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Publication numberCA2392207 A1
Publication typeApplication
Application numberCA 2392207
PCT numberPCT/US2000/032412
Publication date7 Jun 2001
Filing date28 Nov 2000
Priority date6 Dec 1999
Also published asCA2392207C, CA2690259A1, EP1237488A1, EP1237488A4, US6454775, US6660014, US6945977, US20020151906, US20040082962, WO2001039673A1
Publication numberCA 2392207, CA 2392207 A1, CA 2392207A1, CA-A1-2392207, CA2392207 A1, CA2392207A1, PCT/2000/32412, PCT/US/0/032412, PCT/US/0/32412, PCT/US/2000/032412, PCT/US/2000/32412, PCT/US0/032412, PCT/US0/32412, PCT/US0032412, PCT/US032412, PCT/US2000/032412, PCT/US2000/32412, PCT/US2000032412, PCT/US200032412
InventorsDenise Demarais, Michael A. Evans, Stephen A. Leeflang, Christian S. Eversull
ApplicantBacchus Vascular Inc., Denise Demarais, Michael A. Evans, Stephen A. Leeflang, Christian S. Eversull
Export CitationBiBTeX, EndNote, RefMan
External Links: CIPO, Espacenet
Systems and methods for clot disruption and retrieval
CA 2392207 A1
Abstract
Thrombectomy and other treatments are achieved using a catheter (12) having a positioning cage (26) and a macerator (40) within the positioning cage. The catheter is introduced to a target body lumen, typically a blood vessel, and a positioning cage deployed at a treatment site. The macerator is then operated to disrupt thrombus, clot, or other occlusive material at the treatment site, and the catheter is used to collect and remove the disruptive material from the body lumen. In particular examples, the macerator may be radially expansible and optionally rotated and/or axially translated within the positioning cage to effect disruption of the occlusive material.
Description  available in
Claims(36)
1. A catheter for removing occlusive material from a body lumen, said catheter comprising:
a catheter body having a proximal end, a distal end, and a lumen therethrough;
a radially expansible positioning cage near the distal end of the catheter body; and a macerator configured to break up occlusive material within the cage and draw the material into the catheter body lumen.
2. A catheter as in claim 1, further comprising a mechanical pump component disposed within the catheter body lumen.
3. A catheter as in claim 2, wherein the mechanical pump component is adapted to rotate such that it moves occlusive material from the distal end to the proximal end of the catheter body within the lumen.
4. A catheter as in claim 1, further comprising means for selectively adjusting the diameter of the radially expansible positioning cage.
5. A catheter as in claim 1, wherein the radially expansible cage is self-expanding and has a predetermined unconstrained diameter.
6. A catheter as in any of claims 1 to 5, wherein the macerator is radially expansible.
7. A catheter as in claim 6, further comprising means for selectively adjusting the diameter of the macerator.
8. A catheter as in claim 6, wherein the macerator is self-expanding and has a predetermined unconstrained diameter.
9. A catheter as in claim 6, wherein the cage is expansible from an initial width in the range from 1 mm to 4 mm to an expanded width in the range from 2 mm to 40 mm and the macerator has an initial width in the range from 1 mm to 4 mm and an expanded width in the range from 2 mm to 40 mm.
10. A catheter as in claim 6, wherein adjustment of the radial dimension of the macerator is not coupled to expansion of the positioning cage.
11. A catheter as in claim 6, wherein the macerator is rotatable.
12. A catheter as in claim 11, further comprising a drive unit at the proximal end of the catheter body, wherein the drive unit is mechanically coupled to the macerator.
13. A macerator comprising:
a tubular shaft having a proximal end, a distal end, and at least one lumen therethrough;
a wire having a distal section terminating in a distal tip and proximal shank;
wherein the distal tip of the wire is attached to an exterior location near the distal end of the tubular shaft and wherein the proximal shank is slidably received in the lumen of the shaft so that the distal section of the wire can be radially expanded and contracted by axially translating the shank within the shaft.
14. A macerator as in claim 13, wherein the tubular shaft includes only a single lumen which extends the entire length of the shaft and wherein the wire passes into the lumen through a port in a side of the shaft.
15. A macerator as in claim 14, wherein the lumen has an internal diameter of at least 0.25 mm to accommodate both the wire and a guidewire.
16. A macerator as in claim 15, wherein the wire has a maximum diameter in the range from 0.05 mm to 1.3 mm.
17. A macerator as in claim 13, wherein the tubular shaft has at least two lumens, wherein the capture wire is received in a proximal portion of one lumen and the other lumen is configured to receive a guidewire.
18. A macerator as in claim 17, wherein the lumen which receives the capture wire terminates proximally of the distal end of the tubular shaft and wherein the lumen which receives the guidewire extends to the distal end of the shaft.
19. A macerator as in claim 18, wherein the lumen which receives the guidewire extends the entire length of the shaft.
20. A macerator as in claim 13, further comprising a helical rotor disposed over at least a portion of the tubular shaft, wherein said rotor is configured to act as a mechanical pump when the macerator is rotated about its axis.
21. A macerator comprising:
a tubular shaft assembly including:
(a) an outer tube having a proximal end, a distal end, and a lumen therethrough; and (b) an inner tube having a proximal end, a distal end, and a lumen therethrough, wherein the outer tube is slidably and/or rotatably received over the inner tube; and a wire capture coil having one end attached to the proximal end of the inner tube and another end attached to the proximal end of the outer tube, wherein the coil can be radially expanded and collapsed by rotating and/or axially translating the inner tube relative to the outer tube.
22. A macerator as in claim 19, further comprising a helical rotor disposed over at least a portion of the tubular shaft, wherein said rotor is configured to act as a mechanical pump when the macerator is rotated about its axis.
23. A method for removing occlusive material from a body lumen, said method comprising:
positioning a macerator so that it is spaced inwardly from a surrounding wall of the body lumen;
rotating the macerator to engage and disrupt clot without significant shearing; and withdrawing the disrupted clot from the body lumen.
24. A method as in claim 23, further comprising adjusting a width of the macerator.
25. A method as in claim 24, wherein the macerator is a shaped wire.
26. A method as in claim 25, wherein the width is adjusted by relative rotation of a pair of spaced-apart points on the wire.
27. A method as in claim 25, wherein the width is adjusted by relative axial adjustment of a pair of spaced-apart points on the wire.
28. A method as in claim 23, wherein positioning comprises expanding a positioning cage with the body lumen, wherein the macerator is located within the positioning cage.
29. A method as in claim 28, further comprising axially translating the rotating macerator within the positioning cage.
30. A method as in claim 28, wherein the macerator is rotated without axial movement.
31. A kit comprising:
a catheter having a rotatable macerator near a distal end thereof; and instructions for use according to the method of claim 23.
32. A catheter for removing occlusive material from a body lumen, said catheter comprising:
a catheter body having a proximal end, a distal end, and a lumen therethrough;
means for breaking-up occlusive material;
means for positioning said breaking-up means, said positioning means expansible over said breaking-up means near the distal end; and means for drawing said material proximally in the catheter body lumen.
33. A catheter as in claim 32, wherein said catheter body is axially flexible and wherein said drawing means comprises a pump component extending along said flexible catheter body lumen.
34. A catheter as in claim 32, further comprising a guidewire lumen extending proximally from adjacent the distal end.
35. A catheter as in claim 32, further comprising means for filtering luminal flow to inhibit movement of the material axially within the body lumen, the filtering means radially expansible and disposed near the distal end.
36. A catheter as in claim 32, further comprising means for blocking lumenal flow, the blocking means radially expansible and disposed near the distal end.
Classifications
International ClassificationA61M25/00, A61M29/00, A61B17/00, A61B17/22
Cooperative ClassificationA61F2002/016, A61F2002/018, A61F2230/0067, A61F2230/0076, A61F2230/0093, A61B2017/320775, A61M25/0023, A61B17/320725, A61M29/02, A61B2017/2212, A61F2/013, A61B2017/00685
European ClassificationA61F2/01D, A61M29/02, A61M25/00R1, A61B17/3207E
Legal Events
DateCodeEventDescription
3 Feb 2006EEERExamination request
10 Jan 2015MKLALapsed
Effective date: 20141128