U.S. patent application number 14/882929 was filed with the patent office on 2016-03-10 for vessel occluding material extractor.
This patent application is currently assigned to BOSTON SCIENTIFIC SCIMED, INC.. The applicant listed for this patent is BOSTON SCIENTIFIC SCIMED, INC.. Invention is credited to Steven M. Spencer, Jan Weber.
Application Number | 20160066936 14/882929 |
Document ID | / |
Family ID | 33131012 |
Filed Date | 2016-03-10 |
United States Patent
Application |
20160066936 |
Kind Code |
A1 |
Weber; Jan ; et al. |
March 10, 2016 |
VESSEL OCCLUDING MATERIAL EXTRACTOR
Abstract
Methods, devices, and systems for extracting vessel occluding
material are provided. An embodiment of a vessel occluding material
extractor includes a host structure, a plurality of expandable
members, a slide mechanism, and a circumferential member. The host
structure has an elongate axis. The expandable members are
connected to the host structure arrayed radially around the
elongate axis. The slide mechanism is connected to the expandable
members and adjacent the host structure, and is slidable in the
direction of the elongate axis. The circumferential member is
connected to the expandable members between the connection of the
slide mechanism and the host structure to the expandable
members.
Inventors: |
Weber; Jan; (Maastricht,
NL) ; Spencer; Steven M.; (Minneapolis, MN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
BOSTON SCIENTIFIC SCIMED, INC. |
Maple Grove |
MN |
US |
|
|
Assignee: |
BOSTON SCIENTIFIC SCIMED,
INC.
MAPLE GROVE
MN
|
Family ID: |
33131012 |
Appl. No.: |
14/882929 |
Filed: |
October 14, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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14282197 |
May 20, 2014 |
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14882929 |
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13276575 |
Oct 19, 2011 |
8728106 |
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14282197 |
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10411558 |
Apr 10, 2003 |
8070761 |
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13276575 |
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Current U.S.
Class: |
606/159 ;
606/200 |
Current CPC
Class: |
A61B 17/22031 20130101;
A61B 17/320725 20130101; A61B 2017/22094 20130101; A61B 17/221
20130101; A61F 2/013 20130101; A61B 2017/2212 20130101; A61B
2017/22034 20130101 |
International
Class: |
A61B 17/22 20060101
A61B017/22; A61B 17/3207 20060101 A61B017/3207 |
Claims
1. An extractor comprising; a host structure having an elongate
axis; a plurality of expandable members connected to the host
structure arrayed radially around the elongate axis; a slide
mechanism, connected to the expandable members and adjacent the
host structure, and slidable in the direction of the elongate axis;
and a circumferential member connected to the expandable members
between the connection of the slide mechanism and the host
structure.
Description
RELATED APPLICATIONS
[0001] This application is a continuation of U.S. application Ser.
No. 14/282,197, filed May 20, 2014, which is a continuation of U.S.
application Ser. No. 13/276,575, filed Oct. 19, 2011, now U.S. Pat.
No. 8,728,106, which is a U.S. application Ser. No. 10/411,558
filed Apr. 10, 2003, now U.S. Pat. No. 8,070,761.
INTRODUCTION
[0002] Intravascular devices are used in various medical
procedures. For example, certain intravascular devices, such as
catheters and guidewires are generally used to deliver fluids or
other medical devices to specific locations within a patient's
body, such as within the vascular system. Various devices are also
used in treating specific conditions, such as vessel occlusion.
Such treatment devices include devices for extracting vessel
occluding material whether the material is connected to the vessel
or floating in the stream of fluid within the vessel. Needles,
burrs, and blades, for example, are sometimes used in removing
occluding material from a lumen forming a vessel. Additionally,
filtering devices are utilized to remove material that is entrained
within the flow of fluid in the vessel. These devices, either
singly or in combination, operate to extract vessel occluding
material.
[0003] Further, in some cases it is desirable to work at the center
of the occluded region because it can be less occluded and can also
be easier to remove, since the material at the center of the
occlusion is likely newer material. Additionally, in some
situations it is necessary to pass a treatment device through an
occluded region. For example, when utilizing a filter, guidewire,
or other device delivered from an upstream position, it is
necessary to pass the device through the occluded region so that
the filter or other device can be deployed downstream. In either of
the above cases, the centering of the treatment device can be
difficult to achieve and therefore these procedures can take a
significant amount of time and require significant maneuverability
of the treatment device before the objectives of the treatment are
obtained.
BRIEF DESCRIPTION OF THE DRAWINGS
[0004] FIG. 1A illustrates an embodiment of the present invention
in its unexpanded state.
[0005] FIG. 1B illustrates the embodiment of FIG. 1A in its
expanded state.
[0006] FIG. 1C illustrates an end view of the embodiment of FIG.
1B.
[0007] FIG. 2A illustrates an embodiment of the present invention
being positioned in a vessel.
[0008] FIG. 2B illustrates the embodiment of FIG. 2A in a deployed
state.
[0009] FIG. 3A illustrates another embodiment of the present
invention in its unexpanded state.
[0010] FIG. 3B illustrates the embodiment of FIG. 3A in its
expanded state.
[0011] FIG. 4A illustrates an embodiment of the present invention
being positioned in a vessel.
[0012] FIG. 4B illustrates the embodiment of FIG. 4A in a deployed
state.
[0013] FIG. 5A illustrates an embodiment of the present invention
being positioned in a vessel.
[0014] FIG. 5B illustrates the embodiment of FIG. 5A in a deployed
state.
[0015] FIG. 5C illustrates another embodiment of the present
invention in a deployed state.
[0016] FIG. 5D illustrates an end view of the embodiment of FIG.
5C.
[0017] FIG. 5E illustrates another embodiment of the present
invention in a deployed state.
[0018] FIG. 6A illustrates an embodiment of the present invention
being positioned in a vessel.
[0019] FIG. 6B illustrates the embodiment of FIG. 6A in a deployed
state.
[0020] FIG. 7A illustrates an embodiment of the present invention
being positioned in a vessel.
[0021] FIG. 7B illustrates the embodiment of FIG. 7A in a deployed
state.
[0022] FIG. 8A illustrates another embodiment of the present
invention.
[0023] FIG. 8B illustrates a cross-section of the embodiment of
FIG. 8A taken along line 8B-8B
[0024] FIG. 8C illustrates the embodiment of FIG. 8A in a deployed
state.
[0025] FIG. 9A illustrates another embodiment of the present
invention in its expanded state.
[0026] FIG. 9B illustrates area 9B of the embodiment of FIG. 9A in
detail.
[0027] FIG. 9C illustrates an embodiment of a hinge such as that
utilized in the embodiment of FIG. 9B.
[0028] FIG. 10 illustrates a method embodiment of the present
invention.
[0029] FIG. 11 illustrates another method embodiment of the present
invention.
DETAILED DESCRIPTION
[0030] The present invention relates to methods, systems, and
devices for extracting vessel occluding material, such as emboli
and thrombi, from a vessel. The following description is presented
to enable one of ordinary skill in the art to make and use the
invention and is provided in the context of a patent application
and its requirements. Various modifications to the embodiments
shown will be readily apparent to those skilled in the art and are
intended to be within the scope of the present invention. Thus, the
present invention is not intended to be limited to the embodiments
shown, but is to be accorded the widest scope consistent with the
claims.
[0031] Those skilled in the art will appreciate from this
disclosure that vessel occluding material, such as thrombi and
emboli, can include any material that is to be removed or filtered,
including, but not limited to blood clots, and plaque, among
others. Additionally, those skilled in the art will appreciate that
the term "occlusion" as used herein includes partial or complete
blockage of a vessel by vessel occluding material.
[0032] As described herein, the embodiments of the vessel occluding
material extractor can serve many different purposes. For example,
various embodiments of the device can be utilized as a filter or
trap, to break up or capture emboli flowing in the fluid stream
within a vessel. The embodiments shown in FIGS. 1A-4B are such
embodiments and are discussed in detail below. Various embodiments
of the device can be utilized in various positioning embodiments
such as shown in FIGS. 5A-5E illustrates. Various embodiments of
the device can also be utilized to hold the host device in place
within the vessel to allow a treatment device to be advanced along
its length as the embodiment shown in FIGS. 6A and 6B illustrate.
Embodiments of the device can also be utilized to score the surface
of occluding material, blocking the fluid flow in a vessel, as
shown in FIGS. 7A and 7B. Additionally, in embodiments having a
catheter, the catheter can be used to, for example, to deliver
drugs or treatment devices such as in the embodiment of FIGS.
8A-8C, can be utilized to remove the vessel occluding material,
such as by a suction applied through the catheter, or for other
suitable functions, the invention is not so limited. Additionally,
FIGS. 9A-9C illustrate another embodiment of the invention having
hinged expandable members. However, the invention is not so
limited.
[0033] FIGS. 1A-1C illustrate a device embodiment of the present
invention. FIG. 1A illustrates the embodiment in its unexpanded
state, while FIG. 1B illustrates the embodiment in its expanded
state. FIG. 1C illustrates an end view of the embodiment shown in
FIGS. 1A and 1B.
[0034] As shown in the embodiment of FIG. 1A, a vessel occluding
material extracting device 100 includes a host structure 102,
having an elongate axis, and an expandable portion 103. Those
skilled in the art will appreciate that a host structure can be a
catheter, a wire, or the like. The invention is not so limited. As
shown in the embodiments of FIGS. 1A-1C, the expandable portion 103
includes a plurality of expandable members 112, a first collar
110-1, a second collar 110-2, and a circumferential member 114.
[0035] In various embodiments, the expandable members 112 are
connected to the host structure and arrayed radially around the
elongate axis in an axially aligned manner. Those skilled in the
art will appreciate that the expandable members can be constructed
from any suitable material known in the art. Some suitable examples
include metals, such as spring steel, super-elastic materials, such
as Nitinol, polymers, or fabrics, among others.
[0036] Additionally, those skilled in the art will appreciate from
reading this disclosure that the expandable members can be
connected to the host structure in any manner that allows the
extracting device to expand. For example, in the embodiment shown
in FIGS. 1A-1C, the expandable members 112 are connected to first
collar 110-1 at one end and second collar 110-2 at another end. The
first and second collars 110-1 and 110-2 are connected to the host
device 102. In various embodiments, one or both ends of the
expandable members 112 are moveable with respect to each other.
[0037] In the embodiment shown in FIGS. 1A-1C, first collar 110-1
is slidably connected to the host structure 102 and can move from
one position on the host structure 102 to another. The second
collar 110-2 is fixedly attached to a distal end of the host device
102. In this embodiment, the slidable movement of the first collar
110-1 causes the expandable members 112 to bend when the ends of
the expandable members 112 move toward one another. The bending
results in the expansion of the diameter of the expandable portion
103. This is illustrated in the difference in diameter of the
expandable portion 103 in FIGS. 1A and 1B. One of ordinary skill in
the art will recognize numerous manners in which collar 110-1
and/or collar 110-2 can be actuated.
[0038] The second collar 110-2, in this embodiment, is affixed
inside the host structure 102 with one end of the expandable
members 112 bent around the end of the host structure 102. However,
the invention is not so limited. For example, in various
embodiments where an extraction device is connected to a host wire,
both ends of the expandable members will be connected, either
fixedly or movably, to the exterior of the host wire.
[0039] In various embodiments, the expandable portion 103 includes
a circumferential member 114. In various embodiments, as shown in
FIGS. 1A-1C, the circumferential member 114 can be utilized to
maintain a generally uniform lateral spacing between the expandable
members 112. In various embodiments, the circumferential member 114
can be constructed to limit the expansion of the expandable members
112. In various embodiments, the circumferential member 114 is
non-elastic and connected generally mid way between the ends of the
expandable members. In these embodiments, circumferential member
114 can retract to an unexpanded state, shown in FIG. 1A, to reduce
its diameter. In various embodiments, circumferential member 114 is
elastic and expands when the expandable portion 103 is moved from
the unexpanded state in FIG. 1A to the expanded state in FIG.
1B.
[0040] Those skilled in the art will appreciate that the
circumferential member can be constructed from any suitable
material known in the art and can be either elastic or inelastic.
Some suitable examples include metals, such as spring steel or
Nitinol, polymers, or fabrics, among others. Those skilled in the
art will also appreciate that the circumferential member 114 can be
connected to the expandable members in any manner, for example
soldering, gluing, and tying, among others. The invention is not so
limited.
[0041] In FIG. 1C, the device 100 is shown in an expanded state
having twelve (12) expandable members 112, although the invention
is not limited to 12 expandable members. In the embodiment shown,
the circumferential member 114 can be connected to each expandable
member 112 and when expanded, as shown, can operate to serve as a
filter or vessel occluding material trap.
[0042] In various embodiments, the device can be utilized wherein
substantial force could be applied to the expandable members. In
these embodiments, the device can be constructed from a material
that can be deformed and substantially returned to its original
shape. Examples of such materials include plastics, polymers,
stainless steel, and the like. However, the invention is not so
limited.
[0043] FIGS. 2A and 2B illustrates an embodiment of the present
invention being positioned in a vessel. In these Figures, the
device is utilized downstream from an occlusion. The device
operates to filter and/or trap emboli, for example emboli broken
loose from an occlusion by a treatment device and entrained in the
fluid flowing within a vessel.
[0044] In FIG. 2A, the device 200 is inserted into a vessel 220
from a location upstream of an occluded region 230. Those skilled
in the art will appreciate that in some situations, such as when
vessel occluding material completely occludes a vessel, such as
with a total occlusion or chronic total occlusion (CTO), the device
200 can be inserted at a point downstream from the occlusion 230.
In the embodiment shown in FIG. 2A, the device 200 is guided
through the occluded region 230 along guidewire 206 and is
positioned downstream of the occlusion 230.
[0045] As shown in FIG. 2B, once the device 200 is positioned at a
desired location in the vessel 220, it can be expanded by expanding
the expandable portion 203. The expanded device 200 can operate as
a filter/trap device by allowing fluid to flow between the
expandable members 212, while restricting the space through which
emboli can pass, thereby catching or filtering emboli with the
expandable members 212. The device 200 can then be retracted and
the emboli removed therewith.
[0046] In various embodiments, the device 200 can have an expanded
diameter large enough to engage the walls of the vessel 220 such
that the force between the device and the wall of the vessel 202
holds the device 200 in position. However, those skilled in the art
will appreciate that the device 200 can also have an expanded
diameter smaller than the diameter of the vessel 220 thereby
allowing the device 200 to be movable within the vessel 220 while
in its expanded state. This allows for adjustment of the
positioning of the device 200 and allows for the device 200 to be
utilized in situations when the positioning of the occlusion 230 is
such that engaging the walls of the vessel 220 is impractical.
[0047] FIGS. 3A and 3B illustrate another embodiment of a vessel
occluding material extractor that can be utilized as a filter
and/or trap for the straining and/or capturing of emboli therein.
In this embodiment, the device 300 has a filtering material 316
connected thereon to aid in filtering and trapping emboli entrained
in the fluid flowing through the vessel 320. In FIG. 3A, an
embodiment of a device 300 is illustrated in its unexpanded state
prior to reaching its destination within the vessel 320, while in
FIG. 3B, the device 300 is illustrated in its expanded state.
[0048] In the embodiment shown in FIGS. 3A and 3B, the device 300
has a host structure 302, and an expandable portion 303 having two
collars 310-1 and 310-2, a plurality of expandable members 312, a
circumferential member 314, filtering material 316, and a recessed
section 318. The device 300 has a filtering material 316 connected
to the distal end of the expandable members 312.
[0049] In various embodiments, the filtering material 316 has a
plurality of pores formed therein. As one of ordinary skill in the
art will appreciate, the plurality of pores on the filtering
material 316 allow for the passing of fluid there-through and
provide for the filtering of emboli. The pores in the filtering
material 316 can be of any size suitable to implement the various
aspects of the present invention. The invention is not so
limited.
[0050] Those skilled in the art will also appreciate from reading
this disclosure that the filtering material 316 can be constructed
of any suitable material. The invention is not so limited. For
example, the material can be a plurality of wires, such as
stainless steel or
[0051] Nitinol, can be a fabric, or can be a sheet of material,
among others. Additionally, those skilled in the art will
appreciate from reading this disclosure that the circumferential
member 314 and the filter material 316 can be connected, and/or can
be formed as a single unit.
[0052] In the embodiment shown in FIGS. 3A and 3B, the device 300
also has a stop mechanism therein that can restrict the expansion
and/or the retraction of the device 300. For example, in the
embodiment shown, the device 300 has a recessed section 318 formed
in the exterior surface of the host structure 302. A collar 310-1
is slidably connected to the host structure 302 within the recessed
section 318. In the embodiment shown, the collar 310-1 and recessed
section 318 are constructed and arranged such that the ends of the
recessed section 318 form stops that impede the movement of the
collar 310-1 in both the distal and proximal directions, the
invention, however, is not so limited. In various embodiments, the
collar 310-1 can be designed such that its exterior diameter,
including the expandable members 312 connected thereto, is the same
or smaller than the larger exterior diameter of the host device
302. The invention, however, is not so limited.
[0053] Those skilled in the art will appreciate that one or more
stop mechanisms other than that shown in FIGS. 3A and 3B can be
provided to arrest directional movement of a collar, e.g. 310-1, or
the expandable portion 303. The invention is not so limited. For
example, a stop mechanism can be one or more areas on the host
device having a larger or smaller diameter than the general
diameter of the host device. Those areas can extend around the
entire circumference of the host device or around a portion of the
circumference, the invention is not so limited.
[0054] Those skilled in the art will also appreciate from reading
this disclosure that one or more of the expandable members 312 can
have a hollow interior, e.g. 313, formed therein for the
communication of drugs or medication to a treatment site, such as
occluded region 330. Additionally, the hollow interior 313 within
the one or more expandable members 312 can connect with a reservoir
located on the device 300 to retain drugs or medication therein.
Those skilled in the art will understand that the delivery of the
drug to the hollow interior 313 can be by any manner and that a
reservoir can be formed in any manner, such as a reservoir
demonstrated in FIGS. 8A-8C, among others. The invention is not so
limited.
[0055] FIGS. 4A and 4B illustrate a procedure in which an
extraction device, such as that shown in FIGS. 3A and 3B could be
utilized. In these Figures, the device is utilized downstream from
an occlusion and operates to filter and/or trap emboli, for example
emboli broken loose from an occlusion by a treatment device and
entrained in the fluid flowing within the vessel. In FIG. 4A, an
embodiment of a device 400 is illustrated in its unexpanded state
prior to reaching its destination within the vessel 420. In FIG.
4B, the device 400 is illustrated in its expanded state.
[0056] In FIG. 4A, the device 400 is inserted into the vessel 420
from a location upstream of the occluded region 430. In various
embodiments, such as when vessel occluding material completely
occludes a vessel, e.g. CTO, the device 402 can be inserted at a
point downstream from the occlusion 430. In the embodiment shown in
FIG. 4A, the device 400 is guided through the occluded region 430
and is positioned downstream of the occlusion 430.
[0057] In this embodiment, the pore size of the filter material 416
is smaller than the space between the expandable members 412.
Accordingly, this embodiment allows for the filtration and/or
capture of smaller emboli than the device 300 of FIGS. 3A and 3B.
Those skilled in the art will appreciate that one or more filters
having varying pore sizes, such as those shown in FIGS. 1A-4B, can
be utilized in combination to break up large emboli with a filter
having large pores before they reach the pores of a filter having
smaller pores.
[0058] FIGS. 5A-5E illustrate several embodiments of the present
invention being positioned in a vessel. In FIGS. 5A and 5B,
illustrate another embodiment of the present invention being
positioned in a vessel. FIGS. 5A and 5B illustrate the device 500
being positioned and deployed in a vessel 520 for centering and/or
stabilization of a host structure 502. The centering and/or
stabilization of a host structure can allow for better navigation
and stability for passing a treatment device into an opening in an
occlusion as well as for breaking through a full occlusion, such as
a CTO.
[0059] In FIG. 5A, an embodiment of a device 500 is illustrated in
its unexpanded state prior to reaching its destination within a
vessel 520. In FIG. 5B, the device 500 has reached its destination
and has been deployed into its expanded state.
[0060] As shown in FIG. 5A, the device 500 includes a host
structure 502 having an expandable portion 503 connected thereto.
In the embodiments of FIGS. 5A and 5B, the expandable portion 503
includes collars 510-1 and 510-2, expandable members 512, and
circumferential member 514. In various embodiments, the device 500
travels through vessel 520 along a guide catheter or guidewire 506.
In the embodiment shown in FIG. 5A, the extracting or centering
device 500 is positioned proximal to an occluded region 530 in need
of treatment. In this embodiment, a guidewire 506 is utilized to
penetrate and cross the occluded region 530. In various
embodiments, other treatment devices can be utilized.
[0061] As shown in FIG. 5B, the device 500 can be expanded to
provide centralized positioning and/or stability to the delivery of
a treatment device, e.g. guidewire 506. For example, in the
embodiment shown in FIG. 5B, the device 500 is also expanded to
engage the walls of the vessel 520 to hold it in place. In this
way, the device 500 can provide a stable platform proximate to the
treatment area 530 from which to launch a treatment device, e.g.
guidewire 506. This can be accomplished by expanding the expandable
portion 503 to restrict the amount of space in which the device 500
can move and, thereby, restrict the movement of the host structure
502. In this way, the device 500 can allow for a treatment device,
such as a guidewire 506, to be generally centered in the vessel 520
at a position that is proximal to a region 530 needing
treatment.
[0062] By having a stable structure proximate to the treatment
site, there can be less risk of buckling the treatment device when
it is in contact with the occluded region and can allow for more
push force to be applied to the treatment device. This increased
pushability can allow for smaller diameter and more flexible
guidewires and host wires to be utilized. Additionally, when an
embodiment of the present invention is utilized such that it is
held in place within a vessel, the device allows for a guidewire to
be withdrawn without losing the advanced position.
[0063] FIGS. 5C and 5D, illustrate another embodiment of the
present invention being positioned in a vessel. As shown in FIG.
5C, the device 500 includes a host structure 502 having an
expandable portion 503 connected thereto. In the embodiment of
FIGS. 5C, the expandable portion 503 includes collars 510-1 and
510-2, expandable members 512, and circumferential member 514. In
this embodiment, a guidewire 506 can be utilized to penetrate and
cross the occluded region 530. However, other treatment devices can
be utilized. The invention is not so limited.
[0064] As shown in FIG. 5C, the device 500 can be expanded to
provide decentralized positioning and/or stability to the delivery
of a treatment device, in this case guidewire 506 as has been
described previously herein. Those skilled in the art will
appreciate from reading this disclosure that a decentralized
position can be accomplished in any manner.
[0065] For example, FIG. 5D, illustrates an end view of the
embodiment shown in FIG. 5C. As shown in FIG. 5D, in this
embodiment, one or more of the expandable members have different
spring strengths such that some expandable members bend more
readily than others. In the embodiment shown, in FIGS. 5C and 5D,
the expandable members 512-1 have a first spring strength and the
expandable members 512-2 have a second spring strength that is less
than the first spring strength of members 512-1.
[0066] A decentralized position can be accomplished by utilizing
irregular spacing between the expandable members 512. For example,
as shown in FIG. SD, since the expandable members 512-2 have a
greater spring strength, they expand the circumferential member 514
out more. This changes the centering of the host structure 502,
thereby, moving the host structure 502 to a decentralized position.
Examples, of other manners in which decentralizing can be
accomplished include, shortening some of the expandable members 512
and arraying the expandable members 512 in a non-uniform manner
about the host structure 502, among others. The invention is not so
limited.
[0067] In FIG. 5E, illustrate another embodiment of the present
invention being positioned in a vessel. In FIG. 5E, the device 500
includes a host structure 502 having two or more expandable
portions 503 connected thereto. In the embodiment of FIG. 5E, the
expandable portions 503 include collars 510-1 and 510-2, expandable
members 512, and circumferential member 514. In the embodiment
shown in FIG. 5A, the extracting device 500 is positioned proximal
to an occluded region 530 in need of treatment. In this embodiment,
a guidewire 506 is utilized to penetrate and cross the occluded
region 530. In various embodiments, other treatment devices can be
utilized.
[0068] As shown in FIG. 5E, the device 500 can be expanded to
provide centralized positioning and additional stability to the
delivery of a treatment device, e.g. guidewire 506. For example, in
the embodiment shown in FIG. 5E, the expandable portions 503 of the
device 500 expanded to engage the walls of the vessel 520 to hold
the device 500 in place. In this way, the device 500 can provide a
stable platform proximate to the treatment area 530 from which to
launch a treatment device, e.g. guidewire 506 as has been described
previously herein.
[0069] In various embodiments, the expandable portions 503 can be
covered in a non-porous material and, thereby, once the portions
503 are expanded, the portions 503 can act to isolate a section of
vessel 520 that is located between the portions 503 from the flow
of fluid through the vessel 520. In such embodiments, a number of
fluid lumens, such as are shown in the embodiment of FIGS. 8A-8C at
824 can be formed in the host structure 502 of the embodiment shown
in FIG. 5E. In this way, fluid flowing in the vessel 520 can
continue to flow while the device 500 is isolating a section for
treatment between portions 503. Additionally, in such an
embodiment, the drug delivery can be provided through apertures
formed in the host structure 502 between the two expandable
portions 503.
[0070] FIGS. 6A and 6B illustrate an embodiment of the present
invention being positioned in a vessel. The figures illustrate a
vessel occluding material extractor being inserted and deployed in
a vessel to aid in the delivery of a treatment device. In FIG. 6A,
an embodiment of a device 600 is illustrated in its unexpanded
state, while in FIG. 6B, the device 600 is illustrated, in its
expanded state, deployed within a vessel 620.
[0071] As with FIGS. 5A and 5B, the embodiment illustrated in FIGS.
6A and 6B is shown being utilized as a centering device to center a
host structure 602, in this case a catheter, within the vessel 620.
This function can allow for a treatment device 608. In the
embodiment shown in FIG. 6B, the treatment device is a needle.
However, the invention is not so limited. Those skilled in the art
will appreciate that a host structure can be a catheter or wire,
among others. The invention is not so limited.
[0072] In the embodiments of FIGS. 6A and 6B, a device 600 has a
host structure 602 and an expandable portion 603. The expandable
portion 603 includes collars 610-1 and 610-2, expandable members
612, and circumferential member 614. In various embodiments, the
device 600 travels through vessel 620 along a guide catheter or
guidewire 606. In the embodiment shown in FIG. 6A, the extracting
device 600 is positioned proximal to an occluded region 630 in need
of treatment. In this embodiment, a needle 608 is utilized to
penetrate and cross the occluded region 630.
[0073] A treatment device such as needle 608 can be operable to
provide several functions. The invention is not so limited. For
example, needle 608 can be utilized to take a sample of the
occluding material from the occluded region 630. In this way, for
example, the type of material, its fibrosity, and general internal
makeup can be determined.
[0074] The needle 608 can also aid in treating an occlusion by
loosening or extracting some of the occluded material at the region
630. For example, the needle 608 can be utilized to push through
the occluded region 630, in cases of total occlusion or chronic
total occlusion (CTO).
[0075] In various embodiments, the needle 608 can be utilized to
measure the length of the occluded region 630, through use of a
radiopaque needle tip or by examination of the length of a core
sample taken from the occluded region. The measurement can, for
example, be used to help determine the types of treatment options
that are available. By way of example and not by way of limitation,
information on the length of the occlusion can be used to determine
the size and the length of stent to be utilized to recanalize the
vessel.
[0076] Additionally, the needle 608 can also be utilized to
administer anti-thrombogenic or anti-embolic drugs to an area in
need of treatment such as for example, region 630. Those skilled in
the art will appreciate from this disclosure that any treatment
device can be utilized with various embodiments of the invention
and that the invention can be utilized for any suitable treatment
application in any area of the body, including but not limited to
vascular, renal, esophageal, and stomach, among others. Some
examples of treatment devices include, but are not limited to
radiation sources, burrs, blades, filters, drug delivery devices,
needles, optical fibers, guidewires, and catheters, among
others.
[0077] In the embodiments of FIGS. 7A and 7B, a device 700 has a
host structure 702 and an expandable portion 703. In various
embodiments, the expandable portion 703 includes a plurality of
expandable members 712, a first collar 710-1, a second collar
710-2, and a circumferential member 714. In various embodiments,
the device 700 travels through vessel 720 along a guide catheter or
guidewire 706.
[0078] In the embodiment shown in FIG. 7A, the device 700 is
positioned proximal to an occluded region 730 in need of treatment.
In this technique, the device 700 is placed proximal to the surface
of the occluded region 730, and the end surface of the device 700
is utilized to score, loosen, and/or remove vessel occluding
material. In various techniques, the extended ends of the
expandable members 712 are movable as has been described in detail
herein.
[0079] In this embodiment, shown in FIG. 7B for example, expandable
members 712 can be operable to score and/or loosen occluded
material from the occluded region 730. Those skilled in the art
will appreciate that the expandable members 712 can be sharpened to
provide better scoring of the occluding material, whether distal to
the device 700 or between the device and the walls of the vessel
720.
[0080] In various techniques for example, first collar 710-1 can be
moved away from the expandable portion 703 to bend the expandable
members outward, near second collar 710-2 and can be accomplished
either before or after contact with the occluding material. In
various embodiments, the first collar 710-1 can be moved away and
toward the expandable portion 703 repeatedly, thereby moving the
expandable members 712. Additionally, once the device 700 is
positioned, it can be expanded, as the same has been described
herein. These movements can aid in loosening and scoring the
occluded material of the occluded region 730.
[0081] FIGS. 8A-8C, illustrate another embodiment of the present
invention being positioned in a vessel. In the embodiment of FIGS.
8A, 8B, and 8C, a device 800 has a host structure 802 and an
expandable portion 803. In various embodiments, the expandable
portion 803 includes a collar 810, expandable members 812, and
reservoir material 814. In various embodiments the host structure
includes a delivery lumen 822 terminating in an aperture at 826.
This lumen 822 can be utilized for the delivery of materials, such
as drugs or medications, among others. Additionally, in various
embodiments, the host structure 802 can include a fluid flow lumen
824. The blood flow lumen has one or more access ports 828 that
allow fluid flowing through the vessel to be diverted into the
lumen 824 and then out the distal end of the device 800.
[0082] FIG. 8B illustrates a cross-section of the host structure
802. This Figure illustrates the two lumens 822 and 824 formed
therein. Although shown in a side-by-side relation, those skilled
in the art will appreciate that the two lumens can be substantially
co-axial and that the sizes of the respective lumens 822 and 824
can be any suitable sizes. The invention is not so limited.
[0083] In various embodiments, as shown in FIG. 8C, the device 800
is deployed within a vessel 820. In the embodiment shown in FIG.
8C, the device 800 is positioned over an occluded region 830 in
need of treatment. In various embodiments, when the device 500 is
expanded, the expandable members 812 bend outward and expand
reservoir material 814 to create a reservoir therein. The reservoir
is connected through aperture 826 to lumen 822, thereby allowing
the reservoir to house material provided through the lumen 822. In
various embodiments, the reservoir material 814 has one or more
holes 816 therein. The holes 816 allow one or more fluids, such as
liquids, housed within the reservoir to be dispensed into the
vessel 820. As shown in FIG. 8C, the device 800 can be sized such
that when expanded, a part of the expandable portion 803 isolates a
section of the vessel 820. In the case shown in FIG. 8C, the
isolated section of the vessel 820 contains occluding material 830
thereon. By isolating this section of the vessel 820, the device
800 can be utilized to provide drugs or medications, among others,
to the occluding material 830 through use of lumen 822 in
communication with the reservoir and the holes 816 formed in the
reservoir material 816. In the embodiment shown in FIG. 8C, the
device 800 also includes a fluid lumen 824 to allow the fluid
flowing through the vessel 820 to continue to pass through the
vessel 820 while the device 800 is deployed.
[0084] In the embodiments of FIGS. 9A-9C, a device 900 has a host
structure 902 and an expandable portion 903. In various
embodiments, the expandable portion 903 includes a plurality of
expandable members 912, a first collar 910-1, a second collar
910-2, and a circumferential member 914. In various embodiments,
the expandable members 912 are formed from a number of sections. In
various embodiments, the number of sections of an expandable member
912 are hinged together to allow the expandable member to
expand.
[0085] For example, in the embodiment of FIG. 9A a hinge structure
as shown in detail in FIGS. 9B and 9C includes a first section 920
and a second section 922 movably engaged by a pin 924. The
engagement allows one or both sections 920 and 922 to move with
respect to each other. In various embodiments, as shown in FIG. 9B,
the hinging mechanism includes one or more arresting structures
926. In the embodiment shown in FIG. 9B, the arresting structure
926 contacts the surface 928 of section 922 to arrest the
counterclockwise movement of the section 922. However, the
invention is not so limited.
[0086] FIGS. 10 and 11 are block diagrams illustrating method
embodiments of the invention. As those skilled in the art will
appreciate from reading this disclosure, unless explicitly stated,
the methods described herein are not constrained to a particular
order or sequence. Additionally, some of the so described methods
or parts of a single method can occur or be performed at the same
point in time.
[0087] FIG. 10 illustrates a method of extracting vessel occluding
material. In the embodiment of FIG. 10, the method includes
advancing vessel occluding material extractor, having
longitudinally aligned expandable members at block 1010. In various
embodiments, advancing a vessel occluding material extractor,
includes advancing a vessel occluding material extractor having
material spanning between a distal half of the plurality of
expandable members to form a filter. In various embodiments,
advancing a vessel occluding material extractor, includes advancing
a vessel occluding material extractor having a circumferential
member connected to the expandable members.
[0088] The method of FIG. 10 also includes actuating the members to
an expanded state to serve as a clot filter at block 1020. In
various embodiments, actuating the members includes bending the
expandable members to expand the extractor to an expanded state to
form a filtering device.
[0089] FIG. 11 illustrates a method embodiment for extracting
vessel occluding material. In the embodiment of FIG. 11, the method
includes advancing a centering device, having a plurality of
expandable members and an elongate central axis, to a predetermined
position within a lumen, the centering device having a first
diameter at block 1110. In various embodiments, the centering
device includes a catheter centered along the central axis.
[0090] The method of the embodiment of FIG. 11 also includes
expanding the expandable members to expand the centering device to
have a second diameter larger than the first diameter at block 1
120. In various embodiments, expanding the expandable members
includes manually expanding the expandable members. However, the
invention is not so limited.
[0091] The method of FIG. 11 further includes advancing a treatment
device generally parallel to the elongate central axis of the
centering device at block 1130. In various embodiments, advancing a
centering device includes advancing the centering device along a
guidewire. In various embodiments, advancing a treatment device
includes advancing a treatment device through the catheter of the
centering device. In various embodiments, advancing a treatment
device includes advancing a treatment device along the central axis
of the centering device.
[0092] The method of the embodiment illustrated in FIG. 11 includes
positioning the treatment device proximate the centering device at
block 1140. In various embodiments, positioning the treatment
device proximate the centering device includes positioning the
treatment device on the proximal side of the centering device with
respect to the direction the treatment device is advanced. And, in
various embodiments, positioning the treatment device proximate the
centering device includes positioning the treatment device on the
distal side of the centering device with respect to the direction
the treatment device is advanced.
[0093] Although specific embodiments have been illustrated and
described herein, those of ordinary skill in the art will
appreciate that any arrangement calculated to achieve the same
techniques can be substituted for the specific embodiments shown.
This disclosure is intended to cover any and all adaptations or
variations of various embodiments of the invention. It is to be
understood that the above description has been made in an
illustrative fashion, and not a restrictive one. Combination of the
above embodiments, and other embodiments not specifically described
herein will be apparent to those of skill in the art upon reviewing
the above description. The scope of the various embodiments of the
invention includes any other applications in which the above
structures and methods are used. Therefore, the scope of various
embodiments of the invention should be determined with reference to
the appended claims, along with the full range of equivalents to
which such claims are entitled.
[0094] It is emphasized that the Abstract is provided to comply
with 37 C.F.R. .sctn. 1.72(b) requiring an Abstract that will allow
the reader to quickly ascertain the nature of the technical
disclosure. It is submitted with the understanding that it will not
be used to limit the scope of the claims.
[0095] In the foregoing Detailed Description, various features are
grouped together in a single embodiment for the purpose of
streamlining the disclosure. This method of disclosure is not to be
interpreted as reflecting an intention that the embodiments of the
invention require more features than are expressly recited in each
claim. Rather, as the following claims reflect, inventive subject
matter lies in less than all features of a single disclosed
embodiment. Thus, the following claims are hereby incorporated into
the Detailed Description, with each claim standing on its own as a
separate embodiment.
* * * * *