Devices and methods for vascular recanalization

Patent metadata

Field	Value
Publication number	US-10300256-B2
Application number	US-201514692453-A
Country	US
Kind code	B2
Filing date	Apr 21, 2015
Priority date	Feb 23, 2010
Publication date	May 28, 2019
Grant date	May 28, 2019

Abstract

In some embodiments, a medical device for recanalizing a vessel having a blockage and restoring blood flow through an obstructed blood vessel includes an expandable member coupled to a core wire and a hypotube that are movable relative to each other to manipulate the expandable member between various configurations. The expandable member having a capture structure in an expanded configuration. The expandable member can include multiple interstices formed by woven mesh filaments or braided strands through which the material blocking the vessel can pass. The capture structure can include a shape on its external surface that facilitates dislodgement and capture of the material within capture spaces created by the expandable member. Some embodiments include a capture sack or cap for capturing material and preventing material from migrating down stream of the blockage. Superoxygenated blood can be infused distal to the blockage to minimize loss of function during an ischemic event.

First claim

What is claimed is:

1. A method of treating ischemic stroke comprising:
delivering a recanalization device to a neurovascular embolism that at least partially restricts blood flow through a blood vessel, the recanalization device including a tubular member, an elongate member movably disposed within the tubular member, and a self-expanding, braided expandable member constrained at a distal end to the elongate member and at a proximal end to the tubular member;
actuating the recanalization device so that the expandable member expands radially outward in a controlled manner from a collapsed configuration to an expanded configuration to engage at least a portion of the neurovascular embolism and so as to provide controlled blood flow reperfusion through the embolism and treatment of ischemic stroke, wherein the expandable member defines a plurality of openings in a wall of the expandable member and an interior region in fluid communication with the plurality of openings so that at least a portion of the neurovascular embolism enters through at least one opening and into the interior region as the expandable member engages the neurovascular embolism;
actuating the recanalization device to twist the expandable member from the expanded configuration to a contoured, tortuous, or helical configuration;
moving the recanalization device and at least a portion of the neurovascular embolism along the blood vessel; and
withdrawing the recanalization device and at least a portion of the neurovascular embolism from the blood vessel.

2. The method of claim 1 , wherein the expandable member comprises a braid or mesh formed from a shape memory material, and wherein the expandable member has a biased predetermined shape in the expanded configuration.

3. The method of claim 2 , wherein actuating the recanalization device in a controlled manner comprises applying a controlled radial force with the mesh or braid of the expandable member to expand through the neurovascular embolism and masticate or disrupt the neurovascular embolism.

4. The method of claim 1 , wherein actuating the recanalization device comprises retracting the elongate member proximally relative to the tubular member so as to laterally compress the neurovascular embolism against a wall of the blood vessel along a length of the expandable member.

5. The method of claim 1 , wherein actuating the recanalization device comprises axially adjusting a relative position of the tubular member constraining the expandable member at a proximal end or the elongate member constraining the expandable member at a distal end relative to one another so as to laterally compress the neurovascular embolism against a wall of the blood vessel along a length of the expandable member.

6. The method of claim 1 , further comprising infusing an oxygenated or superoxygenated blood through a lumen of the elongate member and into the blood vessel distal to the neurovascular embolism.

7. The method of claim 1 , further comprising accessing an arterial blood vessel by advancing a microcatheter into the arterial blood vessel and through the embolism and then inserting the recanalization device through a lumen of the microcatheter and out of a distal end thereof to a position the expandable member adjacent to or within the embolism.

8. The method of claim 1 , wherein the expandable member in the contoured, tortuous, or helical configuration comprises spiral shelves, and the method further comprises disrupting and capturing at least a second portion of the neurovascular embolism with the spiral shelves.

9. The method of claim 8 , wherein actuating the recanalization device from the expanded configuration to the contoured, tortuous, or helical configuration comprises rotating the elongate member relative to the tubular member, rotating the tubular member relative to the elongate member, or rotating both the tubular member and the elongate member in opposite directions relative to each other.

10. A method of treating a thrombus in a circulatory blood vessel, the method comprising:
delivering a clot treatment device to a thrombus that at least partially restricts blood flow through a blood vessel, the clot treatment device including a tubular member, an elongate member movably disposed within the tubular member, and a self-expanding, braided expandable member coupled at a distal end to a distal portion of the elongate member and at a proximal end to a distal portion of the tubular member, wherein the expandable member is a porous mesh;
actuating the clot treatment device so that the expandable member expands radially outward in a controlled manner from a collapsed configuration to a first expanded configuration to engage at least a portion of the thrombus so as to restore blood flow through the thrombus;
actuating the clot treatment device so that the expandable member twists from the first expanded configuration to a second expanded configuration after laterally compressing the thrombus against a wall of the blood vessel along a length of the expandable member so as to restore blood flow, the expandable member in the second expanded configuration forming an annular capture region along an exterior surface of the expandable member; and
retrieving and removing at least a portion of the thrombus with the expandable member in the second expanded configuration.

11. The method of claim 10 , wherein actuating the clot treatment device from the collapsed configuration to the first expanded configuration comprises axially adjusting a relative position of the tubular member or the elongate member relative to one another so as to laterally compress the thrombus against a wall of the blood vessel along the length of the expandable member.

12. The method of claim 10 , wherein actuating the clot treatment device from the first expanded configuration to the second expanded configuration comprises rotating the elongate member relative to the tubular member, rotating the tubular member relative to the elongate member, or rotating both the tubular member and the elongate member in opposite directions relative to each other so that the expandable member is twisted into the second expanded configuration having variable radial dimensions along the length of the expandable member.

13. The method of claim 10 , wherein the expandable member comprises a braid formed from a shape memory material, and wherein the expandable member has a first biased predetermined shape in the first expanded configuration and a second biased predetermined shape in the second expanded configuration.

14. The method of claim 10 , wherein the mesh comprises sections including wires or filaments of two or more thicknesses, wherein first sections have relatively thinner wires or filaments having a greater density than second sections having relatively thicker wires or filaments, such that moving the expandable member from the first expanded configuration to the second expanded configuration causes the expandable member to form a contoured, tortuous, or helical shape in the second expanded configuration due to a variation in density between the first and second sections of the mesh.

15. The method of claim 10 , wherein the expandable member comprises interstices in a wall of the expandable member and an interior volume in fluid communication with the interstices, and further wherein expanding the expandable member radially outward in a controlled manner from the collapsed configuration to the first expanded configuration captures at least a portion of the thrombus within the interior volume via at least one interstice.

16. The method of claim 10 , fu

Assignees

• Covidien Lp

Inventors

• Aboytes Maria

Classifications

• A61M2025/0004

  having two or more concentrically arranged tubes for forming a concentric catheter system · CPC title

• A61B2017/22054

  with two balloons · CPC title

• A61F2230/0076

  ellipsoidal or ovoid · CPC title

• A61M29/02 Primary

  Dilators made of swellable material {(balloon catheters for angioplasty A61M25/104)} · CPC title

• A61B2017/00867

  shape memory effect · CPC title