Abstract
An intravascular articulating retrieval apparatus may be used to move objects within the vasculature, such as to remove an intravascular filter, tissue and other items from the vasculature. The apparatus has a user interface to manipulate a first and second actuating portion that are coupled to the distal end of the apparatus conduit. A retrieval apparatus may include forceps coupled to the second actuating portion whereby the retrieval actuator opens and closes the forceps for retrieval of an IVF or other device, such as stent or stent graft. An intravascular articulating retrieval apparatus may be used to dissect thrombus from the interior of the vascular wall, move a stent or remove a portion of a stent or stent graft to provide better blood flow or to allow blood flow into a branched vessel.
Claims
1. An Intravascular articulated and actuating retrieval apparatus comprising: a) a mechanical user interface on an interface end; b) catheter coupled to and extending from the user interface, said catheter comprising: i) user end coupled to the user interface; ii) a distal end; and iii) an apparatus conduit extending from the user end to the distal end; c) a first actuating portion coupled to the distal end of the apparatus conduit and comprising a first pivot, d) a retrieval implement coupled to the first actuating portion and comprising a first retrieval implement portion: said user interface comprising: i) a first actuator configured to actuate the first actuating portion to rotate about said first pivot; and ii) a retrieval actuator configured to actuate said first retrieval implement portion from an open position to a closed position; e) a first actuating portion first line extending from the first actuating portion to the first actuator and through the apparatus conduit; f) a retrieval line extending from the retrieval implement to the retrieval actuator and through the apparatus conduit; g) a first actuating portion second line extending from the first actuating portion to the first actuator and through the apparatus conduit; wherein the first actuator comprises a first manipulator coupled to the first actuating portion first line and the first actuating portion second line; wherein rotation of the first manipulator in a first manipulator direction pulls the first actuating portion first line to rotate the first actuating portion about the first pivot a first rotational direction and wherein rotation of the first manipulator in a second manipulator direction, opposite the first manipulator direction, pulls the first actuating portion second line to rotate the first actuating portion about the first pivot a second rotational direction, opposite the first rotational direction; h) a second actuating portion coupled to the first actuating portion by a second pivot; wherein the second actuating portion is distal the first actuating portion and wherein the user interface comprises a second actuator configured to actuate the second actuating portion to rotate about said second pivot; i) a second actuating portion first line extending from the second actuating portion to the second actuator and through the apparatus conduit; wherein the second actuator comprises a second manipulator coupled to the second actuating portion first line, wherein rotation of said second manipulator in a first manipulator direction pulls the second actuating portion first line to rotate the second actuating portion about the second pivot a first rotational direction; j) a second actuating portion second line extending from the second actuating portion to the second actuator and through the apparatus conduit, wherein the second manipulator is coupled to the second actuating portion second line, wherein rotation of the second manipulator in a second manipulator direction, opposite the first manipulator direction, pulls the second actuating portion second line to rotate the second actuating portion about the second pivot a second rotational direction, opposite the first rotational direction.
2. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the first manipulator is a paddle.
3. The Intravascular articulated and articulating retrieval apparatus of claim 2, wherein the rotational axis of the paddle is orthogonal to the length axis of the apparatus conduit.
4. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the second actuating portion rotates orthogonally to the first actuating portion.
5. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the second manipulator is a second paddle.
6. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the rotational axis of the second paddle is orthogonal to the length axis of the apparatus conduit.
7. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the first manipulator is a first dial and the second manipulator is a second dial.
8. The Intravascular articulated and articulating retrieval apparatus of claim 7, wherein the first dial is coupled to a first worm gear and wherein the first actuating portion first line is coupled to the first worm gear and wherein the second dial is coupled to a second worm gear and wherein the second actuating portion first line is coupled to the second worm gear.
9. The Intravascular articulated and articulating retrieval apparatus of claim 8, wherein the first actuating portion second line is coupled to the first worm gear and wherein the second actuating portion second line is coupled to the second worm gear.
10. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the first manipulator is a paddle.
11. The Intravascular articulated and articulating retrieval apparatus of claim 10, wherein the rotational axis of the paddle is orthogonal to the length axis of the apparatus conduit.
12. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the first manipulator is a dial.
13. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the apparatus conduit outer diameter is no more than 20 French.
14. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the apparatus conduit outer diameter is no more than 18 French.
15. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the apparatus conduit outer diameter is no more than 10 French.
16. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the retrieval actuator comprises a retrieval manipulator coupled to the retrieval line, wherein manipulation of the retrieval manipulator in a first direction moves the first retrieval implement portion to a closed position; wherein the retrieval implement is a forceps comprising: i) a first actuating jaw coupled to a jaw pivot; and ii) a second jaw.
17. The Intravascular articulated and articulating retrieval apparatus of claim 16, wherein at least one of the jaws has a serrated edge.
18. The Intravascular articulated and articulating retrieval apparatus of claim 16, wherein both the first and second jaws have a serrated edge.
19. The Intravascular articulated and articulating retrieval apparatus of claim 16, wherein the forceps comprises at least one jaw that has a blade edge.
20. The Intravascular articulated and articulating retrieval apparatus of claim 16, wherein the first and second jaws form a retainer aperture in a closed position.
21. The Intravascular articulated and articulating retrieval apparatus of claim 16, wherein the forceps is a scissor jaw wherein at least one of the first or second jaws has a blade edge and wherein the first and second jaws are configured to extend past each other and overlap in a closed position.
22. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the retrieval implement is a tweezer jaws; and wherein the tweezer jaws have extended ends that extend past each other and overlap in a closed position.
23. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the retrieval implement is an expandable funnel sheath comprising: a) an extended end forming an opening into said expandable funnel sheath; and b) a coupled end coupled to the apparatus conduit; wherein the expandable funnel sheath is manipulated by the retrieval line to open and close, wherein in an open position, the expandable funnel sheath tapers from the extended end towards the coupled end and wherein in a closed position the extended end is collapsed radially inward.
24. The Intravascular articulated and articulating retrieval apparatus of claim 1, wherein the retrieval implement is a hook.
Description
BRIEF DESCRIPTION OF SEVERAL VIEWS OF THE DRAWINGS
(1) The accompanying drawings are included to provide a further understanding of the invention and are incorporated in and constitute a part of this specification, illustrate embodiments of the invention, and together with the description serve to explain the principles of the invention.
(2) FIG. 1 shows a side view of an exemplary actuating retrieval apparatus having a user interface and a forceps end having forceps having a first and second jaw.
(3) FIG. 2 shows a top view of the exemplary articulating retrieval apparatus shown in FIG. 1.
(4) FIG. 3 shows a perspective view of the exemplary articulating retrieval apparatus shown in FIG. 1.
(5) FIGS. 4 to 6 show a vascular wall having an intravascular filter therein.
(6) FIG. 7 shows an introducer sheath and an exemplary articulating retrieval apparatus configured to extend into a vascular vessel through the introducer sheath.
(7) FIGS. 8 and 9 show an exemplary articulating retrieval apparatus configured in a vascular vessel and being actuated to retrieve an intravascular filter lodged in the vascular wall.
(8) FIG. 10 shows a side view of an exemplary articulating retrieval apparatus having the second actuating portion actuated orthogonally to the length axis of the apparatus conduit.
(9) FIG. 11 shows a side view of an exemplary articulating retrieval apparatus having the first actuating portion actuated orthogonally to the length axis of the apparatus conduit.
(10) FIG. 12 shows a side view of an exemplary articulating retrieval apparatus having the second actuating portion actuated orthogonally to the length axis of the apparatus conduit.
(11) FIG. 13 shows a side view of an exemplary articulating retrieval apparatus having the first jaw open.
(12) FIG. 14 shows a side view of an exemplary articulating retrieval apparatus having the first jaw closed.
(13) FIG. 15 shows a top view of a user interface of the exemplary articulating retrieval apparatus having a first actuator and first manipulator and a second actuator and second manipulator.
(14) FIG. 16 shows a side view of an exemplary articulating retrieval apparatus having the second manipulator rotated to actuate the second actuating portion and the forceps coupled thereto.
(15) FIGS. 17 and 18 show a cross-sectional view of an exemplary actuator having a manipulator.
(16) FIG. 19 shows a cross-sectional view of an exemplary articulating retrieval apparatus and a first actuator having a first manipulator.
(17) FIG. 20 shows a cross-sectional view of the exemplary articulating retrieval apparatus shown in FIG. 19 with the manipulator manipulated to actuate the first actuating portion.
(18) FIG. 21 shows a cross-sectional view of an exemplary articulating retrieval apparatus and a user interface having a first and second actuator and first and second manipulators for actuating the first and second actuating portions.
(19) FIG. 22 shows a cross-sectional view of the exemplary articulating retrieval apparatus shown in FIG. 21 with the first manipulator manipulated to actuate the first actuating portion.
(20) FIG. 23 shows cut away view of a user interface having a first and second actuator and first and second manipulators for actuating the first and second actuating portions.
(21) FIGS. 24 and 25 show exemplary forceps having a first and second jaw.
(22) FIGS. 26 to 28 show exemplary forceps having a first and second jaw.
(23) FIGS. 29 to 31 show an exemplary articulating retrieval apparatus retrieving an intravascular filter from a vascular wall.
(24) FIGS. 32 to 34 show an exemplary articulating retrieval apparatus retrieving an intravascular filter from a vascular wall utilizing an inflatable balloon.
(25) FIGS. 35 and 36 show an exemplary articulating retrieval apparatus retrieving an intravascular filter from a vascular wall.
(26) FIGS. 37 to 39 show various forceps structures having a first and second jaw.
(27) FIG. 40 shows a perspective view of an exemplary actuating forceps apparatus.
(28) FIG. 41 shows a top view of exemplary articulating forceps having a retainer aperture between the jaws.
(29) FIG. 42 shows a side view of the exemplary articulating forceps shown in FIG. 41.
(30) FIG. 43 shows a top view of an exemplary actuating forceps apparatus.
(31) FIG. 44 shows a right side view of an exemplary actuating forceps apparatus.
(32) FIG. 45 shows a front view of an exemplary actuating forceps apparatus.
(33) FIG. 46 shows a left side view of an exemplary actuating forceps apparatus.
(34) FIG. 47 shows a back view of an exemplary actuating forceps apparatus.
(35) FIG. 48 shows a cross-sectional view of view of the exemplary articulating retrieval apparatus along line 48-48 of FIG. 47.
(36) FIGS. 49 to 52 show perspective views of exemplary articulating forceps.
(37) FIGS. 53 and 54 shows perspective views of an exemplary expanding funnel sheath.
(38) FIG. 55 shows a side view of an exemplary actuating hook.
(39) FIG. 56 shows a top view of an exemplary actuating hook.
(40) FIG. 57 shows a side view of an exemplary coil hook in a coiled configuration.
(41) FIG. 58 shows a side view of the exemplary coil hook shown in FIG. 57, in an extended configuration.
(42) FIG. 59 shows a side view of an exemplary dual coil hook in an extended configuration a coiled configuration.
(43) FIG. 60 shows a side view of the exemplary coil hook shown in FIG. 58, in a coiled configuration forming a coil hoop between the two coil hooks.
(44) FIGS. 61 and 62 show an actuating retrieval apparatus moving a stent and stent graft.
(45) FIG. 63 show an actuating retrieval apparatus removing thrombus.
(46) Corresponding reference characters indicate corresponding parts throughout the several views of the figures. The figures represent an illustration of some of the embodiments of the present invention and are not to be construed as limiting the scope of the invention in any manner. Further, the figures are not necessarily to scale, some features may be exaggerated to show details of particular components. Therefore, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a representative basis for teaching one skilled in the art to variously employ the present invention.
DETAILED DESCRIPTION OF THE ILLUSTRATED EMBODIMENTS
(47) As used herein, the terms “comprises,” “comprising,” “includes,” “including,” “has,” “having” or any other variation thereof, are intended to cover a non-exclusive inclusion. For example, a process, method, article, or apparatus that comprises a list of elements is not necessarily limited to only those elements but may include other elements not expressly listed or inherent to such process, method, article, or apparatus. Also, use of “a” or “an” are employed to describe elements and components described herein. This is done merely for convenience and to give a general sense of the scope of the invention. This description should be read to include one or at least one and the singular also includes the plural unless it is obvious that it is meant otherwise.
(48) Certain exemplary embodiments of the present invention are described herein and are illustrated in the accompanying figures. The embodiments described are only for purposes of illustrating the present invention and should not be interpreted as limiting the scope of the invention. Other embodiments of the invention, and certain modifications, combinations and improvements of the described embodiments, will occur to those skilled in the art and all such alternate embodiments, combinations, modifications, improvements are within the scope of the present invention.
(49) Referring now to FIGS. 1 to 3, an exemplary articulating retrieval apparatus 10 has a user interface 30 and a forceps end having forceps 60 comprising a first and second jaw. An apparatus conduit 20 extends a length from the user interface end or user end 22 to the distal end 24 wherein a first actuator 40 is coupled thereto. The first actuator is configured to rotate about a first pivot 46 and extends from a coupled end to a distal end. A second actuator 50 is coupled to the first actuator and is configured to rotate about second pivot 56 and extends from a coupled end to a distal end. The forceps are coupled to the second actuator. The actuating assembly 14 has two degrees of freedom. Actuating lines extend from the actuating portions down the apparatus conduit to the user interface. On the user interface end 32 a user may utilize a first actuator 34 to actuate the first actuating portion 40 and a second actuator 35 to actuate the second actuating portion 50. A first jaw of a forceps may be opened and closed using a retrieval actuator 36 that is coupled with a first retrieval line 67 that also extend through the apparatus conduit to the forceps 60. The first jaw rotates about the jaw pivot 66.
(50) FIGS. 4 to 6 show a vascular wall 100 having an intravascular filter (IVF) 104 therein. In FIG. 4 the IVF is within the vascular conduit 102. In FIG. 5, the IVF is lodged in the vascular wall. In FIG. 6, the IVF filter has penetrated through the vascular wall.
(51) Referring now to FIGS. 7 to 9, an introducer sheath 90 is configured through a vascular wall 100 and an exemplary articulating retrieval apparatus 10 is configured to extend into a vascular vessel through the introducer sheath. As shown in FIG. 8, the exemplary articulating retrieval apparatus is configured within the vascular wall. As shown in FIG. 9 the exemplary articulating retrieval apparatus is being actuated to locate the forceps proximal to the IVF for retrieval of the IVF.
(52) Referring now to FIGS. 10 to 12, an exemplary articulating retrieval apparatus 10 has a first actuating 40 and a second actuating portion 50 that can be actuated separately. As shown in FIG. 10, the second actuating portion 50 is actuated orthogonally to the length axis of the apparatus conduit 20. The first actuator is configured to rotate about a first pivot 46 and extends from a coupled end 42 to a distal end 44. The second actuator 50 is coupled to the first actuator about the second pivot 56 and is configured to rotate about second pivot 56 and extends from a coupled end 52 to a distal end 54. As shown in FIG. 11, the first actuating portion 40 is actuated orthogonally to the length axis of the apparatus conduit 20. FIG. 12 shows the actuation of the first actuating portion from parallel with the length axis of the apparatus conduit to orthogonal to the length axis of the apparatus conduit. The length of the first or second actuating portion from the coupled end to the distal end may be about 15 mm or less, about 10 mm or less, about 5 mm or less, about 3 mm or less, about 2 mm or less and any range between and including the values provided.
(53) Referring now to FIGS. 13 and 14, an exemplary articulating retrieval apparatus 10 has forceps 60 with a first actuating jaw 62 and a second jaw 64. As shown in FIG. 13, the first jaw is in an open orientation and in FIG. 14, the first jaw is in a closed orientation. The first jaw rotates about jaw pivot 66.
(54) Referring now to FIGS. 15 to 18, an exemplary articulating retrieval apparatus 10 has a user interface 30 having a first actuator 34 and a second actuator 35. The first actuator has a second manipulator 38, a paddle, that the user is rotating to actuate the second actuating portion 50, as shown in FIG. 16. The user interface also has a first manipulator 34, for actuating the first actuating portion. At least one of the jaws of the forceps 60 may be configured with a blade or blade edge 72 to enable cutting of a device or biological tissue along the vasculature.
(55) As shown in FIGS. 19 and 20, an exemplary articulating retrieval apparatus 10 has a first actuator 34 having a first manipulator 37. The first actuator is coupled with the first actuating portion first line 47 and first actuating portion second line 48. Rotation of the first manipulator a first direction pulls on the first actuating portion first line 47 as shown in FIG. 20 and conversely, rotation of the first manipulator a second direction opposite the first direction, pulls on the first actuating portion second line 48 to actuate the first actuating portion an opposite direction about the first pivot 46.
(56) Referring now to FIGS. 21 and 22, an exemplary articulating retrieval apparatus 10 has a first actuator 34 having a first manipulator 37 and a second actuator 35 having a second manipulator 38. The first and second manipulators are dial that rotate a worm gear 33 coupled with an actuating gear. Rotating the dial in a first direction pulls on the first actuating portion first line 47 as shown in FIG. 22 to rotate the first actuating portion a first direction about the first pivot 46.
(57) FIG. 23 shows cut away view of a user interface 30 having a first actuator 34 and second actuator 35 and first and second manipulators for actuating the first and second actuating portions. The first actuator 34 is coupled with the first actuating portion first line 47 and first actuating portion second line 48. A worm gear 33′ is configured between the first actuator and the first manipulator. The second actuator 35 is coupled with the second actuating portion first line 57 and second actuating portion second line 58. A worm gear 33 is configured between the second actuator and the second manipulator. This actuating assembly 14 enables controlled actuation of the first and second actuating portions separately. This exemplary actuator comprises a worm gear assembly. The actuating lines extend into the conduit 26 of the apparatus conduit 20 having a conduit wall 25 and an outer diameter 27 and inner diameter.
(58) FIGS. 24 and 25 show exemplary forceps 60 having a first actuating jaw 62 and second jaw 64. The first jaw is coupled with the first retrieval line 67 and pivots about jaw pivot 66. Both jaws have a serrated edge 70 to provide better gripping. The serrations form backward facing teeth to retain an object, such as an intravascular filter or tissue. A user interface, not shown pulls and pushes on the retrieval line to close and open the first jaw, respectively.
(59) FIGS. 26 to 28 show exemplary forceps having a first and second jaw. As shown in FIG. 26 the jaws are alligator jaws, having a rounded end with serrations. As shown in FIG. 27, the jaws are alligator jaws that have a smaller radius end.
(60) FIGS. 29 to 31 show an exemplary articulating retrieval apparatus retrieving an intravascular filter from a vascular wall.
(61) FIGS. 32 to 34 show an exemplary articulating retrieval apparatus retrieving an intravascular filter from a vascular wall utilizing an inflatable balloon 80 that is coupled to a balloon line. The balloon line is a conduit to enable gas to fill and inflate the balloon.
(62) FIGS. 35 and 36 show an exemplary articulating retrieval apparatus retrieving an intravascular filter from a vascular wall.
(63) FIGS. 37 to 39 show various forceps 60 having a first actuating jaw 62 and second jaw 64. As shown in FIG. 37, the jaws are tweezer jaws having pointed ends. As shown in FIG. 38 the tweezer jaws are configured to overlap at the extended ends, which may aid in retaining an object therein. FIG. 39 shows the two tweezer jaws configured parallel to each other to allow the extended ends to overlap, as shown in FIG. 38.
(64) Referring now to FIGS. 40 to 48, an exemplary articulating retrieval apparatus 10 has forceps 60, one type of a retrieval implement 11, configured on the distal end 24 of a catheter 20. The catheter is coupled on the user interface 30, on the user end of the catheter. The user implement enables a user to open and close one or both of the forceps jaws. The retrieval actuator 36 is configured as a handle to enable opening and closing of the first actuating jaw 62 with respect to the second jaw 64. The forceps is configured on a first actuating portion 40, that is configured to rotated about the first pivot 46. The actuating portion or portions may be controlled by the first manipulator 37 and second actuator 38; shown as paddle extending from the top of the user interface 30. The retrieval implement shown is coupled to a single actuating portion but a second actuating portion may be use to increase the degrees of freedom of motion. Note that the retrieval implement 11 may be detachably attachable to an actuating member thereby enabling interchanging of the type of retrieval implement used with the user interface 30. The user interface may still be used to articulate the retrieval implement and the retrieval actuator 36 or implement actuator, may be used to open and close a jaw or manipulate the retrieval implement in some way to hold a foreign article, such as an IVC filter, for removal from the body.
(65) As shown in FIGS. 41 and 42, the retrieval implement 11, forceps, have a retainer aperture 61 configured between the first actuating jaw 62 and the second jaw 64, when the jaws are closed. This retainer aperture may provide secure retention of a filter, such as an inferior vena cava (IVC) filter or other item when the item is at least partially retained therein. The first actuating portion 40 pivots about the first pivot 46.
(66) As shown in FIG. 48, a cross-sectional view of the exemplary actuating retrieval apparatus 12, shows the interior actuators, or actuating assembly 14. The first manipulator 37 is coupled with the first actuator 34 to move a first actuating portion (not shown in FIG. 28). The first actuating portion is moved by manipulating a manipulator to pull on one of first actuating portion first line 47 or first actuating portion second line 48. The retrieval implement is controlled by the retrieval actuator 36 that pulls on one of the first retrieval line 67 or second retrieval line 68.
(67) Referring to FIGS. 49 to 50, an exemplary articulating retrieval apparatus 10 has forceps forming a retainer aperture 61 between the first actuating jaw 62 and the second jaw 64, which may also be an actuating jaw, when the jaws are closed. This retainer aperture may provide secure retention of a foreign article for retrieval from the body, such as an IVC filter.
(68) Referring to FIGS. 51 to 52, an exemplary articulating retrieval apparatus 10 has forceps without a retainer aperture between the first actuating jaw 62 and the second jaw 64 when the jaws are closed. This type of forceps may be used for retrieval by gripping a foreign object between the forceps jaws.
(69) Referring to FIGS. 53 and 54, an exemplary retrieval implement 11, an expandable funnel sheath 110, is configured to open up, or expand as shown in FIG. 53, wherein the extended end 114 is enlarged over the coupled end 112. The sheath forms a cylinder that can expand radially out to increase the diameter of the extended end 114 as shown in FIG. 53, and retract or collapse radially to reduce the diameter of the extended end, as shown in FIG. 54. The expandable funnel sheath is funnel shaped in an expanded configuration wherein the sheath tapers down toward the coupled end. A foreign object may be configured with the expandable funnel sheath or within the opening 115 of the expandable funnel sheath and then the expandable funnel sheath may be closed to retain the foreign object within the retracted expandable funnel sheath.
(70) Referring to FIGS. 55 and 56, an exemplary retrieval implement 11, an actuating hook 120, forms a hook shape that can be manipulated by the first actuating portion 40. The hook portion 123 turns back from the hook arm 124. A hook portion turns at least 120 degrees back from the hook arm and as shown turns back about 180 degrees from the hook arm in this embodiment. A foreign object may be secured in the slot formed by the hook portion and retrieved from the body.
(71) Referring to FIGS. 57 and 60, an exemplary retrieval implement 11, an exemplary coil hook 121 is manipulated from a extended configuration, FIG. 58, to a coiled or hook configuration, FIG. 57. The retrieval line, as shown in FIG. 3, may be coupled with coil hook 121 proximal to the extended end 122, whereby creating tension in the retrieval line causes the coil hook to coil to form the coil hook as shown. The extended end coils backward over the coil arm 124 to form a hook, or coil. The coiled portion 133 may be used for retrieval of a foreign object from the body. As shown in FIGS. 59 and 60, an exemplary retrieval implement 11 comprise a pair of coil hooks 121, 121′. The first articulating hook 126 and the second articulating hook 128 are configured to form a coil hoop 127, or enclosed area between the two coiled hooks when in a coiled configuration. This type of implement may very positively retain a foreign object for removal from the body.
(72) As shown in FIGS. 61 and 62 an actuating retrieval apparatus 10 is moving a stent 140 and stent graft 142, respectively.
(73) As shown in FIG. 63, an actuating retrieval apparatus 10 removing thrombus 144 with the retrieval implement 11.
(74) It will be apparent to those skilled in the art that various modifications, combinations and variations can be made in the present invention without departing from the scope of the invention. Specific embodiments, features and elements described herein may be modified, and/or combined in any suitable manner. Thus, it is intended that the present invention cover the modifications, combinations and variations of this invention provided they come within the scope of the appended claims and their equivalents.
