
CA2063741A1 true CA2063741A1 (en) | 1991-01-25 |
Family
ID=23513894
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002063741A Abandoned CA2063741A1 (en) | 1989-07-24 | 1990-07-23 | Distal atherectomy catheter |
Country Status (11)
Country | Link |
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US (2) | US5087265A (en) |
EP (1) | EP0484424B1 (en) |
JP (1) | JPH05501074A (en) |
AT (1) | ATE139895T1 (en) |
AU (1) | AU651950B2 (en) |
CA (1) | CA2063741A1 (en) |
DE (1) | DE69027681T2 (en) |
ES (1) | ES2089023T3 (en) |
FI (1) | FI920301A0 (en) |
RU (1) | RU2068239C1 (en) |
WO (1) | WO1991001114A1 (en) |
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-
1989
- 1989-07-24 US US07/383,606 patent/US5087265A/en not_active Expired - Fee Related
-
1990
- 1990-07-23 AT AT90911965T patent/ATE139895T1/en active
- 1990-07-23 AU AU61551/90A patent/AU651950B2/en not_active Ceased
- 1990-07-23 ES ES90911965T patent/ES2089023T3/en not_active Expired - Lifetime
- 1990-07-23 RU SU905010987A patent/RU2068239C1/en active
- 1990-07-23 JP JP2511322A patent/JPH05501074A/en active Pending
- 1990-07-23 DE DE69027681T patent/DE69027681T2/en not_active Expired - Fee Related
- 1990-07-23 EP EP90911965A patent/EP0484424B1/en not_active Expired - Lifetime
- 1990-07-23 CA CA002063741A patent/CA2063741A1/en not_active Abandoned
- 1990-07-23 WO PCT/US1990/004214 patent/WO1991001114A1/en active IP Right Grant
-
1992
- 1992-01-23 FI FI920301A patent/FI920301A0/en not_active Application Discontinuation
- 1992-02-10 US US07/833,362 patent/US5370651A/en not_active Expired - Fee Related
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WO1991001114A1 (en) | 1991-02-07 |
US5087265A (en) | 1992-02-11 |
FI920301A0 (en) | 1992-01-23 |
DE69027681T2 (en) | 1997-02-20 |
US5370651A (en) | 1994-12-06 |
EP0484424A1 (en) | 1992-05-13 |
DE69027681D1 (en) | 1996-08-08 |
JPH05501074A (en) | 1993-03-04 |
RU2068239C1 (en) | 1996-10-27 |
AU651950B2 (en) | 1994-08-11 |
ATE139895T1 (en) | 1996-07-15 |
EP0484424B1 (en) | 1996-07-03 |
EP0484424A4 (en) | 1992-11-19 |
ES2089023T3 (en) | 1996-10-01 |
AU6155190A (en) | 1991-02-22 |
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Legal Events
Date | Code | Title | Description |
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EEER | Examination request | ||
FZDE | Discontinued |