Inverting thrombectomy apparatuses having enhanced tracking

Patent metadata

Field	Value
Publication number	US-2019133625-A1
Application number	US-201816183149-A
Country	US
Kind code	A1
Filing date	Nov 7, 2018
Priority date	Nov 9, 2017
Publication date	May 9, 2019
Grant date	—

Abstract

Mechanical thrombectomy apparatuses, and particularly knitted rolling tube mechanical thrombectomy apparatuses configured to have improved tracking for delivery through tortious vessels are described herein. Also described herein are methods of removing clots using a mechanical thrombectomy apparatuses in which the clot is larger than the tractor portion of the mechanical thrombectomy apparatus.

First claim

What is claimed is:

1 . An inverting tube apparatus for removing a clot from a vessel, the apparatus comprising:
an inversion support catheter; a puller within a lumen of the inversion support catheter; and a flexible tube extending over a distal end of the inversion support catheter, the flexile tube having a first end coupled at a distal end region of the puller and a second end comprising a cuff that is less flexible that a region of the flexible tube adjacent to the cuff, wherein the flexible tube is configure to be pulled proximally into the inversion support catheter by pulling the puller proximally so that the flexible tube rolls and inverts over a distal end of the inversion support catheter.

2 . The apparatus of claim 1 , wherein the cuff comprises one or more slits along its length extending in a proximal-to-distal direction.

3 . The apparatus of claim 1 , wherein the cuff comprises a polymeric material.

4 . The apparatus of claim 1 , further comprising a cuff retainer configured to prevent the cuff from extending over the distal end of the inversion support catheter.

5 . The apparatus of claim 4 , wherein the cuff retainer comprises one or more filaments coupling the cuff to the inversion support catheter.

6 . The apparatus of claim 4 , wherein the cuff retainer comprises a mechanical stop on the inversion support catheter.

7 . The apparatus of claim 4 , wherein the cuff retainer comprises one or more filament connecting the cuff to the puller through a lateral opening in the inversion support catheter.

8 . The apparatus of claim 4 , wherein a proximal-facing end of the cuff is tapered.

9 . The apparatus of claim 4 , wherein a proximal-facing end of the cuff comprises a low-profile scaffolding extending at least partially around the perimeter of the cuff.

10 . The apparatus of claim 1 , further comprising a first proximal port configured to couple with a vacuum source to apply vacuum through the puller.

11 . The apparatus of claim 1 , further comprising a second proximal port configured to couple with a vacuum source to apply vacuum between the intermediate catheter and the inversion support catheter.

12 . The apparatus of claim 1 , wherein the intermediate catheter is configured to push the cuff over the distal end of the inversion support catheter when the intermediate catheter is advanced distally past the cuff

13 . The apparatus of claim 1 , wherein the flexible tube comprises a knit.

14 . The apparatus of claim 1 , wherein the cuff is radiopaque.

15 . An inverting tube apparatus for removing a clot from a vessel, the apparatus comprising:
an inversion support catheter; a puller within a lumen of the inversion support catheter; and a flexible tube extending over a distal end of the inversion support catheter, the flexile tube having a first end coupled at a distal end region of the puller and a second end comprising a cuff that is less flexible that a region of the flexible tube adjacent to the cuff, wherein the flexible tube is configure to be pulled proximally into the inversion support catheter by pulling the puller proximally so that the flexible tube rolls and inverts over a distal end of the inversion support catheter, and wherein the cuff is tapered at the proximal facing end.

16 . An inverting tube apparatus for removing a clot from a vessel, the apparatus comprising:
an intermediate catheter; an inversion support catheter within a lumen of the intermediate catheter; a puller within a lumen of the inversion support catheter; and a knitted tube extending over the inversion support catheter, the knitted tube having a first end coupled at a distal end region of the puller and a second end that is free, wherein the knitted tube is configured to be pulled proximally into the inversion support catheter by pulling the puller proximally so that the knitted tube rolls and inverts over a distal end of the inversion support catheter, wherein the knitted tube comprises a filament knitted to form a plurality of interlocking loop stitches, and wherein each loop stitch has a stitch length that is between 0.5 mm and 10 mm.

17 . The apparatus of claim 16 , wherein the knitted tube extends over the inversion support catheter with an inner diameter that is within 20% of the outer diameter of the inversion support catheter.

18 . The apparatus of claim 16 , wherein the second end of the knitted tube comprises a cuff that is less flexible that a region of the knitted tube adjacent to the cuff

19 . An inverting mechanical thrombectomy apparatus for removing a clot from a vessel configured to be delivered through a tortious anatomy, the apparatus comprising:
an inversion support catheter extending distally, the inversion support catheter having a distal end and a distal end opening, the inversion support catheter comprising a plurality of slots or cut-out regions along its length to enhance flexibility while maintaining column strength such that the inversion support catheter is able to withstand at least about 500 g of compressive force; a puller extending distally within the inversion support catheter; and a flexible tube extending proximally from a distal end region of the puller, wherein the flexible tube comprises a knitted material that is held in compression along an outside region of the inversion support catheter and inverts over the distal end opening of the inversion support catheter and couples to the puller, and wherein pulling the puller proximally causes the flexible tube to roll from the outside region of the inversion support catheter, over the distal end opening and invert into the inversion support catheter.

Assignees

• Stryker Corp

Inventors

• Wallace Michael P
• Garabedian Robert
• Leguidleguid Roy
• Greenhalgh E Skott

Classifications

• A61B2017/2215

  having an open distal end · CPC title

• A61B17/22031 Primary

  Gripping instruments, e.g. forceps, for removing or smashing calculi (A61B17/221 takes precedence) · CPC title

• A61M25/0074

  Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable · CPC title

• A61B17/320725

  with radially expandable cutting or abrading elements (A61B17/32075 takes precedence) · CPC title

• A61B2017/22079

  with suction of debris · CPC title