Nothing Special   »   [go: up one dir, main page]

WO1999056801A2 - Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders - Google Patents

Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders Download PDF

Info

Publication number
WO1999056801A2
WO1999056801A2 PCT/US1999/009566 US9909566W WO9956801A2 WO 1999056801 A2 WO1999056801 A2 WO 1999056801A2 US 9909566 W US9909566 W US 9909566W WO 9956801 A2 WO9956801 A2 WO 9956801A2
Authority
WO
WIPO (PCT)
Prior art keywords
guidewire
catheter
obstructive matter
proximal
embolectomy
Prior art date
Application number
PCT/US1999/009566
Other languages
French (fr)
Other versions
WO1999056801A3 (en
Inventor
Robert F. Rosenbluth
Brian J. Cox
George R. Greene, Jr.
Original Assignee
Microvention, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Microvention, Inc. filed Critical Microvention, Inc.
Priority to AU37801/99A priority Critical patent/AU767873B2/en
Priority to JP2000546825A priority patent/JP4219558B2/en
Priority to CA002329013A priority patent/CA2329013A1/en
Priority to ES99920259T priority patent/ES2304808T3/en
Priority to DE69938425T priority patent/DE69938425T2/en
Priority to EP99920259A priority patent/EP1079874B1/en
Priority to BR9910169-6A priority patent/BR9910169A/en
Publication of WO1999056801A2 publication Critical patent/WO1999056801A2/en
Publication of WO1999056801A3 publication Critical patent/WO1999056801A3/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A61B17/22032Gripping instruments, e.g. forceps, for removing or smashing calculi having inflatable gripping elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/132Tourniquets
    • A61B17/135Tourniquets inflatable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A61B2017/22034Gripping instruments, e.g. forceps, for removing or smashing calculi for gripping the obstruction or the tissue part from inside
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A61B2017/22042Details of the tip of the guide wire
    • A61B2017/22044Details of the tip of the guide wire with a pointed tip
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22072Implements 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 instrument channel, e.g. for replacing one instrument by the other
    • A61B2017/22074Implements 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 instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
    • A61B2017/22077Implements 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 instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel with a part piercing the tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22082Implements 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 after introduction of a substance
    • A61B2017/22084Implements 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 after introduction of a substance stone- or thrombus-dissolving
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22094Implements 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 for crossing total occlusions, i.e. piercing
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/3207Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B2017/320716Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions comprising means for preventing embolism by dislodged material
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01Filters implantable into blood vessels
    • A61F2002/016Filters implantable into blood vessels made from wire-like elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/01Filters implantable into blood vessels
    • A61F2002/018Filters implantable into blood vessels made from tubes or sheets of material, e.g. by etching or laser-cutting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0073Quadric-shaped
    • A61F2230/008Quadric-shaped paraboloidal
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0091Three-dimensional shapes helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/0021Catheters; Hollow probes characterised by the form of the tubing
    • A61M2025/0042Microcatheters, cannula or the like having outside diameters around 1 mm or less
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M2025/0183Rapid exchange or monorail catheters

Definitions

  • the present invention relates generally to medical methods and devices, and more particularly to thrombolectomy catheters, and methods for using such thrombolectomy catheters, for removing blood clots or other matter from the lumens of blood vessels or other anatomical conduits.
  • thromboembolic disorders such as stroke, pulmonary embolism, peripheral thrombosis, atherosclerosis, and the like, are known to occur in human beings and other mammals.
  • thromboembolic disorders are typically characterized by the presence of a thromboembolus (i.e., a viscoelastic blood clot comprised of platelets, fibrinogen and other clotting proteins) which has become lodged at a specific location in a blood vessel.
  • a thromboembolus i.e., a viscoelastic blood clot comprised of platelets, fibrinogen and other clotting proteins
  • the obstruction created by the thromboembolus may give rise to a condition of blood stasis, with the development of a condition known as thrombophlebitis within the vein.
  • peripheral venous embolisms may migrate to other areas of the body where even more serious untoward effects can result.
  • emboli that originate in the peripheral venous system, and which subsequently migrate through the venous vasculature and become lodged with the lung.
  • tissue ischemia (lack of available oxygen and nutrients required by the tissue) may develop.
  • the ischemic tissue may become infarcted (i.e., necrotic).
  • tissue infarction can result in death and amputation of a limb, myocardial infarction, or stroke.
  • strokes caused by thromboemboli which become lodged in the small blood vessels of the brain continue to be a leading cause of death and disability, throughout the world.
  • thromboembolic disorders are typically treated by one or more of the following treatment modalities: a) pharmacologic treatment wherein thrombolytic agents (e.g., streptokinase, urokinase, tissue plasminogen activator (TPA)) and/or anticoagulant drugs (e.g., heparin, warfarin) are administered in an effort to dissolve and prevent further growth of the clot;
  • thrombolytic agents e.g., streptokinase, urokinase, tissue plasminogen activator (TPA)
  • anticoagulant drugs e.g., heparin, warfarin
  • open surgical procedures e.g., surgical embolectomy or clot removal
  • an incision is made in the blood vessel in which the clot is lodged and the clot is removed through such incision-sometimes with the aid of a balloon-tipped catheter (e.g., a
  • a clot removing/disrupting catheter e.g., a suction-type catheter having a suction tip, clot-capturing type catheter having a clot capturing receptacle (e.g., a basket, coil, hook, etc.), or clot- disrupting catheter having a clot disrupting apparatus (e.g., an ultrasound probe or laser)
  • a clot removing/disrupting catheter e.g., a suction-type catheter having a suction tip, clot-capturing type catheter having a clot capturing receptacle (e.g., a basket, coil, hook, etc.), or clot- disrupting catheter having a clot disrupting apparatus (e.g., an ultrasound probe or laser)
  • the suction tip, clot capturing receptacle or clot disrupting apparatus is used to aspirate, capture & remove, disrupt or ablate the offending clot.
  • pharmacologic treatment has the advantage of being non-invasive and is often effective in lysing or dissolving the clot.
  • the thrombolytic and/or anticoagulant drugs used in these pharmacologic treatments can cause untoward side effects such as bleeding or hemorrhage.
  • time is of the essence, such as cases where an arterial thromboembolism is causing severe tissue ischemia (e.g., an evolving stroke or an evolving myocardial infarction) the time which may be required for the thrombolytic drugs to fully lyse or dissolve the blood clot and restore arterial blood flow may be too long to avoid or . minimize the impending infarction.
  • Open surgical thrombus-removing procedures can, in many cases, be used to rapidly remove clots from the lumens of blood vessels, but such open surgical procedures are notoriously invasive, often require general anesthesia, and the use of such open surgical procedures is generally limited to blood vessels which are located in surgically accessible areas of the body. For example, many patients suffer strokes due to the lodging of blood clots in small arteries located in surgically inaccessible areas of their brains and, thus, are not candidates for open surgical treatment.
  • Transluminal, catheter-based interventional procedures are minimally invasive, can often be performed without general anesthesia, and can in some cases be used to rapidly remove a clot from the lumen of a blood vessel.
  • catheter-based interventional procedures are highly operator-skill-dependent, and can be difficult or impossible to perform in small or tortuous blood vessels.
  • patients who suffer strokes due to the presence of clots in the small, tortuous arteries of their brains may not presently be candidates for catheter-based, transluminal removal of the clot, due to the small size and tortuosity of the arteries in which their clots are located.
  • the trasluminally deployable clot capturing type of catheters could be useable in ischemic strokes, because they are typically capable of removing an offending blood clot without the need for suction or application of energy (e.g., laser, ultrasound) which could be injurious to the delicate, small blood vessels of the brain.
  • energy e.g., laser, ultrasound
  • none of the prior art trasluminally deployable clot capturing type of catheters are believed to be of optimal design for use in the small blood vessels of the brain because they are a) not equipped with appropriate guidewire passage lumens to allow them to be passed over previously inserted, small-diameter (e.g.,
  • 0.006-0.018 inch guidewires they are not adapted for rapid exchange over a guidewire of standard length (e.g., a guidewire which is less than twice the length of the catheter) and c) the clot capturing receptacles of these catheters are not optimally constructed and configured for removal of clots from very small blood . vessels as are typically found in the brain.
  • transluminally deployable clot-capturing type embolectomy catheters of the prior art include those described in United States Patent Nos. 4,706,671 (Weinrib), 4,873,978 (Ginsburg), 5.011.488 (Ginsburg) and PCT International Patent Publication No. WO 97/27808(Wensel, et al.).
  • None of these prior art embolectomy catheters are believed to be optimally designed for treating ischemic stroke.
  • the present invention generally comprises an embolectomy catheter device and method for removing blood clots or other matter from the lumens of blood vessels or other anatomical conduits of a mammalian body.
  • the embolectomy catheters and methods of the present invention are particularly suitable for use in removing clots or thromboemboli from small arteries of the mammalian brain to prevent or minimize the severity of stroke.
  • An embolectomy catheter device of the present invention generally comprises; a) an elongate, pliable clot penetrating catheter which is advanceable, distal end first, through the clot or other obstructive matter (e.g., thrombus, thromboembolus, peices of detached atherosclerotic plaque, foreign matter, etc.) which is to be removed, and b) a matter capturing receptacle which is deployable from the distal end of the catheter after it has been advanced through the obstructive matter, to capture and facilitate removal of the obstructive matter.
  • the matter capturing receptacle is initially disposable in a first or stowed configuration .
  • the receptacle is in a radially collapsed condition and contained upon or within the catheter or otherwise sufficiently compact to pass through the clot or other obstructive matter.
  • the matter capturing receptacle is deployable (e.g., advanceable, projectable and/or expandable) from the catheter such that it assumes a second or expanded configuration wherein the receptacle may receive and at least partially surround the distal aspect of the clot or other obstructive matter so as to facilitate extraction and removal of the blood clot or other obstructive matter along with the catheter.
  • a guidewire lumen may extend longitudinally through the entire length of the catheter (i.e., an "over-the-wire” embodiment) or through only a distal portion of the catheter or through an attached guidewire receiving loop/projection (i.e., a "rapid exchange” embodiment).
  • the guidewire lumen may extend through the matter capturing receptacle such that the catheter (with its matter capturing receptacle in its collapsed or stowed configuration) may be advanced over a guidewire which has previously been passed through the vessel-obstructing clot or other obstructive matter.
  • Such arrangement of the guidewire lumen additionally allows the embolectomy catheter to be exchanged (e.g., removed and replaced with another embolectomy catheter or another type of catheter) if such exchange should become necessary or desirable.
  • This ability to allow the guidewire to remain positioned through the offending clot or other obstructive matter may serve to ensure that the catheter or its replacement can be re-advanced through the clot or other obstructive matter to its desired position.
  • the matter capturing receptacle of the catheter may comprise a distal obstructive matter-engaging portion (e.g., a coil, basket or concave member) of porous construction (e.g., a woven, coiled or mesh structure formed of wire, fiber or fabric), which is attached to the catheter by way of one or more proximal struts (e.g. connector members (e.g., a plurality of thin wires or struts).
  • proximal struts e.g. connector members (e.g., a plurality of thin wires or struts).
  • the matter capturing receptacle is moved to its second (e.g., expanded or operative) configuration, such that the distal obstructive matter -engaging portion 16 of the receptacle will contact and/or at least partially surround the distal aspect of the clot or other obstructive matter.
  • the distal obstructive matter -engaging portion of the receptacle is preferably of permeable construction to permit blood to flow therethrough, but is sufficiently dense (i.e., sufficiently impermeable) to prevent the clot or other obstructive matter from passing therethrough.
  • the distal obstructive matter-engaging portion of the receptacle is useable to retract or draw the clot or other obstructive matter, in the proximal direction, from its then-present location.
  • the proximal strut(s) which extend between the receptacle to the catheter are typically of radially splayed or outwardly angled configuration and is/are preferably configured, oriented and positioned so as to slice, cut or otherwise pass through the matter of the clot or other obstructive matter, when deployed at a sit distal to the clot or other obstructive matter and subsequently retracted in the proximal direction.
  • energy e.g., radio-frequency energy, vibration, heat, etc
  • energy may be applied to the proximal strut(s) during their proximal retraction through the clot or other obstructive matter.
  • a contrast medium injection port may be formed on the proximal portion of the embolectomy catheter, to allow radiographic contrast medium (e.g., dye) to be injected through the catheter while a guidewire remains positioned within the guidewire lumen.
  • radiographic contrast medium e.g., dye
  • a rapid exchange microcatheter which comprises a small diameter flexible microcatheter of a type commonly used in neuroradiology procedures (e.g., ProwlerTM microcatheter, Cordis Endovascular Systems, Miami Lakes, Florida), which has greater flexibility at or near its distal end than at or near its proximal end, and which . includes in accordance with this invention, the addition of a guidewire passage port formed in the sidewall of the catheter, at a spaced distance (e.g., 0.5-35 cm) from its distal tip.
  • a spaced distance e.g., 0.5-35 cm
  • a guidewire receiving loop or projection may be formed in the side of the catheter body.
  • a guidewire deflector may be formed within the main lumen of the catheter adjacent to the guidewire passage aperture, to deflect the proximal end of a guidewire out of the guidewire passage aperture as the catheter is advanced over the guidewire. The formation of such guidewire passage aperture and guidewire deflector allows a guidewire to be passed through only a distal portion of the catheter lumen.
  • This lumen arrangement allows the microcatheter to be exchanged (i.e., removed and replaced by another microcatheter or an embolectomy catheter of the above-summarized design) while the operator holds the guidewire in place by grasping the exteriorized proximal end of the guidewire-even in instances where a standard length guidewire (i.e., not an "exchange-length" guidewire) is used.
  • ischemic stroke caused by a thromboembolism which has become lodged in a small blood vessel of the brain (i.e., blood vessels located in, on or around the brain).
  • the method of the present invention may be carried out using the rapid-exchange microcatheters and embolectomy catheters of the present invention.
  • the preferred method generally comprises the steps of:
  • radiographic contrast medium e.g., dye
  • G. optionally injecting radiographic contrast medium through a lumen of the embolectomy catheter to guide or verify the positioning of the embolectomy catheter relative to the lodged blood clot or other obstructive matter; H. deploying the obstructive matter-capturing receptacle of the embolectomy catheter such that it assumes its second or expanded configuration at a site which is distal (i.e., downstream) of the lodged blood clot or other obstructive matter; I.
  • a proximal portion of the receptacle i.e., proximal struts
  • a proximal portion of the receptacle i.e., proximal struts
  • J. optionally injecting radiographic contrast medium through a lumen of the. embolectomy catheter to determine whether blood flow has been restored through the region of the blood vessel which had previously been deprived of blood flow due to the presence of the clot or other obstructive matter; and, k. retracting the embolectomy catheter to remove the blood clot or other obstructive matter from the body (e.g., withdrawing the embolectomy catheter and the extracted clot ot other obstructive matter through the percutaneous entry tract through which the catheter had previously been inserted.
  • the blood clot or other obstructive matter which is causing an ischemic (i.e., thrombotic or embolic) stroke is removed and arterial bloodflow is restored to the region of the brain which had become ischemic due to the lodging on the offending blood clot or other obstructive matter within the blood vessel.
  • an ischemic i.e., thrombotic or embolic
  • Figure 1 is a perspective view of a human patient having a first embodiment (an "over-the-wire embodiment) of an embolectomy catheter of the present Figure 1 a is a perspective view of the embolectomy catheter device of Figure 1 operatively positioned upon a guidewire, and having its obstructive matter- capturing receptacle disposed in an expanded configuration.
  • Figure 2a is an enlarged longitudinal sectional view of the distal end of the over-the-wire embolectomy catheter of Figure 1 with its obstructive matter- capturing receptacle in a first or stowed position.
  • Figure 2b is an enlarged, broken, longitudinal sectional view of the distal end of the over-the-wire embolectomy catheter of Figure 1 with its obstructive matter-retrieving member in a distally advanced position and its obstructive matter- capturing receptacle disposed in a fully expanded configuration.
  • Figure 2c is a cross-sectional view through line 2c-2c of Figure 2a.
  • Figure 2d is a cross-sectional view through line 2d-2d of Figure 2a.
  • Figure 2d' is a cross-sectional view through line 2d-2d of Figure 2a, modified to show an alternative mode of constructing the guide bores in the distal tip member, through which the wires which form the obstructive matter-capturing receptacle extend.
  • Figure 3a is an enlarged, broken, longitudinal sectional view of the distal end of the over-the-wire microcatheter of the prior art.
  • Figure 3b is an enlarged, broken, longitudinal sectional view of the distal end of a second embodiment (i.e., another over-the-wire embodiment) of an embolectomy catheter of the present invention.
  • Figure 3b' is a cross-sectional view through line 3b'-3b' of Figure 3b.
  • Figure 3c is an enlarged, broken, longitudinal sectional view of the distal end of a rapid exchange microcatheter of the present invention.
  • Figure 3c' is a cross-sectional view through line 3c'-3c' of Figure 3c.
  • Figure 3d is an enlarged, broken, longitudinal sectional view of the distal end of a third embodiment (i.e., a rapid exchange embodiment) of an embolectomy catheter of the present invention.
  • Figure 3d' is a cross-sectional view through line 3d'-3d' of Figure 3d.
  • Figure 3e is an enlarged, longitudinal sectional view of the distal end of a fourth embodiment (i.e., another rapid exchange embodiment) of an embolectomy catheter of the present invention.
  • Figure 3e' is a cross-sectional view through line 3e'-3e' of Figure 3e.
  • Figure 3f is an enlarged, longitudinal sectional view of the distal end of a fifth embodiment (i.e., another rapid exchange embodiment) of an embolectomy catheter of the present invention.
  • Figure 3f is a cross-sectional view through line 3f'-3f of Figure 3f.
  • Figure 4 is a perspective view of the third embodiment (i.e., a.rapid exchange embodiment) of an embolectomy catheter of Figure 3d having a guidewire operatively inserted through its guidewire lumen and its obstructive matter capturing receptacle in its deployed, radially expanded position.
  • a.rapid exchange embodiment i.e., a.rapid exchange embodiment
  • Figure 5 is a perspective view of a first alternative obstructive matter- capturing receptacle which may be incorporated into any of the embolectomy catheters of the p[resent invention.
  • Figure 5' is an enlarged view of portion 5' of Figure 5.
  • Figure 5" shows an alternative construction for portion 5' of Figure 5.
  • Figure 5a is a distal end view of Figure 5.
  • Figure 5b is a perspective view of a second alternative obstructive matter- capturing receptacle which may be incorporated into any of the embolectomy catheters of the present invention.
  • Figure 5b' is a perspective view of the second alternative obstructive matter- capturing receptacle of Figure 5b having a clot captured therewithin and with its support spines being partially retracted into the catheter.
  • Figure 5b" is a perspective view of the second alternative obstructive matter- capturing receptacle of Figure 5b having a clot captured therewithin and with its support spines being further retracted into the catheter so that the obstructive matter capturing receptacle is drawn partially around the captured clot.
  • Figure 5c is a perspective view of a third alternative obstructive matter- capturing receptacle which may be incorporated into any of the embolectomy catheters of the present invention.
  • Figure 6 is a perspective view of an optional guide catheter of the present invention having a proximal obstructive matter containment apparatus operatively deployed therefrom, and an embolectomy catheter of the present invention operatively inserted therethrough.
  • Figure 7 is an elevational view of a variant of the helical basket type obstructive matter capturing receptacle of the catheters shown in Figures 1 , 2b and 4, such variant being constructed of metal ribbon rather than wire.
  • Figure 7a is a cross-sectional view through line 7a-7a of Figure 7, illustrating the manner in which the metal ribbons may be twisted to enhance the ability of the proximal strut portions to the obstructive matter capturing receptacle to cut through the thromboembolic material.
  • Figures 8a-8f are step-wise showings of a procedure wherein the first embodiment (i.e., an over-the-wire embodiment) of an embolectomy catheter of the present invention is used to remove a blood clot from a small blood vessel of a mammalian body.
  • Figures 9a-9d are step-wise showings of a procedure wherein the third embodiment (i.e., a rapid exchange embodiment) of an embolectomy catheter of the present invention is used to remove a blood clot from a small blood vessel of a mammalian body.
  • the third embodiment i.e., a rapid exchange embodiment
  • an embolectomy catheter of the present invention is used to remove a blood clot from a small blood vessel of a mammalian body.
  • Figure 1 shows a human patient in whom an over the wire embodiment of the embolectomy catheter device
  • the catheter device 10 of the present invention has been inserted for the purpose of removing a thromboembolus or blood clot from a small artery located in the patient's brain.
  • the offending clot had been located by ⁇ angiography or other imaging means, and a small (e.g., 0.006-0.010 inch outer diameter) guidewire GW was inserted into the patient's femoral artery and advanced into the artery of the brain in which the clot is located and at least partially through the clot. Thereafter, the catheter device 10 was advanced over the previously inserted guidewire GW to a position were the distal end of the catheter device 10 is near the clot.
  • the first embodiment of the over-the-wire catheter device 10 comprises an elongate, pliable catheter 11 having a clot capturing receptacle 14 deployable from its distal end DE, as shown.
  • the obstructive matter- capturing receptacle 14 is formed of a plurality (e.g., 2 or more) wire members 20 which are initially retractable to substantially straight configurations and a first (i.e., stowed) position, within the catheter 11. (See Figure 2a) When it is desired to deploy the obstructive matter capturing receptacle 14, the preformed wire members
  • proximal portions 18 of the wire members 20 are advanced in the distal direction such that the emerge from the constraint of the catheter 11 and resiliently assume a second (i.e. operative) configuration wherein the distal portions of the wire members form a helical basket 16 having an open proximal mouth or rim 17, as shown in Figure 2b.
  • the helical basket 16 is sufficiently porous to allow blood to flow therethrough, but sufficiently dense to engage and withdraw in the proximal direction, a thromboembolism.
  • a nose cone 30 is positioned on the distal ends of the wire members 18.
  • the proximal portions 18 of the elongate wire members 20 act as connecting members between the helical basket 16 and the catheter 11.
  • These proximal portions 18 of the wire members 20 are of sufficiently small diameter or are otherwise configured to be retracted through a thromboembolism, without causing substantial disruption or segmentation of the thromboembolism.
  • energy may be applied to the proximal portions 18 of the wire members 20 to facilitate their retraction through the thromboembolic material without causing substantial disruption or segmentation of the thromboembolism.
  • the wire members 20 of which the capturing receptacle 14 is formed may be of any suitable material, such as elastic, superelastic or shape memory alloy wire. The distal portions of these wire members are preformed to the shape of the helical basket 16 but are sufficiently elastic to assume substantially straight configurations when retracted through the guide bores 26 and into the catheter 11 and maintained in a taut state under a small amount of proximally directed pressure. (See Figure
  • the proximal ends of these members 20 are attached to the distal end of a longitudinally slidable actuator 24 which is positioned within the lumen 22 of the catheter body 12.
  • a hollow actuator lumen 22a extends through the actuator 24 and is in axial alignment with the lumen 22 of the catheter body 12.
  • the shaft of the actuator 24 has a wire braid or coil 25 formed therein to impart stiffness and strength.
  • a distal tip member 28 is formed on the distal end DE of the catheter body 12, such distal tip member 28 having a hollow tip member lumen 22TM which extends longitudinally through the center thereof, and four (4) wire passage bores 26 which also extending longitudinally therethrough, at radially spaced-apart locations (i.e., the 3, 6, 9 and 12 o'clock positions).
  • the distal tip member 28 may be formed of material which is more rigid than the catheter body 12 and may have a proximal portion 40 of reduced diameter which is inserted into the distal end DE of the catheter body lumen 22, as shown in Figures 2a, 2b and 2d.
  • Each of the four (4) preformed segments 20 which form the obstructive matter capturing receptacle
  • Figure 2d' shows an alternative construction of the distal tip member wherein four (4) cut-out notches 26A.T are formed at the 3, 6, 9 and 12 o'clock positions to serve as discrete guide wire passageways for the individual wire segments 20, in lieu of the wire passage bores 26.
  • a proximal actuator shaft 24' extends to a housing 13 formed on the proximal end of the catheter, and such proximal actuator shaft 24' may be manually advanced and retracted to control deployment and retraction of the obstructive matter capturing receptacle 14.
  • a contrast medium injection port 15 is also formed don the proximal housing 13, for injection of radiographic contrast medium through the lumen 22 and out of the distal end DE of the catheter 11.
  • the outer diameter of the guidewire GW be at least slightly less than the inner diameter of the lumen 22 to permit some radiographic contrast medium to pass through the lumen 22 and out of the distal end of the catheter even when the guidewire is positioned within the lumen.
  • radiographic contrast solutions i.e., dyes
  • radiographic contrast solutions i.e., dyes
  • the actuator 24 When the actuator 24 is withdrawn in the proximal direction, it will pull the wire segments 20 in the proximal direction, through the wire passage bores 26 and into the lumen 22 of the catheter.
  • the segments 20 When the actuator 24 is fully retracted, as shown in Figure 2a, the segments 20 will be drawn fully through the wire passage bores 26 and will assume substantially straight configurations, and the nose cone 30 mounted on the distal end of the obstructive matter capturing receptacle will be in direct abutment with the catheter tip member 28 such that the hollow nose cone lumen 22NC is in axial alignment with the distal tip lumen 22DT and the lumen 22 of the catheter body 12.
  • Second Embodiment Figures 3b and 3b' show a second embodiment of an over-the-wire catheter device 10' which differs from the first embodiment 10 in several ways.
  • the obstructive matter-capturing receptacle (not shown) of this second embodiment is formed by only two (2) wire members 20' instead of four (4) as in the first embodiment 10.
  • the catheter 1 of this second embodiment incorporates an elongate distal segment 270 of reduced diameter and increased flexibility-similar to that of the commercially available microcatheters (e.g., ProwlerTM microcatheter, Cordis Endovascular Systems, Miami Lakes, Florida), an example of which is shown in Figure 3a and generally comprises a proximal portion PP having a lumen L and a distal segment 270 having a lumen 271 which is continuous with the lumen L of the proximal portion PP.
  • the commercially available microcatheters e.g., ProwlerTM microcatheter, Cordis Endovascular Systems, Miami Lakes, Florida
  • this second embodiment of the over the wire embolectomy catheter device 10' comprises an elongate, pliable catheter 11 ' having a helical basket type obstructive matter capturing receptacle (not shown)similar to that of the first embodiment, but wherein the receptacle (not shown) is formed of only two (2) wire members.
  • the obstructive matter capturing receptacle (not shown) of this second embodiment 10' is initially retractable to a first (i.e., stowed) configuration and is subsequently advanceable to second (i.e. operative) configuration which is essentially the same as that described above with respect to the first embodiment 10.
  • the flexible catheter 11' comprises a proximal portion 12' having a first diameter and first flexibility, and a distal portion 270 which has a second (i.e., smaller) diameter and a second (i.e., greater) flexibility.
  • This insert member 28' is a generally cylindrical member having four (4) longitudinal bores 20' extending therethrough, as shown in Figure 3b'.
  • These rapid exchange embolectomy catheter devices 10", 10'" and 10"" incorporate guidewire lumens which extend through only a distal portion of the catheter 11", 11'", 11"" so as to permit the catheter 11", 11"',11"" to be exchanged without the need for use of an exchange-length guidewire (i.e., a guidewire which is long enough to allow the exteriorized portion of the guidewire to be longer than the catheter so that the catheter may be withdrawn, removed and exchanged while holding the guidewire in substantially fixed position.
  • an exchange-length guidewire i.e., a guidewire which is long enough to allow the exteriorized portion of the guidewire to be longer than the catheter so that the catheter may be withdrawn, removed and exchanged while holding the guidewire in substantially fixed position.
  • Third Embodiment Figures 3d and 3d' show a third embodiment (i.e., a rapid exchange type embodiment) of the embolectomy catheter device 10" which is similar in construction to the above described second embodiment 10', but which incorporates a guidewire passage port 267' formed in the sidewall of the catheter 11 " at a spaced distance (e.g., 0.5-35 cm) from its distal end, and a guidewire deflector tube 260' which extends from the guidewire passage port 267' to the lumen 22'.
  • the guidewire deflector tube 260' has a flared distal end which is held in a centered position within the lumen by a plurality of radial support members 264'.
  • Longitudinal passages 266, 266(alt) are formed between the radial support members 264' to allow radiographic contrast medium or other fluid to flow through the lumen 22', past the flared distal end of the guidewire deflector tube 260'. Selected ones of the longitudinal passages 266(alt) are larger than the others 266 to permit the elongate members 20' which form the obstructive matter capturing receptacle to pass therethrough, as shown.
  • the proximal end of a guidewire PEG may be inserted into the distal end opening DEO of the catheter 11 " and, thereafter, the catheter 11 " may be advanced in the distal direction such that the proximal end of the guidewire PEG will enter the flared distal end of the guidewire deflector tube 260', and will be thereby deflected out of the side guidewire passage port 267', as shown.
  • the catheter 11' comprises a main tube 300 which has a proximal portion 302 of a first diameter D1 and a distal portion 304 of a second diameter D2.
  • a side tube 308 is affixed to one side of the distal portion 304 of the main tube 300, and a guidewire passage aperture 310 is formed into the lumen 309 of the side tube 308, such that the lumen 309 of the side tube may be used as the guidewire lumen, and the distal portion of the guidewire GW which emerges from the side tube lumen 309 may then be passed through the separate guidewire lumen of the obstructive matter capturing receptacle 22 (not shown in figure 3e) and/or any nose cone lumen 22NC (not shown in figure 3e), as described fully hereabove.
  • the fifth embodiment (i.e., another rapid exchange embodiment) of the embolectomy catheter device 10"" is similar in construction and operates in the same manner as the fourth embodiment 10'" described above, except that the main tube 300' of this fifth embodiment 10"" is formed of a continuous wire 316 which is would in a tight helical coil, as shown. This construction of the main tube 300' may provide enhanced flexibility over other forms of construction.
  • the embolectomy catheter devices 10, 10', 10", 10'", 10"" of the present invention may incorporate various types of obstructive matter capturing receptacles as alternatives to the helical wire basket type receptacles 14, 14' shown in Figures 1a, 2b and 4.
  • obstructive matter capturing receptacles are shown in Figures 5-7.
  • Figures 5-5a show one alternative obstructive matter-capturing receptacle .
  • 400 which comprises a plurality of elastic or superelastic wire spokes 402 which are preformed to a radially splayed configuration as shown, and which have a membranous or fabric cover 404 disposed thereon to form an umbrella like structure.
  • the membranous or fabric cover 404 may be of non-porous or porous configuration, and is preferably formed of material such as polyethylene, polytetrafluoroethylene, polyurethane, ethylene vinyl acetate or silicone.
  • a central hub is formed at the center of the spokes 402, and a guidewire lumen extends through such central hub such that the guidewire may pass the center of the receptacle 400, in the manner depicted in Figures 5 and 5a.
  • the ends of the spokes 402 may have bulbs 408 formed thereon to minimize trauma to the surrounding blood vessel walls, as shown in Figure 5'. Or, as an alternative to such bulbs 408, atraumatic loops 410 may be formed on the distal ends of the spokes 402 to prevent vascular trauma.
  • the spokes 402 are of sufficiently small diameter to be retracted through a thromboembolism without causing substantial disruption of segmentation of the thromboembolism. Also, in the embodiment shown in Figure 5, it will be appreciated that the spokes 402 may have a greater curvature than that shown, such that the free ends of the spokes 402 will not be in direct contact with the blood vessel wall.
  • Figures 5b-5b" show another obstructive matter capturing receptacle 420 which comprises a plurality of elastic or superelastic wire spokes 402' which are pre- formed to a radially splayed configuration as shown, and a porous fabric (e.g., woven, knitted, mesh or net fabric) sac 422 attached to the spokes 402' to form an umbrella-like structure, as shown.
  • the material used to form this sac 422 may be the same microporous material as specified hereabove with respect to the membranous or fabric cover 404 of the embodiment shown in Figure 5.
  • a central aperture 426 is formed in the sac 422 such that a guidewire GW may be passed through a region among the spokes 402', and through such aperture 426, as shown in Figures 5b and 5b'.
  • Draw lines 424 are attached to the free ends of the spokes 402' and extend through the lumen of the catheter. These draw lines 424 and the spokes 402' are of sufficiently small diameter to be retracted through a thromboembolism without causing substantial disruption or segmentation of the thromboembolism.
  • the receptacle 420 After the receptacle 420 has been advanced through the thromboembolism, it is deployed (e.g., radially expanded) and retracted such that the draw lines 424 and spokes 402' will retract through and will become located proximal to, the thromboembolism. Thereafter, the draw lines 424 are retractable into the catheter to pull distal ends of the spokes 402' inwardly such that the proximal mouth PM of the sac will be drawn partially around the captured obstructive matter in the manner shown in Figures 5b' and 5b".
  • Figure 5c shows another alternative obstructive matter capturing receptacle which employs a resilient, generally football shaped cage to effect radial expansion/contraction of a membranous or fabric cover 444.
  • the cage comprises approximately six (6) elongate members 442 of preformed elastic, super-elastic or shape memory metal wire disposed longitudinally about a longitudinal axis LA, and having the membranous or fabric covering 444 disposed on the distal portions DP thereof.
  • the distal ends DE of the elongate members 442 are attached to a nose cone 446 which has a guidewire passage lumen extending longitudinally therethrough.
  • the members 442 When retracted into the lumen of the catheter, the members 442 will radially compress to a diameter which is received within the catheter lumen. However, when advanced out of the catheter the members 442 will resiiiently expand to the configuration shown.
  • the proximal portions of the members are sufficiently small in diameter to slice, cut or otherwise pass in the proximal direction through a thromboembolism or clot without disrupting or causing fragmentation of the thromboembolism or clot.
  • Figures 7 and 7a show an alternative helical basket type of obstructive matter capturing receptacle 14" which is of the same general configuration, and operates in the same manner, as the helical basket type receptacles 14, 14' shown in Figures
  • the receptacle 14" is formed of a plurality of flat ribbons 500 formed of metal such as cobalt-chromium-nickel alloy (ElgiloyTM, Elgiloy, Inc., Elgin, Illinois), a shape memory and/or super-elastic material such as nickel-titanium alloy, or other suitable metal or plastic.
  • the distal portions of the flat ribbons 500 are . preformed to helical configurations to form the helical basket 502.
  • the proximal portions of the ribbons 500 serve as connector members 504 between the helical basket 502 and the catheter 11.
  • Each ribbon 500 has first and second flat surfaces 512 and first and second edges 514.
  • Each of the ribbons 500 is twisted 90 degrees at a point of transition 510 between the connector members 504 and the helical basket 502. This twisting of the ribbons causes a) the distal portions to be situated with their edges 514 in juxtaposition such that a thromboembolus contained within the helical basket 502 will rest upon the flat surfaces of the ribbons 500, and b) the proximal portions to be situated with their edges aimed in the proximal direction to facilitate retraction of the distal connector members 504 through the thromboembolus without causing the thromboembolus to be substantially fragmented or disrupted.
  • Optional Guide Catheter/Proximal Obstructive Matter Retaining Member As illustrated in figure 6, it may be desirable to use the embolectomy catheter devices 10, 10', 10", 10'", 10"" in conjunction with a guide catheter 50 through which the embolectomy catheter 11 may be advanced.
  • a guide catheter 50 through which the embolectomy catheter 11 may be advanced.
  • a proximal obstructive matter retaining member 52 such as a tubular sheath having a radially flared and splayable distal end as shown in Figure 5a, may be advanced out of the distal end DE of the guide catheter 50 such that the clot C or other obstructive matter may be captured between the distal obstructive matter receiving portion 16 of the receptacle 14 and the flared distal end of the proximal obstructive matter retaining member 52.
  • this optional proximal obstructive matter retaining member 52 may be particularly useful in cases where the thromboembolism is very fresh or has been inadvertently severed or segmented so as to present a danger of breaking apart or fragmenting during the removal procedure.
  • embolectomy catheters of this invention are used to remove thromboemboli from small blood vessels of the brain, it will be .
  • embolectomy catheters 10, 10", 10", 10"', 10" of the present invention may necessarily be of very small diameter (e.g., 0.10-0.20 inches) in order to navigate the tiny blood vessels of the brain, the presence of the retracted obstructive matter capturing receptacle 14, 14', 400, 420 or 440 within that catheter 11 may severely limit the amount of radiographic contrast medium which could be infused though that catheter 11.
  • a small angiography catheter e.g., a microcatheter such as the ProwlerTM microcatheter, Cordis Endovascular Systems, Miami Lakes, Florida
  • a small angiography catheter e.g., a microcatheter such as the ProwlerTM microcatheter, Cordis Endovascular Systems, Miami Lakes, Florida
  • the angiography catheter is withdrawn and removed, leaving the guidewire in place.
  • an embolectomy catheter 10 is withdrawn and removed, leaving the guidewire in place.
  • 10', 10", 10'", 10"" of the present invention is advanced over the pre-positioned guidewire to the location of the thromboembolism.
  • microcatheters of the prior art have not been suitably designed for this novel procedure.
  • Such microcatheters have heretofore of an "over-the-wire” type used primarily in procedures where the catheter is retracted and removed concurrently with the guidewire over which it was inserted.
  • the prior art "over-the-wire” type microcatheters can only be exchanged over a stationary guidewire //the guidewire is an "exchange-length” wire or /fan extension has been attached to the proximal end of the guidewire to permit the exchange.
  • the use of such "exchange-length" guidewire or a guidewire extension may be contraindicated in procedures where the catheters are . being inserted into and withdrawn from tiny delicate vessels of the brain, see,
  • This rapid exchange microcatheter 265 comprises an elongate, flexible catheter having a proximal portion 12" of a first diameter and first flexibility, and a distal portion 270" which has a second (i.e., smaller) diameter and a second (i.e., greater) flexibility.
  • the guidewire deflector tube 260 has a flared distal end which is held in a centered position within the lumen by a plurality of radial support members 264. Longitudinal passages 266 are formed between the radial support members 264 to allow radiographic contrast medium or other fluid to flow through the lumen 271 , past the flared distal end of the guidewire deflector tube 260.
  • a guidewire PEG may be inserted into the distal end opening DEO of the catheter and, thereafter, the catheter may be advanced in the distal direction such that the proximal end of the guidewire PEG will enter the flared distal end of the guidewire deflector tube 260, and will be thereby deflected out of the side guidewire passage port 267, as shown in Figure 3c.
  • Figures 8a-8f illustrate a preferred method of using an the over-the-wire type embolectomy catheter 10 of the invention to remove a obstructive matter such as a thromboembolism or blood clot
  • Figures 9a-9c illustrate a preferred method of using a rapid exchange type embolectomy catheter 10" of the invention to remove such obstructive matter.
  • Over-the-Wire Embolectomy Catheter Figures 8a-8f show a presently preferred method for using the over-the-wire type embolectomy catheter 10 shown in Figures 1 -2d to remove a thromboembolus or clot C which has become lodged immediately downstream of an . arterial bifurcation BE so as to create an ischemic zone IZ of tissue (e.g., brain tissue which is deprived of oxygen and other nutrients) located downstream of the clot C.
  • tissue e.g., brain tissue which is deprived of oxygen and other nutrients
  • a microcatheter such as the rapid exchange microcatheter 265 of Figure 3c (not shown in Figures 8a-8f) is advanced to a position near the obstructive matter or clot C and radiographic contrast medium is injected through the microcatheter to angiographically verify the precise location of the clot C and to visualize or map the anatomy of the blood vessels in the area of the clot.
  • a guidewire having a diameter of 0.01-0.014 inches and a length which is not more than 1.5 times the length of the microcatheter 265 is advanced from the lumen 271 of the microcatheelr 265 until its distal tip DT has passed through the clot C as shown in Figure 8a.
  • the operator will hold the proximal end of the guidewire GW to prevent longitudinal retraction of the guidewire GW while retracting and removing the rapid exchange microcatheter 265.
  • This allows the guidewire GW to remain in its operative position as shown in Figure 8a.
  • the embolectomy catheter 11 having its obstructive matter capturing receptacle retracted to its first configuration (Fig.2a) is advanced over the guidewire GW and through the clot C, such that the distal end opening DEO of the catheter 11 is located downstream of the clot C but still proximal to (i.e., upstream of) the distal tip DT of the guidewire GW.
  • the actuator 28 is advanced in the distal direction to cause the four wire segments 20 which form the obstructive matter capturing receptacle 14 to advance out of the distal end of the catheter such that the nose cone 30 remains upon the guidewire GW.
  • the obstructive matter capturing receptacle 14 is fully deployed to its second or operative configuration at a location distal to (i.e., downstream of) the clot C ( Figure 3d).
  • the embolectomy catheter 11 is retracted in the proximal direction to cause the proximal connector members 18 of the obstructive matter capturing receptacle 14 to pass through the clot, and to further cause the clot to be received within the concave or cavernous interior of the distal obstructive matter receiving portion 16 of the receptacle 14, as shown.
  • the entire embolectomy catheter device 10 with the clot C in tow, may be retracted out of the body-or to a location within a larger blood vessel (e.g., carotid artery) where the clot C and the fully deployed obstructive matter capturing receptacle 14 may be received within the lumen of a larger catheter to further secure the clot for ultimate extraction and removal form the body.
  • a larger blood vessel e.g., carotid artery
  • a microcatheter such as the rapid exchange microcatheter 265 of
  • Figure 3c (not shown in Figures 9a-9d) is advanced to a position near the clot C and radiographic contrast medium is injected through the microcatheter to angiographically verify the precise location of the clot C and to visualize or map the anatomy of the blood vessels in the area of the clot. Thereafter, a guidewire having /56801
  • -26- a diameter of 0.006-0.018 inches and a length which is not more than 1.5 times the length of the microcatheter 265 (i.e., not an "exchange-length" guidewire) is advanced from the lumen 271 of the microcatheetr 265 until its distal tip DT has passed through the clot C as shown in Figure 9a.
  • the operator will hold the proximal end of the guidewire GW to prevent longitudinal retraction of the guidewire GW while retracting and removing the rapid exchange microcatheter 265. This allows the guidewire GW to remain in its operative position as shown in Figure 9a.
  • the exteriorized proximal end of the guidewire is inserted into the distal end opening DEO of the the rapid exchange embolectomy catheter 11" while its obstructive matter capturing receptacle is retracted to its first configuration (Fig.2a) within the distal portion of the catheter 11".
  • the guidewire will be deflected by the guidewire deflection tube 260' (see Figure 3d) and the proximal end of the guidewire will emerge out of the side guidewire passage aperture 267' of the catheter 11 ".
  • the catheter 11 " is advanced through the clot C, such that the distal end opening DEO of the catheter 11" is located downstream of the clot C but still proximal to (i.e., upstream of) the distal tip DT of the guidewire GW, as shown in Figure 9c.
  • the guidewire GW extends along side of the proximal portion of the rapid exchange catheter 11" (i.e., the portion of the catheter proximal to the guidewire passage aperture 267'), as shown.
  • the actuator 28 is advanced in the distal direction to cause the two (2) wire members 20' which form the obstructive matter capturing receptacle 14' to advance out of the distal end of the catheter 11' such that the nose cone 30' remains upon the guidewire GW.
  • the obstructive matter capturing receptacle 14' is fully deployed to its second or operative configuration at a location distal to (i.e., downstream of) the clot C ( Figure 9d).
  • the rapid exchange embolectomy catheter 11' is retracted in the proximal direction to cause the proximal connector members 18' of the obstructive matt ⁇ r capturing receptacle 14' to pass through the clot, and to further cause the clot to be received within the concave or cavernous interior of the helical basket 16' of the receptacle 14'.
  • the clot C is then removed by retraction of the catheter 11', in the same manner shown and described above and shown in Figures 8e and 8f..

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Materials For Medical Uses (AREA)

Abstract

This invention is embolectomy catheters (11), rapid exchange micro-catheters (265), systems, and methods for removing obstructive matter (e.g., thrombus, thromboemboli, embolic fragments of atherosclerotic plaque, forein objects, etc.) from blood vessels. This system is particularly useable for percutaneous removal of thromboemboli or other obstructive matter from small blood vessels of the brain, during an evolving stroke or period of cerebral ischemia. In some embodiments, the embolectomy catheters are advanced over a guide wire (GW) which has been pre-inserted through or around the obstructive matter. These catheters include obstructive matter capturing receptacles (14) which are deployed after the catheter has been advanced at least partially through the obstructive matter. The receptacles may include at least one proximal strut (20), which is designed to be retractable through a blood clot and a distal matter-receiving portion (16) which is designed to prevent a blood clot from passing therethrough.

Description

EMBOLECTOMY CATHETERS AND METHODS FOR TREATING STROKE AND OTHER SMALL VESSEL THROMBOEMBOLIC DISORDERS
FIELD OF THE INVENTION
The present invention relates generally to medical methods and devices, and more particularly to thrombolectomy catheters, and methods for using such thrombolectomy catheters, for removing blood clots or other matter from the lumens of blood vessels or other anatomical conduits.
BACKGROUND OF THE INVENTION
Various types of thromboembolic disorders, such as stroke, pulmonary embolism, peripheral thrombosis, atherosclerosis, and the like, are known to occur in human beings and other mammals. Such thromboembolic disorders are typically characterized by the presence of a thromboembolus (i.e., a viscoelastic blood clot comprised of platelets, fibrinogen and other clotting proteins) which has become lodged at a specific location in a blood vessel.
In cases where the thromboembolism is located in a vein, the obstruction created by the thromboembolus may give rise to a condition of blood stasis, with the development of a condition known as thrombophlebitis within the vein. Moreover, peripheral venous embolisms may migrate to other areas of the body where even more serious untoward effects can result. For example, the majority of pulmonary embolisms are caused by emboli that originate in the peripheral venous system, and which subsequently migrate through the venous vasculature and become lodged with the lung.
In cases where the thromboembolus is located within an artery, the normal flow of arterial blood may be blocked or disrupted, and tissue ischemia (lack of available oxygen and nutrients required by the tissue) may develop. In such cases, if the thromboembolism is not relieved, the ischemic tissue may become infarcted (i.e., necrotic). Depending on the type and location of the arterial thromboembolus, such tissue infarction can result in death and amputation of a limb, myocardial infarction, or stroke. Notably, strokes caused by thromboemboli which become lodged in the small blood vessels of the brain continue to be a leading cause of death and disability, throughout the world. In modern medical practice, thromboembolic disorders are typically treated by one or more of the following treatment modalities: a) pharmacologic treatment wherein thrombolytic agents (e.g., streptokinase, urokinase, tissue plasminogen activator (TPA)) and/or anticoagulant drugs (e.g., heparin, warfarin) are administered in an effort to dissolve and prevent further growth of the clot;
b) open surgical procedures (e.g., surgical embolectomy or clot removal) wherein an incision is made in the blood vessel in which the clot is lodged and the clot is removed through such incision-sometimes with the aid of a balloon-tipped catheter (e.g., a
"Fogarty Catheter") which is passed through the incision and into the lumen of the blood vessel where its balloon is inflated and used to extract the clot out of the incision; and,
c) transluminal catheter-based interventional procedures wherein a clot removing/disrupting catheter (e.g., a suction-type catheter having a suction tip, clot-capturing type catheter having a clot capturing receptacle (e.g., a basket, coil, hook, etc.), or clot- disrupting catheter having a clot disrupting apparatus (e.g., an ultrasound probe or laser)) is percutaneously inserted and advanced through the patient's vasculature to a location adjacent the clot. The suction tip, clot capturing receptacle or clot disrupting apparatus is used to aspirate, capture & remove, disrupt or ablate the offending clot. 9/56801
-3-
Each of the above-listed treatment modalities has its own set of advantages and disadvantages. For example, pharmacologic treatment has the advantage of being non-invasive and is often effective in lysing or dissolving the clot. However, the thrombolytic and/or anticoagulant drugs used in these pharmacologic treatments can cause untoward side effects such as bleeding or hemorrhage. Also, in cases where time is of the essence, such as cases where an arterial thromboembolism is causing severe tissue ischemia (e.g., an evolving stroke or an evolving myocardial infarction) the time which may be required for the thrombolytic drugs to fully lyse or dissolve the blood clot and restore arterial blood flow may be too long to avoid or . minimize the impending infarction.
Open surgical thrombus-removing procedures can, in many cases, be used to rapidly remove clots from the lumens of blood vessels, but such open surgical procedures are notoriously invasive, often require general anesthesia, and the use of such open surgical procedures is generally limited to blood vessels which are located in surgically accessible areas of the body. For example, many patients suffer strokes due to the lodging of blood clots in small arteries located in surgically inaccessible areas of their brains and, thus, are not candidates for open surgical treatment.
Transluminal, catheter-based interventional procedures are minimally invasive, can often be performed without general anesthesia, and can in some cases be used to rapidly remove a clot from the lumen of a blood vessel. However, such catheter-based interventional procedures are highly operator-skill-dependent, and can be difficult or impossible to perform in small or tortuous blood vessels. Thus, patients who suffer strokes due to the presence of clots in the small, tortuous arteries of their brains may not presently be candidates for catheter-based, transluminal removal of the clot, due to the small size and tortuosity of the arteries in which their clots are located.
In concept, the trasluminally deployable clot capturing type of catheters could be useable in ischemic strokes, because they are typically capable of removing an offending blood clot without the need for suction or application of energy (e.g., laser, ultrasound) which could be injurious to the delicate, small blood vessels of the brain. However, none of the prior art trasluminally deployable clot capturing type of catheters are believed to be of optimal design for use in the small blood vessels of the brain because they are a) not equipped with appropriate guidewire passage lumens to allow them to be passed over previously inserted, small-diameter (e.g.,
0.006-0.018 inch) guidewires, b) they are not adapted for rapid exchange over a guidewire of standard length (e.g., a guidewire which is less than twice the length of the catheter) and c) the clot capturing receptacles of these catheters are not optimally constructed and configured for removal of clots from very small blood . vessels as are typically found in the brain.
Examples of transluminally deployable clot-capturing type embolectomy catheters of the prior art include those described in United States Patent Nos. 4,706,671 (Weinrib), 4,873,978 (Ginsburg), 5.011.488 (Ginsburg) and PCT International Patent Publication No. WO 97/27808(Wensel, et al.). However, for the reasons stated above and/or other reasons, none of these prior art embolectomy catheters are believed to be optimally designed for treating ischemic stroke.
Thus, there exists a need for the development of new transluminally insertable, clot-capturing type embolectomy catheters which are advanceable and exchangeable over pre-inserted small diameter guidewires, and which are constructed to rapidly and selectively remove blood clots or other matter from small, delicate blood vessels of the brain, so as to provide an effective treatment for evolving strokes and other thromboembolic disorders.
SUMMARY OF THE INVENTION The present invention generally comprises an embolectomy catheter device and method for removing blood clots or other matter from the lumens of blood vessels or other anatomical conduits of a mammalian body. The embolectomy catheters and methods of the present invention are particularly suitable for use in removing clots or thromboemboli from small arteries of the mammalian brain to prevent or minimize the severity of stroke. A. Embolectomy Catheters of the Present Invention
An embolectomy catheter device of the present invention generally comprises; a) an elongate, pliable clot penetrating catheter which is advanceable, distal end first, through the clot or other obstructive matter (e.g., thrombus, thromboembolus, peices of detached atherosclerotic plaque, foreign matter, etc.) which is to be removed, and b) a matter capturing receptacle which is deployable from the distal end of the catheter after it has been advanced through the obstructive matter, to capture and facilitate removal of the obstructive matter. The matter capturing receptacle is initially disposable in a first or stowed configuration . wherein the receptacle is in a radially collapsed condition and contained upon or within the catheter or otherwise sufficiently compact to pass through the clot or other obstructive matter. Thereafter, the matter capturing receptacle is deployable (e.g., advanceable, projectable and/or expandable) from the catheter such that it assumes a second or expanded configuration wherein the receptacle may receive and at least partially surround the distal aspect of the clot or other obstructive matter so as to facilitate extraction and removal of the blood clot or other obstructive matter along with the catheter.
A guidewire lumen may extend longitudinally through the entire length of the catheter (i.e., an "over-the-wire" embodiment) or through only a distal portion of the catheter or through an attached guidewire receiving loop/projection (i.e., a "rapid exchange" embodiment). In either of these embodiments of the catheter, the guidewire lumen may extend through the matter capturing receptacle such that the catheter (with its matter capturing receptacle in its collapsed or stowed configuration) may be advanced over a guidewire which has previously been passed through the vessel-obstructing clot or other obstructive matter. Such arrangement of the guidewire lumen additionally allows the embolectomy catheter to be exchanged (e.g., removed and replaced with another embolectomy catheter or another type of catheter) if such exchange should become necessary or desirable. This ability to allow the guidewire to remain positioned through the offending clot or other obstructive matter may serve to ensure that the catheter or its replacement can be re-advanced through the clot or other obstructive matter to its desired position.
The matter capturing receptacle of the catheter may comprise a distal obstructive matter-engaging portion (e.g., a coil, basket or concave member) of porous construction (e.g., a woven, coiled or mesh structure formed of wire, fiber or fabric), which is attached to the catheter by way of one or more proximal struts (e.g. connector members (e.g., a plurality of thin wires or struts). Initially, with the matter capturing receptacle disposed in its first (e.g., collapsed or stowed) configuration, the distal end of the catheter is advanced through the clot or other . obstructive matter. After the catheter has been advanced through the clot or other obstructive matter, the matter capturing receptacle is moved to its second (e.g., expanded or operative) configuration, such that the distal obstructive matter -engaging portion 16 of the receptacle will contact and/or at least partially surround the distal aspect of the clot or other obstructive matter. The distal obstructive matter -engaging portion of the receptacle is preferably of permeable construction to permit blood to flow therethrough, but is sufficiently dense (i.e., sufficiently impermeable) to prevent the clot or other obstructive matter from passing therethrough. In this manner, the distal obstructive matter-engaging portion of the receptacle is useable to retract or draw the clot or other obstructive matter, in the proximal direction, from its then-present location. The proximal strut(s) which extend between the receptacle to the catheter are typically of radially splayed or outwardly angled configuration and is/are preferably configured, oriented and positioned so as to slice, cut or otherwise pass through the matter of the clot or other obstructive matter, when deployed at a sit distal to the clot or other obstructive matter and subsequently retracted in the proximal direction. To assist such proximal strut(s) in passing through the clot or other obstructive matter, energy (e.g., radio-frequency energy, vibration, heat, etc) may be applied to the proximal strut(s) during their proximal retraction through the clot or other obstructive matter.
A contrast medium injection port may be formed on the proximal portion of the embolectomy catheter, to allow radiographic contrast medium (e.g., dye) to be injected through the catheter while a guidewire remains positioned within the guidewire lumen.
B. Rapid Exchange Mlcrocatheter Useable In Conjunction with
Embolectomy Catheters of the Present Invention Further in accordance with the present invention, there is provided a rapid exchange microcatheter which comprises a small diameter flexible microcatheter of a type commonly used in neuroradiology procedures (e.g., Prowler™ microcatheter, Cordis Endovascular Systems, Miami Lakes, Florida), which has greater flexibility at or near its distal end than at or near its proximal end, and which . includes in accordance with this invention, the addition of a guidewire passage port formed in the sidewall of the catheter, at a spaced distance (e.g., 0.5-35 cm) from its distal tip. (Alternatively, a guidewire receiving loop or projection may be formed in the side of the catheter body.) A guidewire deflector may be formed within the main lumen of the catheter adjacent to the guidewire passage aperture, to deflect the proximal end of a guidewire out of the guidewire passage aperture as the catheter is advanced over the guidewire. The formation of such guidewire passage aperture and guidewire deflector allows a guidewire to be passed through only a distal portion of the catheter lumen. This lumen arrangement allows the microcatheter to be exchanged (i.e., removed and replaced by another microcatheter or an embolectomy catheter of the above-summarized design) while the operator holds the guidewire in place by grasping the exteriorized proximal end of the guidewire-even in instances where a standard length guidewire (i.e., not an "exchange-length" guidewire) is used.
C. Methods of the Present Invention for Removing Clots or Other Matter from Blood Vessels
Further in accordance with the present invention, there are provided a method for treating ischemic stroke caused by a thromboembolism which has become lodged in a small blood vessel of the brain (i.e., blood vessels located in, on or around the brain). The method of the present invention may be carried out using the rapid-exchange microcatheters and embolectomy catheters of the present invention. The preferred method generally comprises the steps of:
A. percutaneously inserting a guidewire (alone or in combination with a guide catheter) into an intracranial blood vessel, using the Seldinger technique or other appropriate method of percutaneous guidewire placement;
B. advancing a microcatheter over the guidewire, or separately from the guidewire, through the vasculature until the microcatheter is near the site at which the blood clot or other obstructive matter is located;
C. passing radiographic contrast medium (e.g., dye) through the microcatheter under radiographic visualization to verify the exact location of the obstructive matter and/or to map the vascular anatomy in the area of the obstruction;
D. advancing the guidewire (or a separate small guidewire) through the microcatheter until such guidewire becomes located in a desired operative position relative to the obstructive matter (e.g., such that its distal end has fully or partially traversed or passed through the thromboembolism or other obstructive matter);
E. withdrawing and removing the microcatheter while substantially maintaining the small guidewire in its operative position (e.g., preventing the guidewire from moving so far as to loose the access to the obstructive matter that the presence of the guidewire provides);
F. advancing a matter-capturing type embolectomy catheter (such as an embolectomy catheter of the present invention) which has an obstructive matter- capturing receptacle deployable therefrom, over the operatively positioned guidewire until the distal end of the embolectomy catheter has advanced fully or at least partially through the obstructive matter (e.g., has penetrated through an obstructive thromboembolism);
G. optionally injecting radiographic contrast medium through a lumen of the embolectomy catheter to guide or verify the positioning of the embolectomy catheter relative to the lodged blood clot or other obstructive matter; H. deploying the obstructive matter-capturing receptacle of the embolectomy catheter such that it assumes its second or expanded configuration at a site which is distal (i.e., downstream) of the lodged blood clot or other obstructive matter; I. retracting the obstructive matter-capturing receptacle such that a proximal portion of the receptacle (i.e., proximal struts) passes through the thromboembolism and at least a portion of the clot or other obstructive matter becomes located within the obstructive matter-receiving portion of the obstructive matter-capturing receptacle;
J. optionally injecting radiographic contrast medium through a lumen of the. embolectomy catheter to determine whether blood flow has been restored through the region of the blood vessel which had previously been deprived of blood flow due to the presence of the clot or other obstructive matter; and, k. retracting the embolectomy catheter to remove the blood clot or other obstructive matter from the body (e.g., withdrawing the embolectomy catheter and the extracted clot ot other obstructive matter through the percutaneous entry tract through which the catheter had previously been inserted.
Thus, by the above-summarized method of the present intention, the blood clot or other obstructive matter which is causing an ischemic (i.e., thrombotic or embolic) stroke is removed and arterial bloodflow is restored to the region of the brain which had become ischemic due to the lodging on the offending blood clot or other obstructive matter within the blood vessel.
Further elements, objects and advantages of the present invention will become apparent to those of skill in the art upon reading and understanding of the following detailed description of preferred embodiments and consideration of the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a perspective view of a human patient having a first embodiment (an "over-the-wire embodiment) of an embolectomy catheter of the present Figure 1 a is a perspective view of the embolectomy catheter device of Figure 1 operatively positioned upon a guidewire, and having its obstructive matter- capturing receptacle disposed in an expanded configuration.
Figure 2a is an enlarged longitudinal sectional view of the distal end of the over-the-wire embolectomy catheter of Figure 1 with its obstructive matter- capturing receptacle in a first or stowed position.
Figure 2b is an enlarged, broken, longitudinal sectional view of the distal end of the over-the-wire embolectomy catheter of Figure 1 with its obstructive matter-retrieving member in a distally advanced position and its obstructive matter- capturing receptacle disposed in a fully expanded configuration.
Figure 2c is a cross-sectional view through line 2c-2c of Figure 2a.
Figure 2d is a cross-sectional view through line 2d-2d of Figure 2a.
Figure 2d' is a cross-sectional view through line 2d-2d of Figure 2a, modified to show an alternative mode of constructing the guide bores in the distal tip member, through which the wires which form the obstructive matter-capturing receptacle extend.
Figure 3a is an enlarged, broken, longitudinal sectional view of the distal end of the over-the-wire microcatheter of the prior art.
Figure 3b is an enlarged, broken, longitudinal sectional view of the distal end of a second embodiment (i.e., another over-the-wire embodiment) of an embolectomy catheter of the present invention.
Figure 3b' is a cross-sectional view through line 3b'-3b' of Figure 3b.
Figure 3c is an enlarged, broken, longitudinal sectional view of the distal end of a rapid exchange microcatheter of the present invention. Figure 3c' is a cross-sectional view through line 3c'-3c' of Figure 3c.
Figure 3d is an enlarged, broken, longitudinal sectional view of the distal end of a third embodiment (i.e., a rapid exchange embodiment) of an embolectomy catheter of the present invention.
Figure 3d' is a cross-sectional view through line 3d'-3d' of Figure 3d. Figure 3e is an enlarged, longitudinal sectional view of the distal end of a fourth embodiment (i.e., another rapid exchange embodiment) of an embolectomy catheter of the present invention.
Figure 3e' is a cross-sectional view through line 3e'-3e' of Figure 3e. Figure 3f is an enlarged, longitudinal sectional view of the distal end of a fifth embodiment (i.e., another rapid exchange embodiment) of an embolectomy catheter of the present invention.
Figure 3f is a cross-sectional view through line 3f'-3f of Figure 3f.
Figure 4 is a perspective view of the third embodiment (i.e., a.rapid exchange embodiment) of an embolectomy catheter of Figure 3d having a guidewire operatively inserted through its guidewire lumen and its obstructive matter capturing receptacle in its deployed, radially expanded position.
Figure 5 is a perspective view of a first alternative obstructive matter- capturing receptacle which may be incorporated into any of the embolectomy catheters of the p[resent invention.
Figure 5' is an enlarged view of portion 5' of Figure 5.
Figure 5" shows an alternative construction for portion 5' of Figure 5.
Figure 5a is a distal end view of Figure 5.
Figure 5b is a perspective view of a second alternative obstructive matter- capturing receptacle which may be incorporated into any of the embolectomy catheters of the present invention.
Figure 5b' is a perspective view of the second alternative obstructive matter- capturing receptacle of Figure 5b having a clot captured therewithin and with its support spines being partially retracted into the catheter. Figure 5b" is a perspective view of the second alternative obstructive matter- capturing receptacle of Figure 5b having a clot captured therewithin and with its support spines being further retracted into the catheter so that the obstructive matter capturing receptacle is drawn partially around the captured clot.
Figure 5c is a perspective view of a third alternative obstructive matter- capturing receptacle which may be incorporated into any of the embolectomy catheters of the present invention.
Figure 6 is a perspective view of an optional guide catheter of the present invention having a proximal obstructive matter containment apparatus operatively deployed therefrom, and an embolectomy catheter of the present invention operatively inserted therethrough.
Figure 7 is an elevational view of a variant of the helical basket type obstructive matter capturing receptacle of the catheters shown in Figures 1 , 2b and 4, such variant being constructed of metal ribbon rather than wire.
Figure 7a is a cross-sectional view through line 7a-7a of Figure 7, illustrating the manner in which the metal ribbons may be twisted to enhance the ability of the proximal strut portions to the obstructive matter capturing receptacle to cut through the thromboembolic material. Figures 8a-8f are step-wise showings of a procedure wherein the first embodiment (i.e., an over-the-wire embodiment) of an embolectomy catheter of the present invention is used to remove a blood clot from a small blood vessel of a mammalian body.
Figures 9a-9d are step-wise showings of a procedure wherein the third embodiment (i.e., a rapid exchange embodiment) of an embolectomy catheter of the present invention is used to remove a blood clot from a small blood vessel of a mammalian body.
The particular embodiments shown in these drawings, and additional embodiments of the invention, may now be better understood by reading and understanding the following detailed description wherein specific reference is made to the structures and steps illustrated or shown in the drawings.
DETAILED DESCRIPTION OF THE INVENTION A. Over-the Wire Embodiments of the Embolectomy Catheter Device :
Referring now to the drawings, wherein the showings are for the purpose of describing and illustrating exemplary embodiments of the present invention, and not for the purpose of limiting the scope of the invention, Figure 1 shows a human patient in whom an over the wire embodiment of the embolectomy catheter device
10 of the present invention has been inserted for the purpose of removing a thromboembolus or blood clot from a small artery located in the patient's brain. Prior to introduction of the catheter device 10 the offending clot had been located by ■ angiography or other imaging means, and a small (e.g., 0.006-0.010 inch outer diameter) guidewire GW was inserted into the patient's femoral artery and advanced into the artery of the brain in which the clot is located and at least partially through the clot. Thereafter, the catheter device 10 was advanced over the previously inserted guidewire GW to a position were the distal end of the catheter device 10 is near the clot.
First Embodiment
As shown in Figures 1-2e, the first embodiment of the over-the-wire catheter device 10 comprises an elongate, pliable catheter 11 having a clot capturing receptacle 14 deployable from its distal end DE, as shown. The obstructive matter- capturing receptacle 14 is formed of a plurality (e.g., 2 or more) wire members 20 which are initially retractable to substantially straight configurations and a first (i.e., stowed) position, within the catheter 11. (See Figure 2a) When it is desired to deploy the obstructive matter capturing receptacle 14, the preformed wire members
20 are advanced in the distal direction such that the emerge from the constraint of the catheter 11 and resiliently assume a second (i.e. operative) configuration wherein the distal portions of the wire members form a helical basket 16 having an open proximal mouth or rim 17, as shown in Figure 2b. When in such operative configuration (Figure 2b), the helical basket 16 is sufficiently porous to allow blood to flow therethrough, but sufficiently dense to engage and withdraw in the proximal direction, a thromboembolism. A nose cone 30 is positioned on the distal ends of the wire members 18. The proximal portions 18 of the elongate wire members 20 act as connecting members between the helical basket 16 and the catheter 11. These proximal portions 18 of the wire members 20 are of sufficiently small diameter or are otherwise configured to be retracted through a thromboembolism, without causing substantial disruption or segmentation of the thromboembolism.
In some embodiments energy (e.g. heat, vibration, etc) may be applied to the proximal portions 18 of the wire members 20 to facilitate their retraction through the thromboembolic material without causing substantial disruption or segmentation of the thromboembolism. The wire members 20 of which the capturing receptacle 14 is formed may be of any suitable material, such as elastic, superelastic or shape memory alloy wire. The distal portions of these wire members are preformed to the shape of the helical basket 16 but are sufficiently elastic to assume substantially straight configurations when retracted through the guide bores 26 and into the catheter 11 and maintained in a taut state under a small amount of proximally directed pressure. (See Figure
2a) However, when these preformed wire members are extended or advanced through the guide bores 26 and out of the distal end DE of the catheter 11, ' and relieved of the surrounding restraint of the catheter 11 and the proximally-directed tension, they will resiliently self-coil into the generally frustoconical shape of the helical basket 16.
To facilitate the desired advancement and retraction if these preformed wire members 20, the proximal ends of these members 20 are attached to the distal end of a longitudinally slidable actuator 24 which is positioned within the lumen 22 of the catheter body 12. A hollow actuator lumen 22a extends through the actuator 24 and is in axial alignment with the lumen 22 of the catheter body 12. The shaft of the actuator 24 has a wire braid or coil 25 formed therein to impart stiffness and strength. A distal tip member 28 is formed on the distal end DE of the catheter body 12, such distal tip member 28 having a hollow tip member lumen 22TM which extends longitudinally through the center thereof, and four (4) wire passage bores 26 which also extending longitudinally therethrough, at radially spaced-apart locations (i.e., the 3, 6, 9 and 12 o'clock positions). The distal tip member 28 may be formed of material which is more rigid than the catheter body 12 and may have a proximal portion 40 of reduced diameter which is inserted into the distal end DE of the catheter body lumen 22, as shown in Figures 2a, 2b and 2d. Each of the four (4) preformed segments 20 which form the obstructive matter capturing receptacle
14, when advanced out of the catheter 11 must pass through a respective one of the wire passage bores 26 formed in the catheter tip member 28. Figure 2d' shows an alternative construction of the distal tip member wherein four (4) cut-out notches 26A.T are formed at the 3, 6, 9 and 12 o'clock positions to serve as discrete guide wire passageways for the individual wire segments 20, in lieu of the wire passage bores 26.
A proximal actuator shaft 24' extends to a housing 13 formed on the proximal end of the catheter, and such proximal actuator shaft 24' may be manually advanced and retracted to control deployment and retraction of the obstructive matter capturing receptacle 14. A contrast medium injection port 15 is also formed don the proximal housing 13, for injection of radiographic contrast medium through the lumen 22 and out of the distal end DE of the catheter 11. In this regard, it is preferable that the outer diameter of the guidewire GW be at least slightly less than the inner diameter of the lumen 22 to permit some radiographic contrast medium to pass through the lumen 22 and out of the distal end of the catheter even when the guidewire is positioned within the lumen. Also, radiographic contrast solutions (i.e., dyes) of minimal viscosity may be selected to enhance the ability of the contrast medium to pass through the lumen 22 while the guidewire GW is positioned therewithin. When the actuator 24 is withdrawn in the proximal direction, it will pull the wire segments 20 in the proximal direction, through the wire passage bores 26 and into the lumen 22 of the catheter. When the actuator 24 is fully retracted, as shown in Figure 2a, the segments 20 will be drawn fully through the wire passage bores 26 and will assume substantially straight configurations, and the nose cone 30 mounted on the distal end of the obstructive matter capturing receptacle will be in direct abutment with the catheter tip member 28 such that the hollow nose cone lumen 22NC is in axial alignment with the distal tip lumen 22DT and the lumen 22 of the catheter body 12.
Second Embodiment Figures 3b and 3b' show a second embodiment of an over-the-wire catheter device 10' which differs from the first embodiment 10 in several ways. For example, the obstructive matter-capturing receptacle (not shown) of this second embodiment is formed by only two (2) wire members 20' instead of four (4) as in the first embodiment 10. Also, the catheter 1 of this second embodiment incorporates an elongate distal segment 270 of reduced diameter and increased flexibility-similar to that of the commercially available microcatheters (e.g., Prowler™ microcatheter, Cordis Endovascular Systems, Miami Lakes, Florida), an example of which is shown in Figure 3a and generally comprises a proximal portion PP having a lumen L and a distal segment 270 having a lumen 271 which is continuous with the lumen L of the proximal portion PP.
With specific reference to Figures 3b and 3b', this second embodiment of the over the wire embolectomy catheter device 10' comprises an elongate, pliable catheter 11 ' having a helical basket type obstructive matter capturing receptacle (not shown)similar to that of the first embodiment, but wherein the receptacle (not shown) is formed of only two (2) wire members. As in the above described first embodiment, the obstructive matter capturing receptacle (not shown) of this second embodiment 10' is initially retractable to a first (i.e., stowed) configuration and is subsequently advanceable to second (i.e. operative) configuration which is essentially the same as that described above with respect to the first embodiment 10.
In this second embodiment, the flexible catheter 11' comprises a proximal portion 12' having a first diameter and first flexibility, and a distal portion 270 which has a second (i.e., smaller) diameter and a second (i.e., greater) flexibility. An insert member 28' having four (4) guide bores 26' extending longitudinally therethrough, is positioned within the lumen 271' of, and is coextensive with, the distal portion 270 of the catheter 11'. This insert member 28' is a generally cylindrical member having four (4) longitudinal bores 20' extending therethrough, as shown in Figure 3b'. However, since the obstructive matter capturing receptacle (not shown) of this embodiment is formed of only two (2) elongate members 20', the remaining two guide bores 26' remain unoccupied and may serve as passageways through which radiographic contrast medium (e.g., dye), medicaments, perfusion solution or other fluid my flow. B. Rapid Exchange Embodiments of the Embolectomy Catheter Device: Figures 3d, 3d',3e, 3e', 3f, 3f and 4 are illustrative of rapid exchange embodiments of the embolectomy catheter device 10", 10'" and 10"". These rapid exchange embolectomy catheter devices 10", 10'" and 10"" incorporate guidewire lumens which extend through only a distal portion of the catheter 11", 11'", 11"" so as to permit the catheter 11", 11"',11"" to be exchanged without the need for use of an exchange-length guidewire (i.e., a guidewire which is long enough to allow the exteriorized portion of the guidewire to be longer than the catheter so that the catheter may be withdrawn, removed and exchanged while holding the guidewire in substantially fixed position. These rapid-exchange embodiments are particularly suited for the treatment of stroke by removing thromboemboli from small blood vessels of the brain (i.e., blood vessels located on, in or around the brain), as the use of exchange-iength guidewires may be undesirable in such delicate neuroradiological procedures, see, Morris, P., Practical Neuroradiology, Chapter 2, page 41 (Williams & Wilkins 1997)
Third Embodiment Figures 3d and 3d' show a third embodiment (i.e., a rapid exchange type embodiment) of the embolectomy catheter device 10" which is similar in construction to the above described second embodiment 10', but which incorporates a guidewire passage port 267' formed in the sidewall of the catheter 11 " at a spaced distance (e.g., 0.5-35 cm) from its distal end, and a guidewire deflector tube 260' which extends from the guidewire passage port 267' to the lumen 22'. The guidewire deflector tube 260' has a flared distal end which is held in a centered position within the lumen by a plurality of radial support members 264'. Longitudinal passages 266, 266(alt) are formed between the radial support members 264' to allow radiographic contrast medium or other fluid to flow through the lumen 22', past the flared distal end of the guidewire deflector tube 260'. Selected ones of the longitudinal passages 266(alt) are larger than the others 266 to permit the elongate members 20' which form the obstructive matter capturing receptacle to pass therethrough, as shown. The proximal end of a guidewire PEG may be inserted into the distal end opening DEO of the catheter 11 " and, thereafter, the catheter 11 " may be advanced in the distal direction such that the proximal end of the guidewire PEG will enter the flared distal end of the guidewire deflector tube 260', and will be thereby deflected out of the side guidewire passage port 267', as shown.
Fourth Embodiment In the fourth embodiment (i.e., another rapid exchange embodiment) sown in Figures 3e and 3e', the catheter 11'" comprises a main tube 300 which has a proximal portion 302 of a first diameter D1 and a distal portion 304 of a second diameter D2. A side tube 308 is affixed to one side of the distal portion 304 of the main tube 300, and a guidewire passage aperture 310 is formed into the lumen 309 of the side tube 308, such that the lumen 309 of the side tube may be used as the guidewire lumen, and the distal portion of the guidewire GW which emerges from the side tube lumen 309 may then be passed through the separate guidewire lumen of the obstructive matter capturing receptacle 22 (not shown in figure 3e) and/or any nose cone lumen 22NC (not shown in figure 3e), as described fully hereabove.
Fifth Embodiment The fifth embodiment (i.e., another rapid exchange embodiment) of the embolectomy catheter device 10"" is similar in construction and operates in the same manner as the fourth embodiment 10'" described above, except that the main tube 300' of this fifth embodiment 10"" is formed of a continuous wire 316 which is would in a tight helical coil, as shown. This construction of the main tube 300' may provide enhanced flexibility over other forms of construction. C. Alternative Components and Optional Elements Which May be Incorporated into any Embodiment of the Embolectomy Catheter Devices:
/. Alternative Types of Obstructive matter Capturing Receptacles:
The embolectomy catheter devices 10, 10', 10", 10'", 10"" of the present invention may incorporate various types of obstructive matter capturing receptacles as alternatives to the helical wire basket type receptacles 14, 14' shown in Figures 1a, 2b and 4. In particular, several alternative obstructive matter capturing receptacles are shown in Figures 5-7.
Figures 5-5a show one alternative obstructive matter-capturing receptacle . 400 which comprises a plurality of elastic or superelastic wire spokes 402 which are preformed to a radially splayed configuration as shown, and which have a membranous or fabric cover 404 disposed thereon to form an umbrella like structure. The membranous or fabric cover 404 may be of non-porous or porous configuration, and is preferably formed of material such as polyethylene, polytetrafluoroethylene, polyurethane, ethylene vinyl acetate or silicone. A central hub is formed at the center of the spokes 402, and a guidewire lumen extends through such central hub such that the guidewire may pass the center of the receptacle 400, in the manner depicted in Figures 5 and 5a. The ends of the spokes 402 may have bulbs 408 formed thereon to minimize trauma to the surrounding blood vessel walls, as shown in Figure 5'. Or, as an alternative to such bulbs 408, atraumatic loops 410 may be formed on the distal ends of the spokes 402 to prevent vascular trauma. The spokes 402 are of sufficiently small diameter to be retracted through a thromboembolism without causing substantial disruption of segmentation of the thromboembolism. Also, in the embodiment shown in Figure 5, it will be appreciated that the spokes 402 may have a greater curvature than that shown, such that the free ends of the spokes 402 will not be in direct contact with the blood vessel wall.
Figures 5b-5b" show another obstructive matter capturing receptacle 420 which comprises a plurality of elastic or superelastic wire spokes 402' which are pre- formed to a radially splayed configuration as shown, and a porous fabric (e.g., woven, knitted, mesh or net fabric) sac 422 attached to the spokes 402' to form an umbrella-like structure, as shown. The material used to form this sac 422 may be the same microporous material as specified hereabove with respect to the membranous or fabric cover 404 of the embodiment shown in Figure 5. A central aperture 426 is formed in the sac 422 such that a guidewire GW may be passed through a region among the spokes 402', and through such aperture 426, as shown in Figures 5b and 5b'. Draw lines 424 are attached to the free ends of the spokes 402' and extend through the lumen of the catheter. These draw lines 424 and the spokes 402' are of sufficiently small diameter to be retracted through a thromboembolism without causing substantial disruption or segmentation of the thromboembolism. After the receptacle 420 has been advanced through the thromboembolism, it is deployed (e.g., radially expanded) and retracted such that the draw lines 424 and spokes 402' will retract through and will become located proximal to, the thromboembolism. Thereafter, the draw lines 424 are retractable into the catheter to pull distal ends of the spokes 402' inwardly such that the proximal mouth PM of the sac will be drawn partially around the captured obstructive matter in the manner shown in Figures 5b' and 5b".
Figure 5c shows another alternative obstructive matter capturing receptacle which employs a resilient, generally football shaped cage to effect radial expansion/contraction of a membranous or fabric cover 444. As shown, the cage comprises approximately six (6) elongate members 442 of preformed elastic, super-elastic or shape memory metal wire disposed longitudinally about a longitudinal axis LA, and having the membranous or fabric covering 444 disposed on the distal portions DP thereof. The distal ends DE of the elongate members 442 are attached to a nose cone 446 which has a guidewire passage lumen extending longitudinally therethrough. When retracted into the lumen of the catheter, the members 442 will radially compress to a diameter which is received within the catheter lumen. However, when advanced out of the catheter the members 442 will resiiiently expand to the configuration shown. The proximal portions of the members are sufficiently small in diameter to slice, cut or otherwise pass in the proximal direction through a thromboembolism or clot without disrupting or causing fragmentation of the thromboembolism or clot.
Figures 7 and 7a show an alternative helical basket type of obstructive matter capturing receptacle 14" which is of the same general configuration, and operates in the same manner, as the helical basket type receptacles 14, 14' shown in Figures
1a and 4, but wherein the receptacle 14" is formed of a plurality of flat ribbons 500 formed of metal such as cobalt-chromium-nickel alloy (Elgiloy™, Elgiloy, Inc., Elgin, Illinois), a shape memory and/or super-elastic material such as nickel-titanium alloy, or other suitable metal or plastic. The distal portions of the flat ribbons 500 are . preformed to helical configurations to form the helical basket 502. The proximal portions of the ribbons 500 serve as connector members 504 between the helical basket 502 and the catheter 11. Each ribbon 500 has first and second flat surfaces 512 and first and second edges 514. Each of the ribbons 500 is twisted 90 degrees at a point of transition 510 between the connector members 504 and the helical basket 502. This twisting of the ribbons causes a) the distal portions to be situated with their edges 514 in juxtaposition such that a thromboembolus contained within the helical basket 502 will rest upon the flat surfaces of the ribbons 500, and b) the proximal portions to be situated with their edges aimed in the proximal direction to facilitate retraction of the distal connector members 504 through the thromboembolus without causing the thromboembolus to be substantially fragmented or disrupted.
Optional Guide Catheter/Proximal Obstructive Matter Retaining Member: As illustrated in figure 6, it may be desirable to use the embolectomy catheter devices 10, 10', 10", 10'", 10"" in conjunction with a guide catheter 50 through which the embolectomy catheter 11 may be advanced. When such guide catheter
50 id used, a proximal obstructive matter retaining member 52, such as a tubular sheath having a radially flared and splayable distal end as shown in Figure 5a, may be advanced out of the distal end DE of the guide catheter 50 such that the clot C or other obstructive matter may be captured between the distal obstructive matter receiving portion 16 of the receptacle 14 and the flared distal end of the proximal obstructive matter retaining member 52. The use of this optional proximal obstructive matter retaining member 52 may be particularly useful in cases where the thromboembolism is very fresh or has been inadvertently severed or segmented so as to present a danger of breaking apart or fragmenting during the removal procedure.
D. Rapid Exchange Microcatheter Useable in Conjunction with the Embolectomy Catheters:
In many procedures wherein the embolectomy catheters of this invention are used to remove thromboemboli from small blood vessels of the brain, it will be . desirable to initially perform an angiogram of the blood vessel wherein the thromboembolism is believed to be located to a) verify the exact location of the thromboembolism and b) radiographically map the vascular anatomy in the immediate area of the thromboembolism and c) guide and verify the passage of a small guidewire through the offending thromboembolism. Because the embolectomy catheters 10, 10", 10", 10"', 10"" of the present invention may necessarily be of very small diameter (e.g., 0.10-0.20 inches) in order to navigate the tiny blood vessels of the brain, the presence of the retracted obstructive matter capturing receptacle 14, 14', 400, 420 or 440 within that catheter 11 may severely limit the amount of radiographic contrast medium which could be infused though that catheter 11. Thus, in many instances, it may be desirable to initially insert a small angiography catheter (e.g., a microcatheter such as the Prowler™ microcatheter, Cordis Endovascular Systems, Miami Lakes, Florida), an example of which is shown in Figure 3a, into the obstructed blood vessel to perform the initial angiography and to accomplish precise positioning of the guidewire through the thromboembolism. After the initial angiography has been performed and the guidewire has been precisely positioned, the angiography catheter is withdrawn and removed, leaving the guidewire in place. Thereafter, an embolectomy catheter 10,
10', 10", 10'", 10"" of the present invention is advanced over the pre-positioned guidewire to the location of the thromboembolism.
However, the microcatheters of the prior art have not been suitably designed for this novel procedure. Such microcatheters have heretofore of an "over-the-wire" type used primarily in procedures where the catheter is retracted and removed concurrently with the guidewire over which it was inserted. Thus, as those skilled in the art will appreciate, the prior art "over-the-wire" type microcatheters can only be exchanged over a stationary guidewire //the guidewire is an "exchange-length" wire or /fan extension has been attached to the proximal end of the guidewire to permit the exchange. However, the use of such "exchange-length" guidewire or a guidewire extension may be contraindicated in procedures where the catheters are . being inserted into and withdrawn from tiny delicate vessels of the brain, see,
Morris, P., Practical Neuroradiology, Chapter 2, page 41 (Williams & Wilkins 1997) In view of this shortcoming of the prior art microcatheters, applicant has devised the rapid-exchange microcatheter 265 shown in Figures 3c and 3c'. This rapid exchange microcatheter 265 comprises an elongate, flexible catheter having a proximal portion 12" of a first diameter and first flexibility, and a distal portion 270" which has a second (i.e., smaller) diameter and a second (i.e., greater) flexibility. A guidewire passage port 267 formed in the sidewall of the catheter near the distal end of its proximal portion 12", and a guidewire deflector tube 260 which extends from the guidewire passage port 267 to the lumen 271. The guidewire deflector tube 260 has a flared distal end which is held in a centered position within the lumen by a plurality of radial support members 264. Longitudinal passages 266 are formed between the radial support members 264 to allow radiographic contrast medium or other fluid to flow through the lumen 271 , past the flared distal end of the guidewire deflector tube 260. The proximal end of a guidewire PEG may be inserted into the distal end opening DEO of the catheter and, thereafter, the catheter may be advanced in the distal direction such that the proximal end of the guidewire PEG will enter the flared distal end of the guidewire deflector tube 260, and will be thereby deflected out of the side guidewire passage port 267, as shown in Figure 3c. E. Methods for Using the Invention to Remove Clots or Other Obstructive Matter from Blood Vessels:
Figures 8a-8f illustrate a preferred method of using an the over-the-wire type embolectomy catheter 10 of the invention to remove a obstructive matter such as a thromboembolism or blood clot, while Figures 9a-9c illustrate a preferred method of using a rapid exchange type embolectomy catheter 10" of the invention to remove such obstructive matter. These exemplary procedures are described in detail in the paragraphs below.
Preferred Use of the Over-the-Wire Embolectomy Catheter Figures 8a-8f show a presently preferred method for using the over-the-wire type embolectomy catheter 10 shown in Figures 1 -2d to remove a thromboembolus or clot C which has become lodged immediately downstream of an . arterial bifurcation BE so as to create an ischemic zone IZ of tissue (e.g., brain tissue which is deprived of oxygen and other nutrients) located downstream of the clot C. The preferred procedures depicted in these drawings are described in the paragraphs herebelow.
Initially, a microcatheter such as the rapid exchange microcatheter 265 of Figure 3c (not shown in Figures 8a-8f) is advanced to a position near the obstructive matter or clot C and radiographic contrast medium is injected through the microcatheter to angiographically verify the precise location of the clot C and to visualize or map the anatomy of the blood vessels in the area of the clot. Thereafter, a guidewire having a diameter of 0.01-0.014 inches and a length which is not more than 1.5 times the length of the microcatheter 265 (i.e., not an "exchange-length" guidewire) is advanced from the lumen 271 of the microcatheelr 265 until its distal tip DT has passed through the clot C as shown in Figure 8a.
Threrafter, the operator will hold the proximal end of the guidewire GW to prevent longitudinal retraction of the guidewire GW while retracting and removing the rapid exchange microcatheter 265. This allows the guidewire GW to remain in its operative position as shown in Figure 8a. Thereafter, as shown in Figure 8b, the embolectomy catheter 11 having its obstructive matter capturing receptacle retracted to its first configuration (Fig.2a) is advanced over the guidewire GW and through the clot C, such that the distal end opening DEO of the catheter 11 is located downstream of the clot C but still proximal to (i.e., upstream of) the distal tip DT of the guidewire GW.
Thereafter, as shown in figures 8c and 8d, the actuator 28 is advanced in the distal direction to cause the four wire segments 20 which form the obstructive matter capturing receptacle 14 to advance out of the distal end of the catheter such that the nose cone 30 remains upon the guidewire GW. In this manner, the obstructive matter capturing receptacle 14 is fully deployed to its second or operative configuration at a location distal to (i.e., downstream of) the clot C (Figure 3d).
Thereafter, as shown in Figure 8e, the embolectomy catheter 11 is retracted in the proximal direction to cause the proximal connector members 18 of the obstructive matter capturing receptacle 14 to pass through the clot, and to further cause the clot to be received within the concave or cavernous interior of the distal obstructive matter receiving portion 16 of the receptacle 14, as shown.
Thereafter, as shown in Figure 8f, the entire embolectomy catheter device 10, with the clot C in tow, may be retracted out of the body-or to a location within a larger blood vessel (e.g., carotid artery) where the clot C and the fully deployed obstructive matter capturing receptacle 14 may be received within the lumen of a larger catheter to further secure the clot for ultimate extraction and removal form the body.
Preferred Use of the Rapid Exchange Embolectomy Catheter The preferred method of using a rapid exchange type embolectomy catheter of this invention 10" is shown in Figures 9a-9d.
Initially, a microcatheter such as the rapid exchange microcatheter 265 of
Figure 3c (not shown in Figures 9a-9d) is advanced to a position near the clot C and radiographic contrast medium is injected through the microcatheter to angiographically verify the precise location of the clot C and to visualize or map the anatomy of the blood vessels in the area of the clot. Thereafter, a guidewire having /56801
-26- a diameter of 0.006-0.018 inches and a length which is not more than 1.5 times the length of the microcatheter 265 (i.e., not an "exchange-length" guidewire) is advanced from the lumen 271 of the microcatheetr 265 until its distal tip DT has passed through the clot C as shown in Figure 9a. Threrafter, the operator will hold the proximal end of the guidewire GW to prevent longitudinal retraction of the guidewire GW while retracting and removing the rapid exchange microcatheter 265. This allows the guidewire GW to remain in its operative position as shown in Figure 9a.
Thereafter, as shown in Figure 9b, the exteriorized proximal end of the guidewire is inserted into the distal end opening DEO of the the rapid exchange embolectomy catheter 11" while its obstructive matter capturing receptacle is retracted to its first configuration (Fig.2a) within the distal portion of the catheter 11". As the catheter is advanced in the distal direction over the guidewire GW, the guidewire will be deflected by the guidewire deflection tube 260' (see Figure 3d) and the proximal end of the guidewire will emerge out of the side guidewire passage aperture 267' of the catheter 11 ". The catheter 11 " is advanced through the clot C, such that the distal end opening DEO of the catheter 11" is located downstream of the clot C but still proximal to (i.e., upstream of) the distal tip DT of the guidewire GW, as shown in Figure 9c. The guidewire GW extends along side of the proximal portion of the rapid exchange catheter 11" (i.e., the portion of the catheter proximal to the guidewire passage aperture 267'), as shown.
Thereafter, as shown in figure 9d, the actuator 28 is advanced in the distal direction to cause the two (2) wire members 20' which form the obstructive matter capturing receptacle 14' to advance out of the distal end of the catheter 11' such that the nose cone 30' remains upon the guidewire GW. In this manner, the obstructive matter capturing receptacle 14' is fully deployed to its second or operative configuration at a location distal to (i.e., downstream of) the clot C (Figure 9d).
Thereafter, the rapid exchange embolectomy catheter 11' is retracted in the proximal direction to cause the proximal connector members 18' of the obstructive mattβr capturing receptacle 14' to pass through the clot, and to further cause the clot to be received within the concave or cavernous interior of the helical basket 16' of the receptacle 14'. The clot C is then removed by retraction of the catheter 11', in the same manner shown and described above and shown in Figures 8e and 8f.. It is to be appreciated that the invention has been described herein with reference to certain exemplary embodiments only, and no effort has been made to exhaustively describe each an every possible embodiment of the invention. Indeed, as those skilled in the art will appreciate, various additions, deletions, modifications and/or alterations may be made to he above described embodiments without departing from the spirit and scope of the invention. It is intended that all such additions, deletions, alterations and modifications be included within the scope of the following claims.

Claims

CLAIMS What is claimed is:
1. An embolectomy catheter device for removing a blood clot or other obstructive matter from a blood vessel, said device comprising: an elongate flexible catheter body having a proximal end, a distal end, and . a guidewire lumen which extends longitudinally through at least a portion thereof; an obstructive matter capturing receptacle which is initially disposed in a first stowed configuration which is passable through the obstructive matter, and is subsequently deployable to a second radially expanded configuration; said obstructive matter capturing receptacle having a guidewire lumen which extends longitudinally therethrough in alignment with the guidewire lumen of said catheter body, such that the obstructive matter capturing receptacle and the catheter body may be advanced over a previously positioned guidewire.
2. The embolectomy catheter device of Claim 1 wherein the obstructive matter capturing receptacle is sufficiently porous to allow blood to flow therethrough, but sufficiently non-porous to prevent a blood clot from passing therethrough.
3. The embolectomy catheter device of Claim 2 wherein said obstructive matter capturing receptacle has openings of 100-1000 microns formed therein, to provide a porosity of 25% to 90%.
4. The embolectomy catheter device of Claim 1 wherein the obstructive matter capturing receptacle is formed of pre-formed, elastic material which collapses to said first configuration when retracted into the catheter, and expands to said second configuration when advanced out of said catheter.
5. The embolectomy catheter of Claim 4 wherein the obstructive matter capturing receptacle is formed of a material which is superelastic at body temperature.
6. The embolectomy catheter of Claim 5 wherein the obstructive matter capturing receptacle is formed of a nickel-titanium alloy which is superelastic at body temperature.
7. The embolectomy catheter device of Claim 1 wherein; the catheter further comprises a plurality of member guide passageways which extend through the distal end of the catheter; the obstructive matter capturing receptacle comprises a plurality of elongate, members which are preformed to generally helical configurations, and which extend through the guide passageways formed in the distal end of the catheter; said elongate members being retractable in a proximal direction through said guide passageways whereby they will assume substantially straight configurations; and, said elongate members being advanceable in a distal direction through said guide passageways such that they will assume their generally helical configurations and will form said generally concave clot capturing receptacle.
8. The embolectomy catheter device of Claim 7 further comprising a tip member formed on the distal ends of said elongate members, said guidewire lumen of the receptacle extends through said tip member.
9. The embolectomy catheter device of Claim 1 further comprising: a proximal connector formed on the proximal end of the catheter body, said proximal connector having an injection port formed therein to permit radiographic contrast medium to be injected through a lumen of the catheter body while a guidewire is positioned within the guidewire lumen of the catheter body.
10. The embolectomy catheter device of Claim 1 wherein distal portions of said elongate members are biased to configurations which form a distal obstructive matter receiving portion of the obstructive matter capturing receptacle.
11. The embolectomy catheter device of Claim 1 wherein distal portions of said elongate members will, when unconstrained, form a distal obstructive matter receiving portion of the receptacle and proximal portions of said elongate members will form struts which extend from the catheter body to the distal obstructive matter receiving portion of the receptacle.
12. The embolectomy catheter device of Claim 11 wherein said struts are configured and positioned to pass through a clot when withdrawn therethrough in a proximal direction, but the distal obstructive matter receiving portion of the receptacle is sufficiently dense to prevent that clot from passing therethrough.
13. An over the wire embodiment of the embolectomy catheter of Claim 1 wherein the guidewire lumen extends longitudinally through substantially the entire catheter body.
14. A rapid exchange embodiment of the embolectomy catheter of Claim 1 wherein the catheter further comprises a guidewire passage aperture formed in the catheter a spaced distance proximal to the catheter's distal end, and wherein the guidewire lumen extends within the catheter at least from the guidewire passage aperture to the distal end of the catheter.
15. The embolectomy catheter device of Claim 14 further comprising a guidewire deflector positioned within the guidewire lumen and configured to deflect the proximal end of a guidewire out of the guidewire passage aperture, as the catheter is advanced in the distal direction over the guidewire.
16. The embolectomy catheter device of Claim 15 wherein the guidewire deflector comprises a curved guidewure deflector tube having a proximal end positioned at the guidewire passage aperture and a distal end positioned within the guidewire lumen of the catheter such that the proximal end of the guidewire will be received within the distal end of the curved guidewire deflector tube and will thereafter pass through the curved guidewire deflector tube and out of the guidewire passage aperture.
17. The embolectomy catheter device of Claim 16 wherein the distal end of the curved guidewire deflector tube is larger in diameter than the rest of the curved guidewire deflector tube to facilitate entry of the proximal end of the guidewire into the distal end of the curved guidewire deflector tube.
18. The embolectomy catheter device of Claim 16 wherein at least one support member is attached to the distal end of the curved guidewire deflector tube to hold the distal end of the curved guidewire deflector tube in a substantially centered position within the guidewire lumen of the catheter.
19. The embolectomy catheter device of Claim 17 wherein the guidewire lumen additionally extends through the portion of the catheter proximal to the guidewire passage aperture and is used for injection of radiographic contrast medium as well as for passage of the guidewire, and wherein at least one flow passageway is formed adjacent the distal end of the curved guidewire deflector tube to allow radiographic contrast medium to flow past the curved guidewire deflector tube and out of the distal end of the catheter.
20. The embolectomy catheter device of Claim 1 wherein the catheter body is of greater flexibility near its distal end than near its proximal end.
21. The embolectomy catheter device of Claim 20 wherein at least a portion of the catheter body between its proximal and distal ends is of gradually increasing flexibility over its entire length.
22. The embolectomy catheter device of Claim 20 wherein the catheter body comprises at least two discrete regions of differing flexibility.
23. The embolectomy catheter device of Claim 20 wherein the catheter body comprises at least two discrete regions of differing diameter.
24. The embolectomy catheter device of Claim 23 wherein said discrete regions of differing diameter are also of differing flexibility.
25. The embolectomy catheter of Claim 1 wherein the obstructive matter capturing receptacle and catheter body are constructed so as to be extractable, with the removed obstructive matter, through a percutaneous vascular access tract.
26. A rapid exchange microcatheter comprising: an elongate, flexible catheter having a proximal end and a distal end, said catheter having greater flexibility near its distal end than near its proximal end; a lumen which extends longitudinally through the catheter; and, a guidewire passage aperture formed in the catheter a spaced distance proximal to the catheter's distal end such that the proximal end of a guidewire, which has been inserted into the distal end of the catheter lumen, may pass out of the guidewire passage aperture such that the guidewire extends only through a distal portion of the catheter lumen.
27. The rapid exchange microcatheter of Claim 26 further comprising a
guidewire deflector positioned within the catheter lumen and configured to deflect the proximal end of a guidewire out of the guidewire passage aperture, as the catheter is advanced in the distal direction over the guidewire.
28. The rapid exchange catheter device of Claim 27 wherein the guidewire deflector comprises a curved guidewire deflector tube having a proximal end positioned at the guidewire passage aperture and a distal end positioned within the lumen of the catheter such that the proximal end of the guidewire will be received within the distal end of the curved guidewire deflector tube and will thereafter pass, through the curved guidewire deflector tube and out of the guidewire passage aperture.
29. The rapid exchange microcatheter of Claim 28 wherein the distal end of the curved guidewire deflector tube is larger in diameter than the rest of the curved guidewire deflector tube to facilitate entry of the proximal end of the guidewire into the distal end of the curved guidewire deflector tube.
30. The rapid exchange microcatheter device of Claim 28 wherein at least one support member is attached to the distal end of the curved guidewire deflector tube to hold the distal end of the curved guidewire deflector tube in a substantially centered position within the guidewire lumen of the catheter.
31. The rapid exchange microcatheter device of Claim 30 wherein the catheter lumen extends through the portion of the catheter proximal to the guidewire passage aperture and is used for injection of radiographic contrast medium as well as for passage of the guidewire, and wherein at least one flow passageway is formed adjacent the distal end of the curved guidewire deflector tube to allow radiographic contrast medium to flow past the guidewire deflector tube and out of the distal end of the catheter.
32. The rapid exchange microcatheter of Claim 31 wherein the catheter body comprises at least two discrete regions of differing flexibility.
33. The rapid exchange microcatheter of Claim 32 wherein the catheter body comprises at least two discrete regions of differing diameter.
34. The rapid exchange microcatheter of Claim 33 wherein said discrete regions of differing diameter are also of differing flexibility.
35. A system for removing obstructive matter such as a clot from a blood vessel of the brain of a mammalian patient, said system comprising: a guidewire which has a proximal end and a distal end; a microcatheter which comprises an elongate, flexible tube having a proximal end and a distal end, said tube having i) a proximal portion of a first diameter, ii) a distal portion of a second diameter smaller than said first diameter iii) a lumen which extends longitudinally through the tube; and, an embolectomy catheter device which comprises I) an elongate flexible embolectomy catheter body having a proximal end, a distal end, and a guidewire lumen which extends longitudinally through at least a portion thereof; and, ii) an obstructive matter capturing receptacle which is initially disposed in a radially collapsed configuration and is subsequently deployable to a radially expanded configuration wherein it has a proximal opening through which at least a portion of the obstructive matter may be received within the obstructive matter capturing receptacle; said guidewire, microcatheter and embolectomy catheter being relatively sized and configured to remove said obstructive matter by a procedure which comprises the steps of: A. inserting the microcatheter into the patient's vasculature and advancing the microcatheter to a location near the obstructive matter; /56801
-35- B. injecting radiographic contrast medium through the microcatheter lumen under radiographic visualization to obtain an angiogram of the vasculature in the area of the obstructive matter; C. advancing the guidewire to a desired operative position wherein i) the distal end of the guidewire has passed at least partially through the obstructive matter and ii) a portion of the guidewire adjacent its proximal end remains located outside of the patient's body; D. withdrawing and removing the microcatheter while holding the portion of the guidewire which remains outside of the patient's body to , prevent the guidewire from undergoing substantial longitudinal retraction during the withdrawal and removal of the microcatheter; E. inserting the proximal end of the guidewire into the distal end of the embolectomy catheter with the obstructive matter capturing receptacle being disposed in its radially collapsed configuration; F. advancing the embolectomy catheter device in the distal direction over the guidewire until the distal end of the embolectomy catheter has passed at least partially through the obstructive matter ; G. deploying the obstructive matter capturing receptacle to its radially expanded configuration; H. retracting at least the obstructive matter capturing receptacle to cause at least a portion of the obstructive matter to be received within the obstructive matter capturing receptacle through the proximal opening thereof; and, I. withdrawing the embolectomy catheter device and the obstructive matter, thereby removing the obstructive matter from the position in which it had been lodged.
36. The system of Claim 35 wherein the obstructive matter capturing receptacle and the embolectomy catheter body are constructed such that Step I of the /56801
-36- procedure may be accomplished by withdrawing the embolectomy catheter device and the removed obstructive matter through a percutaneous puncture tract.
37. The system of Claim 35 wherein the obstructive matter capturing member of the embolectomy catheter device has a guidewire passage opening which extends longitudinally therethrough, said guidewire passage opening being aligned with the guidewire lumen of the embolectomy catheter body such that when the embolectomy catheter device is advanced in the distal direction in Step F of the procedure, the guidewire will pass through the guidewire passage, opening of the obstructive matter capturing receptacle as well as through the guidewire iumen of the embolectomy catheter body.
38. The system of Claim 35 wherein at least a proximal portion of the obstructive matter capturing receptacle is adapted to be drawn about the obstructive matter to aid in the containment of the obstructive matter by the obstructive matter capturing receptacle, said obstructive matter capturing receptacle being thereby constructed such that Step H of the procedure may further comprise causing at least a proximal portion of the obstructive matter capturing receptacle to be drawn about the obstructive matter after at least a portion of the obstructive matter has been received within the obstructive matter capturing receptacle to aid in the containment of the obstructive matter by the obstructive matter capturing receptacle.
39. The system of Claim 35 wherein the system further comprises: a proximal catheter through which said embolectomy catheter device is advanced, said proximal catheter comprising a flexible tube which has a lumen extending longitudinally therethrough, and wherein said proximal catheter is sized and configured relative to said obstructive matter capturing receptacle such that Step I of the procedure may comprise I) withdrawing said embolectomy catheter device and the obstructive matter such that at least a portion of the obstructive matter will be received within the proximal catheter and, thereafter, ii) withdrawing the proximal catheter along with withdrawal of the embolectomy catheter device to effect removal of the obstructive matter.
40. The system of Claim 35 wherein the proximal catheter further comprises a proximal obstructive matter receiving member which is deployable from the distal end of the proximal catheter, such that Step I of the procedure may further comprise I) deploying the proximal obstructive matter receiving member from the proximal catheter and ii) withdrawing the embolectomy catheter device such that the obstructive matter will be substantially captured between the obstructive matter, capturing receptacle and said proximal obstructive matter receiving member.
41. The system of Claim 35 wherein the obstructive matter capturing receptacle comprises i) a distal obstructive matter containment portion and ii) at least one proximal strut which extends between the obstructive matter containment portion and the embolectomy catheter body when the obstructive matter capturing receptacle is deployed to its operative, radially expanded configuration, said at least one proximal member being sized and configured to pass through the obstructive matter such that, when the obstructive matter capturing receptacle is retracted in Step H, said at least one proximal member will pass through the obstructive matter.
42. The system of Claim 35 wherein the embolectomy catheter body comprises at least two discrete regions of differing flexibility.
43. The system of Claim 35 wherein the embolectomy catheter body comprises at least two discrete regions of differing diameter.
44. The system of Claim 43 wherein said discrete regions of differing diameter are also of differing flexibility.
45. The system of Claim 35 wherein the microcatheter catheter body comprises at least two discrete regions of differing flexibility.
46. The system of Claim 35 wherein the microcatheter catheter body comprises at least two discrete regions of differing diameter.
47. The system of Claim 46 wherein said discrete regions of differing diameter are also of differing flexibility.
48. A method for removing a bloodflow-obstructing blood clot or other obstructive matter from a blood vessel located on, in or around the brain of a mammalian patient, said method comprising the steps of: A. providing an embolectomy catheter device which comprises i) an elongate flexible embolectomy catheter body having a proximal end and a distal end, and, ii) a obstructive matter capturing receptacle which is initially disposed in a radially collapsed configuration and is subsequently deployable to a radially expanded configuration wherein it has a proximal opening through which at least a portion of the obstructive matter may be received within the obstructive matter capturing receptacle, and iii) a guidewire lumen which extends through said obstructive matter capturing receptacle and through at least a portion of the embolectomy catheter body; B. providing a guidewire which has a proximal end and a distal end, said guidewire being sized for percutaneous insertion into the vasculature of the patient subsequent transluminal advancement to an operative guidewire position whereat the distal end of the guidewire has traversed at least partially through the lodged blood obstructive matter; C. percutaneously inserting the guidewire and advancing the guidewire to said operative guidewire position; 6801
-39- D. causing the guidewire to be received within the guidewire lumen of the embolectomy catheter device and advancing the embolectomy catheter device over the guidewire until the distal end of the embolectomy catheter body has traversed the lodged obstructive matter; E. deploying the obstructive matter capturing receptacle to its radially expanded configuration; F. retracting at least the obstructive matter capturing receptacle in the proximal direction to cause at least a portion of the obstructive matter to be received within the obstructive matter capturing receptacle; and, G. withdrawing the embolectomy catheter device, the guidewire and the obstructive matter, thereby restoring blood flow to the blood vessel within which the obstructive matter had been lodged.
49. The method of Claim 48 wherein, prior to Step C, the method further comprises: injecting an first quantity of radiographic contrast medium under radiographic visualization to radiographically verify the location at which the obstructive matter is presently lodged.
50. The method of Claim 49 wherein the first quantity of radiographic contrast medium is injected through a separate microcatheter, and wherein the method prior to Step D comprises the additional steps of: providing a microcatheter which comprises an elongate, flexible tube having a proximal end and a distal end, said tube having i) a proximal portion of a first diameter, ii) a distal portion of a second diameter smaller than said first diameter iii) at least one lumen which extends longitudinally through the tube; causing the guidewire to be received within the lumen of the microcatheter and advancing the microcatheter and guidewire until the distal end of the microcatheter is located near the location at which the obstructive matter is believed to be lodged; injecting the first quantity of radiographic contrast medium through the lumen of the microcatheter under radiographic visualization to radiographically verify the location at which the obstructive matter is presently lodged; further advancing the guidewire through the microcatheter until the guidewire has reached the operative guidewire location whereat its distal end has at least partially traversed the obstructive matter; holding the guidewire at said operative guidewire location while withdrawing the microcatheter from the patients body; and, therafter, proceeding with Steps D through G of the method.
51. The method of Claim 48 wherein the microcatheter is a rapid exchange microcatheter which further comprises; a guidewire passage aperture formed in communication with the lumen of the microcatheter at a spaced distance proximal to the catheter's distal end, and wherein the step of causing the guidewire to be received within the lumen of the microcatheter further comprises causing the proximal end of the guidewire to emerge out of the guidewire passage aperture such that the guidewire extends only through a distal portion of the microcatheter lumen, and, wherein, the guidewire comprises a non-exchange-length guidewire.
52. The method of Claim 48 wherein the obstructive matter capturing receptacle of the embolectomy catheter device comprises a distal obstructive matter receiving portion which has a proximal opening and at least one proximal strut member which extends between the embolectomy catheter body and the distal obstructive matter receiving portion of the receptacle, and wherein Step F of the method further comprises: retracting at least the obstructive matter capturing receptacle in the proximal direction such that its at least one proximal connector member will pass through the obstructive matter and least a portion of the obstructive matter will be received within its distal obstructive matter capturing portion.
53. The method of Claim 48 wherein Step H is accomplished by withdrawing the embolectomy catheter device and the removed obstructive matter through a percutaneous vascular access tract.
54. The method of Claim 53 wherein the embolectomy catheter is inserted through a percutaneous vascular access tract and wherein Step H is accomplished. by withdrawing the embolectomy catheter device and the removed obstructive matter through the same percutaneous vascular access tract through which the embolectomy catheter was inserted.
55. An embolectomy catheter device for removing a blood clot or other obstructive matter from a blood vessel, said device comprising: an elongate flexible catheter body having a proximal end, a distal end, and a guidewire lumen which extends longitudinally through at least a portion thereof; an obstructive matter capturing receptacle which is initially disposed in a first stowed configuration which is passable through the obstructive matter, and is subsequently deployable to a second radially expanded configuration; said obstructive matter capturing receptacle comprising a distal obstructive matter receiving portion and at least one proximal strut which extends from the catheter body to the distal obstructive matter receiving portion of the receptacle; said at least one proximal strut being configured to be passable through a blood clot when retracted in the proximal direction.
56. The embolectomy catheter device of Claim 55 wherein the obstructive matter capturing receptacle is sufficiently porous to allow blood to flow therethrough, but sufficiently non-porous to prevent a blood clot from passing therethrough.
57. The embolectomy catheter device of Claim 56 wherein said obstructive matter capturing receptacle has openings of 100-1000 microns formed therein, to provide a porosity of 25% to 90%.
58. The embolectomy catheter device of Claim 55 wherein the obstructive matter capturing receptacle is at least partially formed of pre-formed, elastic material which collapses to said first configuration when retracted into the catheter, and expands to said second configuration when advanced out of said catheter.
59. The embolectomy catheter of Claim 58 wherein the obstructive matter capturing receptacle is formed at least partially of a material which is superelastic at body temperature.
60. The embolectomy catheter of Claim 59 wherein the obstructive matter capturing receptacle is formed of a nickel-titanium alloy which is superelastic at body temperature.
61. The embolectomy catheter device of Claim 55 wherein; the catheter further comprises a plurality of member guide passageways which extend through the distal end of the catheter; the obstructive matter capturing receptacle comprises a plurality of elongate members having distal portions which are preformed to assume the configuration of the distal obstructive matter receiving portion of the receptacle and proximal portions which form said at least one strut, said elongate members extending through the guide passageways formed in the distal end of the catheter; said elongate members being retractable in a proximal direction through said guide passageways whereby they will assume substantially straight configurations; and, said elongate members being advanceable in a distal direction through said guide passageways such that they will form said distal obstructive matter receiving portion and said at least one proximal strut.
62. The embolectomy catheter device of Claim 55 further comprising a tip member formed on the distal ends of said elongate members, said guidewire lumen of the receptacle extends through said tip member.
63. The embolectomy catheter device of Claim 55 further comprising: a proximal connector formed on the proximal end of the catheter body, said proximal connector having an injection port formed therein to permit radiographic contrast medium to be injected through a lumen of the catheter body while a guidewire is positioned within the guidewire lumen of the catheter body.
64. The embolectomy catheter device of Claim 55 wherein said struts are configured and positioned to pass through a clot when withdrawn therethrough in a proximal direction, but the distal obstructive matter receiving portion of the receptacle is sufficiently dense to prevent that clot from passing therethrough.
65. An over the wire embodiment of the embolectomy catheter of Claim 55 wherein the guidewire lumen extends longitudinally through substantially the entire catheter body.
66. A rapid exchange embodiment of the embolectomy catheter of Claim 55 wherein the catheter further comprises a guidewire passage aperture formed in the catheter a spaced distance proximal to the catheter's distal end, and wherein the guidewire lumen extends within the catheter at least from the guidewire passage aperture to the distal end of the catheter.
67. The embolectomy catheter device of Claim 66 further comprising a guidewire deflector positioned within the guidewire lumen and configured to deflect the proximal end of a guidewire out of the guidewire passage aperture, as the catheter is advanced in the distal direction over the guidewire.
68. The embolectomy catheter device of Claim 67 wherein the guidewire deflector comprises a curved guidewure deflector tube having a proximal end positioned at the guidewire passage aperture and a distal end positioned within the guidewire lumen of the catheter such that the proximal end of the guidewire will be received within the distal end of the curved guidewire deflector tube and will thereafter pass through the curved guidewire deflector tube and out of the guidewire passage aperture.
69. The embolectomy catheter device of Claim 68 wherein the distal end of the curved guidewire deflector tube is larger in diameter than the rest of the curved guidewire deflector tube to facilitate entry of the proximal end of the guidewire into the distal end of the curved guidewire deflector tube.
70. The embolectomy catheter device of Claim 68 wherein at least one support member is attached to the distal end of the curved guidewire deflector tube to hold the distal end of the curved guidewire deflector tube in a substantially centered position within the guidewire lumen of the catheter.
71. The embolectomy catheter device of Claim 66 wherein the guidewire lumen additionally extends through the portion of the catheter proximal to the guidewire passage aperture and is used for injection of radiographic contrast medium as well as for passage of the guidewire, and wherein at least one flow passageway is formed adjacent the distal end of the curved guidewire deflector tube to allow radiographic contrast medium to flow past the curved guidewire deflector tube and out of the distal end of the catheter.
72. The embolectomy catheter device of Claim 55 wherein the catheter body is of greater flexibility near its distal end than near its proximal end.
73. The embolectomy catheter device of Claim 72 wherein at least a portion of the the catheter body between its proximal and distal ends is of gradually increasing flexibility over its entire length.
74. The embolectomy catheter device of Claim 72 wherein the catheter body comprises at least two discrete regions of differing flexibility.
75. The embolectomy catheter device of Claim 72 wherein the catheter body comprises at least two discrete regions of differing diameter.
76. The embolectomy catheter device of Claim 75 wherein said discrete regions of differing diameter are also of differing flexibility.
77. The embolectomy catheter of Claim 55 wherein the obstructive matter capturing receptacle and catheter body are constructed so as to be extractable, with the removed obstructive matter, through a percutaneous vascular access tract.
PCT/US1999/009566 1998-05-01 1999-04-30 Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders WO1999056801A2 (en)

Priority Applications (7)

Application Number Priority Date Filing Date Title
AU37801/99A AU767873B2 (en) 1998-05-01 1999-04-30 Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
JP2000546825A JP4219558B2 (en) 1998-05-01 1999-04-30 Embolization catheter for the treatment of stroke and other small vessel thromboembolism
CA002329013A CA2329013A1 (en) 1998-05-01 1999-04-30 Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
ES99920259T ES2304808T3 (en) 1998-05-01 1999-04-30 EMBOLECTOMY CATHETERS TO TREAT CEREBROVASCULAR ACCIDENTS AND OTHER THROMBOEMBOLIC DISORDERS IN SMALL VESSELS.
DE69938425T DE69938425T2 (en) 1998-05-01 1999-04-30 EMBOLEKTOMY CATHETER FOR TREATING INFECT AND OTHER THROMBOEM POLYSTROLEASES IN SMALL VESSELS
EP99920259A EP1079874B1 (en) 1998-05-01 1999-04-30 Embolectomy catheters for treating stroke and other small vessel thromboembolic disorders
BR9910169-6A BR9910169A (en) 1998-05-01 1999-04-30 Embolectomy catheters and methods of treating stroke and other thromboembolic disorders of smaller vessels

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US09/071,561 US6511492B1 (en) 1998-05-01 1998-05-01 Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
US09/071,561 1998-05-01

Publications (2)

Publication Number Publication Date
WO1999056801A2 true WO1999056801A2 (en) 1999-11-11
WO1999056801A3 WO1999056801A3 (en) 2000-04-06

Family

ID=22102122

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1999/009566 WO1999056801A2 (en) 1998-05-01 1999-04-30 Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders

Country Status (11)

Country Link
US (6) US6511492B1 (en)
EP (3) EP1079874B1 (en)
JP (1) JP4219558B2 (en)
CN (1) CN1203811C (en)
AT (1) ATE390154T1 (en)
AU (1) AU767873B2 (en)
BR (1) BR9910169A (en)
CA (1) CA2329013A1 (en)
DE (1) DE69938425T2 (en)
ES (3) ES2430352T3 (en)
WO (1) WO1999056801A2 (en)

Cited By (78)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2001019260A1 (en) * 1999-09-16 2001-03-22 Scimed Life Systems, Inc. Laser-resistant medical retrieval device
WO2001097697A1 (en) * 2000-06-22 2001-12-27 White Geoffrey H Method and apparatus for performing percutaneous thromboembolectomies
WO2002022028A3 (en) * 2000-09-14 2002-06-13 Cook Urological Inc Minimally-invasive medical retrieval device
EP1272110A1 (en) * 2000-03-31 2003-01-08 Bacchus Vascular Inc. Expansible shearing catheters for thrombus and occlusive material removal
EP1296728A2 (en) * 2000-06-29 2003-04-02 Concentric Medical, Inc. Systems, methods and devices for removing obstructions from a blood vessel
EP1355692A1 (en) * 2001-01-09 2003-10-29 Microvention, Inc. Embolectomy catheters and method for treatment
EP1408875A1 (en) * 2001-07-24 2004-04-21 Incept Llc Apparatus and methods for aspirating emboli
WO2004084739A1 (en) * 2003-03-27 2004-10-07 Nihon University Wire for inserting into biological duct
US6893450B2 (en) 1999-03-26 2005-05-17 Cook Urological Incorporated Minimally-invasive medical retrieval device
WO2006122460A1 (en) 2005-05-17 2006-11-23 Microport Medical (Shanghai) Co., Ltd. Dual guide-wire distal end protector
EP1991141A1 (en) * 2006-02-22 2008-11-19 Strauss, Bradley H. Guide-wire sleeve for facilitation of lesion crossing
JP2009142677A (en) * 2001-08-22 2009-07-02 Gore Enterp Holdings Inc Apparatus and method for treating stroke and controlling cerebral blood flow characteristic
US7691121B2 (en) 1998-05-01 2010-04-06 Microvention, Inc. Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
US7780693B2 (en) 2001-06-27 2010-08-24 Salviac Limited Catheter
US7789860B2 (en) 2001-06-27 2010-09-07 Salviac Limited Catheter for delivery and/or retrieval of a medical device
JP2011104388A (en) * 2011-01-13 2011-06-02 Microvention Inc Catheter for embolectomy and handling method thereof
JP2015042272A (en) * 2014-10-03 2015-03-05 マイクロベンション インコーポレイテッド Embolectomy catheter and handling method
CH709547A1 (en) * 2014-04-17 2015-10-30 Stg Medical Ag Aspiration catheter.
US9198682B2 (en) 2011-04-13 2015-12-01 Olympus Corporation Endoscope treatment tool
WO2015189354A1 (en) * 2014-06-13 2015-12-17 Neuravi Limited Devices for removal of acute blockages from blood vessels
US9301769B2 (en) 2011-03-09 2016-04-05 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US9345509B2 (en) 2006-02-22 2016-05-24 Baylis Medical Company Inc. Guide-wire dilation device for facilitation of lesion crossing
US9351749B2 (en) 2010-10-22 2016-05-31 Neuravi Limited Clot engagement and removal system
US9445829B2 (en) 2013-03-14 2016-09-20 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
WO2017070801A1 (en) * 2015-10-28 2017-05-04 Stg Medical Ag Aspiration catheter
US9642635B2 (en) 2013-03-13 2017-05-09 Neuravi Limited Clot removal device
US9675413B2 (en) 2002-04-08 2017-06-13 Medtronic Ardian Luxembourg S.A.R.L. Methods and apparatus for renal neuromodulation
US9707035B2 (en) 2002-04-08 2017-07-18 Medtronic Ardian Luxembourg S.A.R.L. Methods for catheter-based renal neuromodulation
US9855096B2 (en) 2012-05-11 2018-01-02 Medtronic Ardian Luxembourg S.A.R.L. Multi-electrode catheter assemblies for renal neuromodulation and associated systems and methods
US9888961B2 (en) 2013-03-15 2018-02-13 Medtronic Ardian Luxembourg S.A.R.L. Helical push wire electrode
US10039896B2 (en) 2011-05-23 2018-08-07 Nitiloop Ltd. Deployment mechanism for body vessel insertion devices
US10076382B2 (en) 2010-10-25 2018-09-18 Medtronic Ardian Luxembourg S.A.R.L. Catheter apparatuses having multi-electrode arrays for renal neuromodulation and associated systems and methods
US10201360B2 (en) 2013-03-14 2019-02-12 Neuravi Limited Devices and methods for removal of acute blockages from blood vessels
US10265086B2 (en) 2014-06-30 2019-04-23 Neuravi Limited System for removing a clot from a blood vessel
US10285720B2 (en) 2014-03-11 2019-05-14 Neuravi Limited Clot retrieval system for removing occlusive clot from a blood vessel
AU2017204628B2 (en) * 2002-10-17 2019-07-25 W. L. Gore & Associates, Inc. Embolic filter frame having looped support strut elements
US10363054B2 (en) 2014-11-26 2019-07-30 Neuravi Limited Clot retrieval device for removing occlusive clot from a blood vessel
US10420570B2 (en) 2013-03-14 2019-09-24 Neuravi Limited Clot retrieval devices
US10582939B2 (en) 2008-07-22 2020-03-10 Neuravi Limited Clot capture systems and associated methods
US10617435B2 (en) 2014-11-26 2020-04-14 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
EP3641671A4 (en) * 2017-06-20 2020-05-27 Eskridge, Joe, Michael Stent retriever having an expandable fragment guard
US10736690B2 (en) 2014-04-24 2020-08-11 Medtronic Ardian Luxembourg S.A.R.L. Neuromodulation catheters and associated systems and methods
US10792056B2 (en) 2014-06-13 2020-10-06 Neuravi Limited Devices and methods for removal of acute blockages from blood vessels
US10842498B2 (en) 2018-09-13 2020-11-24 Neuravi Limited Systems and methods of restoring perfusion to a vessel
US11147572B2 (en) 2016-09-06 2021-10-19 Neuravi Limited Clot retrieval device for removing occlusive clot from a blood vessel
US11213678B2 (en) 2013-09-09 2022-01-04 Medtronic Ardian Luxembourg S.A.R.L. Method of manufacturing a medical device for neuromodulation
US11253278B2 (en) 2014-11-26 2022-02-22 Neuravi Limited Clot retrieval system for removing occlusive clot from a blood vessel
US11259824B2 (en) 2011-03-09 2022-03-01 Neuravi Limited Clot retrieval device for removing occlusive clot from a blood vessel
US11311304B2 (en) 2019-03-04 2022-04-26 Neuravi Limited Actuated clot retrieval catheter
US11395669B2 (en) 2020-06-23 2022-07-26 Neuravi Limited Clot retrieval device with flexible collapsible frame
US11395667B2 (en) 2016-08-17 2022-07-26 Neuravi Limited Clot retrieval system for removing occlusive clot from a blood vessel
US11406416B2 (en) 2018-10-02 2022-08-09 Neuravi Limited Joint assembly for vasculature obstruction capture device
ES2921403A1 (en) * 2022-02-03 2022-08-25 Fundacion Para La Investigacion Del Hospital Univ Y Politecnico La Fe De La Comunidad Valenciana Double conical double spiral embolic device during the practice of endovascular procedures (Machine-translation by Google Translate, not legally binding)
US11439418B2 (en) 2020-06-23 2022-09-13 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US11517340B2 (en) 2019-12-03 2022-12-06 Neuravi Limited Stentriever devices for removing an occlusive clot from a vessel and methods thereof
US11529495B2 (en) 2019-09-11 2022-12-20 Neuravi Limited Expandable mouth catheter
US11633198B2 (en) 2020-03-05 2023-04-25 Neuravi Limited Catheter proximal joint
US11712231B2 (en) 2019-10-29 2023-08-01 Neuravi Limited Proximal locking assembly design for dual stent mechanical thrombectomy device
US11717308B2 (en) 2020-04-17 2023-08-08 Neuravi Limited Clot retrieval device for removing heterogeneous clots from a blood vessel
US11730501B2 (en) 2020-04-17 2023-08-22 Neuravi Limited Floating clot retrieval device for removing clots from a blood vessel
US11737771B2 (en) 2020-06-18 2023-08-29 Neuravi Limited Dual channel thrombectomy device
US11759217B2 (en) 2020-04-07 2023-09-19 Neuravi Limited Catheter tubular support
US11779364B2 (en) 2019-11-27 2023-10-10 Neuravi Limited Actuated expandable mouth thrombectomy catheter
US11839725B2 (en) 2019-11-27 2023-12-12 Neuravi Limited Clot retrieval device with outer sheath and inner catheter
US11864781B2 (en) 2020-09-23 2024-01-09 Neuravi Limited Rotating frame thrombectomy device
US11872354B2 (en) 2021-02-24 2024-01-16 Neuravi Limited Flexible catheter shaft frame with seam
US11871946B2 (en) 2020-04-17 2024-01-16 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US11883043B2 (en) 2020-03-31 2024-01-30 DePuy Synthes Products, Inc. Catheter funnel extension
US11937839B2 (en) 2021-09-28 2024-03-26 Neuravi Limited Catheter with electrically actuated expandable mouth
US11937836B2 (en) 2020-06-22 2024-03-26 Neuravi Limited Clot retrieval system with expandable clot engaging framework
US11937837B2 (en) 2020-12-29 2024-03-26 Neuravi Limited Fibrin rich / soft clot mechanical thrombectomy device
US11944327B2 (en) 2020-03-05 2024-04-02 Neuravi Limited Expandable mouth aspirating clot retrieval catheter
US11974764B2 (en) 2021-06-04 2024-05-07 Neuravi Limited Self-orienting rotating stentriever pinching cells
US12011186B2 (en) 2021-10-28 2024-06-18 Neuravi Limited Bevel tip expandable mouth catheter with reinforcing ring
US12029442B2 (en) 2021-01-14 2024-07-09 Neuravi Limited Systems and methods for a dual elongated member clot retrieval apparatus
US12064130B2 (en) 2021-03-18 2024-08-20 Neuravi Limited Vascular obstruction retrieval device having sliding cages pinch mechanism
US12076037B2 (en) 2011-03-09 2024-09-03 Neuravi Limited Systems and methods to restore perfusion to a vessel
US12133657B2 (en) 2021-09-16 2024-11-05 Neuravi Limited Clot retrieval device for removing occlusive clot from a blood vessel

Families Citing this family (517)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060149343A1 (en) * 1996-12-02 2006-07-06 Palomar Medical Technologies, Inc. Cooling system for a photocosmetic device
JP4328888B2 (en) 1997-11-07 2009-09-09 サルヴィアック・リミテッド Embolic protection device
US7491216B2 (en) * 1997-11-07 2009-02-17 Salviac Limited Filter element with retractable guidewire tip
US9498604B2 (en) 1997-11-12 2016-11-22 Genesis Technologies Llc Medical device and method
US7314477B1 (en) 1998-09-25 2008-01-01 C.R. Bard Inc. Removable embolus blood clot filter and filter delivery unit
US20030082152A1 (en) * 1999-03-10 2003-05-01 Hedrick Marc H. Adipose-derived stem cells and lattices
US6702811B2 (en) 1999-04-05 2004-03-09 Medtronic, Inc. Ablation catheter assembly with radially decreasing helix and method of use
AU3844499A (en) * 1999-05-07 2000-11-21 Salviac Limited Improved filter element for embolic protection device
US6964672B2 (en) * 1999-05-07 2005-11-15 Salviac Limited Support frame for an embolic protection device
JP2002543875A (en) * 1999-05-07 2002-12-24 サルヴィアック・リミテッド Improved filter element for embolic protection devices
US6918921B2 (en) * 1999-05-07 2005-07-19 Salviac Limited Support frame for an embolic protection device
US6544279B1 (en) * 2000-08-09 2003-04-08 Incept, Llc Vascular device for emboli, thrombus and foreign body removal and methods of use
US6142987A (en) * 1999-08-03 2000-11-07 Scimed Life Systems, Inc. Guided filter with support wire 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
US6660013B2 (en) * 1999-10-05 2003-12-09 Omnisonics Medical Technologies, Inc. Apparatus for removing plaque from blood vessels using ultrasonic energy
US20040097996A1 (en) 1999-10-05 2004-05-20 Omnisonics Medical Technologies, Inc. Apparatus and method of removing occlusions using an ultrasonic medical device operating in a transverse mode
US6660021B1 (en) * 1999-12-23 2003-12-09 Advanced Cardiovascular Systems, Inc. Intravascular device and system
US6575997B1 (en) * 1999-12-23 2003-06-10 Endovascular Technologies, Inc. Embolic basket
US6402771B1 (en) 1999-12-23 2002-06-11 Guidant Endovascular Solutions Snare
US9113936B2 (en) * 1999-12-23 2015-08-25 Abbott Laboratories Snare
US6695813B1 (en) * 1999-12-30 2004-02-24 Advanced Cardiovascular Systems, Inc. Embolic protection devices
US7918820B2 (en) * 1999-12-30 2011-04-05 Advanced Cardiovascular Systems, Inc. Device for, and method of, blocking emboli in vessels such as blood arteries
US6540722B1 (en) * 1999-12-30 2003-04-01 Advanced Cardiovascular Systems, Inc. Embolic protection devices
US6443926B1 (en) * 2000-02-01 2002-09-03 Harold D. Kletschka Embolic protection device having expandable trap
US20040167567A1 (en) * 2001-03-23 2004-08-26 Cano Gerald G. Method and apparatus for capturing objects beyond an operative site in medical procedures
GB2369575A (en) * 2000-04-20 2002-06-05 Salviac Ltd An embolic protection system
US6692486B2 (en) * 2000-05-10 2004-02-17 Minnesota Medical Physics, Llc Apparatus and method for treatment of cerebral aneurysms, arterial-vascular malformations and arterial fistulas
US6939362B2 (en) * 2001-11-27 2005-09-06 Advanced Cardiovascular Systems, Inc. Offset proximal cage for embolic filtering devices
US6730104B1 (en) * 2000-06-29 2004-05-04 Concentric Medical, Inc. Methods and devices for removing an obstruction from a blood vessel
US8298257B2 (en) * 2000-06-29 2012-10-30 Concentric Medical, Inc. Systems, methods and devices for removing obstructions from a blood vessel
US7766921B2 (en) * 2000-06-29 2010-08-03 Concentric Medical, Inc. Systems, methods and devices for removing obstructions from a blood vessel
US7727242B2 (en) * 2000-06-29 2010-06-01 Concentric Medical, Inc. Systems, methods and devices for removing obstructions from a blood vessel
US6964670B1 (en) * 2000-07-13 2005-11-15 Advanced Cardiovascular Systems, Inc. Embolic protection guide wire
US6537294B1 (en) * 2000-10-17 2003-03-25 Advanced Cardiovascular Systems, Inc. Delivery systems for embolic filter devices
US6893451B2 (en) * 2000-11-09 2005-05-17 Advanced Cardiovascular Systems, Inc. Apparatus for capturing objects beyond an operative site utilizing a capture device delivered on a medical guide wire
US6506203B1 (en) * 2000-12-19 2003-01-14 Advanced Cardiovascular Systems, Inc. Low profile sheathless embolic protection system
US6645223B2 (en) * 2001-04-30 2003-11-11 Advanced Cardiovascular Systems, Inc. Deployment and recovery control systems for embolic protection devices
IL143007A0 (en) * 2001-05-07 2002-04-21 Rafael Medical Technologies In Retrievable intravascular support structures
US6814739B2 (en) 2001-05-18 2004-11-09 U.S. Endoscopy Group, Inc. Retrieval device
US6929652B1 (en) * 2001-06-01 2005-08-16 Advanced Cardiovascular Systems, Inc. Delivery and recovery systems having steerability and rapid exchange operating modes for embolic protection systems
US6638245B2 (en) * 2001-06-26 2003-10-28 Concentric Medical, Inc. Balloon catheter
US7640952B2 (en) * 2001-06-28 2010-01-05 Lithotech Medical Ltd. Method for manufacturing a surgical device for extracting a foreign object
WO2003002006A1 (en) * 2001-06-28 2003-01-09 Lithotech Medical Ltd. Foreign body retrieval device
US6599307B1 (en) * 2001-06-29 2003-07-29 Advanced Cardiovascular Systems, Inc. Filter device for embolic protection systems
US7678128B2 (en) * 2001-06-29 2010-03-16 Advanced Cardiovascular Systems, Inc. Delivery and recovery sheaths for medical devices
US7338510B2 (en) 2001-06-29 2008-03-04 Advanced Cardiovascular Systems, Inc. Variable thickness embolic filtering devices and method of manufacturing the same
US20030032941A1 (en) * 2001-08-13 2003-02-13 Boyle William J. Convertible delivery systems for medical devices
US7029488B2 (en) * 2001-08-22 2006-04-18 Gore Enterprise Holdings, Inc. Mechanical thrombectomy device for use in cerebral vessels
US7063714B2 (en) * 2001-08-22 2006-06-20 Gore Enterprise Holdings, Inc. Apparatus and methods for treating stroke and controlling cerebral flow characteristics
US6902540B2 (en) * 2001-08-22 2005-06-07 Gerald Dorros Apparatus and methods for treating stroke and controlling cerebral flow characteristics
US6929634B2 (en) * 2001-08-22 2005-08-16 Gore Enterprise Holdings, Inc. Apparatus and methods for treating stroke and controlling cerebral flow characteristics
US6638294B1 (en) 2001-08-30 2003-10-28 Advanced Cardiovascular Systems, Inc. Self furling umbrella frame for carotid filter
US6592606B2 (en) 2001-08-31 2003-07-15 Advanced Cardiovascular Systems, Inc. Hinged short cage for an embolic protection device
US8262689B2 (en) * 2001-09-28 2012-09-11 Advanced Cardiovascular Systems, Inc. Embolic filtering devices
US7749243B2 (en) * 2001-10-19 2010-07-06 Boston Scientific Scimed, Inc. Embolus extractor
AU2002350164A1 (en) * 2001-11-08 2003-05-19 William D. Hare Rapid exchange catheter with stent deployment, therapeutic infusion, and lesion sampling features
US6648904B2 (en) * 2001-11-29 2003-11-18 Palomar Medical Technologies, Inc. Method and apparatus for controlling the temperature of a surface
ATE319378T1 (en) 2001-12-03 2006-03-15 Ekos Corp CATHETER WITH MULTIPLE ULTRASONIC EMITTING PARTS
EP1455681B1 (en) 2001-12-21 2014-09-17 Salviac Limited A support frame for an embolic protection device
US7241304B2 (en) 2001-12-21 2007-07-10 Advanced Cardiovascular Systems, Inc. Flexible and conformable embolic filtering devices
US20030135162A1 (en) * 2002-01-17 2003-07-17 Scimed Life Systems, Inc. Delivery and retrieval manifold for a distal protection filter
US9204956B2 (en) 2002-02-20 2015-12-08 C. R. Bard, Inc. IVC filter with translating hooks
DE60315425T2 (en) * 2002-03-05 2008-06-26 Salviac Ltd. SYSTEM FOR PROTECTION FROM EMBOLICS
US7349995B2 (en) * 2002-03-07 2008-03-25 Intel Corporation Computing device with scalable logic block to respond to data transfer requests
US20030187495A1 (en) 2002-04-01 2003-10-02 Cully Edward H. Endoluminal devices, embolic filters, methods of manufacture and use
US8774913B2 (en) * 2002-04-08 2014-07-08 Medtronic Ardian Luxembourg S.A.R.L. Methods and apparatus for intravasculary-induced neuromodulation
US7717934B2 (en) 2002-06-14 2010-05-18 Ev3 Inc. Rapid exchange catheters usable with embolic protection devices
US7276058B2 (en) * 2002-06-19 2007-10-02 Palomar Medical Technologies, Inc. Method and apparatus for treatment of cutaneous and subcutaneous conditions
US6887258B2 (en) * 2002-06-26 2005-05-03 Advanced Cardiovascular Systems, Inc. Embolic filtering devices for bifurcated vessels
US7172614B2 (en) * 2002-06-27 2007-02-06 Advanced Cardiovascular Systems, Inc. Support structures for embolic filtering devices
US20050119684A1 (en) * 2002-07-12 2005-06-02 Guterman Lee R. Aneurysm buttress arrangement
DE10233085B4 (en) * 2002-07-19 2014-02-20 Dendron Gmbh Stent with guide wire
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
US7331973B2 (en) * 2002-09-30 2008-02-19 Avdanced Cardiovascular Systems, Inc. Guide wire with embolic filtering attachment
US20040064099A1 (en) * 2002-09-30 2004-04-01 Chiu Jessica G. Intraluminal needle injection substance delivery system with filtering capability
US7252675B2 (en) * 2002-09-30 2007-08-07 Advanced Cardiovascular, Inc. Embolic filtering devices
US7682366B2 (en) 2002-10-16 2010-03-23 Olympus Corporation Calculus manipulation apparatus
US20040093012A1 (en) 2002-10-17 2004-05-13 Cully Edward H. Embolic filter frame having looped support strut elements
AU2003269460A1 (en) * 2002-10-18 2004-05-04 Arieh Sher Atherectomy system with imaging guidewire
US20040088000A1 (en) * 2002-10-31 2004-05-06 Muller Paul F. Single-wire expandable cages for embolic filtering devices
CA2511499C (en) * 2002-12-23 2010-08-03 Lithotech Medical Ltd. Surgical device for extracting a foreign object and method for manufacturing thereof
US8591540B2 (en) * 2003-02-27 2013-11-26 Abbott Cardiovascular Systems Inc. Embolic filtering devices
US20040172055A1 (en) * 2003-02-27 2004-09-02 Huter Scott J. Embolic filtering devices
US20050209672A1 (en) * 2004-03-02 2005-09-22 Cardiomind, Inc. Sliding restraint stent delivery systems
US20040193178A1 (en) * 2003-03-26 2004-09-30 Cardiomind, Inc. Multiple joint implant delivery systems for sequentially-controlled implant deployment
EP1608299B1 (en) * 2003-03-26 2010-05-12 Cardiomind, Inc. Implant delivery catheter with electrolytically erodible joints
US7771463B2 (en) * 2003-03-26 2010-08-10 Ton Dai T Twist-down implant delivery technologies
US20040210140A1 (en) * 2003-04-15 2004-10-21 Omnisonics Medical Technologies, Inc. Apparatus and method for preshaped ultrasonic probe
US9301829B2 (en) * 2003-07-30 2016-04-05 Boston Scientific Scimed, Inc. Embolic protection aspirator
US8393328B2 (en) 2003-08-22 2013-03-12 BiO2 Medical, Inc. Airway assembly and methods of using an airway assembly
JP2007503918A (en) * 2003-09-04 2007-03-01 セカント メディカル エルエルシー Intravascular snare for capturing and removing arterial emboli
US20050119687A1 (en) * 2003-09-08 2005-06-02 Dacey Ralph G.Jr. Methods of, and materials for, treating vascular defects with magnetically controllable hydrogels
JP4455002B2 (en) * 2003-10-06 2010-04-21 オリンパス株式会社 High frequency knife
US7344550B2 (en) * 2003-10-21 2008-03-18 Boston Scientific Scimed, Inc. Clot removal device
US7892251B1 (en) 2003-11-12 2011-02-22 Advanced Cardiovascular Systems, Inc. Component for delivering and locking a medical device to a guide wire
US20050187514A1 (en) * 2004-02-09 2005-08-25 Omnisonics Medical Technologies, Inc. Apparatus and method for an ultrasonic medical device operating in a torsional mode
US7794414B2 (en) * 2004-02-09 2010-09-14 Emigrant Bank, N.A. Apparatus and method for an ultrasonic medical device operating in torsional and transverse modes
US7651521B2 (en) * 2004-03-02 2010-01-26 Cardiomind, Inc. Corewire actuated delivery system with fixed distal stent-carrying extension
US7678129B1 (en) * 2004-03-19 2010-03-16 Advanced Cardiovascular Systems, Inc. Locking component for an embolic filter assembly
US7686825B2 (en) 2004-03-25 2010-03-30 Hauser David L Vascular filter device
US20050228417A1 (en) * 2004-03-26 2005-10-13 Teitelbaum George P Devices and methods for removing a matter from a body cavity of a patient
DK1737385T3 (en) * 2004-04-16 2011-03-21 Cook Inc Detachable vena cava filter with anchoring device for diminished trauma
US8105349B2 (en) * 2004-04-16 2012-01-31 Cook Medical Technologies Llc Removable vena cava filter having primary struts for enhanced retrieval and delivery
US7625390B2 (en) * 2004-04-16 2009-12-01 Cook Incorporated Removable vena cava filter
US7699867B2 (en) * 2004-04-16 2010-04-20 Cook Incorporated Removable vena cava filter for reduced trauma in collapsed configuration
JP4918637B2 (en) * 2004-04-16 2012-04-18 クック メディカル テクノロジーズ エルエルシー Retrievable vena cava filter with anchor hooks positioned inward in a folded configuration
US20050267488A1 (en) * 2004-05-13 2005-12-01 Omnisonics Medical Technologies, Inc. Apparatus and method for using an ultrasonic medical device to treat urolithiasis
US20050256410A1 (en) * 2004-05-14 2005-11-17 Omnisonics Medical Technologies, Inc. Apparatus and method for an ultrasonic probe capable of bending with aid of a balloon
US7296442B2 (en) * 2004-07-15 2007-11-20 Owens-Brockway Glass Container Inc. Neck ring cooling
US7704267B2 (en) 2004-08-04 2010-04-27 C. R. Bard, Inc. Non-entangling vena cava filter
US7931659B2 (en) * 2004-09-10 2011-04-26 Penumbra, Inc. System and method for treating ischemic stroke
US9655633B2 (en) 2004-09-10 2017-05-23 Penumbra, Inc. System and method for treating ischemic stroke
US20060058837A1 (en) * 2004-09-10 2006-03-16 Arani Bose System and method for treating ischemic stroke
US7393181B2 (en) 2004-09-17 2008-07-01 The Penn State Research Foundation Expandable impeller pump
US8167901B2 (en) * 2004-09-27 2012-05-01 Cook Medical Technologies Llc Removable vena cava filter comprising struts having axial bends
US7824416B2 (en) * 2004-10-06 2010-11-02 Boston Scientific Scimed, Inc. Medical retrieval device
US8795315B2 (en) * 2004-10-06 2014-08-05 Cook Medical Technologies Llc Emboli capturing device having a coil and method for capturing emboli
US8118816B2 (en) 2004-11-05 2012-02-21 Scimed Life Systems, Inc. Releasable medical basket and related methods of use
US7794473B2 (en) 2004-11-12 2010-09-14 C.R. Bard, Inc. Filter delivery system
US20060116610A1 (en) * 2004-11-30 2006-06-01 Omnisonics Medical Technologies, Inc. Apparatus and method for an ultrasonic medical device with variable frequency drive
US8038696B2 (en) * 2004-12-06 2011-10-18 Boston Scientific Scimed, Inc. Sheath for use with an embolic protection filter
US8267954B2 (en) * 2005-02-04 2012-09-18 C. R. Bard, Inc. Vascular filter with sensing capability
US20060184194A1 (en) * 2005-02-15 2006-08-17 Cook Incorporated Embolic protection device
EP2433590B1 (en) * 2005-02-18 2020-05-06 Covidien LP Rapid exchange catheter with embolic filter
US20060190024A1 (en) * 2005-02-24 2006-08-24 Bei Nianjiong Recovery catheter apparatus and method
US8945169B2 (en) 2005-03-15 2015-02-03 Cook Medical Technologies Llc Embolic protection device
US8221446B2 (en) 2005-03-15 2012-07-17 Cook Medical Technologies Embolic protection device
US20060229657A1 (en) * 2005-03-30 2006-10-12 Wasicek Lawrence D Single operator exchange embolic protection filter
US9259305B2 (en) 2005-03-31 2016-02-16 Abbott Cardiovascular Systems Inc. Guide wire locking mechanism for rapid exchange and other catheter systems
US7955344B2 (en) * 2005-04-01 2011-06-07 Nexgen Medical Systems, Inc. Thrombus removal system and process
US7955345B2 (en) * 2005-04-01 2011-06-07 Nexgen Medical Systems, Inc. Thrombus removal system and process
US8603122B2 (en) 2005-04-01 2013-12-10 Nexgen Medical Systems, Incorporated Thrombus removal system and process
USRE47376E1 (en) 2005-04-01 2019-05-07 Nexgen Medical Systems, Incorporated Thrombus removal system and process
US8475487B2 (en) * 2005-04-07 2013-07-02 Medrad, Inc. Cross stream thrombectomy catheter with flexible and expandable cage
US7856985B2 (en) 2005-04-22 2010-12-28 Cynosure, Inc. Method of treatment body tissue using a non-uniform laser beam
US20060259132A1 (en) * 2005-05-02 2006-11-16 Cook Incorporated Vascular stent for embolic protection
US20060276805A1 (en) * 2005-05-03 2006-12-07 Yu Chun H Vessel recanalizer
US12115057B2 (en) 2005-05-12 2024-10-15 C.R. Bard, Inc. Tubular filter
CA2607580C (en) 2005-05-12 2016-12-20 C.R. Bard Inc. Removable embolus blood clot filter
US20070073379A1 (en) * 2005-09-29 2007-03-29 Chang Jean C Stent delivery system
US7850708B2 (en) * 2005-06-20 2010-12-14 Cook Incorporated Embolic protection device having a reticulated body with staggered struts
US8109962B2 (en) 2005-06-20 2012-02-07 Cook Medical Technologies Llc Retrievable device having a reticulation portion with staggered struts
US7766934B2 (en) * 2005-07-12 2010-08-03 Cook Incorporated Embolic protection device with an integral basket and bag
US7771452B2 (en) 2005-07-12 2010-08-10 Cook Incorporated Embolic protection device with a filter bag that disengages from a basket
US8187298B2 (en) * 2005-08-04 2012-05-29 Cook Medical Technologies Llc Embolic protection device having inflatable frame
US8062327B2 (en) 2005-08-09 2011-11-22 C. R. Bard, Inc. Embolus blood clot filter and delivery system
US8377092B2 (en) 2005-09-16 2013-02-19 Cook Medical Technologies Llc Embolic protection device
US8632562B2 (en) * 2005-10-03 2014-01-21 Cook Medical Technologies Llc Embolic protection device
US8182508B2 (en) * 2005-10-04 2012-05-22 Cook Medical Technologies Llc Embolic protection device
US20070088382A1 (en) * 2005-10-13 2007-04-19 Bei Nianjiong J Embolic protection recovery catheter assembly
US8252017B2 (en) * 2005-10-18 2012-08-28 Cook Medical Technologies Llc Invertible filter for embolic protection
US20070100414A1 (en) * 2005-11-02 2007-05-03 Cardiomind, Inc. Indirect-release electrolytic implant delivery systems
US8216269B2 (en) 2005-11-02 2012-07-10 Cook Medical Technologies Llc Embolic protection device having reduced profile
US20070100372A1 (en) * 2005-11-02 2007-05-03 Cook Incorporated Embolic protection device having a filter
US8152831B2 (en) * 2005-11-17 2012-04-10 Cook Medical Technologies Llc Foam embolic protection device
MX344147B (en) 2005-11-18 2016-12-07 Bard Inc C R Vena cava filter with filament.
WO2007066328A2 (en) * 2005-12-07 2007-06-14 Hadasit Medical Research Services And Development Ltd. Means and method of removal of embolic material from a blood vessel
US20070161963A1 (en) 2006-01-09 2007-07-12 Smalling Medical Ventures, Llc Aspiration thrombectomy catheter system, and associated methods
ES2524778T3 (en) 2006-02-01 2014-12-12 The Cleveland Clinic Foundation An apparatus to increase blood flow through a clogged blood vessel
WO2007092820A2 (en) 2006-02-03 2007-08-16 Lazarus Effect, Inc. Methods and devices for restoring blood flow within blocked vasculature
US7959676B2 (en) * 2006-02-13 2011-06-14 Lanx, Inc. Method and apparatus for intervertebral disc support and repair
WO2007103545A2 (en) * 2006-03-08 2007-09-13 Berger Peter B Embolic removal for orthopedic procedures
EP3115070B8 (en) 2006-03-23 2019-05-08 The Penn State Research Foundation Heart assist device with expandable impeller pump
US7846175B2 (en) * 2006-04-03 2010-12-07 Medrad, Inc. Guidewire and collapsable filter system
WO2007133366A2 (en) 2006-05-02 2007-11-22 C. R. Bard, Inc. Vena cava filter formed from a sheet
US7993302B2 (en) * 2006-05-09 2011-08-09 Stephen Hebert Clot retrieval device
US9326842B2 (en) 2006-06-05 2016-05-03 C. R . Bard, Inc. Embolus blood clot filter utilizable with a single delivery system or a single retrieval system in one of a femoral or jugular access
US7586957B2 (en) 2006-08-02 2009-09-08 Cynosure, Inc Picosecond laser apparatus and methods for its operation and use
US9162039B2 (en) * 2006-08-18 2015-10-20 David M. Hoganson Flow directed guidewire
US20080071307A1 (en) 2006-09-19 2008-03-20 Cook Incorporated Apparatus and methods for in situ embolic protection
US9149609B2 (en) * 2006-10-16 2015-10-06 Embolitech, Llc Catheter for removal of an organized embolic thrombus
US20080269774A1 (en) * 2006-10-26 2008-10-30 Chestnut Medical Technologies, Inc. Intracorporeal Grasping Device
US7842006B2 (en) * 2006-11-17 2010-11-30 Cfd Research Corporation Thrombectomy microcatheter
CN101605509B (en) * 2006-12-15 2012-09-19 生物传感器国际集团有限公司 Stent systems
US10182833B2 (en) 2007-01-08 2019-01-22 Ekos Corporation Power parameters for ultrasonic catheter
US9901434B2 (en) 2007-02-27 2018-02-27 Cook Medical Technologies Llc Embolic protection device including a Z-stent waist band
US10076346B2 (en) 2007-04-17 2018-09-18 Covidien Lp Complex wire formed devices
US10064635B2 (en) * 2007-04-17 2018-09-04 Covidien Lp Articulating retrieval devices
US11202646B2 (en) * 2007-04-17 2021-12-21 Covidien Lp Articulating retrieval devices
US8535334B2 (en) 2007-04-17 2013-09-17 Lazarus Effect, Inc. Complex wire formed devices
US8216209B2 (en) 2007-05-31 2012-07-10 Abbott Cardiovascular Systems Inc. Method and apparatus for delivering an agent to a kidney
JP2008295728A (en) 2007-05-31 2008-12-11 Olympus Medical Systems Corp Treatment tool
KR20100039330A (en) * 2007-06-08 2010-04-15 싸이노슈어, 인코포레이티드 Thermal surgical monitoring
US8591521B2 (en) 2007-06-08 2013-11-26 United States Endoscopy Group, Inc. Retrieval device
ES2471118T3 (en) 2007-06-22 2014-06-25 Ekos Corporation Method and apparatus for the treatment of intracranial hemorrhages
US8439937B2 (en) * 2007-06-25 2013-05-14 Cardiovascular Systems, Inc. System, apparatus and method for opening an occluded lesion
US9125683B2 (en) 2007-06-26 2015-09-08 Roxwood Medical Inc. Method and apparatus for placing a catheter within a vasculature
US9126020B2 (en) 2007-06-26 2015-09-08 Roxwood Medical, Inc. Catheter apparatus with telescoping lumen catheters and its use in methods for treating vasculatures
EP2977072A1 (en) 2007-06-26 2016-01-27 Roxwood Medical, Inc. Catheter apparatus for treating vasculatures
US9358037B2 (en) 2007-06-26 2016-06-07 Roxwood Medical, Inc. Method and apparatus for centering a microcatheter within a vasculature
US7867273B2 (en) 2007-06-27 2011-01-11 Abbott Laboratories Endoprostheses for peripheral arteries and other body vessels
US10376685B2 (en) 2007-08-31 2019-08-13 Mermaid Medical Vascular Aps Thrombus detection device and method
US8668712B2 (en) * 2007-08-31 2014-03-11 BiO2 Medical, Inc. Multi-lumen central access vena cava filter apparatus and method of using same
US9687333B2 (en) 2007-08-31 2017-06-27 BiO2 Medical, Inc. Reduced profile central venous access catheter with vena cava filter and method
US9039728B2 (en) 2007-08-31 2015-05-26 BiO2 Medical, Inc. IVC filter catheter with imaging modality
US8613753B2 (en) 2007-08-31 2013-12-24 BiO2 Medical, Inc. Multi-lumen central access vena cava filter apparatus and method of using same
US8252018B2 (en) * 2007-09-14 2012-08-28 Cook Medical Technologies Llc Helical embolic protection device
US9138307B2 (en) 2007-09-14 2015-09-22 Cook Medical Technologies Llc Expandable device for treatment of a stricture in a body vessel
US8419748B2 (en) * 2007-09-14 2013-04-16 Cook Medical Technologies Llc Helical thrombus removal device
US9034007B2 (en) * 2007-09-21 2015-05-19 Insera Therapeutics, Inc. Distal embolic protection devices with a variable thickness microguidewire and methods for their use
US8088140B2 (en) * 2008-05-19 2012-01-03 Mindframe, Inc. Blood flow restorative and embolus removal methods
US8066757B2 (en) 2007-10-17 2011-11-29 Mindframe, Inc. Blood flow restoration and thrombus management methods
US8926680B2 (en) * 2007-11-12 2015-01-06 Covidien Lp Aneurysm neck bridging processes with revascularization systems methods and products thereby
US9198687B2 (en) * 2007-10-17 2015-12-01 Covidien Lp Acute stroke revascularization/recanalization systems processes and products thereby
US10123803B2 (en) 2007-10-17 2018-11-13 Covidien Lp Methods of managing neurovascular obstructions
US11337714B2 (en) 2007-10-17 2022-05-24 Covidien Lp Restoring blood flow and clot removal during acute ischemic stroke
US20100256600A1 (en) * 2009-04-04 2010-10-07 Ferrera David A Neurovascular otw pta balloon catheter and delivery system
US8585713B2 (en) 2007-10-17 2013-11-19 Covidien Lp Expandable tip assembly for thrombus management
US20100022951A1 (en) * 2008-05-19 2010-01-28 Luce, Forward, Hamilton 7 Scripps, Llp Detachable hub/luer device and processes
US9220522B2 (en) * 2007-10-17 2015-12-29 Covidien Lp Embolus removal systems with baskets
US20100174309A1 (en) * 2008-05-19 2010-07-08 Mindframe, Inc. Recanalization/revascularization and embolus addressing systems including expandable tip neuro-microcatheter
US9827084B2 (en) * 2007-10-26 2017-11-28 Embolitech, Llc Intravascular guidewire filter system for pulmonary embolism protection and embolism removal or maceration
US20090163851A1 (en) * 2007-12-19 2009-06-25 Holloway Kenneth A Occlusive material removal device having selectively variable stiffness
US11589880B2 (en) 2007-12-20 2023-02-28 Angiodynamics, Inc. System and methods for removing undesirable material within a circulatory system utilizing during a surgical procedure
US10517617B2 (en) 2007-12-20 2019-12-31 Angiodynamics, Inc. Systems and methods for removing undesirable material within a circulatory system utilizing a balloon catheter
CN102036611B (en) 2007-12-26 2015-01-28 拉撒路效应公司 Retrieval systems and methods for use thereof
US8246672B2 (en) * 2007-12-27 2012-08-21 Cook Medical Technologies Llc Endovascular graft with separately positionable and removable frame units
EP2237828A4 (en) * 2008-01-07 2013-06-05 Intersect Partners Llc Novel enhanced ptna rapid exchange type of catheter system
KR20150096807A (en) 2008-02-22 2015-08-25 마이크로 테라퓨틱스 인코포레이티드 Methods and apparatus for flow restoration
US8313525B2 (en) 2008-03-18 2012-11-20 Medtronic Ventor Technologies, Ltd. Valve suturing and implantation procedures
WO2009126935A2 (en) * 2008-04-11 2009-10-15 Mindframe, Inc. Monorail neuro-microcatheter for delivery of medical devices to treat stroke, processes and products thereby
US20110112564A1 (en) * 2008-05-21 2011-05-12 Wolf Yehuda G Device And Method For Crossing Occlusions
US20090292307A1 (en) * 2008-05-22 2009-11-26 Nasser Razack Mechanical embolectomy device and method
US7873404B1 (en) * 2008-05-29 2011-01-18 Seth Caplan Method for performing angioplasty and angiography with a single catheter
US8939991B2 (en) 2008-06-08 2015-01-27 Hotspur Technologies, Inc. Apparatus and methods for removing obstructive material from body lumens
WO2009155571A1 (en) * 2008-06-19 2009-12-23 Coherex Medical, Inc. Clot retrieval method and device
EP2307086B1 (en) * 2008-07-03 2015-04-15 Hotspur Technologies, Inc Apparatus for treating obstructions within body lumens
US9101382B2 (en) 2009-02-18 2015-08-11 Hotspur Technologies, Inc. Apparatus and methods for treating obstructions within body lumens
US8945160B2 (en) 2008-07-03 2015-02-03 Hotspur Technologies, Inc. Apparatus and methods for treating obstructions within body lumens
WO2010009407A1 (en) * 2008-07-17 2010-01-21 Tyco Healthcare Group Lp Spirally conformable infusion catheter
US8777976B2 (en) * 2008-07-22 2014-07-15 Neuravi Limited Clot capture systems and associated methods
US20150257705A1 (en) * 2008-08-06 2015-09-17 Carag Ag Catheter for Measuring the Blood Flow of a Body Tissue
EP2288300A2 (en) * 2008-08-29 2011-03-02 Rapid Medical Ltd. Embolectomy device
US8864792B2 (en) 2008-08-29 2014-10-21 Rapid Medical, Ltd. Device and method for clot engagement
US9034008B2 (en) 2008-08-29 2015-05-19 Rapid Medical Ltd. Device and method involving stabilization during clot removal
US9005237B2 (en) 2008-08-29 2015-04-14 Rapid Medical Ltd. Device and method for clot capture
US8758364B2 (en) 2008-08-29 2014-06-24 Rapid Medical Ltd. Device and method for clot engagement and capture
WO2010030728A2 (en) * 2008-09-12 2010-03-18 Boston Scientific Scimed, Inc. Devices and systems for delivery of therapeutic agents to body lumens
US20100087850A1 (en) * 2008-10-03 2010-04-08 Nasser Razack Mechanical Embolectomy Device and Method
JP5366497B2 (en) * 2008-10-14 2013-12-11 アクセスポイント テクノロジーズ有限会社 Embolic material excision capture device
US8246648B2 (en) * 2008-11-10 2012-08-21 Cook Medical Technologies Llc Removable vena cava filter with improved leg
WO2010068814A1 (en) * 2008-12-10 2010-06-17 Boston Scientific Scimed, Inc. Introducer sheath with an embolic coil device and methods for making the same
US10226563B2 (en) * 2008-12-23 2019-03-12 Silk Road Medical, Inc. Methods and systems for treatment of acute ischemic stroke
US8388644B2 (en) * 2008-12-29 2013-03-05 Cook Medical Technologies Llc Embolic protection device and method of use
US20100204684A1 (en) * 2009-01-13 2010-08-12 Garrison Michi E Methods and systems for performing neurointerventional procedures
US8641753B2 (en) * 2009-01-31 2014-02-04 Cook Medical Technologies Llc Preform for and an endoluminal prosthesis
US20100204712A1 (en) * 2009-02-11 2010-08-12 Mark Mallaby Neurovascular microcatheter device, system and methods for use thereof
US20100204672A1 (en) * 2009-02-12 2010-08-12 Penumra, Inc. System and method for treating ischemic stroke
US8361095B2 (en) * 2009-02-17 2013-01-29 Cook Medical Technologies Llc Loop thrombectomy device
US20120109057A1 (en) 2009-02-18 2012-05-03 Hotspur Technologies, Inc. Apparatus and methods for treating obstructions within body lumens
US20100211094A1 (en) * 2009-02-18 2010-08-19 Cook Incorporated Umbrella distal embolic protection device
JP4510125B1 (en) * 2009-02-20 2010-07-21 株式会社ウィルファイン Intravascular thrombus trap
EP2403583B1 (en) * 2009-03-06 2016-10-19 Lazarus Effect, Inc. Retrieval systems
US20100274277A1 (en) * 2009-04-27 2010-10-28 Cook Incorporated Embolic protection device with maximized flow-through
TR201907891T4 (en) 2009-06-15 2019-06-21 Perflow Medical Ltd Apparatus for maintaining blood flow through a blocked vein.
US8657870B2 (en) * 2009-06-26 2014-02-25 Biosensors International Group, Ltd. Implant delivery apparatus and methods with electrolytic release
MX2012001288A (en) 2009-07-29 2012-06-19 Bard Inc C R Tubular filter.
US9220523B2 (en) 2009-09-14 2015-12-29 The Spectranetics Corporation Snaring systems and methods
SE534637C2 (en) * 2009-09-15 2011-11-01 St Jude Medical Systems Ab Quick change guide unit with pressure sensor
WO2011081814A1 (en) 2009-12-28 2011-07-07 Cook Medical Technologies Llc Endoluminal device with kink-resistant regions
WO2011091383A1 (en) 2010-01-22 2011-07-28 Lazarus Effect, Inc. Retrieval systems and methods for use thereof
US9211396B2 (en) * 2010-02-23 2015-12-15 Covidien Lp Devices and methods for vascular recanalization
US9050126B2 (en) * 2010-02-26 2015-06-09 Cardiovascular Systems, Inc. Rotational atherectomy device with electric motor
US20110264133A1 (en) 2010-03-01 2011-10-27 Tyco Healthcare Group Lp Introducer sheaths, thrombus collection devices and associated methods
GB2478592B (en) 2010-03-12 2012-02-29 Cook Medical Technologies Llc Obstruction removal assembly and method
WO2011119872A1 (en) 2010-03-24 2011-09-29 Nexgen Medical Systems, Inc. Thrombus removal system and process
US8814892B2 (en) 2010-04-13 2014-08-26 Mivi Neuroscience Llc Embolectomy devices and methods for treatment of acute ischemic stroke condition
KR20130054952A (en) 2010-04-14 2013-05-27 마이크로벤션, 인코포레이티드 Implant delivery device
WO2012009675A2 (en) 2010-07-15 2012-01-19 Lazarus Effect, Inc. Retrieval systems and methods for use thereof
US9943668B2 (en) 2010-07-16 2018-04-17 Sub3 Vascular, Llc Guidewire and catheter system and method for treating a blood clot
US9561094B2 (en) 2010-07-23 2017-02-07 Nfinium Vascular Technologies, Llc Devices and methods for treating venous diseases
US9039749B2 (en) 2010-10-01 2015-05-26 Covidien Lp Methods and apparatuses for flow restoration and implanting members in the human body
US9107691B2 (en) * 2010-10-19 2015-08-18 Distal Access, Llc Apparatus for rotating medical devices, systems including the apparatus, and associated methods
US8845621B2 (en) 2010-10-19 2014-09-30 Distal Access, Llc Apparatus for rotating medical devices, systems including the apparatus, and associated methods
ES2751156T3 (en) * 2010-10-20 2020-03-30 Medtronic Ardian Luxembourg Catheter devices having expandable mesh structures for renal neuromodulation
US8801736B2 (en) 2010-11-19 2014-08-12 Gil Vardi Percutaneous thrombus extraction device and method
WO2012074426A1 (en) * 2010-11-30 2012-06-07 Globetek 2000 Pty Ltd Device for concrements extraction from tubular structures
US10123865B2 (en) 2010-12-16 2018-11-13 BiO2 Medical, Inc. Vascular filter assembly having low profile sheath
WO2012094641A2 (en) 2011-01-06 2012-07-12 Thoratec Corporation Percutaneous heart pump
US10022212B2 (en) 2011-01-13 2018-07-17 Cook Medical Technologies Llc Temporary venous filter with anti-coagulant delivery method
US8821478B2 (en) * 2011-03-04 2014-09-02 Boston Scientific Scimed, Inc. Catheter with variable stiffness
EP2688516B1 (en) 2011-03-21 2022-08-17 Cephea Valve Technologies, Inc. Disk-based valve apparatus
US11458290B2 (en) * 2011-05-11 2022-10-04 Ekos Corporation Ultrasound system
BR112013030183A2 (en) 2011-05-23 2017-12-05 Lazarus Effect Inc interventional medical device for recovering and securing an obstruction within a vessel lumen, method of securing an obstruction within a vessel, method of preparing a retrieval device, medical device retrieval system, for securing an obstruction within a lumen and for use with a catheter configured to be navigated through the vasculature, interventional medical device to secure a retrieval device having one or more obstructions located therein for removal of a body and stent retrieval device to expand against one or more occlusive bodies in a vasculature
US9345499B2 (en) 2011-05-26 2016-05-24 Covidien Lp Pressure activated foreign body removal system and method of use
WO2012168936A1 (en) * 2011-06-09 2012-12-13 Safeback Re-Entry Medical Ltd Devices and methods for bypassing occlusions in vessels
AU2012203620B9 (en) 2011-06-24 2014-10-02 Cook Medical Technologies Llc Helical Stent
US11026708B2 (en) 2011-07-26 2021-06-08 Thrombx Medical, Inc. Intravascular thromboembolectomy device and method using the same
US10779855B2 (en) 2011-08-05 2020-09-22 Route 92 Medical, Inc. Methods and systems for treatment of acute ischemic stroke
US10327790B2 (en) 2011-08-05 2019-06-25 Route 92 Medical, Inc. Methods and systems for treatment of acute ischemic stroke
EP2741694B1 (en) * 2011-08-11 2017-02-15 Boston Scientific Scimed, Inc. Expandable scaffold with cutting elements mounted thereto
US20130085514A1 (en) * 2011-09-30 2013-04-04 Tyco Healthcare Group Lp Rotating occlusion treatment system
US12096951B2 (en) 2011-10-05 2024-09-24 Penumbra, Inc. System and method for treating ischemic stroke
CN104159525A (en) * 2011-10-24 2014-11-19 急速医疗有限公司 Clot removal devices and methods
CN102462565B (en) * 2011-10-25 2014-03-26 张石江 Recyclable and adjustable interventional stent for constricting blood vessels
US9302031B2 (en) 2011-11-22 2016-04-05 Cook Medical Technologies Llc Tubular drainage device
US9707325B2 (en) 2011-12-02 2017-07-18 Cook Medical Technologies Llc Drainage system with occlusion member
US9119659B2 (en) 2011-12-03 2015-09-01 Ouroboros Medical, Inc. Safe cutting heads and systems for fast removal of a target tissue
US11083475B2 (en) 2012-02-22 2021-08-10 Carter J. Kovarik Medical device to remove an obstruction from a body lumen, vessel or organ
US9592066B2 (en) 2012-02-22 2017-03-14 Carter J. Kovarik Selectively bendable remote gripping tool
US9901245B2 (en) 2012-02-22 2018-02-27 Carter J. Kovarik Selectively bendable remote gripping tool
US9095127B2 (en) 2012-02-22 2015-08-04 Carter J. Kovarik Selectively bendable remote gripping tool
USD780547S1 (en) 2013-08-08 2017-03-07 Carter J. Kovarik Pick up device with flexible shaft portion
US9832980B2 (en) 2012-02-22 2017-12-05 Carter J. Kovarik Selectively bendable remote gripping tool
US10226266B2 (en) 2012-02-22 2019-03-12 Carter J. Kovarik Selectively bendable remote gripping tool
CA2867181C (en) 2012-03-16 2020-08-11 Microvention, Inc. Stent and stent delivery device
US9780518B2 (en) 2012-04-18 2017-10-03 Cynosure, Inc. Picosecond laser apparatus and methods for treating target tissues with same
US9126013B2 (en) 2012-04-27 2015-09-08 Teleflex Medical Incorporated Catheter with adjustable guidewire exit position
US8721517B2 (en) 2012-05-14 2014-05-13 Thoratec Corporation Impeller for catheter pump
CN103417257B (en) * 2012-05-14 2016-03-30 微创神通医疗科技(上海)有限公司 Intracranial vessel gets pin device
DE102013008168A1 (en) 2012-05-14 2013-11-14 Thoratec Corporation Impeller for catheter pump
US9446179B2 (en) 2012-05-14 2016-09-20 Thoratec Corporation Distal bearing support
US9872947B2 (en) 2012-05-14 2018-01-23 Tc1 Llc Sheath system for catheter pump
US20130338690A1 (en) * 2012-06-15 2013-12-19 Gadal Consulting, LLC Device and method for removing unwanted material in a vascular conduit
US9358329B2 (en) 2012-07-03 2016-06-07 Thoratec Corporation Catheter pump
US9421311B2 (en) 2012-07-03 2016-08-23 Thoratec Corporation Motor assembly for catheter pump
EP4186557A1 (en) 2012-07-03 2023-05-31 Tc1 Llc Motor assembly for catheter pump
US10799330B2 (en) * 2012-07-05 2020-10-13 Mermaid Medical Vascular Aps Multi-lumen sheath central venous catheter with vena cava filter apparatus and method of using same
US10099034B2 (en) 2012-07-27 2018-10-16 The Regents Of The University Of California Microinjection catheter
EP2882350B1 (en) 2012-08-13 2019-09-25 MicroVention, Inc. Shaped removal device
US9308007B2 (en) 2012-08-14 2016-04-12 W. L. Gore & Associates, Inc. Devices and systems for thrombus treatment
US9597171B2 (en) 2012-09-11 2017-03-21 Covidien Lp Retrieval catheter with expandable tip
EP3821830B1 (en) 2012-09-24 2024-10-16 Inari Medical, Inc. Device for treating vascular occlusion
US11419620B2 (en) 2012-10-03 2022-08-23 The University Of Toledo Minimally invasive thrombectomy
WO2014055609A1 (en) * 2012-10-03 2014-04-10 The University Of Toledo Minimally invasive thrombectomy invention
JP6381536B2 (en) 2012-10-22 2018-08-29 ロックスウッド メディカル, インコーポレイテッド Method and apparatus for aligning a microcatheter within a vascular system
US9456834B2 (en) 2012-10-31 2016-10-04 Covidien Lp Thrombectomy device with distal protection
WO2014071372A1 (en) * 2012-11-05 2014-05-08 Boston Scientific Scimed, Inc. Devices for delivering energy to body lumens
JP6317751B2 (en) 2012-11-08 2018-04-25 ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. System for performing medical procedures
US8784434B2 (en) 2012-11-20 2014-07-22 Inceptus Medical, Inc. Methods and apparatus for treating embolism
US9095321B2 (en) 2012-11-21 2015-08-04 Medtronic Ardian Luxembourg S.A.R.L. Cryotherapeutic devices having integral multi-helical balloons and methods of making the same
US9232991B2 (en) 2013-02-19 2016-01-12 Cook Medical Technologies Llc Apparatus and method for retrieving an implanted device from a body vessel
US11077294B2 (en) 2013-03-13 2021-08-03 Tc1 Llc Sheath assembly for catheter pump
US11033728B2 (en) 2013-03-13 2021-06-15 Tc1 Llc Fluid handling system
WO2014164136A1 (en) 2013-03-13 2014-10-09 Thoratec Corporation Fluid handling system
US9308302B2 (en) 2013-03-15 2016-04-12 Thoratec Corporation Catheter pump assembly including a stator
JP6437517B2 (en) 2013-03-15 2018-12-12 インセラ セラピューティクス,インク. Vascular treatment apparatus and method
US20160030649A1 (en) 2013-03-15 2016-02-04 Thoratec Corporation Catheter pump assembly including a stator
US8679150B1 (en) 2013-03-15 2014-03-25 Insera Therapeutics, Inc. Shape-set textile structure based mechanical thrombectomy methods
US8690907B1 (en) 2013-03-15 2014-04-08 Insera Therapeutics, Inc. Vascular treatment methods
EP2973894A2 (en) 2013-03-15 2016-01-20 Cynosure, Inc. Picosecond optical radiation systems and methods of use
US8715314B1 (en) 2013-03-15 2014-05-06 Insera Therapeutics, Inc. Vascular treatment measurement methods
WO2014151123A1 (en) * 2013-03-15 2014-09-25 Microvention, Inc. Multi-component obstruction removal system and method
WO2014151209A1 (en) * 2013-03-18 2014-09-25 Virginia Commonwealth Univerisity Dynamic aspiration methods and systems
WO2014204860A1 (en) 2013-06-18 2014-12-24 Slik Road Medical, Inc. Methods and systems for tretment of acute ischemic stroke
US9259237B2 (en) * 2013-07-12 2016-02-16 Inceptus Medical, Llc Methods and apparatus for treating pulmonary embolism
KR20160040226A (en) 2013-07-19 2016-04-12 아우로보로스 메디컬, 아이엔씨 An anti-clogging device for a vacuum-assisted, tissue removal system
US9402708B2 (en) 2013-07-25 2016-08-02 Covidien Lp Vascular devices and methods with distal protection
US10010328B2 (en) 2013-07-31 2018-07-03 NeuVT Limited Endovascular occlusion device with hemodynamically enhanced sealing and anchoring
US9681876B2 (en) 2013-07-31 2017-06-20 EMBA Medical Limited Methods and devices for endovascular embolization
CN104434262B (en) * 2013-09-16 2016-09-14 中国人民解放军第二军医大学 A kind of medical apparatus and instruments removing pancreatic stones
US10383644B2 (en) 2013-10-17 2019-08-20 Covidien Lp Mechanical thrombectomy with proximal occlusion
WO2015061365A1 (en) * 2013-10-21 2015-04-30 Inceptus Medical, Llc Methods and apparatus for treating embolism
DE202013105452U1 (en) * 2013-11-29 2015-03-04 Pfm Medical Ag System for connecting a medical implant with an insertion aid
US9265512B2 (en) 2013-12-23 2016-02-23 Silk Road Medical, Inc. Transcarotid neurovascular catheter
US8900265B1 (en) 2014-01-03 2014-12-02 Legacy Ventures LLC Clot retrieval system
CN106413593B (en) * 2014-03-04 2019-10-15 莱克马克医学公司 Intravascular Thrombus embolectomy device with multiple grumeleuse joint elements
US9572666B2 (en) 2014-03-17 2017-02-21 Evalve, Inc. Mitral valve fixation device removal devices and methods
US9241699B1 (en) 2014-09-04 2016-01-26 Silk Road Medical, Inc. Methods and devices for transcarotid access
EP3131615B1 (en) 2014-04-15 2021-06-09 Tc1 Llc Sensors for catheter pumps
EP3479854A1 (en) 2014-04-15 2019-05-08 Tc1 Llc Catheter pump with access ports
WO2015160990A1 (en) 2014-04-15 2015-10-22 Thoratec Corporation Catheter pump introducer systems and methods
WO2015160942A1 (en) 2014-04-15 2015-10-22 Thoratec Corporation Catheter pump with off-set motor position
US10667836B2 (en) 2014-04-28 2020-06-02 Boston Scientific Scimed, Inc. Tissue resectors, hand operated tissue resecting systems, and associated methods
EP3378419B1 (en) * 2014-05-18 2020-03-25 Legacy Ventures LLC Clot retrieval system
EP3151904A4 (en) 2014-06-04 2018-02-14 Nfinium Vascular Technologies, LLC Low radial force vascular device and method of occlusion
CA2939315C (en) 2014-06-09 2018-09-11 Inceptus Medical, Llc Retraction and aspiration device for treating embolism and associated systems and methods
WO2016028644A1 (en) 2014-08-18 2016-02-25 Thoratec Corporation Guide features for percutaneous catheter pump
US11027104B2 (en) 2014-09-04 2021-06-08 Silk Road Medical, Inc. Methods and devices for transcarotid access
US10729454B2 (en) * 2014-09-10 2020-08-04 Teleflex Life Sciences Limited Guidewire capture
US10092742B2 (en) 2014-09-22 2018-10-09 Ekos Corporation Catheter system
US20160089227A1 (en) * 2014-09-26 2016-03-31 Yince Loh Clot and foreign body retrieval system and method for use
WO2016054480A2 (en) * 2014-10-03 2016-04-07 The Regent Of The University Of Colorado, A Body Corporate Venous access catheters and methods for portal venous system catheterization
US10456159B2 (en) 2014-10-17 2019-10-29 Transmed7, Llc Thrombo-embolic protection and embolectomy/thrombectomy devices and methods
EP4306080A3 (en) 2014-12-09 2024-04-10 Cephea Valve Technologies, Inc. Replacement cardiac valves and method of manufacture
US9884184B2 (en) 2014-12-30 2018-02-06 The Spectranetics Corporation Wire hook coupling for lead extension and extraction
US10576274B2 (en) 2014-12-30 2020-03-03 Spectranetics Llc Expanding coil coupling for lead extension and extraction
US10105533B2 (en) 2014-12-30 2018-10-23 The Spectranetics Corporation Multi-loop coupling for lead extension and extraction
US9731113B2 (en) 2014-12-30 2017-08-15 The Spectranetics Corporation Collapsing coil coupling for lead extension and extraction
ES2577288B8 (en) 2015-01-13 2019-01-10 Anaconda Biomed S L Device for thrombectomy
US11771446B2 (en) 2020-10-19 2023-10-03 Anaconda Biomed, S.L. Thrombectomy system and method of use
EP3639768A1 (en) 2018-10-16 2020-04-22 Anaconda Biomed, S.L. A device for extraction of thrombus from a blood vessel and a thrombectomy apparatus
EP3804797A1 (en) 2015-01-22 2021-04-14 Tc1 Llc Motor assembly with heat exchanger for catheter pump
EP3247420B1 (en) 2015-01-22 2019-10-02 Tc1 Llc Reduced rotational mass motor assembly for catheter pump
WO2016118784A1 (en) 2015-01-22 2016-07-28 Thoratec Corporation Attachment mechanisms for motor of catheter pump
ES2770321T3 (en) 2015-02-04 2020-07-01 Route 92 Medical Inc Rapid Aspiration Thrombectomy System
US11065019B1 (en) 2015-02-04 2021-07-20 Route 92 Medical, Inc. Aspiration catheter systems and methods of use
US10456560B2 (en) 2015-02-11 2019-10-29 Covidien Lp Expandable tip medical devices and methods
US9907890B2 (en) 2015-04-16 2018-03-06 Tc1 Llc Catheter pump with positioning brace
US10362965B2 (en) * 2015-04-22 2019-07-30 Acclarent, Inc. System and method to map structures of nasal cavity
EP3288625A4 (en) * 2015-04-28 2019-01-02 Imricor Medical Systems, Inc. Mr compatible puncture catheter
AU2016262564B2 (en) 2015-05-14 2020-11-05 Cephea Valve Technologies, Inc. Replacement mitral valves
CN107708581B (en) 2015-06-10 2021-11-19 Ekos公司 Ultrasonic wave guide tube
US10376673B2 (en) 2015-06-19 2019-08-13 Evalve, Inc. Catheter guiding system and methods
CN111658077B (en) 2015-07-16 2023-11-03 珀弗娄医疗有限公司 Devices and methods for vascular occlusion removal
CA3029186C (en) 2015-07-24 2022-03-15 Ichor Vascular Inc. Embolectomy system and methods of making and using same
US9999493B2 (en) 2015-08-06 2018-06-19 Kp Medcure, Inc. Axial lengthening thrombus capture system
EP3331458B1 (en) * 2015-08-06 2020-05-27 KP Medcure, Inc. Axially lengthening thrombus capture system
US10463386B2 (en) 2015-09-01 2019-11-05 Mivi Neuroscience, Inc. Thrombectomy devices and treatment of acute ischemic stroke with thrombus engagement
US10596354B2 (en) 2015-09-25 2020-03-24 Mark Taber Guide wires, catheters, and guide wire catheter systems and methods
US10639456B2 (en) 2015-09-28 2020-05-05 Microvention, Inc. Guidewire with torque transmission element
EP4233744A3 (en) 2015-10-23 2023-11-01 Inari Medical, Inc. Device for intravascular treatment of vascular occlusion
US9700332B2 (en) 2015-10-23 2017-07-11 Inari Medical, Inc. Intravascular treatment of vascular occlusion and associated devices, systems, and methods
US10342571B2 (en) 2015-10-23 2019-07-09 Inari Medical, Inc. Intravascular treatment of vascular occlusion and associated devices, systems, and methods
JP2018534105A (en) 2015-10-26 2018-11-22 アムニス セラピューティクス リミテッド System for thrombus removal
EP3380021B1 (en) * 2015-11-25 2023-06-14 Neuravi Limited A clot retrieval device for removing occlusive clot from a blood vessel
EP3389757A4 (en) 2015-12-18 2019-08-21 Inari Medical, Inc. Catheter shaft and associated devices, systems, and methods
EP3416568A4 (en) 2016-02-16 2019-10-16 Insera Therapeutics, Inc. Aspiration devices and anchored flow diverting devices
US10183145B2 (en) 2016-02-24 2019-01-22 Incept, Llc Enhanced flexibility neurovascular catheter
AU2017227088B2 (en) * 2016-02-29 2022-01-06 Merit Medical Systems, Inc. Catheter systems, kits, and methods for gaining access to a vessel
US10736632B2 (en) 2016-07-06 2020-08-11 Evalve, Inc. Methods and devices for valve clip excision
CN109475418A (en) 2016-07-13 2019-03-15 波士顿科学国际有限公司 For the instrument and method in the intravascular maintenance smoothness adjacent with nearby performing the operation
WO2018017678A1 (en) 2016-07-21 2018-01-25 Thoratec Corporation Fluid seals for catheter pump motor assembly
EP3808401A1 (en) 2016-07-21 2021-04-21 Tc1 Llc Gas-filled chamber for catheter pump motor assembly
US10974027B2 (en) 2016-07-29 2021-04-13 Cephea Valve Technologies, Inc. Combination steerable catheter and systems
US10646689B2 (en) 2016-07-29 2020-05-12 Cephea Valve Technologies, Inc. Mechanical interlock for catheters
US10661052B2 (en) 2016-07-29 2020-05-26 Cephea Valve Technologies, Inc. Intravascular device delivery sheath
US10639151B2 (en) 2016-07-29 2020-05-05 Cephea Valve Technologies, Inc. Threaded coil
US11324495B2 (en) 2016-07-29 2022-05-10 Cephea Valve Technologies, Inc. Systems and methods for delivering an intravascular device to the mitral annulus
CN106264661A (en) * 2016-08-25 2017-01-04 苗立夫 A kind of Endovascular break catching apparatus
US10933216B2 (en) 2016-08-29 2021-03-02 Cephea Valve Technologies, Inc. Multilumen catheter
US11109967B2 (en) 2016-08-29 2021-09-07 Cephea Valve Technologies, Inc. Systems and methods for loading and deploying an intravascular device
US11045315B2 (en) 2016-08-29 2021-06-29 Cephea Valve Technologies, Inc. Methods of steering and delivery of intravascular devices
US10874512B2 (en) 2016-10-05 2020-12-29 Cephea Valve Technologies, Inc. System and methods for delivering and deploying an artificial heart valve within the mitral annulus
US11071564B2 (en) 2016-10-05 2021-07-27 Evalve, Inc. Cardiac valve cutting device
CN110100052B (en) 2016-10-14 2021-04-30 因赛普特斯医学有限责任公司 Knitting machine and method of use
PT3528717T (en) 2016-10-24 2024-09-24 Inari Medical Inc Devices and methods for treating vascular occlusion
US10363138B2 (en) 2016-11-09 2019-07-30 Evalve, Inc. Devices for adjusting the curvature of cardiac valve structures
US10653426B2 (en) 2017-01-06 2020-05-19 Incept, Llc Thromboresistant coatings for aneurysm treatment devices
JP7466307B2 (en) 2017-01-09 2024-04-12 ユナイテッド ステイツ エンドスコピー グループ,インコーポレイテッド Endoscopic Snare
CN114984407A (en) 2017-01-10 2022-09-02 92号医疗公司 System, catheter and catheter advancement device for performing medical procedures in intracranial vessels
CN110461401B (en) 2017-01-20 2022-06-07 92号医疗公司 Single operator intracranial medical device delivery system and method of use
AU2018203053B2 (en) 2017-01-23 2020-03-05 Cephea Valve Technologies, Inc. Replacement mitral valves
JP7046078B2 (en) 2017-01-23 2022-04-01 セフィア・バルブ・テクノロジーズ,インコーポレイテッド Replacement mitral valve
WO2018137030A1 (en) * 2017-01-26 2018-08-02 Goyal Mayank Thrombus retrieval stents and methods of using for treatment of ischemic stroke
CN110536650B (en) * 2017-02-08 2023-06-02 瓦斯科尔勒治疗股份有限公司 Axially elongated thrombus capture system
CN110573092B (en) 2017-02-24 2023-04-18 因赛普特斯医学有限责任公司 Vasoocclusive devices and methods
EP3618734B1 (en) 2017-05-03 2021-06-30 Medtronic Vascular, Inc. Tissue-removing catheter
US11690645B2 (en) 2017-05-03 2023-07-04 Medtronic Vascular, Inc. Tissue-removing catheter
US11129630B2 (en) 2017-05-12 2021-09-28 Covidien Lp Retrieval of material from vessel lumens
US10722257B2 (en) 2017-05-12 2020-07-28 Covidien Lp Retrieval of material from vessel lumens
US11298145B2 (en) 2017-05-12 2022-04-12 Covidien Lp Retrieval of material from vessel lumens
US10709464B2 (en) 2017-05-12 2020-07-14 Covidien Lp Retrieval of material from vessel lumens
US11191555B2 (en) 2017-05-12 2021-12-07 Covidien Lp Retrieval of material from vessel lumens
IL252608B (en) 2017-06-01 2021-06-30 Amnis Therapeutics Ltd Devices for the removal of clots
EP3638134B1 (en) 2017-06-12 2023-08-16 Covidien LP Tools for sheathing treatment devices and associated systems
US10478322B2 (en) 2017-06-19 2019-11-19 Covidien Lp Retractor device for transforming a retrieval device from a deployed position to a delivery position
US10575864B2 (en) 2017-06-22 2020-03-03 Covidien Lp Securing element for resheathing an intravascular device and associated systems and methods
JP7254775B2 (en) 2017-09-06 2023-04-10 イナリ メディカル, インコーポレイテッド Hemostasis valve and method of use
JP2020533153A (en) 2017-09-11 2020-11-19 スロンムエックス メディカル インコーポレイテッドThrombx Medical Inc. Intravascular thromboembolectomy devices and methods
US11885051B2 (en) 2017-10-14 2024-01-30 Inceptus Medical, Llc Braiding machine and methods of use
CA3195810A1 (en) 2017-10-16 2022-04-21 Michael Bruce Horowitz Clot removal methods and devices with multiple independently controllable elements
US20220104839A1 (en) 2017-10-16 2022-04-07 Retriever Medical, Inc. Clot Removal Methods and Devices with Multiple Independently Controllable Elements
US20190110804A1 (en) 2017-10-16 2019-04-18 Michael Bruce Horowitz Catheter based retrieval device with proximal body having axial freedom of movement
US11351346B2 (en) 2017-10-24 2022-06-07 Venkat Tummala Balloon sheath and associated methods
US20200323634A1 (en) * 2017-10-30 2020-10-15 Cephea Valve Technologies, Inc. Insert For Distal End Cap
US10105154B1 (en) * 2017-11-09 2018-10-23 Pebble Hill Partners, Llc Basket for a catheter device
CN108143464A (en) * 2018-01-19 2018-06-12 上海唯域医疗科技有限公司 It takes bolt conduit and takes bolt device for take bolt conduit
CA3089554A1 (en) 2018-01-25 2019-08-01 Ischemicure Ltd. Devices, systems and methods to remove blood clots
US11154314B2 (en) 2018-01-26 2021-10-26 Inari Medical, Inc. Single insertion delivery system for treating embolism and associated systems and methods
CN110090063B (en) 2018-01-30 2022-07-08 上海沃比医疗科技有限公司 Thrombus capturing device and method thereof
CA3092248A1 (en) 2018-02-26 2019-08-29 Mirko Mirkov Q-switched cavity dumped sub-nanosecond laser
US11395665B2 (en) 2018-05-01 2022-07-26 Incept, Llc Devices and methods for removing obstructive material, from an intravascular site
WO2019213179A1 (en) * 2018-05-01 2019-11-07 Imperative Care, Inc. Systems and devices for removing obstructive material from an intravascular site
EP3787523A4 (en) 2018-05-01 2022-02-23 Incept, LLC Devices and methods for removing obstructive material from an intravascular site
AU2019269606B2 (en) 2018-05-17 2024-08-22 Route 92 Medical, Inc. Aspiration catheter systems and methods of use
US11172948B2 (en) 2018-05-25 2021-11-16 Mubin I. Syed Arterial embolus retriever
CN112638317B (en) 2018-05-30 2024-07-02 艾露姆技术股份有限公司 Integrated thrombectomy and filtration device and method of use
US11839460B2 (en) * 2018-06-06 2023-12-12 DePuy Synthes Products, Inc. Device and method to detect and remove blood clots for treatment of ischemic stroke using force and electromagnetic sensing
US11471582B2 (en) 2018-07-06 2022-10-18 Incept, Llc Vacuum transfer tool for extendable catheter
WO2020010310A1 (en) 2018-07-06 2020-01-09 Imperative Care, Inc. Sealed neurovascular extendable catheter
CN112638240A (en) 2018-07-20 2021-04-09 艾露姆技术股份有限公司 Neurovascular distal access support catheter, aspiration catheter or device shaft
EP3836855B1 (en) 2018-08-13 2024-09-25 Inari Medical, Inc. System for treating embolism and associated devices and methods
CN109125892A (en) * 2018-08-14 2019-01-04 张海军 A kind of distal end blocking type stereo spiral pigtail structure pulmonary thrombosis suction catheter
CN209422031U (en) * 2018-09-11 2019-09-24 南京微创医学科技股份有限公司 A kind of stone extraction basket and the two-chamber end cap for stone extraction basket
CN109009327B (en) * 2018-09-21 2020-08-04 陆巍 Calculus removing device for urology surgery
US12102531B2 (en) 2018-10-22 2024-10-01 Evalve, Inc. Tissue cutting systems, devices and methods
US11172946B2 (en) 2018-10-26 2021-11-16 Progressive NEURO, Inc. Apparatus, system, and method for vasculature obstruction removal
US11197685B2 (en) 2018-11-15 2021-12-14 Progressive NEURO, Inc. Apparatus, system, and method for vasculature obstruction removal
US11253279B2 (en) 2018-11-15 2022-02-22 Progressive NEURO, Inc. Apparatus, system, and method for vasculature obstruction removal
US11724068B2 (en) 2018-11-16 2023-08-15 Cephea Valve Technologies, Inc. Intravascular delivery system
US12114863B2 (en) 2018-12-05 2024-10-15 Microvention, Inc. Implant delivery system
CN109512487B (en) * 2019-01-03 2020-06-16 西北工业大学 Safe surgical instrument for grasping and removing thrombus and use method
EP3908211B1 (en) 2019-01-08 2024-10-09 Progressive Neuro, Inc. System for vasculature obstruction removal
US11534191B2 (en) 2019-01-11 2022-12-27 Anaconda Biomed, S.L. Loading device for loading a medical device into a catheter
USD943743S1 (en) * 2019-01-15 2022-02-15 Olympus Corporation Stone retrieval basket for medical device
US11766539B2 (en) 2019-03-29 2023-09-26 Incept, Llc Enhanced flexibility neurovascular catheter
WO2020206101A1 (en) * 2019-04-05 2020-10-08 Traverse Vascular, Inc. Reentry catheters for traversing chronic total occlusions
US11819236B2 (en) 2019-05-17 2023-11-21 Medtronic Vascular, Inc. Tissue-removing catheter
US11266427B2 (en) 2019-07-10 2022-03-08 Neuravi Limited Self-expanding intravascular medical device
US10792054B1 (en) 2019-07-11 2020-10-06 Eduardo Lorenzo Catheter for thromboembolic disease with mechanic waves, injection and ejection
CN110314272B (en) * 2019-08-06 2021-06-08 河南科技大学第一附属医院 Thrombus aspiration catheter with telescopic thrombus block crushing assembly
CN113347916A (en) 2019-10-15 2021-09-03 因普瑞缇夫护理公司 System and method for multivariate stroke detection
JP2022551992A (en) 2019-10-16 2022-12-14 イナリ メディカル, インコーポレイテッド Systems, devices and methods for treating vascular occlusions
WO2021108371A1 (en) * 2019-11-27 2021-06-03 Ischemicure Ltd Devices, systems and methods to remove blood clots
US20220313953A1 (en) * 2019-12-09 2022-10-06 Mg Stroke Analytics Inc. Catheter Redirection Systems for Use in Gaining Access to Cerebral Arteries
US11259821B2 (en) 2019-12-18 2022-03-01 Imperative Care, Inc. Aspiration system with accelerated response
WO2021127004A1 (en) 2019-12-18 2021-06-24 Imperative Care, Inc. Methods and systems for treating venous thromboembolic disease
US11638637B2 (en) 2019-12-18 2023-05-02 Imperative Care, Inc. Method of removing embolic material with thrombus engagement tool
CN115916075A (en) 2020-01-30 2023-04-04 尤利耶尔医疗股份公司 Device and method for neurovascular intraluminal intervention
US11648020B2 (en) 2020-02-07 2023-05-16 Angiodynamics, Inc. Device and method for manual aspiration and removal of an undesirable material
CN113747934B (en) 2020-03-10 2024-07-09 因普瑞缇夫护理公司 Enhanced flexibility neurovascular catheter
US12048448B2 (en) 2020-05-06 2024-07-30 Evalve, Inc. Leaflet grasping and cutting device
JP2023535052A (en) * 2020-07-23 2023-08-15 アルテア メディカル リミテッド A catheter-based device for treating obstructions in body lumens
CN111820990B (en) * 2020-07-23 2021-12-17 上海心玮医疗科技股份有限公司 Three-dimensional spiral intracranial thrombus removal support
US11207497B1 (en) 2020-08-11 2021-12-28 Imperative Care, Inc. Catheter with enhanced tensile strength
EP4225167A4 (en) * 2020-10-09 2024-10-09 Route 92 Medical Inc Aspiration catheter systems and methods of use
US11697003B2 (en) 2020-11-30 2023-07-11 TICI 3 Therapeutics, Inc. Vasculature navigation systems and methods
US11090466B1 (en) 2020-11-30 2021-08-17 TICI 3 Therapeutics, Inc. Catheter systems and devices for acute ischemic stroke thrombectomy
CN113180781A (en) * 2021-06-01 2021-07-30 上海融脉医疗科技有限公司 Winding type net disc support and conveying device thereof
JP2024521996A (en) * 2021-06-14 2024-06-05 ストライカー コーポレイション Implant delivery systems and methods of use - Patents.com
CN117615722A (en) 2021-06-18 2024-02-27 丝路医疗公司 Systems and methods for vascular intervention
CN114209392A (en) * 2021-11-26 2022-03-22 上海玮琅医疗科技有限公司 Double-guide-wire thrombus cutting and thrombus capturing bracket assembly
US11737767B2 (en) 2022-01-21 2023-08-29 Julier Medical AG Neurovascular catheter and method of use
US20240016509A1 (en) * 2022-07-14 2024-01-18 Rishi Razdan Umbrella Catheter Device
CN117122442A (en) * 2022-08-17 2023-11-28 上海科罡医疗技术有限公司 Device for blocking thrombus in blood vessel
CN116327318B (en) * 2023-05-30 2023-09-15 北京久事神康医疗科技有限公司 Bolt taking device

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4706671A (en) 1985-05-02 1987-11-17 Weinrib Harry P Catheter with coiled tip
US4873978A (en) 1987-12-04 1989-10-17 Robert Ginsburg Device and method for emboli retrieval
US5011488A (en) 1988-12-07 1991-04-30 Robert Ginsburg Thrombus extraction system
WO1997027808A1 (en) 1996-02-02 1997-08-07 Regents Of The University Of California Clot capture coil

Family Cites Families (67)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US488960A (en) * 1892-12-27 brintnall
US3472230A (en) * 1966-12-19 1969-10-14 Fogarty T J Umbrella catheter
US3568659A (en) * 1968-09-24 1971-03-09 James N Karnegis Disposable percutaneous intracardiac pump and method of pumping blood
US3635223A (en) 1969-12-02 1972-01-18 Us Catheter & Instr Corp Embolectomy catheter
US3923065A (en) 1974-09-09 1975-12-02 Jerome Nozick Embolectomy catheter
US3996938A (en) 1975-07-10 1976-12-14 Clark Iii William T Expanding mesh catheter
US4046150A (en) 1975-07-17 1977-09-06 American Hospital Supply Corporation Medical instrument for locating and removing occlusive objects
US4030503A (en) 1975-11-05 1977-06-21 Clark Iii William T Embolectomy catheter
US4064150A (en) * 1976-05-26 1977-12-20 University Of Illinois Foundation Synthesis of isoprenoid 1,5-dienes
IT1126526B (en) 1979-12-07 1986-05-21 Enrico Dormia SURGICAL EXTRACTOR TO REMOVE FOREIGN BODIES THAT ARE FOUND IN THE NATURAL ROUTES OF THE HUMAN BODY, AS CALCULATIONS AND SIMILAR
US4425908A (en) 1981-10-22 1984-01-17 Beth Israel Hospital Blood clot filter
US4643184A (en) 1982-09-29 1987-02-17 Mobin Uddin Kazi Embolus trap
US4590938A (en) 1984-05-04 1986-05-27 Segura Joseph W Medical retriever device
US4957482A (en) * 1988-12-19 1990-09-18 Surgical Systems & Instruments, Inc. Atherectomy device with a positive pump means
US4926858A (en) * 1984-05-30 1990-05-22 Devices For Vascular Intervention, Inc. Atherectomy device for severe occlusions
US4807626A (en) 1985-02-14 1989-02-28 Mcgirr Douglas B Stone extractor and method
US4790812A (en) 1985-11-15 1988-12-13 Hawkins Jr Irvin F Apparatus and method for removing a target object from a body passsageway
US4706679A (en) 1986-01-27 1987-11-17 Westinghouse Electric Corp. Disposable monitor for an EEG head set
JPH0255064A (en) 1988-08-03 1990-02-23 Toa O Skin removal for throm bus in blood vessel using catheter and throm bus removing system in blood vessel using catheter
US5034001A (en) * 1989-09-08 1991-07-23 Advanced Cardiovascular Systems, Inc. Method of repairing a damaged blood vessel with an expandable cage catheter
US5092839A (en) 1989-09-29 1992-03-03 Kipperman Robert M Coronary thrombectomy
CA2048307C (en) * 1990-08-14 1998-08-18 Rolf Gunther Method and apparatus for filtering blood in a blood vessel of a patient
US5100423A (en) * 1990-08-21 1992-03-31 Medical Engineering & Development Institute, Inc. Ablation catheter
US5057114A (en) 1990-09-18 1991-10-15 Cook Incorporated Medical retrieval basket
US5449372A (en) * 1990-10-09 1995-09-12 Scimed Lifesystems, Inc. Temporary stent and methods for use and manufacture
CA2060067A1 (en) * 1991-01-28 1992-07-29 Lilip Lau Stent delivery system
US5167239A (en) * 1991-05-30 1992-12-01 Endomedix Corporation Anchorable guidewire
SE9101839L (en) * 1991-06-14 1992-10-12 Ams Medinvent Sa DEVICE FOR TRANSLUMINAL REMOVAL OR IMPLANTATION OF A STENT AND APPARATUS INCLUDING A SOUND DEVICE
US5645533A (en) * 1991-07-05 1997-07-08 Scimed Life Systems, Inc. Apparatus and method for performing an intravascular procedure and exchanging an intravascular device
US5192286A (en) * 1991-07-26 1993-03-09 Regents Of The University Of California Method and device for retrieving materials from body lumens
FR2696092B1 (en) * 1992-09-28 1994-12-30 Lefebvre Jean Marie Kit for medical use composed of a filter and its device for placement in the vessel.
ATE149325T1 (en) * 1992-10-12 1997-03-15 Schneider Europ Ag CATHETER WITH A VESSEL SUPPORT
US5540707A (en) * 1992-11-13 1996-07-30 Scimed Life Systems, Inc. Expandable intravascular occlusion material removal devices and methods of use
US5490859A (en) * 1992-11-13 1996-02-13 Scimed Life Systems, Inc. Expandable intravascular occlusion material removal devices and methods of use
US5527326A (en) 1992-12-29 1996-06-18 Thomas J. Fogarty Vessel deposit shearing apparatus
US5354310A (en) * 1993-03-22 1994-10-11 Cordis Corporation Expandable temporary graft
US5549953A (en) * 1993-04-29 1996-08-27 National Research Council Of Canada Optical recording media having optically-variable security properties
US5391172A (en) * 1993-05-24 1995-02-21 Advanced Cardiovascular Systems, Inc. Stent delivery system with coaxial catheter handle
US5413559A (en) * 1993-07-08 1995-05-09 Sirhan; Motasim M. Rapid exchange type over-the-wire catheter
US5985411A (en) * 1994-03-14 1999-11-16 Upf Corporation Self-supporting pleated filter composite
US5488960A (en) * 1994-04-11 1996-02-06 Abbott Laboratories Coronary sinus catheter introducer system
EP0964714A1 (en) * 1994-06-24 1999-12-22 Advanced Cardiovascular Systems, Inc. Catheters having a reusable proximal body
DE69536046D1 (en) * 1994-07-08 2010-04-01 Ev3 Inc System for performing an intravascular procedure
US5549626A (en) * 1994-12-23 1996-08-27 New York Society For The Ruptured And Crippled Maintaining The Hospital For Special Surgery Vena caval filter
JP3625837B2 (en) 1995-01-27 2005-03-02 シメッド ライフ システムズ,インコーポレイテッド Embolic device
US5556408A (en) * 1995-04-27 1996-09-17 Interventional Technologies Inc. Expandable and compressible atherectomy cutter
WO1997038631A1 (en) 1996-04-18 1997-10-23 Applied Medical Resources Corporation Remote clot management
US5957900A (en) 1996-07-10 1999-09-28 Asahi Kogaku Kogyo Kabushiki Kaisha Treatment accessory for endoscope
US5972019A (en) * 1996-07-25 1999-10-26 Target Therapeutics, Inc. Mechanical clot treatment device
US6066158A (en) 1996-07-25 2000-05-23 Target Therapeutics, Inc. Mechanical clot encasing and removal wire
US5941895A (en) * 1996-09-04 1999-08-24 Hemodynamics, Inc. Cardiovascular stent and retrieval apparatus
US5882329A (en) * 1997-02-12 1999-03-16 Prolifix Medical, Inc. Apparatus and method for removing stenotic material from stents
AU6657098A (en) * 1997-02-12 1998-08-26 Prolifix Medical, Inc. Apparatus for removal of material from stents
US5814064A (en) * 1997-03-06 1998-09-29 Scimed Life Systems, Inc. Distal protection device
US5911734A (en) * 1997-05-08 1999-06-15 Embol-X, Inc. Percutaneous catheter and guidewire having filter and medical device deployment capabilities
US5941896A (en) * 1997-09-08 1999-08-24 Montefiore Hospital And Medical Center Filter and method for trapping emboli during endovascular procedures
US5891114A (en) * 1997-09-30 1999-04-06 Target Therapeutics, Inc. Soft-tip high performance braided catheter
KR20010031350A (en) 1997-10-21 2001-04-16 추후제출 Photoacoustic removal of occlusions from blood vessels
US5908435A (en) * 1997-10-23 1999-06-01 Samuels; Shaun L. W. Expandable lumen device and method of use
WO1999023952A1 (en) 1997-11-12 1999-05-20 William Dubrul Biological passageway occlusion removal
US5961526A (en) 1998-02-18 1999-10-05 Boston Scientific Corporation Coaxial needle and severing snare
US6511492B1 (en) * 1998-05-01 2003-01-28 Microvention, Inc. Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
US7150756B2 (en) * 1999-04-01 2006-12-19 Scion Cardio-Vascular, Inc Radiopaque locking frame, filter and flexible end
US6325797B1 (en) * 1999-04-05 2001-12-04 Medtronic, Inc. Ablation catheter and method for isolating a pulmonary vein
US6663650B2 (en) * 2000-06-29 2003-12-16 Concentric Medical, Inc. Systems, methods and devices for removing obstructions from a blood vessel
US7331976B2 (en) * 2003-04-29 2008-02-19 Rex Medical, L.P. Distal protection device
US7722634B2 (en) * 2003-07-03 2010-05-25 Regents Of The University Of Minnesota Medical device and method of intravenous filtration

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4706671A (en) 1985-05-02 1987-11-17 Weinrib Harry P Catheter with coiled tip
US4873978A (en) 1987-12-04 1989-10-17 Robert Ginsburg Device and method for emboli retrieval
US5011488A (en) 1988-12-07 1991-04-30 Robert Ginsburg Thrombus extraction system
WO1997027808A1 (en) 1996-02-02 1997-08-07 Regents Of The University Of California Clot capture coil

Cited By (145)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8100935B2 (en) 1998-05-01 2012-01-24 Microvention, Inc. Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
US7691121B2 (en) 1998-05-01 2010-04-06 Microvention, Inc. Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
US8784441B2 (en) 1998-05-01 2014-07-22 Microvention, Inc. Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
US6893450B2 (en) 1999-03-26 2005-05-17 Cook Urological Incorporated Minimally-invasive medical retrieval device
US8007502B2 (en) 1999-09-16 2011-08-30 Scimed Life Systems, Inc. Laser-resistant medical retrieval device
US6752811B2 (en) 1999-09-16 2004-06-22 Scimed Life Systems, Inc. Laser-resistant medical retrieval device
WO2001019260A1 (en) * 1999-09-16 2001-03-22 Scimed Life Systems, Inc. Laser-resistant medical retrieval device
US6368328B1 (en) 1999-09-16 2002-04-09 Scimed Life Systems, Inc. Laser-resistant medical retrieval device
EP1272110A1 (en) * 2000-03-31 2003-01-08 Bacchus Vascular Inc. Expansible shearing catheters for thrombus and occlusive material removal
EP1272110A4 (en) * 2000-03-31 2007-07-18 Bacchus Vascular Inc Expansible shearing catheters for thrombus and occlusive material removal
WO2001097697A1 (en) * 2000-06-22 2001-12-27 White Geoffrey H Method and apparatus for performing percutaneous thromboembolectomies
EP1296728A2 (en) * 2000-06-29 2003-04-02 Concentric Medical, Inc. Systems, methods and devices for removing obstructions from a blood vessel
EP1296728A4 (en) * 2000-06-29 2009-09-09 Concentric Medical Inc Systems, methods and devices for removing obstructions from a blood vessel
AU2001289110B2 (en) * 2000-09-14 2005-11-17 Cook Urological Inc. Minimally-invasive medical retrieval device
KR100868108B1 (en) * 2000-09-14 2008-11-10 쿡 유로러지컬 인코포레이티드 Minimally-invasive medical retrieval device
WO2002022028A3 (en) * 2000-09-14 2002-06-13 Cook Urological Inc Minimally-invasive medical retrieval device
EP1355692A4 (en) * 2001-01-09 2005-12-21 Microvention Inc Embolectomy catheters and method for treatment
EP2319575A1 (en) * 2001-01-09 2011-05-11 MicroVention, Inc. Embolectomy catheters and method for treatment
JP2004520893A (en) * 2001-01-09 2004-07-15 マイクロ ベンション インコーポレイテッド Embolectomy catheter and handling method
EP1355692A1 (en) * 2001-01-09 2003-10-29 Microvention, Inc. Embolectomy catheters and method for treatment
US7789860B2 (en) 2001-06-27 2010-09-07 Salviac Limited Catheter for delivery and/or retrieval of a medical device
US7780693B2 (en) 2001-06-27 2010-08-24 Salviac Limited Catheter
US7967837B2 (en) 2001-06-27 2011-06-28 Salviac Limited Catheter
EP1408875A1 (en) * 2001-07-24 2004-04-21 Incept Llc Apparatus and methods for aspirating emboli
JP2009142677A (en) * 2001-08-22 2009-07-02 Gore Enterp Holdings Inc Apparatus and method for treating stroke and controlling cerebral blood flow characteristic
US9707035B2 (en) 2002-04-08 2017-07-18 Medtronic Ardian Luxembourg S.A.R.L. Methods for catheter-based renal neuromodulation
US9675413B2 (en) 2002-04-08 2017-06-13 Medtronic Ardian Luxembourg S.A.R.L. Methods and apparatus for renal neuromodulation
AU2017204628B2 (en) * 2002-10-17 2019-07-25 W. L. Gore & Associates, Inc. Embolic filter frame having looped support strut elements
WO2004084739A1 (en) * 2003-03-27 2004-10-07 Nihon University Wire for inserting into biological duct
US7621935B2 (en) 2003-03-27 2009-11-24 Nihon University Wire for inserting into biological duct
CN100409815C (en) * 2003-03-27 2008-08-13 学校法人日本大学 Wire for inserting into biological duct
EP1882490A4 (en) * 2005-05-17 2008-06-25 Microport Medical Shanghai Co Dual guide-wire distal end protector
EP1882490A1 (en) * 2005-05-17 2008-01-30 Microport Medical (Shanghai) Co., Ltd. Dual guide-wire distal end protector
WO2006122460A1 (en) 2005-05-17 2006-11-23 Microport Medical (Shanghai) Co., Ltd. Dual guide-wire distal end protector
EP1991141A1 (en) * 2006-02-22 2008-11-19 Strauss, Bradley H. Guide-wire sleeve for facilitation of lesion crossing
EP1991141A4 (en) * 2006-02-22 2013-09-18 Strauss Bradley H Guide-wire sleeve for facilitation of lesion crossing
US8617192B2 (en) 2006-02-22 2013-12-31 Bradley H. Strauss Guide-wire sleeve for facilitation of lesion crossing
US9345509B2 (en) 2006-02-22 2016-05-24 Baylis Medical Company Inc. Guide-wire dilation device for facilitation of lesion crossing
US11529157B2 (en) 2008-07-22 2022-12-20 Neuravi Limited Clot capture systems and associated methods
US10582939B2 (en) 2008-07-22 2020-03-10 Neuravi Limited Clot capture systems and associated methods
US11871949B2 (en) 2010-10-22 2024-01-16 Neuravi Limited Clot engagement and removal system
US10292723B2 (en) 2010-10-22 2019-05-21 Neuravi Limited Clot engagement and removal system
US11246612B2 (en) 2010-10-22 2022-02-15 Neuravi Limited Clot engagement and removal system
US9351749B2 (en) 2010-10-22 2016-05-31 Neuravi Limited Clot engagement and removal system
US11116572B2 (en) 2010-10-25 2021-09-14 Medtronic Ardian Luxembourg S.A.R.L. Catheter apparatuses having multi-electrode arrays for renal neuromodulation and associated systems and methods
US10076382B2 (en) 2010-10-25 2018-09-18 Medtronic Ardian Luxembourg S.A.R.L. Catheter apparatuses having multi-electrode arrays for renal neuromodulation and associated systems and methods
JP2011104388A (en) * 2011-01-13 2011-06-02 Microvention Inc Catheter for embolectomy and handling method thereof
US9642639B2 (en) 2011-03-09 2017-05-09 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US10952760B2 (en) 2011-03-09 2021-03-23 Neuravi Limited Clot retrieval device for removing a clot from a blood vessel
US11259824B2 (en) 2011-03-09 2022-03-01 Neuravi Limited Clot retrieval device for removing occlusive clot from a blood vessel
US10034680B2 (en) 2011-03-09 2018-07-31 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US9301769B2 (en) 2011-03-09 2016-04-05 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US12059164B2 (en) 2011-03-09 2024-08-13 Neuravi Limited Clot retrieval device for removing occlusive clot from a blood vessel
US11998223B2 (en) 2011-03-09 2024-06-04 Neuravi Limited Clot retrieval device for removing a clot from a blood vessel
US10743894B2 (en) 2011-03-09 2020-08-18 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US12076037B2 (en) 2011-03-09 2024-09-03 Neuravi Limited Systems and methods to restore perfusion to a vessel
US10299811B2 (en) 2011-03-09 2019-05-28 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US10588649B2 (en) 2011-03-09 2020-03-17 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US10292722B2 (en) 2011-03-09 2019-05-21 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US9198682B2 (en) 2011-04-13 2015-12-01 Olympus Corporation Endoscope treatment tool
US10039896B2 (en) 2011-05-23 2018-08-07 Nitiloop Ltd. Deployment mechanism for body vessel insertion devices
US9855096B2 (en) 2012-05-11 2018-01-02 Medtronic Ardian Luxembourg S.A.R.L. Multi-electrode catheter assemblies for renal neuromodulation and associated systems and methods
US10512504B2 (en) 2012-05-11 2019-12-24 Medtronic Ardian Luxembourg S.A.R.L. Multi-electrode catheter assemblies for renal neuromodulation and associated systems and methods
US9642635B2 (en) 2013-03-13 2017-05-09 Neuravi Limited Clot removal device
US10080575B2 (en) 2013-03-13 2018-09-25 Neuravi Limited Clot removal device
US10517622B2 (en) 2013-03-13 2019-12-31 Neuravi Limited Clot removal device
US10792055B2 (en) 2013-03-13 2020-10-06 Neuravi Limited Clot removal device
US11937835B2 (en) 2013-03-14 2024-03-26 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US10390850B2 (en) 2013-03-14 2019-08-27 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US10357265B2 (en) 2013-03-14 2019-07-23 Neuravi Limited Devices and methods for removal of acute blockages from blood vessels
US11103264B2 (en) 2013-03-14 2021-08-31 Neuravi Limited Devices and methods for removal of acute blockages from blood vessels
US10588648B2 (en) 2013-03-14 2020-03-17 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US10610246B2 (en) 2013-03-14 2020-04-07 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US11839392B2 (en) 2013-03-14 2023-12-12 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US11547427B2 (en) 2013-03-14 2023-01-10 Neuravi Limited Clot retrieval devices
US10675045B2 (en) 2013-03-14 2020-06-09 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US10278717B2 (en) 2013-03-14 2019-05-07 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US11871945B2 (en) 2013-03-14 2024-01-16 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US10201360B2 (en) 2013-03-14 2019-02-12 Neuravi Limited Devices and methods for removal of acute blockages from blood vessels
US10420570B2 (en) 2013-03-14 2019-09-24 Neuravi Limited Clot retrieval devices
US9445829B2 (en) 2013-03-14 2016-09-20 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US9888961B2 (en) 2013-03-15 2018-02-13 Medtronic Ardian Luxembourg S.A.R.L. Helical push wire electrode
US10792098B2 (en) 2013-03-15 2020-10-06 Medtronic Ardian Luxembourg S.A.R.L. Helical push wire electrode
US11213678B2 (en) 2013-09-09 2022-01-04 Medtronic Ardian Luxembourg S.A.R.L. Method of manufacturing a medical device for neuromodulation
US11484328B2 (en) 2014-03-11 2022-11-01 Neuravi Limited Clot retrieval system for removing occlusive clot from a blood vessel
US10285720B2 (en) 2014-03-11 2019-05-14 Neuravi Limited Clot retrieval system for removing occlusive clot from a blood vessel
CH709547A1 (en) * 2014-04-17 2015-10-30 Stg Medical Ag Aspiration catheter.
US10736690B2 (en) 2014-04-24 2020-08-11 Medtronic Ardian Luxembourg S.A.R.L. Neuromodulation catheters and associated systems and methods
US11464563B2 (en) 2014-04-24 2022-10-11 Medtronic Ardian Luxembourg S.A.R.L. Neuromodulation catheters and associated systems and methods
US11446045B2 (en) 2014-06-13 2022-09-20 Neuravi Limited Devices and methods for removal of acute blockages from blood vessels
US10441301B2 (en) 2014-06-13 2019-10-15 Neuravi Limited Devices and methods for removal of acute blockages from blood vessels
US10682152B2 (en) 2014-06-13 2020-06-16 Neuravi Limited Devices and methods for removal of acute blockages from blood vessels
US10792056B2 (en) 2014-06-13 2020-10-06 Neuravi Limited Devices and methods for removal of acute blockages from blood vessels
WO2015189354A1 (en) * 2014-06-13 2015-12-17 Neuravi Limited Devices for removal of acute blockages from blood vessels
US11076876B2 (en) 2014-06-30 2021-08-03 Neuravi Limited System for removing a clot from a blood vessel
US10265086B2 (en) 2014-06-30 2019-04-23 Neuravi Limited System for removing a clot from a blood vessel
US11944333B2 (en) 2014-06-30 2024-04-02 Neuravi Limited System for removing a clot from a blood vessel
JP2015042272A (en) * 2014-10-03 2015-03-05 マイクロベンション インコーポレイテッド Embolectomy catheter and handling method
US11980379B2 (en) 2014-11-26 2024-05-14 Neuravi Limited Clot retrieval system for removing occlusive clot from a blood vessel
US10617435B2 (en) 2014-11-26 2020-04-14 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US11253278B2 (en) 2014-11-26 2022-02-22 Neuravi Limited Clot retrieval system for removing occlusive clot from a blood vessel
US10363054B2 (en) 2014-11-26 2019-07-30 Neuravi Limited Clot retrieval device for removing occlusive clot from a blood vessel
US11712256B2 (en) 2014-11-26 2023-08-01 Neuravi Limited Clot retrieval device for removing occlusive clot from a blood vessel
US11857210B2 (en) 2014-11-26 2024-01-02 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
WO2017070801A1 (en) * 2015-10-28 2017-05-04 Stg Medical Ag Aspiration catheter
US11395667B2 (en) 2016-08-17 2022-07-26 Neuravi Limited Clot retrieval system for removing occlusive clot from a blood vessel
US11147572B2 (en) 2016-09-06 2021-10-19 Neuravi Limited Clot retrieval device for removing occlusive clot from a blood vessel
US11266435B2 (en) 2017-06-20 2022-03-08 Joe Michael Eskridge Stent retriever having an expandable fragment guard
EP3641671A4 (en) * 2017-06-20 2020-05-27 Eskridge, Joe, Michael Stent retriever having an expandable fragment guard
US10842498B2 (en) 2018-09-13 2020-11-24 Neuravi Limited Systems and methods of restoring perfusion to a vessel
US11963693B2 (en) 2018-10-02 2024-04-23 Neuravi Limited Joint assembly for vasculature obstruction capture device
US11406416B2 (en) 2018-10-02 2022-08-09 Neuravi Limited Joint assembly for vasculature obstruction capture device
US11311304B2 (en) 2019-03-04 2022-04-26 Neuravi Limited Actuated clot retrieval catheter
US11969180B2 (en) 2019-03-04 2024-04-30 Neuravi Limited Actuated clot retrieval catheter
US11529495B2 (en) 2019-09-11 2022-12-20 Neuravi Limited Expandable mouth catheter
US12029864B2 (en) 2019-09-11 2024-07-09 Neuravi Limited Expandable mouth catheter
US12004731B2 (en) 2019-10-29 2024-06-11 Neuravi Limited Proximal locking assembly design for dual stent mechanical thrombectomy device
US11712231B2 (en) 2019-10-29 2023-08-01 Neuravi Limited Proximal locking assembly design for dual stent mechanical thrombectomy device
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
US12023058B2 (en) 2019-12-03 2024-07-02 Neuravi Limited Stentriever devices for removing an occlusive clot from a vessel and methods thereof
US11517340B2 (en) 2019-12-03 2022-12-06 Neuravi Limited Stentriever devices for removing an occlusive clot from a vessel and methods thereof
US11633198B2 (en) 2020-03-05 2023-04-25 Neuravi Limited Catheter proximal joint
US11944327B2 (en) 2020-03-05 2024-04-02 Neuravi Limited Expandable mouth aspirating clot retrieval catheter
US11883043B2 (en) 2020-03-31 2024-01-30 DePuy Synthes Products, Inc. Catheter funnel extension
US11759217B2 (en) 2020-04-07 2023-09-19 Neuravi Limited Catheter tubular support
US11730501B2 (en) 2020-04-17 2023-08-22 Neuravi Limited Floating clot retrieval device for removing clots from a blood vessel
US12048446B2 (en) 2020-04-17 2024-07-30 Neuravi Limited Clot retrieval device for removing heterogeneous clots from a blood vessel
US11717308B2 (en) 2020-04-17 2023-08-08 Neuravi Limited Clot retrieval device for removing heterogeneous clots from a blood vessel
US11871946B2 (en) 2020-04-17 2024-01-16 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US11737771B2 (en) 2020-06-18 2023-08-29 Neuravi Limited Dual channel thrombectomy device
US11937836B2 (en) 2020-06-22 2024-03-26 Neuravi Limited Clot retrieval system with expandable clot engaging framework
US11439418B2 (en) 2020-06-23 2022-09-13 Neuravi Limited Clot retrieval device for removing clot from a blood vessel
US11395669B2 (en) 2020-06-23 2022-07-26 Neuravi Limited Clot retrieval device with flexible collapsible frame
US11864781B2 (en) 2020-09-23 2024-01-09 Neuravi Limited Rotating frame thrombectomy device
US11937837B2 (en) 2020-12-29 2024-03-26 Neuravi Limited Fibrin rich / soft clot mechanical thrombectomy device
US12029442B2 (en) 2021-01-14 2024-07-09 Neuravi Limited Systems and methods for a dual elongated member clot retrieval apparatus
US11872354B2 (en) 2021-02-24 2024-01-16 Neuravi Limited Flexible catheter shaft frame with seam
US12064130B2 (en) 2021-03-18 2024-08-20 Neuravi Limited Vascular obstruction retrieval device having sliding cages pinch mechanism
US11974764B2 (en) 2021-06-04 2024-05-07 Neuravi Limited Self-orienting rotating stentriever pinching cells
US12133657B2 (en) 2021-09-16 2024-11-05 Neuravi Limited Clot retrieval device for removing occlusive clot from a blood vessel
US11937839B2 (en) 2021-09-28 2024-03-26 Neuravi Limited Catheter with electrically actuated expandable mouth
US12011186B2 (en) 2021-10-28 2024-06-18 Neuravi Limited Bevel tip expandable mouth catheter with reinforcing ring
ES2921403A1 (en) * 2022-02-03 2022-08-25 Fundacion Para La Investigacion Del Hospital Univ Y Politecnico La Fe De La Comunidad Valenciana Double conical double spiral embolic device during the practice of endovascular procedures (Machine-translation by Google Translate, not legally binding)
WO2023148413A1 (en) * 2022-02-03 2023-08-10 Fundación Para La Investigación Del Hospital Universitario Y Politécnico La Fe De La Comunidad Valenciana Embolic protection device having a double conical spiral for embolic protection during endovascular procedures

Also Published As

Publication number Publication date
US7691121B2 (en) 2010-04-06
WO1999056801A3 (en) 2000-04-06
EP1949921A3 (en) 2008-08-06
US8100935B2 (en) 2012-01-24
CA2329013A1 (en) 1999-11-11
DE69938425D1 (en) 2008-05-08
EP1079874B1 (en) 2008-03-26
US20080015541A1 (en) 2008-01-17
EP1949921B1 (en) 2013-11-06
ES2430352T3 (en) 2013-11-20
US6511492B1 (en) 2003-01-28
EP2335748A1 (en) 2011-06-22
JP4219558B2 (en) 2009-02-04
EP2335748B1 (en) 2013-07-10
CN1308508A (en) 2001-08-15
US20040133232A1 (en) 2004-07-08
US6685722B1 (en) 2004-02-03
EP1949921A2 (en) 2008-07-30
US20140135803A9 (en) 2014-05-15
CN1203811C (en) 2005-06-01
EP1079874A2 (en) 2001-03-07
EP1079874A4 (en) 2004-12-29
DE69938425T2 (en) 2009-01-02
AU3780199A (en) 1999-11-23
ES2304808T3 (en) 2008-10-16
US8784441B2 (en) 2014-07-22
US20140257245A1 (en) 2014-09-11
ATE390154T1 (en) 2008-04-15
AU767873B2 (en) 2003-11-27
ES2440723T3 (en) 2014-01-30
BR9910169A (en) 2002-12-31
JP2002513646A (en) 2002-05-14
US20100145371A1 (en) 2010-06-10

Similar Documents

Publication Publication Date Title
AU767873B2 (en) Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
EP2319575B1 (en) Embolectomy catheter
AU2016273879B2 (en) Devices and systems for thrombus treatment
JP4152071B2 (en) Mechanical clot treatment device using distal filter
WO2010014447A2 (en) Embolectomy stroke device
JP2011104388A (en) Catheter for embolectomy and handling method thereof
AU2001232748B2 (en) Embolectomy catheters and method for treatment
JP2015042272A (en) Embolectomy catheter and handling method
AU2007202936A1 (en) Embolectomy catheters and method for treatment
AU2001232748A1 (en) Embolectomy catheters and method for treatment

Legal Events

Date Code Title Description
WWE Wipo information: entry into national phase

Ref document number: 99807578.7

Country of ref document: CN

AK Designated states

Kind code of ref document: A2

Designated state(s): AE AL AM AT AU AZ BA BB BG BR BY CA CH CN CU CZ DE DK EE ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MD MG MK MN MW MX NO NZ PL PT RO RU SD SE SG SI SK SL TJ TM TR TT UA UG UZ VN YU ZA ZW

AL Designated countries for regional patents

Kind code of ref document: A2

Designated state(s): GH GM KE LS MW SD SL SZ UG ZW AM AZ BY KG KZ MD RU TJ TM AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN GW ML MR NE SN TD TG

121 Ep: the epo has been informed by wipo that ep was designated in this application
DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
AK Designated states

Kind code of ref document: A3

Designated state(s): AE AL AM AT AU AZ BA BB BG BR BY CA CH CN CU CZ DE DK EE ES FI GB GD GE GH GM HR HU ID IL IN IS JP KE KG KP KR KZ LC LK LR LS LT LU LV MD MG MK MN MW MX NO NZ PL PT RO RU SD SE SG SI SK SL TJ TM TR TT UA UG UZ VN YU ZA ZW

AL Designated countries for regional patents

Kind code of ref document: A3

Designated state(s): GH GM KE LS MW SD SL SZ UG ZW AM AZ BY KG KZ MD RU TJ TM AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE BF BJ CF CG CI CM GA GN GW ML MR NE SN TD TG

ENP Entry into the national phase

Ref document number: 2329013

Country of ref document: CA

Ref document number: 2329013

Country of ref document: CA

Kind code of ref document: A

ENP Entry into the national phase

Ref document number: 2000 546825

Country of ref document: JP

Kind code of ref document: A

NENP Non-entry into the national phase

Ref country code: KR

WWE Wipo information: entry into national phase

Ref document number: 37801/99

Country of ref document: AU

WWE Wipo information: entry into national phase

Ref document number: 1999920259

Country of ref document: EP

REG Reference to national code

Ref country code: DE

Ref legal event code: 8642

WWP Wipo information: published in national office

Ref document number: 1999920259

Country of ref document: EP

WWG Wipo information: grant in national office

Ref document number: 37801/99

Country of ref document: AU