Endovascular devices and methods for exploiting intramural space

Patent metadata

Field	Value
Publication number	US-12295597-B2
Application number	US-202318243309-A
Country	US
Kind code	B2
Filing date	Sep 7, 2023
Priority date	Sep 12, 2005
Publication date	May 13, 2025
Grant date	May 13, 2025

Abstract

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing a first intravascular device having a distal portion with a concave side, inserting the first device into the vascular lumen, positioning the distal portion in the vascular wall, and orienting the concave side of the distal portion toward the vascular lumen.

First claim

What is claimed is:

1. An intravascular device for exploiting subintimal space within a vascular wall of a vessel, comprising:
an elongate shaft including a bulbous distal tip, a first lumen extending through the elongate shaft to a distalmost extent of the bulbous distal tip, an elongate side port disposed proximal of the bulbous distal tip, and a second lumen extending through the elongate shaft to the elongate side port; and
a deployable element comprising a proximal portion disposed within the second lumen and a distal portion disposed within the elongate side port;
wherein distal advancement of the proximal portion of the deployable element causes the distal portion of the deployable element to protrude radially outward from the elongate side port.

2. The intravascular device of claim 1 , wherein a distal end of the deployable element remains within the elongate shaft when the distal portion of the deployable element extends radially outward from the elongate side port.

3. The intravascular device of claim 1 , wherein the distal portion of the deployable element forms a radial curvature with a concave side facing toward a true lumen of the vessel when the distal portion of the deployable element protrudes radially outward from the elongate side port within the vascular wall.

4. The intravascular device of claim 1 , wherein the distal portion of the deployable element forms a U-shape when the distal portion of the deployable element protrudes radially outward from the elongate side port.

5. An intravascular device for exploiting subintimal space within a vascular wall of a vessel, comprising:
an elongate shaft including a bulbous distal tip, a first lumen extending through the elongate shaft to a distalmost extent of the bulbous distal tip, a recess formed in an outer surface of the elongate shaft proximal of the bulbous distal tip, and a second lumen extending through the elongate shaft to the recess; and
a deployable element disposed within the recess and extending proximally within the second lumen from the recess in a delivery configuration;
wherein the deployable element is configured to shift between the delivery configuration in which the deployable element is disposed within a circumference defined by an outer surface of the elongate shaft and an expanded configuration in which at least a portion of the deployable element extends radially outward of the circumference defined by the outer surface of the elongate shaft;
wherein distal advancement of the proximal portion of the deployable element causes the deployable element to shift toward the expanded configuration.

6. The intravascular device of claim 5 , wherein in the expanded configuration a distal end of the deployable element is not disposed outside of the elongate shaft.

7. The intravascular device of claim 5 , wherein in the expanded configuration the deployable element assumes a preformed shape outside of the elongate shaft.

8. The intravascular device of claim 7 , wherein the preformed shape includes a first segment extending circumferentially from a proximal end of the recess to a first bend, a second segment extending circumferentially from a distal end of the recess to a second bend, and a third segment extending from the first bend to the second bend.

9. The intravascular device of claim 8 , wherein in the expanded configuration the first segment and the second segment extend generally perpendicular to a central longitudinal axis of the elongate shaft.

10. The intravascular device of claim 5 , wherein distal advancement of the proximal portion with the deployable element disposed within the subintimal space causes the deployable element to extend circumferentially within the vascular wall.

11. The intravascular device of claim 10 , wherein in the expanded configuration the deployable element is configured to extend circumferentially around at least 25% of a circumference of a true lumen of the vessel.

12. The intravascular device of claim 11 , wherein in the expanded configuration the deployable element is configured to extend circumferentially around at least 40% of a circumference of a true lumen of the vessel.

13. The intravascular device of claim 5 , wherein in the expanded configuration the bulbous distal tip is configured to direct a re-entry device advanced through the first lumen toward a true lumen of the vessel.

14. An intravascular device for exploiting subintimal space within a vascular wall of a vessel, comprising:
an elongate shaft including a bulbous distal tip, a first lumen extending through the elongate shaft to a distalmost extent of the bulbous distal tip, a longitudinally oriented recess formed in an outer surface of the elongate shaft proximal of the bulbous distal tip, and a second lumen extending within the elongate shaft proximally from the recess; and
a deployable element disposed within the recess and extending proximally within the second lumen from the recess in a straightened configuration;
wherein the deployable element is configured to shift between the straightened configuration in which the deployable element extends axially along the elongate shaft and an expanded configuration in which a portion of the deployable element extends radially outward of a circumference defined by an outer surface of the elongate shaft;
wherein distal advancement of a proximal portion of the deployable element causes the deployable element to shift toward the expanded configuration.

15. The intravascular device of claim 14 , wherein in the straightened configuration the deployable element extends substantially parallel to a central longitudinal axis of the elongate shaft.

16. The intravascular device of claim 14 , wherein in the expanded configuration, a section of the proximal portion of the deployable element forms the portion of the deployable element extending radially outward of the circumference defined by the outer surface of the elongate shaft.

17. The intravascular device of claim 14 , wherein in the expanded configuration within the subintimal space, the portion of the deployable element extending radially outward of the circumference defined by the outer surface of the elongate shaft forms a radial curvature having a concave side facing toward a true lumen of the vessel.

18. The intravascular device of claim 14 , wherein the portion of the deployable element extending radially outward of the circumference defined by the outer surface of the elongate shaft in the expanded configuration excludes a distalmost end of the deployable element.

19. The intravascular device of claim 14 , wherein distal advancement of the proximal portion of the deployable element engages a distalmost end of the deployable element against a stop disposed within the elongate shaft.

20. The intravascular device of claim 19 , wherein the stop is disposed distal of the recess.

Assignees

• Boston Scient Scimed Inc

Inventors

• Kugler Chad J
• Olson Matthew J
• Atkinson Robert E

Classifications

• A61M2025/0197

  for creating an artificial passage within the body, e.g. in order to go around occlusions · CPC title

• A61M25/104

  used for angioplasty · CPC title

• A61M25/0194

  Tunnelling catheters · CPC title

• A61B17/3417

  Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating (syringe needles A61M5/32; dilators A61M29/00) · CPC title

• A61M2025/006

  having a special surface topography or special surface properties, e.g. roughened or knurled surface · CPC title