Anchoring and Non-Occluding Intravascular Device for Use During Clot Removal Via Aspiration and/or Mechanical Extraction Device
20220233204 · 2022-07-28
Inventors
Cpc classification
A61B17/22
HUMAN NECESSITIES
A61B17/221
HUMAN NECESSITIES
International classification
A61B17/22
HUMAN NECESSITIES
Abstract
An anchoring and non-occluding intravascular device including a guide catheter and an anchor supporting structure disposed on the guide catheter and deployable from a contracted state to an enlarged state having an enlarged outer diameter relative to that while in a contracted state. In both the contracted and in the enlarged state the anchor supporting structure is configured to allow passage of blood distally beyond the anchor supporting structure; and the anchoring is provided exclusively by the anchor supporting structure. In use, prior to capture and retrieval of a clot within a vessel, the anchor supporting structure being deployed from the contracted state to the enlarged state. While in the enlarged state, the deployed anchor supporting structure anchoring in place the guide catheter in the vessel while still allowing blood flow through the vessel distally beyond the deployed anchor supporting structure.
Claims
1. An anchoring and non-occluding intravascular device comprising: a guide catheter including a catheter shaft with a proximal end, an opposite distal end, and a lumen defined longitudinally therein; and an anchor supporting structure disposed on the guide catheter and deployable from a contracted state to an enlarged state having an enlarged outer diameter relative to that while in a contracted state; wherein in both the contracted and in the enlarged state the anchor supporting structure is configured to allow passage of blood distally beyond the anchor supporting structure; and wherein the anchoring is provided exclusively by the anchor supporting structure.
2. The anchoring and non-occluding intravascular device of claim 1, wherein the anchor supporting structure is a mesh anchor supporting structure having a proximal end and an opposite free distal end, the proximal end of the mesh anchor supporting structure is mounted to the distal end of the catheter shaft of the guide catheter.
3. The anchoring and non-occluding intravascular device of claim 2, wherein, while in the contracted state, the free distal end of the mesh anchor supporting structure is invertible within itself and receivable inside the lumen of the catheter shaft.
4. The anchoring and non-occluding intravascular device of claim 2, wherein the mesh anchor supporting structure is cone shape, cylindrical shape or a combination thereof.
5. The anchoring and non-occluding intravascular device of claim 2, further comprising: a protective sleeve disposed about the catheter shaft of the guide catheter and anchor supporting structure while in the contracted state; and a wire secured to a proximal end of the protective sleeve and extending in a proximal direction.
6. The anchoring and non-occluding intravascular device of claim 2, further comprising: a balloon catheter disposed within the lumen of the guide catheter; wherein the balloon catheter has a catheter shaft with at least one lumen extending axially therethrough for inflating/deflating a compliant balloon mounted to a distal end of the catheter shaft of the balloon catheter and aligned in a longitudinal direction within the anchor supporting structure; wherein the inflated compliant balloon transitioning the anchor supporting structure from the contracted state to the enlarged state.
7. The anchoring and non-occluding vascular device of claim 1, further comprising a compliant balloon disposed proximate the distal end of the catheter shaft of the guide catheter; the compliant balloon being inflatable via an inflation lumen extending longitudinally therein the catheter shaft of the guide catheter; wherein in an inflated state the compliant balloon: (i) has a C-shape or U-shape profile that includes two arm sections each terminating in a free end and an intermediate curved section between the two arm sections; and (ii) is disposed partially around an outer circumference of the catheter shaft of the guide catheter.
8. A method for using an anchoring and non-occluding intravascular device including a guide catheter including a catheter shaft with a proximal end, an opposite distal end, and a lumen defined longitudinally therein; and an anchor supporting structure deployable from a contracted state to an enlarged state having an enlarged outer diameter relative to that while in the contracted state, wherein while in both the contracted state and the enlarged state the anchor supporting structure is configured to allow passage of blood distally beyond the anchor supporting structure; the method comprising the steps of: prior to capture and retrieval of a clot within a vessel, deploying the anchor supporting structure from the contracted state to the enlarged state; while in the enlarged state, the deployed anchor supporting structure anchoring in place the guide catheter in the vessel while still allowing blood flow through the vessel distally beyond the deployed anchor supporting structure; and wherein the anchoring of the guide catheter within the vessel is provided exclusively by the anchor supporting structure.
9. The method of claim 8, wherein the anchor supporting structure is a mesh anchor supporting structure having a proximal end and an opposite free distal end; the proximal end of the mesh anchor supporting structure is mounted to the distal end of the catheter shaft of the guide catheter.
10. The method of claim 9, wherein the deploying step comprises using a pushing device advanced through the lumen of the guide catheter to push out from the distal end of the catheter shaft the free distal end of the mesh anchor supporting structure while in the contracted state inverted within itself and received within the lumen at the distal end of the catheter shaft.
11. The method of claim 9, wherein the mesh anchor supporting structure is cone shape, cylindrical shape, or a combination thereof.
12. The method of claim 9, wherein the deploying step comprises retracting in a proximal direction a protective sleeve disposed about the catheter shaft of the guide catheter and anchor supporting structure while in the contracted state using a wire.
13. The method of claim 9, wherein the anchoring and non-occluding intravascular device further comprise a deflated compliant balloon mounted to a distal end of a balloon catheter disposed within the lumen of the guide catheter, wherein the deflated compliant balloon is aligned in a longitudinal direction within the mesh anchor supporting structure; and the deploying step comprises, after the deflated compliant balloon and anchor supporting structure fully emerge from the distal end of the guide catheter, inflating the balloon with inflation media thereby expanding the mesh anchor supporting structure to physically contact and anchor within an inner wall of the vessel the mesh anchor supporting structure and the guide catheter mounted thereto.
14. The method of claim 8, wherein the anchor supporting structure is a compliant balloon disposed partially about a circumference of the catheter shaft proximate the distal end of the guide catheter; and the deploying step comprises inflating the compliant balloon via inflation media introduced through an inflation lumen defined in the guide catheter; wherein in an inflated state the compliant balloon has a C-shape or U-shape profile including two arm sections each terminating in a free end and an intermediate curved section between the two arm sections.
15. The method of claim 14, wherein a portion of the intermediate curved section of the inflated compliant balloon physically contacts an inner wall of the vessel anchoring the guide catheter in place within the vessel while spaces defined between the two arm sections of the inflated compliant balloon and the inner wall of the vessel allow blood flow therethrough and distally beyond the inflated compliant balloon.
16. The method of claim 8, wherein capture and retrieval of the clot comprises aspiration and/or mechanical extraction device.
Description
BRIEF DESCRIPTION OF THE DRAWING
[0008] The foregoing and other features of the present invention will be more readily apparent from the following detailed description and drawings illustrative of the invention wherein like reference numbers refer to similar elements throughout the several views and in which:
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DETAILED DESCRIPTION OF THE INVENTION
[0020] The terms “distal” or “proximal” are used in the following description with respect to a position or direction relative to the treating physician or medical interventionalist. “Distal” or “distally” are a position distant from or in a direction away from the physician or interventionalist. “Proximal” or “proximally” or “proximate” are a position near or in a direction toward the physician or medical interventionalist. The terms “occlusion”, “clot” or “blockage” are used interchangeably.
[0021] The present inventive anchoring and non-occluding intravascular device provides back-up support that prevents or minimizes proximal movement of the guide catheter during subsequent medical procedures (e.g., aspiration and/or mechanical retrieval of the clot) without occluding (e.g., cutting off completely or entirely stopping) blood flow through the artery/vessel distally beyond the deployed anchoring and non-occluding intravascular device. In some configurations the present inventive anchoring and non-occluding intravascular device includes a self-expanding anchor structure (e.g., skeleton, frame, perforated or mesh structure) having a plurality of openings defined therein that allows blood flow distally beyond when deployed. While in an expanded/enlarged/deployed state, the anchor structure maintains the position of the guide catheter within the artery/vessel during capture and retrieval of the occlusion while permitting blow flow distally beyond the deployed anchor structure. In another embodiment of the present invention, rather than using a self-expanding structure, an inflatable balloon or other radially outward mechanical expanding device may be used with the singular or only purpose to deploy (expand/enlarge) the anchor supporting structure (i.e., the balloon in this configuration is not being used as the anchor supporting structure itself to maintain the guide catheter in place within the artery/vessel). Yet in still another embodiment of the present invention, an inflatable balloon itself may serve as the anchor supporting structure to maintain the guide catheter in position (prevent or minimize back-up) within the artery/vessel, but such design of the inflatable balloon still intentionally allows at blood flow (i.e., the inflated balloon neither occludes nor stops blood flow) distally beyond the deployed balloon.
[0022] Referring to
[0023] In preparation of being introduced into the vessel or artery 97, the anchor supporting structure 110, 110′ while maintained in a wrapped-down, folded or otherwise compressed/contracted state (having a reduced outer diameter relative to that while in an expanded/enlarged state) is tucked/flipped/inverted within itself to be received inside the lumen 115 proximate the distal end 125 of the catheter shaft 105 of the guide catheter 100, as illustrated in
[0024] Other mechanical configurations are contemplated for maintaining the anchor supporting structure in a compressed/contracted state having a reduced outer diameter prior to being deployed (during delivery to a target site within the artery/vessel). For instance, the anchor supporting structure may be retained in a compressed/contracted state (having a reduced outer diameter) by a protective sleeve disposed about the outer perimeter of the mesh anchor supporting structure, rather than by the inner wall of the lumen 115 of the catheter shaft 105 of the guide catheter 100 (as depicted in
[0025] As an alternative to employing a self-expanding anchor supporting structure automatically transitioning to an expanded state having an enlarged diameter upon removal of a mechanical constraining device (e.g., lumen of the guide catheter or protective sleeve), an anchor supporting structure may be employed that deploys (i.e., expands in diameter) only upon application of a mechanical radially outward expanding force. In this configuration, an inflatable compliant balloon or other mechanical expansion device may be used, wherein the balloon is used for the sole purpose of deploying the anchor supporting structure to its expanded state having an enlarged outer diameter. In other words, the compliant balloon itself when inflated never physically contacts the inner wall of the artery/vessel and thus no back-up support is provided by the inflated compliant balloon itself. Instead of relying on the balloon, movement (back-up) of the guide catheter is prevented or minimized only by the deployed anchor supporting structure 110, 110′ in an expanded state physically contacting the inner wall of the artery/vessel. A series of catheters may be employed in accordance with this embodiment as illustrated in
[0026] In yet another configuration an inflatable compliant balloon may be used itself as the anchor supporting structure. Contrary to conventional balloon guide catheters wherein the inflated balloon is intended to occlude blood flow, the design of the balloon itself as the anchor supporting structure in this configuration of the present inventive anchoring and non-occluding intravascular device intentionally allows at least a certain amount of blood flow distally beyond the inflated balloon in spaces defined between the inner wall of the artery/vessel and the inflated balloon. To achieve this desired goal, the present inventive balloon anchor supporting structure is geometrically designed so that in an inflated/expanded state the inflated balloon maintains the guide catheter in place within the artery/vessel prior to capture and thereafter retrieval of the clot while permitting blood flow distally beyond the inflated balloon. An ancillary or supplemental catheter 400 tracks over a guide wire within the artery/vessel 450 to a position on a proximal side or face of the clot, blockage or occlusion. A compliant balloon 655 (while in a deflated state) is wrapped partially about the outer perimeter of a guide catheter proximate its distal end. The guide catheter with the wrapped about deflated balloon 655 together are introduced into a proximal end of the lumen 415 of the ancillary or supplemental catheter 400.
[0027] In operation, a guidewire is introduced into the vessel/artery to a desired location on a proximal side of the target clot, occlusion or blockage. Typically, the guidewire is introduced into the body via the carotid artery for anterior vasculature access or the subclavian artery for posterior vascular access. However, other arteries/vessels may be selected based on the location in the body of the targeted clot, blockage or occlusion. Once the guidewire is properly positioned, an ancillary or supplemental catheter is advanced over the guidewire (i.e., the guidewire is received within the lumen of the ancillary or supplemental catheter) to the proximal side of the clot, blockage or occlusion using standard imaging, e.g., X-ray imaging. Next, the guide catheter 100 together with the anchor supporting structure (in a retracted or compressed state) is introduced into the proximal end of the ancillary or supplemental catheter 400 and advanced through the lumen to the opposite distal end. Upon emerging from the distal end of the ancillary or supplemental catheter, the anchor supporting structure 110, 110′ is deployed to an expanded state. Deployment of the anchor supporting structure depends on the specific design of the device. In
[0028] Numerous benefits are provided by the present inventive anchoring and non-occluding intravascular device over conventional guide catheters that employ a balloon to provide back-up support to the guide catheter. As previously mentioned, an advantage of the present inventive anchoring and non-occluding intravascular device is that there is no occlusion (completely cutting off or entirely stopping) of blood flow distally beyond the deployed anchor supporting structure. Even when deployed the present inventive anchor supporting structure allows the flow of blood distally thereof. Moreover, in those embodiments of the present inventive anchoring and non-occluding intravascular device in which the balloon itself has been eliminated altogether and replaced by a mesh anchor supporting structure, the need for a separate lumen to inflate the balloon is also unnecessary. Elimination altogether of the inflation lumen allows for a larger inner diameter lumen (e.g., approximately 0.082″-approximately 0.091″) of the guide catheter able to accommodate ancillary devices (e.g., microcatheters) therein having a larger outer diameter. Because the present inventive anchor supporting structure is deployed before the microcatheter and stentriever are introduced into the lumen of the guide catheter, this novel configuration provides anchoring or restraint of movement of the guide catheter where it really counts (i.e., during clot retrieval and/or aspiration). An additional benefit of the present inventive perforated or mesh anchoring structure is that it may be stiffened by double braiding (e.g., one inner braid forming the lumen and a second outer braid forming a wire protective cage) to prevent or minimize collapse of the distal tip of the guide catheter during aspiration. During retrieval of the microcatheter and stentriever with the clot embedded therein, the funnel (cone) or cylindrical shape of the perforated or mesh structure encases the captured clot, blockage or occlusion thereby improving the performance efficiency of full retrieval.
[0029] Yet another benefit of the present inventive anchoring and non-occluding intravascular device over conventional balloon guide catheters is the reduced cost of manufacture in several respects. Balloons of conventional guide catheters are required to remain intact at relative high pressure for a relatively long time and expand with accurate symmetry—all of such manufacturing considerations or requirements of which are not capable of being tested. The present inventive mesh anchor supporting structure is a simple assembly that eliminates the need for such manufacturing requirements. Furthermore, balloons of conventional guide catheters must be manufactured of a relatively soft polymer, exhibiting relative high elongation properties, and a relatively long shelf life to ensure proper expansion. These considerations make the balloon the weak point of the design of conventional balloon guide catheters and are very expensive to manufacture. In contrast, the guide catheter shaft to which the mesh anchor supporting structure is mounted in the present inventive anchor and non-occluding intravascular device has fewer segments than a conventional balloon guide catheter thereby lowering the cost of manufacture.
[0030] Since back-up support is provided by the anchor supporting structure rather than the construction of the guide catheter itself, still yet another benefit of the present inventive anchoring and non-occluding intravascular device is that the entire length of the guide catheter may be coated with a hydrophilic coating to assist in trackability.
[0031] Thus, while there have been shown, described, and pointed out fundamental novel features of the invention as applied to a preferred embodiment thereof, it will be understood that various omissions, substitutions, and changes in the form and details of the systems/devices illustrated, and in their operation, may be made by those skilled in the art without departing from the spirit and scope of the invention. For example, it is expressly intended that all combinations of those elements and/or steps that perform substantially the same function, in substantially the same way, to achieve the same results be within the scope of the invention. Substitutions of elements from one described embodiment to another are also fully intended and contemplated. It is also to be understood that the drawings are not necessarily drawn to scale, but that they are merely conceptual in nature. It is the intention, therefore, to be limited only as indicated by the scope of the claims appended hereto.
[0032] Every issued patent, pending patent application, publication, journal article, book or any other reference cited herein is each incorporated by reference in their entirety.