CA2322651A1 - Expandable atherectomy burr - Google Patents
Expandable atherectomy burr Download PDFInfo
- Publication number
- CA2322651A1 CA2322651A1 CA002322651A CA2322651A CA2322651A1 CA 2322651 A1 CA2322651 A1 CA 2322651A1 CA 002322651 A CA002322651 A CA 002322651A CA 2322651 A CA2322651 A CA 2322651A CA 2322651 A1 CA2322651 A1 CA 2322651A1
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- Prior art keywords
- burr
- tube
- drive
- drive shaft
- distal
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320725—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with radially expandable cutting or abrading elements
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320004—Surgical cutting instruments abrasive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B2017/320733—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a flexible cutting or scraping element, e.g. with a whip-like distal filament member
Abstract
An atherectomy burr has an operating diameter that is larger than the diameter of a catheter in which the burr is routed. The burr may include a polymeric balloon that is coated with an abrasive and that expands when the burr is rotated. Alternatively, the burr may include a polymeric tube that is coated with an abrasive and secured to the proximal end of the burr. When the burr is rotated, the polymeric tube expands by centrifugal force. Alternatively, the burr may comprise a metallic strip wound over a mandrel. When the strip is tightly coiled to the mandrel, its outer diameter decreases. The outer diameter of the burr increases as the metallic strip expands. In addition, the burr can be formed as a wire spring wound over a drive tube. The distal end of the spring is coupled to a nose cone that can move within a distal lumen in the drive tube. The maximum expansion of the burr is controlled by the distance that the nose cone can be retracted into the lumen. In addition, the present invention includes a burr having an indexable outer diameter. Various indexing mechanisms are disclosed for selectively increasing or decreasing the distance between a proximal and distal end of the burr. As the length of the burr changes, the outer diameter of a number of cutting blades is changed to allow a physician to create different sized lumens in a patient's vessel.
Description
WO 99144513 PC"T/US99/03851 EXPANDABLE ATHERECTOMY BURR
Related Application This application is related to U.S. provisional application No. 60/076,963 filed March S, 1998.
Field of the Invention The present invention relates to medical devices in general, and in particular to atherectomy devices for removing occluding material from a patient's blood vessels.
Background of the Invention Arteriosclerosis is a common vascular disease in which a patient's blood vessels become hardened and blocked by plaque or clots that impede blood flow.
Left untreated, this condition is a major contributing factor to the occurrence of high blood pressure, strokes and cardiac arrest.
To treat arteriosclerosis, many invasive and non-invasive techniques have been developed. For example, cardiac bypass surgery is now a commonly performed procedure whereby an occluded cardiac artery is bypassed with a segment of a healthy blood vessel that is obtained from elsewhere in the body. While this procedure is generally successful, it is fairly traumatic because the entire chest cavity must be opened to access the occluded vessel. Therefore, the procedure is not generally performed on elderly or relatively frail patients.
One example of a promising minimally invasive technique that can be performed on a greater number of patients is to remove the occluding material from a patient's vessel in an atherectomy procedure. To perform this procedure, a guide catheter is typically inserted into the patient's femoral artery and advanced unti! the distal end of the guide catheter is located in the patient's ostium. A guide wire is then WO 99/44513 PC"f/US99/03851 inserted through the guide catheter and traversed into the coronary arteries and past the occluded material to be treated. Then, as described in U.S. Patent No.
4,990,134, issued to Auth, an atherectomy catheter having a small abrasive burr is advanced through the guide catheter and over the guide wire to the point of the occlusion. The burr is then rotated at high speed and passed through the occlusion to remove particles that are sufficiently small such that they will not reembolize in the distal vasculature. As the burr removes the occlusion, a larger lumen is created in the vessel and blood flow is restored.
It is well recognized that the risk of certain patient complications increases with the size of the guide catheter through which minimally invasive devices are routed. Larger guide catheters require larger access holes in the femoral artery, creating the potential for patient complications, such as the sealing of the puncture site after completion of the procedure. Therefore, physicians generally wish to utilize the smallest possible guide catheter during a procedure. However, the smaller size guide catheters can only accommodate corresponding smaller size ablation buns.
Therefore, if a large vessel is to be treated, a larger burr and corresponding larger guide catheter must be used to successfully remove all of the occlusion from the patient's vessel.
In addition, it has also been discovered that when performing an atherectomy procedure as described earlier, it has been beneficial to remove only a small amount of the occlusion at a time. Therefore, currently many procedures are performed using multiple passes through the occlusion with different sized ablation burrs.
While these procedures have proven effective, the use of multiple devices for a single procedure adds both time and cost to the procedure.
Given the disadvantages of the existing atherectomy devices, there is a need for an atherectomy device that can treat dii~erent size vessels while being traversed through a small guide catheter.
Summary of the Invention To eliminate the need for a physician to utilize larger guide catheters in order to route a larger diameter ablation bun in a patient, the present invention comprises an expandable ablation bun. The ablated diameter preferably has a diameter that exceeds the diameter of a guide catheter through which the burr is routed.
According to one embodiment of the invention, the ablation burr includes a polymeric balloon that expands as the bun is rotated. A portion of the balloon is coated with an abrasive such that the balloon will ablate an occlusion as the bun is rotated and advanced through a vessel.
In another embodiment of the invention, the expandable burr comprises a generally solid core with a nose section having a fixed, maximum outer diameter and a stepped proximal section with a smaller outer diameter. Positioned over the stepped section is a polymeric tube that is coated with an abrasive material. As the burr is rotated, the elastomeric tube expands by centrifugal force, thereby increasing the maximum outer diameter of the burr in order to create a larger lumen in a patient's vessel.
In yet another embodiment of the invention, the ablation burr comprises a mandrel that is secured to a drive shaft. A metallic strip surrounds the mandrel. At least a portion of the metallic strip and mandrel is covered with an abrasive.
When the metallic strip is tightly coiled around the mandrel, its outer diameter decreases. When released, the metallic strip will expand to the original outer diameter of the bun.
In yet another embodiment of the invention, the ablation bun includes a wire spring that is wound over a drive tube. A portion of the wire spring is coated with an abrasive material to ablate an occlusion in a patient's vessel as the bun is rotated. A
distal end of the spring is coupled to a nose cone that can move axially within the distal end of the drive tube. As the burr is rotated, the nose cone is drawn into the lumen. The maximum outer diameter of the bun is limited by the distance that the nose cone can move within the drive tube.
According to another aspect of the present invention, an ablation bun includes an indexing mechanism which allows the outer diameter of the burr to be selectively adjusted to create varying sized lumens in the patient's vessel. By selectively controlling the length of the burr, the compression of a series of cutting blades that are coupled to the distal and proximal ends of the bun is changed in order to vary the outer diameter of the burr.
In one embodiment, the indexing mechanism includes a tube having a drive tube slidably secured to the proximal end thereof. The drive tube includes a fixed washer disposed at its distal end. The washer includes a number of teeth positioned around a distal rim. Disposed at the distal end of the tube is an indexing ring having a series of slots that encircle the indexing ring. Each slot has a dii~erent depth. A slide washer having a set of teeth that engage the teeth on the fixed washer is positioned over the indexing ring and tube. The slide washer includes a pin that engages a canted edge of the slots as the bun is rotated. The maximum distance that the drive tube can move with respect to a distal end of the burr is limited by the depth of the slot in which the pin on the slide washer is located. By controlling the movement of the drive tube with respect to the distal end of the burr, the maximum outer diameter of the cutting blades is controlled. As the blades are compressed by retrieving the burr into a catheter, the pin on the slide washer is moved to the next slot on the indexing ring such that the outer diameter of the bun can be varied.
In another embodiment of the invention, the indexing mechanism includes a drive tube having a race that extends around the perimeter of the drive tube along an axis that is canted with respect to its longitudinal axis. A traveling ball fits within the race. The drive tube also includes a series of ratchet teeth that extend around the perimeter of drive tube. Positioned over the drive tube is a proximal locking tube having a hole through which the traveling ball extends. Slidably aligned with the proximal locking tube is a distal locking tube that is coupled to the distal end of the ablation bun. Positioned over the proximal and distal locking tubes is a traveling tube 1 S having a hole in which a portion of the traveling ball is seated. As the drive tube is rotated with respect to the cutting blades, the traveling ball moves in the race thereby moving the traveling tube along the length of the drive tube and limiting the distance by which the distal end of the burr can move with respect to the proximal end of the burr and hence changing the maximum outer diameter of the cutting blades.
In yet another embodiment of the invention, the indexing mechanism includes a drive tube having a serpentine channel disposed around the perimeter of the drive tube. A proximal locking tube is slidably affixed over the proximal end of the drive tube. A distal locking tube is slidably aligned with the drive tube. The distal locking tube engages a distal end of the ablation burr. Positioned over the drive tube is a traveling tube having a pin that operates as a cam within the serpentine channel. As the pin moves within the channel, the traveling tube limits the movement of the distal locking tube with respect to the drive tube and hence limits the maximum outer diameter of the cutting blades.
Brief Description of the Drawings The foregoing aspects and many of the attendant advantages of this invention will become more readily appreciated as the same becomes better understood by reference to the following detailed description, when taken in conjunction with the accompanying drawings, wherein:
FIGURES lA and 1B illustrate an expandable balloon ablation burr according to a first embodiment of the present invention;
Related Application This application is related to U.S. provisional application No. 60/076,963 filed March S, 1998.
Field of the Invention The present invention relates to medical devices in general, and in particular to atherectomy devices for removing occluding material from a patient's blood vessels.
Background of the Invention Arteriosclerosis is a common vascular disease in which a patient's blood vessels become hardened and blocked by plaque or clots that impede blood flow.
Left untreated, this condition is a major contributing factor to the occurrence of high blood pressure, strokes and cardiac arrest.
To treat arteriosclerosis, many invasive and non-invasive techniques have been developed. For example, cardiac bypass surgery is now a commonly performed procedure whereby an occluded cardiac artery is bypassed with a segment of a healthy blood vessel that is obtained from elsewhere in the body. While this procedure is generally successful, it is fairly traumatic because the entire chest cavity must be opened to access the occluded vessel. Therefore, the procedure is not generally performed on elderly or relatively frail patients.
One example of a promising minimally invasive technique that can be performed on a greater number of patients is to remove the occluding material from a patient's vessel in an atherectomy procedure. To perform this procedure, a guide catheter is typically inserted into the patient's femoral artery and advanced unti! the distal end of the guide catheter is located in the patient's ostium. A guide wire is then WO 99/44513 PC"f/US99/03851 inserted through the guide catheter and traversed into the coronary arteries and past the occluded material to be treated. Then, as described in U.S. Patent No.
4,990,134, issued to Auth, an atherectomy catheter having a small abrasive burr is advanced through the guide catheter and over the guide wire to the point of the occlusion. The burr is then rotated at high speed and passed through the occlusion to remove particles that are sufficiently small such that they will not reembolize in the distal vasculature. As the burr removes the occlusion, a larger lumen is created in the vessel and blood flow is restored.
It is well recognized that the risk of certain patient complications increases with the size of the guide catheter through which minimally invasive devices are routed. Larger guide catheters require larger access holes in the femoral artery, creating the potential for patient complications, such as the sealing of the puncture site after completion of the procedure. Therefore, physicians generally wish to utilize the smallest possible guide catheter during a procedure. However, the smaller size guide catheters can only accommodate corresponding smaller size ablation buns.
Therefore, if a large vessel is to be treated, a larger burr and corresponding larger guide catheter must be used to successfully remove all of the occlusion from the patient's vessel.
In addition, it has also been discovered that when performing an atherectomy procedure as described earlier, it has been beneficial to remove only a small amount of the occlusion at a time. Therefore, currently many procedures are performed using multiple passes through the occlusion with different sized ablation burrs.
While these procedures have proven effective, the use of multiple devices for a single procedure adds both time and cost to the procedure.
Given the disadvantages of the existing atherectomy devices, there is a need for an atherectomy device that can treat dii~erent size vessels while being traversed through a small guide catheter.
Summary of the Invention To eliminate the need for a physician to utilize larger guide catheters in order to route a larger diameter ablation bun in a patient, the present invention comprises an expandable ablation bun. The ablated diameter preferably has a diameter that exceeds the diameter of a guide catheter through which the burr is routed.
According to one embodiment of the invention, the ablation burr includes a polymeric balloon that expands as the bun is rotated. A portion of the balloon is coated with an abrasive such that the balloon will ablate an occlusion as the bun is rotated and advanced through a vessel.
In another embodiment of the invention, the expandable burr comprises a generally solid core with a nose section having a fixed, maximum outer diameter and a stepped proximal section with a smaller outer diameter. Positioned over the stepped section is a polymeric tube that is coated with an abrasive material. As the burr is rotated, the elastomeric tube expands by centrifugal force, thereby increasing the maximum outer diameter of the burr in order to create a larger lumen in a patient's vessel.
In yet another embodiment of the invention, the ablation burr comprises a mandrel that is secured to a drive shaft. A metallic strip surrounds the mandrel. At least a portion of the metallic strip and mandrel is covered with an abrasive.
When the metallic strip is tightly coiled around the mandrel, its outer diameter decreases. When released, the metallic strip will expand to the original outer diameter of the bun.
In yet another embodiment of the invention, the ablation bun includes a wire spring that is wound over a drive tube. A portion of the wire spring is coated with an abrasive material to ablate an occlusion in a patient's vessel as the bun is rotated. A
distal end of the spring is coupled to a nose cone that can move axially within the distal end of the drive tube. As the burr is rotated, the nose cone is drawn into the lumen. The maximum outer diameter of the bun is limited by the distance that the nose cone can move within the drive tube.
According to another aspect of the present invention, an ablation bun includes an indexing mechanism which allows the outer diameter of the burr to be selectively adjusted to create varying sized lumens in the patient's vessel. By selectively controlling the length of the burr, the compression of a series of cutting blades that are coupled to the distal and proximal ends of the bun is changed in order to vary the outer diameter of the burr.
In one embodiment, the indexing mechanism includes a tube having a drive tube slidably secured to the proximal end thereof. The drive tube includes a fixed washer disposed at its distal end. The washer includes a number of teeth positioned around a distal rim. Disposed at the distal end of the tube is an indexing ring having a series of slots that encircle the indexing ring. Each slot has a dii~erent depth. A slide washer having a set of teeth that engage the teeth on the fixed washer is positioned over the indexing ring and tube. The slide washer includes a pin that engages a canted edge of the slots as the bun is rotated. The maximum distance that the drive tube can move with respect to a distal end of the burr is limited by the depth of the slot in which the pin on the slide washer is located. By controlling the movement of the drive tube with respect to the distal end of the burr, the maximum outer diameter of the cutting blades is controlled. As the blades are compressed by retrieving the burr into a catheter, the pin on the slide washer is moved to the next slot on the indexing ring such that the outer diameter of the bun can be varied.
In another embodiment of the invention, the indexing mechanism includes a drive tube having a race that extends around the perimeter of the drive tube along an axis that is canted with respect to its longitudinal axis. A traveling ball fits within the race. The drive tube also includes a series of ratchet teeth that extend around the perimeter of drive tube. Positioned over the drive tube is a proximal locking tube having a hole through which the traveling ball extends. Slidably aligned with the proximal locking tube is a distal locking tube that is coupled to the distal end of the ablation bun. Positioned over the proximal and distal locking tubes is a traveling tube 1 S having a hole in which a portion of the traveling ball is seated. As the drive tube is rotated with respect to the cutting blades, the traveling ball moves in the race thereby moving the traveling tube along the length of the drive tube and limiting the distance by which the distal end of the burr can move with respect to the proximal end of the burr and hence changing the maximum outer diameter of the cutting blades.
In yet another embodiment of the invention, the indexing mechanism includes a drive tube having a serpentine channel disposed around the perimeter of the drive tube. A proximal locking tube is slidably affixed over the proximal end of the drive tube. A distal locking tube is slidably aligned with the drive tube. The distal locking tube engages a distal end of the ablation burr. Positioned over the drive tube is a traveling tube having a pin that operates as a cam within the serpentine channel. As the pin moves within the channel, the traveling tube limits the movement of the distal locking tube with respect to the drive tube and hence limits the maximum outer diameter of the cutting blades.
Brief Description of the Drawings The foregoing aspects and many of the attendant advantages of this invention will become more readily appreciated as the same becomes better understood by reference to the following detailed description, when taken in conjunction with the accompanying drawings, wherein:
FIGURES lA and 1B illustrate an expandable balloon ablation burr according to a first embodiment of the present invention;
FIGURES 2A-2D illustrate an ablation burr with an expandable end according to a second embodiment of the present invention;
FIGURES 3A-3D illustrate an expandable burr that is formed from a strip of superelastic material according to a third embodiment of the present invention;
FIGURES 4A and 4B illustrate an expandable spring ablation burr including an indexing mechanism to control the outer diameter of the burr according to another aspect of the present invention;
FIGURE SA illustrates an isometric view of an ablation bun including an indexing mechanism for selectively changing the outer diameter of the bun according to another aspect of the present invention;
FIGURE SB illustrates the ablation bun shown in FIGURE SA with the parts shown in an exploded relationship;
FIGURES 6A and 6B illustrate another embodiment of an ablation burr with an indexing mechanism for selectively changing the outer diameter of the burr according to the present invention; and FIGURES 7A and 7B illustrate yet another embodiment of an ablation bun with an indexing mechanism for selectively changing the outer diameter of the burr according to the present invention.
Detailed Description of the Preferred Embodiment As will be explained in further detail below, the present invention is an ablation bun having an outer diameter that may be expanded to exceed the diameter of a guide catheter through which the bun is routed. Additionally, the present invention is an ablation burr including a mechanism for selectively changing the outer diameter of the ablation burr so that varying sized lumens can be created in a patient's vessel using the same burr.
FIGURE lA illustrates an atherectomy device in accordance with a first aspect of the present invention. The atherectomy device 20 is routed from a position outside a patient's body to a point near the site of a vascular occlusion through a guide catheter 22. Extending through the guide catheter 22 is a drive shaft 24 that is coupled at its proximal end to a source of rotational motion such as an electric motor or gas turbine (not shown) that rotates the drive shaft 24 at high speed, e.g., between 20,000 and 250,000 rpm. Disposed at a distal end of the drive shaft 24 is an ablation bun 28 that when rotated by the drive shaft 24 ablates a new lumen through the occlusion in order to permit blood to flow freely through the vessel.
Extending through the drive shaft 24 and the ablation burr 28 is a guide wire 26 that can be steered by a physician in order to guide the ablation burr through the vascular occlusion.
As indicated above, it is generally desirable that the ablation burr 28 be routed through the smallest possible guide catheter to the point near the vascular occlusion.
In the past, if the diameter of the vessel in which the occlusion was located was greater than the diameter of the ablation burr, the entire atherectomy device including drive shaft, ablation burr and catheter had to be removed from the patient and replaced with a larger diameter catheter that could accommodate a larger diameter burr if all of the occlusion was to be removed. To facilitate maximal lumen size after ablation, the maximum outer diameter of the ablation burr 28 is expandable such that its maximum diameter exceeds the diameter of the guide catheter used to route the burr to the site of the occlusion.
According to the embodiment of the invention as shown in FIGURES lA and 1B, the ablation burr 28 comprises a length of hypotube 30 coupled to a distal end of the drive shaft 24. The hypotube 30 includes one or more holes 32 that allow fluid to flow in or out of the hypotube. Surrounding the hypotube 30 is a polymeric balloon 34, having an abrasive 36 disposed on at least a portion of the outer surface of the balloon. The distal end of the ablation burr 28 fits behind a concave surface of a tip 37 that prevents the seal of the polymeric balloon from becoming unglued from the hypotube 30 as the burr is advanced through an occlusion.
When the drive shaft is not being rotated, the balloon 34 collapses into an unexpended state as shown in FIGURE lA. In its unexpended state, the outer diameter of the ablation burr 28 is smaller than the inner diameter of the guide catheter 22.
When the drive shaft 24 is rotated, fluid surrounding the drive shaft or within the drive shaft is expelled through the holes 32 in the hypotube causing the balloon 34 to expand to its maximum diameter. The maximum diameter is generally larger than the inner diameter of the guide catheter 22. The bun is then advanced over the occlusion to create a lumen in the patient's vessel. When the drive shaft 24 ceases to rotate, the balloon 34 collapses, and the burr can be removed through the guide catheter 22.
In the presently preferred embodiment of the invention, the polymeric balloon 34 is made from a non-stretchable plastic material such as an oriented polyethylene terephthalate polymer (PET). However, it is believed that other plastics or elastomeric materials may also be used.
The abrasive 36 disposed on the outer surface of the balloon preferably comprises small diamond. chips approximately 2-25 microns in size.
If the balloon 34 is made of PET, the abrasive 36 is secured to the balloon by creating a thin base layer of silver using vacuum deposition techniques. Once the base layer is applied to the balloon, a layer of metal such as nickel having a slurry of diamond particles disposed therein can be plated to the base layer using an electro- or electroless plating method as is done with conventional burrs.
In some instances, it may be desirable to etch or mask a portion of the balloon with a pattern of dots or other shapes so that the base layer does not completely surround the balloon. If the abrasive is only plated to the etched pattern, it may allow the balloon to more easily expand and collapse.
In addition to electroplating, it is believed that other techniques could be used to secure the abrasive to the balloon, such as by using an adhesive or chemically bonding sites on the outer surface of the polymeric balloon to which metal ions such as copper, silver, gold, or nickel may bond. These sites may be bonded to the balloon surface using a high-vacuum plasma system or by incorporating chemicals (such as carbon, silver, etc.) with the polymer prior to the extrusion of the balloon.
Alternatively, it is believed that pulse cathode arc ion deposition could be used to incorporate bonding sites on the surface of the elastomer.
FIGURES 2A and 2B illustrate another embodiment of an expandable ablation burr according to the present invention. The expandable ablation bun 40 is mounted to the distal end of a conventional drive shaft 24 that rotates the bun at high speeds.
A guide wire 26 extends through the drive shaft 24 and the ablation bun 40 so that the burr can guide through a vascular occlusion. The bun is formed as a solid core (except for the lumen through which the guide wire extends) that is made of metal or other suitable material and includes a generally bullet-shaped nose section 42 having a maximum diameter that begins at approximately the midpoint of the burr and tapers in diameter to the distal tip of the burr. The burr 40 also contains a proximal stepped section 44 having a substantially constant diameter that is less than the maximum diameter of the nose section.
Secured over the stepped section 44 of the burr with an adhesive or a mechanical fastener is a polymeric tube 46 having an outer diameter that is substantially equal to or greater than the maximum outer diameter of the nose section 42. The length of the polymeric tube 46 is preferably longer than the length of the stepped section 44 such that a portion of the polymeric tube overhangs the WO 99/44513 PC'f/US99/03851 _g_ proximal end of the solid core. An abrasive coating is disposed on at least a portion of the outer surface of the tube 46 and the nose section 42. The abrasive is secured to the tube 46 in the same manner as the abrasive is secured to the expandable balloon described above.
S When the drive shaft 24 is not rotated, the ablation burr 40 has a maximum outer diameter that is smaller than the inner diameter of a guide catheter 22 through which the burr is routed.
As shown in FIGURE 2B, when the drive shaft 24 is rotated, the proximal end of the elastomeric tube 46 expands due to centrifugal force. The proximal end of the ablation bun 40 extends radially outward, therefore allowing the bun to ablate a larger lumen as it is advanced in a vessel. As the drive shaft 24 is slowed, the centrifugal force on the proximal end of the polymeric tube 46 decreases and the outer diameter of the ablation burr returns to its unexpanded state. The ablation burr can then be withdrawn from the patient through the guide catheter 22.
FIGURES 2C and 2D illustrate a cross-section of an alternative embodiment of the expandable ablation bun shown in FIGURES 2A and 2B. An ablation bun 40' includes a generally solid core including a distal nose section 42 and a proximal stepped section 44. A polymeric tube 46' is bonded to the stepped section 44 such that the outer diameter of the polymeric tube is approximately equal to the maximum diameter of the nose section 42 when the burr is in an unexpanded state. In contrast to the embodiment shown in FIGURES 2A and 2B, a proximal end 48 of the polymeric tube 46' is tapered to the drive shaft 24. In addition, the polymeric tube 46' includes one or more holes 50 disposed about its periphery to control the outer diameter of the burr as the burr is rotated.
FIGURE 2D illustrates the ablation burr 40' as the drive shaft 24 is rotated.
Centrifugal force causes a center section of the polymeric tube that lies between the proximal end of the solid core and the proximal end 48 of the tube to expand radially outward. As the burr begins spinning, centrifugal force expands the polymeric tube.
Fluid then fills the interior cavity of the tube and is also acted on by the centrifugal force. To prevent the tube from over expanding, fluid is allowed to vent out the one or more holes 50 that surround the tube 46' such that the volumetric rate at which the fluid vents from the tube reaches an equilibrium with the volumetric rate at which it enters the interior of the tube and the expansion of the tube is halted. The one or more holes 50 increase in size as the speed of the bun increases and the tube expands.
As the rotational speed of the ablation burr is decreased, the outer diameter of the WO 99/44513 PCT/US99l03851 bun decreases so that the burr can be withdrawn through the catheter. Because the end 48 of the polymeric tube 46' is closed to meet the drive shaft 24, the polymeric tube 46' is less likely to catch the distal end of the guide catheter as the burr is withdrawn from the patient.
Although the polymeric tube is preferably positioned at the proximal end of the bun, it may be advantageous to place the tube at the distal end of the burr in order to remove certain occlusions.
In simulated ablation tests, the ablation burrs illustrated in FIGURES 2A-2D
appear to cause less trauma to the vessel walls and a more even cutting than a conventional burr. In addition, the spinning polymeric tube appears to self center the bun in the center of the patient's vessel. Finally, it is believed that the increased surface area of the polymeric tube creates less heat at the point where it contacts the occlusion, thereby reducing the likelihood of vessel spasm or clotting.
It is currently believed that polymer used to make the polymeric tube should have a stress/strain characteristic that allows the materials to be stretched to a known point but not beyond. One technique to achieve the desired stress/strain characteristics is to stretch the polymeric material as it cools.
Alternatively, it is possible to incorporate an inelastic string or band into the tube that straightens as the tube expands and reaches a maximum size but cannot be stretched any further.
In some instances, it may be desirable to coat the outer surface of the core and polymeric tube with a hydrophilic coating such as HydropassTM, available from Boston Scientific and described in U.S. Patent No. 5,702,754. The hydrophilic coating attracts water molecules, thereby making the surface slippery and easier to advance along the guide catheter. In addition, the hydrophilic coating may be beneficial during ablation since less torque may be transferred to a vessel wall if the bun stalls. In addition, the differential cutting ability of the burr may be enhanced due to the increased ability of the burr to slide over soft tissues.
FIGURES 3A-3D illustrate yet another embodiment of an expandable ablation bun according to the present invention. Secured to the distal end of a drive shaft 24 is a mandrel 60. The mandrel is cylindrical and has a generally bullet-shaped nose at the distal and proximal ends and a central lumen 62 extending through it so that the mandrel may be threaded over a guide wire 26. A central portion 61 of the mandrel has a reduced diameter compared to the maximum diameter of the distal and proximal ends. Surrounding the central cylindrical portion 61 of the mandrel 60 is a metallic strip 64 that is coiled around the mandrel as a spring. The metallic strip 64 preferably has a length that is equal to the length between the bullet-shaped ends of the mandrel f0 and a width that is selected such that the strip wraps completely around the mandrel with some overlap onto itself. The metallic strip 64 includes a tab 66 that is fixed within a corresponding slot 68 disposed on the outer surface of the mandrel as S shown in the cross-section FIGURE 3B viewed from the distal end of the ablation burr. The tab is secured in the slot with either an adhesive or by welding the tab in the slot.
At least a portion of the outer surface of the metallic strip 64 and the distal end of the mandrel 60 is covered with an abrasive 72 that is plated onto the strip and mandrel in order to ablate a vascular occlusion when the ablation bun is rotated.
FIGURES 3C and 3D illustrate a cross section of the drive shaft, metallic strip, and mandrel. in order to fit the ablation bun within the guide catheter 22, the metallic strip 64 is more tightly wrapped around the mandrel in order to reduce its outer diameter as shown in FIGURE 3D. Upon emerging from the distal end of the 1 S catheter 22, the metallic strip will spring open to resume its original shape shown in FIGURE 3C and its outer diameter will therefore increase. Because the proximal and distal ends of the metallic strip 64 are tapered to follow the contour of the bullet-shaped ends of the mandrel, the metallic strip can be recompressed by pulling it into the distal end of the guide catheter 22.
In the presently preferred embodiment of the invention, the metallic strip 64 is made of a superelastic metal such as Nitinol.
As will be appreciated, to ablate an occlusion in a blood vessel, the metallic strip 64 must be rotated in the direction of the arrow 74 (FIGURE 3B) such that an edge 70 of the strip extending along the length of the bun trails the movement of the bun in order to avoid further uncoiling the strip and possibly cutting into the vessel wall.
Yet another alternative embodiment of the expandable ablation burr of the present invention is shown in FIGURES 4A and 4B. The ablation burr 80 includes a coiled wire spring 82 that is wound around the longitudinal axis of a central drive tube 84. Plated to the outer surfaces of at least some of the individual spring coils is an abrasive to ablate an occlusion in a patient's vessel as the burr is rotated. The spring 82 is wound into a generally ellipsoidal shape with a maximum diameter at a midpoint that is larger than the diameter of the guide catheter 22 through which the bun is routed. The distal end of the spring 82 is secured to a nose cone 86 at the WO 99/44513 PC'f/US99103851 distal end of the burr while the proximal end of the spring is secured to the proximal end of the drive tube 84 by a band 85 that overlaps a few proximal coils of the spring.
The drive tube 84 has a proximal lumen 90 into which the distal end of the drive shaft 24 is inserted and secured. A distal lumen 92 of the tube receives a correspondingly shaped shaft 94 that extends from a rear surface of the nose cone 86.
The distal lumen 92 and the shaft 94 of the nose cone are shaped such that the shaft moves axially within the lumen but cannot be rotated in the lumen. Therefore, any torque induced in the drive tube 84 by the drive shaft 24 will be transmitted to the nose cone 86 and the distal end of the spring 82. Although not shown in FIGURES 4A and 4B, the drive tube 84 and nose cone 86 preferably include a lumen extending therethrough for passage of a guide wire.
When the ablation burr 80 is positioned in the guide catheter 22 as shown in FIGURE 4A, the spring 82 is compressed, thereby reducing its outer diameter.
When the ablation burr 80 extends out the distal end of the guide catheter 22, as shown in 1 S FIGURE 4B, the spring 82 expands into its ellipsoidal shape, thereby increasing the maximum outer diameter of the bun. As the spring 82 expands radially outward, the shaft 94 of the nose cone 86 is drawn into the distal lumen 92. Rotation of the burr will further draw the shaft 94 into the distal lumen 92 until the proximal end of the shaft engages the end of the lumen 92. The length of the lumen 92 and the shaft 94 of the nose cone therefore control the maximum diameter of the spring 82. As a bun is withdrawn into the guide catheter 22, the spring 82 is compressed and the shaft 94 will move distally in the lumen 92.
In many instances, it is desirable to have an ablation burr that can assume several fixed outer diameters. For example, when creating an initial lumen in an occluded vessel, it is generally advisable to utilize the smallest diameter bun available.
In the past, if the size of the lumen needed to be increased, the entire ablation bun had to be removed from the patient and successively larger burrs used until a lumen of the desired size was created. To eliminate the need for multiple ablation burrs, another aspect of the invention is an ablation burr with an indexable outer diameter.
As the burr is rotated and passed over an occlusion, the outer diameter of the bun can be selectively increased to remove additional occluding material from the vessel.
FIGURES SA and SB illustrate a first embodiment of an ablation burr according to the present invention having an indexable outer diameter. The ablation bun 100 is disposed at the distal end of a drive shaft 24. The bun includes a central lumen so that the ablation burr can be passed over a guide wire 104.
Surrounding the drive shaft 24 is a catheter 106 having a flared distal end 108 that operates to aid in selectively changing the outer diameter of the bun in a manner described below.
To remove the occluding material from a vessel, the ablation bun includes a number of leaf blades 110 that are secured between a nose cone 112 and a ring 113 at the distal end of the burr. The blades 110 extend proximally over the burr to a leaf retaining ring 114 at the proximal end of the bun. At least a portion of each blade 110 is covered with an abrasive 116 such that when the ablation burr 100 is rotated by the drive shaft 24, the abrasive 116 will remove occluding material from a patient's blood vessel. A polymeric sleeve (not shown) preferably is positioned inside the blades 110 to prevent the blades from causing excessive turbulence in the blood as the burr is rotated.
By selectively changing the distance between the proximal and distal ends of the burr, the amount by which the blades may expand radially outward changes, thereby allowing the burr to create varying sized lumens in a vessel.
1 S As shown in FIGURE SB, to control the diameter of the burr, the ablation burr 100 includes a tube 120 that transmits power from the drive shaft 24 to the distal end of the burr. At the distal end of the tube 120 is an indexing ring 122 having a diameter that is larger than the diameter of the tube 120. In the proximal rim of the indexing ring 122 are a number of slots 124. Each slot includes a first edge 126 that is canted with respect to the longitudinal axis of the tube 120 and a second edge 128 that extends parallel to the longitudinal axis of the tube 120. Each of the slots 124 disposed around the perimeter of the indexing ring has a different depth that controls the outer diameter of the ablation bun.
Pinned to the proximal end of the tube 120 is a drive tube 130. The drive shaft 24 is secured to the proximal end of the drive tube 130. In addition, the drive tube 130 has a central bore through which the tube 120 can fit. The drive tube includes a longitudinally extending slot 132 on its outer surface into which a pin 134 is fitted. The pin 134 is secured to the outer surface of the tube 120 so that the tube 120 can move longitudinally within the drive tube 130 but torque from the drive tube 130 is transferred to the tube 120 or vice versa.
At the distal end of the drive tube 130 is a fixed washer 136. The fixed washer 136 has a diameter that is larger than the diameter of the drive tube 130. The distal rim of the fixed washer 136 includes a number of teeth 138.
Positioned over the indexing ring 122 is a slide washer 140. The slide washer 140 has an inner diameter substantially equal to the outer diameter of the indexing ring 122 and an outer diameter substantially equal to the outer diameter of the fixed washer 136. The proximal rim of the slide washer 140 contains a number of teeth 142 that mate with the teeth 138 of the fixed washer 136. The slide washer 140 also includes a pin 144 that rides along the edges 126 and 128 of the slots 124 in the indexing ring 122. Finally, the burr includes a spring 150 disposed between the back surface of the ring 113 and the distal end of the slide washer 140.
When rotated by the drive shaft 24, centrifugal force causes the blades 110 to be radially expanded, thereby compressing the tube 120 and the drive tube 130.
This in turn causes the pin 144 to slide along a canted edge 126 of a slot 124 in the indexing ring 122. As the pin 144 travels along the canted edge 126, the teeth 142 on the slide washer 140 rotate with respect to the teeth 138 on the fixed washer 136.
The maximum distance by which the drive tube 130 can be compressed over the tube 120 is limited by the depth of the slots 124 extending around the index ring 122, thereby limiting the diameter of the burr.
To index the ablation burr to its next outer diameter, the bun is pulled into the catheter 106. The flared distal end 108 of the catheter engages the blades 110 and compresses them and the spring 150 causes the pin 144 on the slide washer 140 to travel along the straight edge 128 of a slot 124 to a position proximal to the slots of the indexing ring 122. The force of the spring 150 pushes the slide washer 140 proximally thereby causing the teeth 142 on the slide washer and the teeth 138 on the fixed washer to seat and further rotate the pin 144 to the next slot around the indexing ring 122.
In operation, a physician sets the diameter of the burr to the smallest setting to ablate an initial lumen in the patient's vessel. Then, by sequentially spinning the bun, stopping it and retracting it into the catheter, the diameter can be increased or decreased depending on the position of the pin 144 over the indexing ring 122 until a desired lumen diameter is reached.
In the presently preferred embodiment of the invention, the various components of the indexable burr 100 are made by micro-machining. However, it is believed that other fabrication techniques such as metal injection molding could also be used.
FIGURES 6A and 6B illustrate another embodiment of an indexable ablation burr according to the present invention. The ablation bun 200 includes a drive tube 204 into which the distal end of the drive shaft 24 is inserted and secured. The drive tube 204 also includes a race 206 that circumscribes the perimeter of the drive tube. The race 206 is canted with respect to the longitudinal axis of the drive tube such that the race traverses a portion of the length of the drive tube 204. A
traveling ball 208 rests within the race 206.
Disposed distal to the race 208 is a series of ratchet teeth 210 that are cut into the outer surface of the drive tube 204. The teeth operate to discretely step the maximum outer diameter of the ablation burr and to transfer the rotational motion of the drive shaft 24 to the burr in conjunction with a rachet tab 216 as described below.
Disposed over the proximal end of the drive tube 204 is a proximal locking tube 212. The proximal locking tube 212 is generally cylindrical but has a stepped section 214 at its distal end such that half the perimeter of the proximal locking tube 212 is removed. The locking tube 212 also includes a ratchet tab 216 that extends inwardly from the inner surface of the locking tube in approximately the middle of the stepped section 214. The ratchet tab 216 engages the ratchet teeth 210 when the proximal locking tube 212 is positioned over the drive tube 204.
Finally, the proximal locking tube 212 includes a hole 218 that is cut in the outer surface of the locking tube 212 at a position proximal to the stepped section 214. The hole 218 is sized such that a portion of the traveling ball 208 will extend through the hole 218 when the proximal locking tube 212 is positioned over the drive tube 204.
Axially aligned with the distal end of the drive tube 204 is a distal locking tube 220. The locking tube 220 is generally cylindrical but has a stepped section 222 at its proximal end that mates with the stepped section 214 of the proximal locking tube 212 when the proximal and distal locking tubes are axially aligned. The stepped sections 214 and 222 maintain a rotational coupling between the distal and proximal ends of the ablation burr while allowing the distance between the proximal and distal locking tubes to vary.
Surrounding the burr are a number of blades 226 that extend radially outward from a ring 228. The ring 228 is held in place between a nose cone 230 and a locking ring 232 at the distal end of the burr. The locking ring is secured to the distal end of the distal locking tube 220. The blades 226 are folded back over the outside of the burr and are secured around the proximal end of the locking tube 212 by a leaf retaining ring 236. Although not shown, the ablation burr 200 preferably includes a polymeric liner inside the blades 226 to prevent the blades from causing excessive turbulence in the patient's blood as the burr is rotated.
Finally, the ablation burr 200 includes a traveling tube 240 that fits over the proximal and distal locking tubes 212 and 220. The traveling tube 240 includes a hole 242 disposed in its perimeter. The hole forms a detent into which a top portion of the traveling ball 208 is seated. The distal rim of the traveling tube 240 engages the rear or the proximal surface of the ring 228 from which the blades 226 extend.
To expand or contract the ablation bun 200, the drive shaft 24 is rotated in a direction that is opposite to the direction used during ablation while the blades 226 are held stationary. The ablation bun 200 is retracted into a catheter having a distal end that captures the blades and holds them still as the drive shaft is rotated.
As shown in FIGURE 6B, when the drive tube 204 is rotated in the clockwise direction, the ratchet tab 216 rides over the ratchet teeth 210. This causes the traveling ball 208 to move in the race 206 that extends around the outer surface of the drive tube 204 thereby pushing the traveling tube 240 proximally or distally with respect to the drive tube 204. Because the distal rim of the traveling tube engages the rear or proximal surface of the ring 228 from which the blades 226 extend, the distance between the proximal and distal ends of the blades is varied and hence the maximum expansion of the ablation bun is controlled.
When the drive tube 204 is rotated in the counterclockwise direction and the blades 226 are free, the ratchet teeth 210 engage the ratchet tab 216 causing the traveling tube to rotate with the burr and leaving the traveling ball 208 in the same place in the race 206. Centrifugal force on the blades 226 will cause the nose cone 230 to be drawn proximally until the rear surface of the ring 228 engages the distal rim of the traveling tube 240 and the expansion of the burr is halted.
Therefore, by changing the position of the traveling tube 240 over the main tube 204, the maximum diameter of the bun is controlled.
In operation, the physician may position the traveling ball in the race such that the burr has a minimum diameter in order to create an initial lumen in a vessel. Then the bun is then withdrawn into the catheter to hold the blades and the position of the traveling ball changed to increase the size of the lumen without having to remove the atherectomy device from the patient.
Again, parts of the ablation burr 200 are preferably made by machining but could be made by other techniques such as metal injection molding.
FIGURES 7A and 7B show another alternative embodiment of an indexable ablation bun according to the present invention. The ablation burr 300 includes a drive tube 302 into which the distal end of the drive shaft 24 is inserted and secured.
The drive tube 302 is generally cylindrical except for a stepped semi-circular section 304 at the distal end of the tube, whereby half the circumference of the tube is removed. The drive tube 302 also includes a serpentine channel 306 disposed about the outer surface of the tube proximal to the stepped section 304. The serpentine channel306 operates to control the maximum diameter of the ablation burr in a manner described below.
Disposed over a proximal end of the drive tube 302 is a spring 310. The spring abuts a ring 311 that is formed around the perimeter of the drive tube 302 to prevent the spring from moving forward on the drive tube. Also disposed over the proximal end of the drive tube 302 behind the spring 310 is a proximal locking tube 312. At its proximal rim, the proximal locking tube 312 includes a notch into which a pin 316 that extends radially outward from the proximal end of the drive tube 302 is inserted. The pin 316 operates to transfer rotation energy of the drive tube 302 to the proximal locking tube 312 while allowing the locking tube 312 some axial motion along the drive tube.
Positioned distal to and axially aligned with the drive tube 302 is a distal locking tube 320. The distal locking tube 320 is generally circular with a stepped semi-circular section 322 that mates with the stepped section 304 on the drive tube 302. At the distal end of the burr are a set of blades 330 that extend outwardly from a ring 332 and are held in place at the distal end of the burr by a nose cone 334 and a retaining ring {not shown). The retaining ring is secured within the distal end of the distal locking tube 320. As with the indexable burrs described above, an elastomeric liner is preferably positioned inside the blade to prevent excessive turbulence of the blood in a lumen.
Extending over the drive tube 302 and the distal locking tube 320 is a traveling tube 340. At its proximal end, the traveling tube 340 includes a larger diameter flange 342 with a proximally extending tab 344 secured thereto.
Extending radially inward from the end of the tab 344 is a follower pin 346.
As shown in FIGURE 7B, the tab 344 and follower pin 346 operate as a cam within the serpentine track 306 that is formed around the outer surface of the drive tube 302. The track 306 includes a number of alternating bends 308, 310 that open towards the distal and proximal ends of the drive tube 302, respectively. Each of the bends 308 that open towards the distal end of the drive tube 302 are located at a different position along the length of the drive tube 302.
The depth of the channel 306 varies as the channel proceeds around the drive tube 302. Positioned in the channel near each of the bends 308, 310 is a step 354. At each step, the depth of the channel increases. The depth then decreases in the channel until the next bend where the depth again increases with a step. This pattern continues around the circumference of the drive tube 302.
As the ablation burr 300 is pulled into a catheter having a distal end which prevents the collapse or bending of the blades 330, a pull on the drive coil causes retraction of the drive tube 302. This causes a relative movement of the traveling tube 340 in a distal direction (relative to the drive tube). The follower pin 346 will move to a distal end of the slot in the serpentine channel 306. Releasing the drive coil will allow spring 310 to move the drive tube 302 distal which will result in the traveling tube pin moving into a proximal end of the slot in the serpentine channel 306. As the pin 346 moves back and forth in the channel, it is forced to move in one direction due to a series of ramps in the channel. As the pin 346 moves to the distal end of a slot, it moves over a ramp which prevents it from returning back down that slot. It is forced to return at an angle down to the adjacent slot.
Before reaching the bottom of the adjacent slot, it again travels over a ramp, which prevents it from returning up the slot it had just traveled down. The pin is now in an analogous position to the position in which it started. Because the proximal end of each slot is at a slightly different position (along a proximal/distal line on the drive tube), the overall length of the burr is therefore adjusted with each proximal/distal movement of the pin.
As can be seen from the above description, the present invention provides various mechanisms for selectively controlling the diameter of an ablation burr. By controlling the diameter of the burr, it is not necessary to remove the bun, drive shaft and catheter in order to ablate a larger diameter lumen in a patient.
While the preferred embodiments of the invention has been illustrated and described, it will be appreciated that various changes can be made therein without departing from the spirit and scope of the invention. The scope of the invention should therefore be determined from the following claims and equivalents thereto.
FIGURES 3A-3D illustrate an expandable burr that is formed from a strip of superelastic material according to a third embodiment of the present invention;
FIGURES 4A and 4B illustrate an expandable spring ablation burr including an indexing mechanism to control the outer diameter of the burr according to another aspect of the present invention;
FIGURE SA illustrates an isometric view of an ablation bun including an indexing mechanism for selectively changing the outer diameter of the bun according to another aspect of the present invention;
FIGURE SB illustrates the ablation bun shown in FIGURE SA with the parts shown in an exploded relationship;
FIGURES 6A and 6B illustrate another embodiment of an ablation burr with an indexing mechanism for selectively changing the outer diameter of the burr according to the present invention; and FIGURES 7A and 7B illustrate yet another embodiment of an ablation bun with an indexing mechanism for selectively changing the outer diameter of the burr according to the present invention.
Detailed Description of the Preferred Embodiment As will be explained in further detail below, the present invention is an ablation bun having an outer diameter that may be expanded to exceed the diameter of a guide catheter through which the bun is routed. Additionally, the present invention is an ablation burr including a mechanism for selectively changing the outer diameter of the ablation burr so that varying sized lumens can be created in a patient's vessel using the same burr.
FIGURE lA illustrates an atherectomy device in accordance with a first aspect of the present invention. The atherectomy device 20 is routed from a position outside a patient's body to a point near the site of a vascular occlusion through a guide catheter 22. Extending through the guide catheter 22 is a drive shaft 24 that is coupled at its proximal end to a source of rotational motion such as an electric motor or gas turbine (not shown) that rotates the drive shaft 24 at high speed, e.g., between 20,000 and 250,000 rpm. Disposed at a distal end of the drive shaft 24 is an ablation bun 28 that when rotated by the drive shaft 24 ablates a new lumen through the occlusion in order to permit blood to flow freely through the vessel.
Extending through the drive shaft 24 and the ablation burr 28 is a guide wire 26 that can be steered by a physician in order to guide the ablation burr through the vascular occlusion.
As indicated above, it is generally desirable that the ablation burr 28 be routed through the smallest possible guide catheter to the point near the vascular occlusion.
In the past, if the diameter of the vessel in which the occlusion was located was greater than the diameter of the ablation burr, the entire atherectomy device including drive shaft, ablation burr and catheter had to be removed from the patient and replaced with a larger diameter catheter that could accommodate a larger diameter burr if all of the occlusion was to be removed. To facilitate maximal lumen size after ablation, the maximum outer diameter of the ablation burr 28 is expandable such that its maximum diameter exceeds the diameter of the guide catheter used to route the burr to the site of the occlusion.
According to the embodiment of the invention as shown in FIGURES lA and 1B, the ablation burr 28 comprises a length of hypotube 30 coupled to a distal end of the drive shaft 24. The hypotube 30 includes one or more holes 32 that allow fluid to flow in or out of the hypotube. Surrounding the hypotube 30 is a polymeric balloon 34, having an abrasive 36 disposed on at least a portion of the outer surface of the balloon. The distal end of the ablation burr 28 fits behind a concave surface of a tip 37 that prevents the seal of the polymeric balloon from becoming unglued from the hypotube 30 as the burr is advanced through an occlusion.
When the drive shaft is not being rotated, the balloon 34 collapses into an unexpended state as shown in FIGURE lA. In its unexpended state, the outer diameter of the ablation burr 28 is smaller than the inner diameter of the guide catheter 22.
When the drive shaft 24 is rotated, fluid surrounding the drive shaft or within the drive shaft is expelled through the holes 32 in the hypotube causing the balloon 34 to expand to its maximum diameter. The maximum diameter is generally larger than the inner diameter of the guide catheter 22. The bun is then advanced over the occlusion to create a lumen in the patient's vessel. When the drive shaft 24 ceases to rotate, the balloon 34 collapses, and the burr can be removed through the guide catheter 22.
In the presently preferred embodiment of the invention, the polymeric balloon 34 is made from a non-stretchable plastic material such as an oriented polyethylene terephthalate polymer (PET). However, it is believed that other plastics or elastomeric materials may also be used.
The abrasive 36 disposed on the outer surface of the balloon preferably comprises small diamond. chips approximately 2-25 microns in size.
If the balloon 34 is made of PET, the abrasive 36 is secured to the balloon by creating a thin base layer of silver using vacuum deposition techniques. Once the base layer is applied to the balloon, a layer of metal such as nickel having a slurry of diamond particles disposed therein can be plated to the base layer using an electro- or electroless plating method as is done with conventional burrs.
In some instances, it may be desirable to etch or mask a portion of the balloon with a pattern of dots or other shapes so that the base layer does not completely surround the balloon. If the abrasive is only plated to the etched pattern, it may allow the balloon to more easily expand and collapse.
In addition to electroplating, it is believed that other techniques could be used to secure the abrasive to the balloon, such as by using an adhesive or chemically bonding sites on the outer surface of the polymeric balloon to which metal ions such as copper, silver, gold, or nickel may bond. These sites may be bonded to the balloon surface using a high-vacuum plasma system or by incorporating chemicals (such as carbon, silver, etc.) with the polymer prior to the extrusion of the balloon.
Alternatively, it is believed that pulse cathode arc ion deposition could be used to incorporate bonding sites on the surface of the elastomer.
FIGURES 2A and 2B illustrate another embodiment of an expandable ablation burr according to the present invention. The expandable ablation bun 40 is mounted to the distal end of a conventional drive shaft 24 that rotates the bun at high speeds.
A guide wire 26 extends through the drive shaft 24 and the ablation bun 40 so that the burr can guide through a vascular occlusion. The bun is formed as a solid core (except for the lumen through which the guide wire extends) that is made of metal or other suitable material and includes a generally bullet-shaped nose section 42 having a maximum diameter that begins at approximately the midpoint of the burr and tapers in diameter to the distal tip of the burr. The burr 40 also contains a proximal stepped section 44 having a substantially constant diameter that is less than the maximum diameter of the nose section.
Secured over the stepped section 44 of the burr with an adhesive or a mechanical fastener is a polymeric tube 46 having an outer diameter that is substantially equal to or greater than the maximum outer diameter of the nose section 42. The length of the polymeric tube 46 is preferably longer than the length of the stepped section 44 such that a portion of the polymeric tube overhangs the WO 99/44513 PC'f/US99/03851 _g_ proximal end of the solid core. An abrasive coating is disposed on at least a portion of the outer surface of the tube 46 and the nose section 42. The abrasive is secured to the tube 46 in the same manner as the abrasive is secured to the expandable balloon described above.
S When the drive shaft 24 is not rotated, the ablation burr 40 has a maximum outer diameter that is smaller than the inner diameter of a guide catheter 22 through which the burr is routed.
As shown in FIGURE 2B, when the drive shaft 24 is rotated, the proximal end of the elastomeric tube 46 expands due to centrifugal force. The proximal end of the ablation bun 40 extends radially outward, therefore allowing the bun to ablate a larger lumen as it is advanced in a vessel. As the drive shaft 24 is slowed, the centrifugal force on the proximal end of the polymeric tube 46 decreases and the outer diameter of the ablation burr returns to its unexpanded state. The ablation burr can then be withdrawn from the patient through the guide catheter 22.
FIGURES 2C and 2D illustrate a cross-section of an alternative embodiment of the expandable ablation bun shown in FIGURES 2A and 2B. An ablation bun 40' includes a generally solid core including a distal nose section 42 and a proximal stepped section 44. A polymeric tube 46' is bonded to the stepped section 44 such that the outer diameter of the polymeric tube is approximately equal to the maximum diameter of the nose section 42 when the burr is in an unexpanded state. In contrast to the embodiment shown in FIGURES 2A and 2B, a proximal end 48 of the polymeric tube 46' is tapered to the drive shaft 24. In addition, the polymeric tube 46' includes one or more holes 50 disposed about its periphery to control the outer diameter of the burr as the burr is rotated.
FIGURE 2D illustrates the ablation burr 40' as the drive shaft 24 is rotated.
Centrifugal force causes a center section of the polymeric tube that lies between the proximal end of the solid core and the proximal end 48 of the tube to expand radially outward. As the burr begins spinning, centrifugal force expands the polymeric tube.
Fluid then fills the interior cavity of the tube and is also acted on by the centrifugal force. To prevent the tube from over expanding, fluid is allowed to vent out the one or more holes 50 that surround the tube 46' such that the volumetric rate at which the fluid vents from the tube reaches an equilibrium with the volumetric rate at which it enters the interior of the tube and the expansion of the tube is halted. The one or more holes 50 increase in size as the speed of the bun increases and the tube expands.
As the rotational speed of the ablation burr is decreased, the outer diameter of the WO 99/44513 PCT/US99l03851 bun decreases so that the burr can be withdrawn through the catheter. Because the end 48 of the polymeric tube 46' is closed to meet the drive shaft 24, the polymeric tube 46' is less likely to catch the distal end of the guide catheter as the burr is withdrawn from the patient.
Although the polymeric tube is preferably positioned at the proximal end of the bun, it may be advantageous to place the tube at the distal end of the burr in order to remove certain occlusions.
In simulated ablation tests, the ablation burrs illustrated in FIGURES 2A-2D
appear to cause less trauma to the vessel walls and a more even cutting than a conventional burr. In addition, the spinning polymeric tube appears to self center the bun in the center of the patient's vessel. Finally, it is believed that the increased surface area of the polymeric tube creates less heat at the point where it contacts the occlusion, thereby reducing the likelihood of vessel spasm or clotting.
It is currently believed that polymer used to make the polymeric tube should have a stress/strain characteristic that allows the materials to be stretched to a known point but not beyond. One technique to achieve the desired stress/strain characteristics is to stretch the polymeric material as it cools.
Alternatively, it is possible to incorporate an inelastic string or band into the tube that straightens as the tube expands and reaches a maximum size but cannot be stretched any further.
In some instances, it may be desirable to coat the outer surface of the core and polymeric tube with a hydrophilic coating such as HydropassTM, available from Boston Scientific and described in U.S. Patent No. 5,702,754. The hydrophilic coating attracts water molecules, thereby making the surface slippery and easier to advance along the guide catheter. In addition, the hydrophilic coating may be beneficial during ablation since less torque may be transferred to a vessel wall if the bun stalls. In addition, the differential cutting ability of the burr may be enhanced due to the increased ability of the burr to slide over soft tissues.
FIGURES 3A-3D illustrate yet another embodiment of an expandable ablation bun according to the present invention. Secured to the distal end of a drive shaft 24 is a mandrel 60. The mandrel is cylindrical and has a generally bullet-shaped nose at the distal and proximal ends and a central lumen 62 extending through it so that the mandrel may be threaded over a guide wire 26. A central portion 61 of the mandrel has a reduced diameter compared to the maximum diameter of the distal and proximal ends. Surrounding the central cylindrical portion 61 of the mandrel 60 is a metallic strip 64 that is coiled around the mandrel as a spring. The metallic strip 64 preferably has a length that is equal to the length between the bullet-shaped ends of the mandrel f0 and a width that is selected such that the strip wraps completely around the mandrel with some overlap onto itself. The metallic strip 64 includes a tab 66 that is fixed within a corresponding slot 68 disposed on the outer surface of the mandrel as S shown in the cross-section FIGURE 3B viewed from the distal end of the ablation burr. The tab is secured in the slot with either an adhesive or by welding the tab in the slot.
At least a portion of the outer surface of the metallic strip 64 and the distal end of the mandrel 60 is covered with an abrasive 72 that is plated onto the strip and mandrel in order to ablate a vascular occlusion when the ablation bun is rotated.
FIGURES 3C and 3D illustrate a cross section of the drive shaft, metallic strip, and mandrel. in order to fit the ablation bun within the guide catheter 22, the metallic strip 64 is more tightly wrapped around the mandrel in order to reduce its outer diameter as shown in FIGURE 3D. Upon emerging from the distal end of the 1 S catheter 22, the metallic strip will spring open to resume its original shape shown in FIGURE 3C and its outer diameter will therefore increase. Because the proximal and distal ends of the metallic strip 64 are tapered to follow the contour of the bullet-shaped ends of the mandrel, the metallic strip can be recompressed by pulling it into the distal end of the guide catheter 22.
In the presently preferred embodiment of the invention, the metallic strip 64 is made of a superelastic metal such as Nitinol.
As will be appreciated, to ablate an occlusion in a blood vessel, the metallic strip 64 must be rotated in the direction of the arrow 74 (FIGURE 3B) such that an edge 70 of the strip extending along the length of the bun trails the movement of the bun in order to avoid further uncoiling the strip and possibly cutting into the vessel wall.
Yet another alternative embodiment of the expandable ablation burr of the present invention is shown in FIGURES 4A and 4B. The ablation burr 80 includes a coiled wire spring 82 that is wound around the longitudinal axis of a central drive tube 84. Plated to the outer surfaces of at least some of the individual spring coils is an abrasive to ablate an occlusion in a patient's vessel as the burr is rotated. The spring 82 is wound into a generally ellipsoidal shape with a maximum diameter at a midpoint that is larger than the diameter of the guide catheter 22 through which the bun is routed. The distal end of the spring 82 is secured to a nose cone 86 at the WO 99/44513 PC'f/US99103851 distal end of the burr while the proximal end of the spring is secured to the proximal end of the drive tube 84 by a band 85 that overlaps a few proximal coils of the spring.
The drive tube 84 has a proximal lumen 90 into which the distal end of the drive shaft 24 is inserted and secured. A distal lumen 92 of the tube receives a correspondingly shaped shaft 94 that extends from a rear surface of the nose cone 86.
The distal lumen 92 and the shaft 94 of the nose cone are shaped such that the shaft moves axially within the lumen but cannot be rotated in the lumen. Therefore, any torque induced in the drive tube 84 by the drive shaft 24 will be transmitted to the nose cone 86 and the distal end of the spring 82. Although not shown in FIGURES 4A and 4B, the drive tube 84 and nose cone 86 preferably include a lumen extending therethrough for passage of a guide wire.
When the ablation burr 80 is positioned in the guide catheter 22 as shown in FIGURE 4A, the spring 82 is compressed, thereby reducing its outer diameter.
When the ablation burr 80 extends out the distal end of the guide catheter 22, as shown in 1 S FIGURE 4B, the spring 82 expands into its ellipsoidal shape, thereby increasing the maximum outer diameter of the bun. As the spring 82 expands radially outward, the shaft 94 of the nose cone 86 is drawn into the distal lumen 92. Rotation of the burr will further draw the shaft 94 into the distal lumen 92 until the proximal end of the shaft engages the end of the lumen 92. The length of the lumen 92 and the shaft 94 of the nose cone therefore control the maximum diameter of the spring 82. As a bun is withdrawn into the guide catheter 22, the spring 82 is compressed and the shaft 94 will move distally in the lumen 92.
In many instances, it is desirable to have an ablation burr that can assume several fixed outer diameters. For example, when creating an initial lumen in an occluded vessel, it is generally advisable to utilize the smallest diameter bun available.
In the past, if the size of the lumen needed to be increased, the entire ablation bun had to be removed from the patient and successively larger burrs used until a lumen of the desired size was created. To eliminate the need for multiple ablation burrs, another aspect of the invention is an ablation burr with an indexable outer diameter.
As the burr is rotated and passed over an occlusion, the outer diameter of the bun can be selectively increased to remove additional occluding material from the vessel.
FIGURES SA and SB illustrate a first embodiment of an ablation burr according to the present invention having an indexable outer diameter. The ablation bun 100 is disposed at the distal end of a drive shaft 24. The bun includes a central lumen so that the ablation burr can be passed over a guide wire 104.
Surrounding the drive shaft 24 is a catheter 106 having a flared distal end 108 that operates to aid in selectively changing the outer diameter of the bun in a manner described below.
To remove the occluding material from a vessel, the ablation bun includes a number of leaf blades 110 that are secured between a nose cone 112 and a ring 113 at the distal end of the burr. The blades 110 extend proximally over the burr to a leaf retaining ring 114 at the proximal end of the bun. At least a portion of each blade 110 is covered with an abrasive 116 such that when the ablation burr 100 is rotated by the drive shaft 24, the abrasive 116 will remove occluding material from a patient's blood vessel. A polymeric sleeve (not shown) preferably is positioned inside the blades 110 to prevent the blades from causing excessive turbulence in the blood as the burr is rotated.
By selectively changing the distance between the proximal and distal ends of the burr, the amount by which the blades may expand radially outward changes, thereby allowing the burr to create varying sized lumens in a vessel.
1 S As shown in FIGURE SB, to control the diameter of the burr, the ablation burr 100 includes a tube 120 that transmits power from the drive shaft 24 to the distal end of the burr. At the distal end of the tube 120 is an indexing ring 122 having a diameter that is larger than the diameter of the tube 120. In the proximal rim of the indexing ring 122 are a number of slots 124. Each slot includes a first edge 126 that is canted with respect to the longitudinal axis of the tube 120 and a second edge 128 that extends parallel to the longitudinal axis of the tube 120. Each of the slots 124 disposed around the perimeter of the indexing ring has a different depth that controls the outer diameter of the ablation bun.
Pinned to the proximal end of the tube 120 is a drive tube 130. The drive shaft 24 is secured to the proximal end of the drive tube 130. In addition, the drive tube 130 has a central bore through which the tube 120 can fit. The drive tube includes a longitudinally extending slot 132 on its outer surface into which a pin 134 is fitted. The pin 134 is secured to the outer surface of the tube 120 so that the tube 120 can move longitudinally within the drive tube 130 but torque from the drive tube 130 is transferred to the tube 120 or vice versa.
At the distal end of the drive tube 130 is a fixed washer 136. The fixed washer 136 has a diameter that is larger than the diameter of the drive tube 130. The distal rim of the fixed washer 136 includes a number of teeth 138.
Positioned over the indexing ring 122 is a slide washer 140. The slide washer 140 has an inner diameter substantially equal to the outer diameter of the indexing ring 122 and an outer diameter substantially equal to the outer diameter of the fixed washer 136. The proximal rim of the slide washer 140 contains a number of teeth 142 that mate with the teeth 138 of the fixed washer 136. The slide washer 140 also includes a pin 144 that rides along the edges 126 and 128 of the slots 124 in the indexing ring 122. Finally, the burr includes a spring 150 disposed between the back surface of the ring 113 and the distal end of the slide washer 140.
When rotated by the drive shaft 24, centrifugal force causes the blades 110 to be radially expanded, thereby compressing the tube 120 and the drive tube 130.
This in turn causes the pin 144 to slide along a canted edge 126 of a slot 124 in the indexing ring 122. As the pin 144 travels along the canted edge 126, the teeth 142 on the slide washer 140 rotate with respect to the teeth 138 on the fixed washer 136.
The maximum distance by which the drive tube 130 can be compressed over the tube 120 is limited by the depth of the slots 124 extending around the index ring 122, thereby limiting the diameter of the burr.
To index the ablation burr to its next outer diameter, the bun is pulled into the catheter 106. The flared distal end 108 of the catheter engages the blades 110 and compresses them and the spring 150 causes the pin 144 on the slide washer 140 to travel along the straight edge 128 of a slot 124 to a position proximal to the slots of the indexing ring 122. The force of the spring 150 pushes the slide washer 140 proximally thereby causing the teeth 142 on the slide washer and the teeth 138 on the fixed washer to seat and further rotate the pin 144 to the next slot around the indexing ring 122.
In operation, a physician sets the diameter of the burr to the smallest setting to ablate an initial lumen in the patient's vessel. Then, by sequentially spinning the bun, stopping it and retracting it into the catheter, the diameter can be increased or decreased depending on the position of the pin 144 over the indexing ring 122 until a desired lumen diameter is reached.
In the presently preferred embodiment of the invention, the various components of the indexable burr 100 are made by micro-machining. However, it is believed that other fabrication techniques such as metal injection molding could also be used.
FIGURES 6A and 6B illustrate another embodiment of an indexable ablation burr according to the present invention. The ablation bun 200 includes a drive tube 204 into which the distal end of the drive shaft 24 is inserted and secured. The drive tube 204 also includes a race 206 that circumscribes the perimeter of the drive tube. The race 206 is canted with respect to the longitudinal axis of the drive tube such that the race traverses a portion of the length of the drive tube 204. A
traveling ball 208 rests within the race 206.
Disposed distal to the race 208 is a series of ratchet teeth 210 that are cut into the outer surface of the drive tube 204. The teeth operate to discretely step the maximum outer diameter of the ablation burr and to transfer the rotational motion of the drive shaft 24 to the burr in conjunction with a rachet tab 216 as described below.
Disposed over the proximal end of the drive tube 204 is a proximal locking tube 212. The proximal locking tube 212 is generally cylindrical but has a stepped section 214 at its distal end such that half the perimeter of the proximal locking tube 212 is removed. The locking tube 212 also includes a ratchet tab 216 that extends inwardly from the inner surface of the locking tube in approximately the middle of the stepped section 214. The ratchet tab 216 engages the ratchet teeth 210 when the proximal locking tube 212 is positioned over the drive tube 204.
Finally, the proximal locking tube 212 includes a hole 218 that is cut in the outer surface of the locking tube 212 at a position proximal to the stepped section 214. The hole 218 is sized such that a portion of the traveling ball 208 will extend through the hole 218 when the proximal locking tube 212 is positioned over the drive tube 204.
Axially aligned with the distal end of the drive tube 204 is a distal locking tube 220. The locking tube 220 is generally cylindrical but has a stepped section 222 at its proximal end that mates with the stepped section 214 of the proximal locking tube 212 when the proximal and distal locking tubes are axially aligned. The stepped sections 214 and 222 maintain a rotational coupling between the distal and proximal ends of the ablation burr while allowing the distance between the proximal and distal locking tubes to vary.
Surrounding the burr are a number of blades 226 that extend radially outward from a ring 228. The ring 228 is held in place between a nose cone 230 and a locking ring 232 at the distal end of the burr. The locking ring is secured to the distal end of the distal locking tube 220. The blades 226 are folded back over the outside of the burr and are secured around the proximal end of the locking tube 212 by a leaf retaining ring 236. Although not shown, the ablation burr 200 preferably includes a polymeric liner inside the blades 226 to prevent the blades from causing excessive turbulence in the patient's blood as the burr is rotated.
Finally, the ablation burr 200 includes a traveling tube 240 that fits over the proximal and distal locking tubes 212 and 220. The traveling tube 240 includes a hole 242 disposed in its perimeter. The hole forms a detent into which a top portion of the traveling ball 208 is seated. The distal rim of the traveling tube 240 engages the rear or the proximal surface of the ring 228 from which the blades 226 extend.
To expand or contract the ablation bun 200, the drive shaft 24 is rotated in a direction that is opposite to the direction used during ablation while the blades 226 are held stationary. The ablation bun 200 is retracted into a catheter having a distal end that captures the blades and holds them still as the drive shaft is rotated.
As shown in FIGURE 6B, when the drive tube 204 is rotated in the clockwise direction, the ratchet tab 216 rides over the ratchet teeth 210. This causes the traveling ball 208 to move in the race 206 that extends around the outer surface of the drive tube 204 thereby pushing the traveling tube 240 proximally or distally with respect to the drive tube 204. Because the distal rim of the traveling tube engages the rear or proximal surface of the ring 228 from which the blades 226 extend, the distance between the proximal and distal ends of the blades is varied and hence the maximum expansion of the ablation bun is controlled.
When the drive tube 204 is rotated in the counterclockwise direction and the blades 226 are free, the ratchet teeth 210 engage the ratchet tab 216 causing the traveling tube to rotate with the burr and leaving the traveling ball 208 in the same place in the race 206. Centrifugal force on the blades 226 will cause the nose cone 230 to be drawn proximally until the rear surface of the ring 228 engages the distal rim of the traveling tube 240 and the expansion of the burr is halted.
Therefore, by changing the position of the traveling tube 240 over the main tube 204, the maximum diameter of the bun is controlled.
In operation, the physician may position the traveling ball in the race such that the burr has a minimum diameter in order to create an initial lumen in a vessel. Then the bun is then withdrawn into the catheter to hold the blades and the position of the traveling ball changed to increase the size of the lumen without having to remove the atherectomy device from the patient.
Again, parts of the ablation burr 200 are preferably made by machining but could be made by other techniques such as metal injection molding.
FIGURES 7A and 7B show another alternative embodiment of an indexable ablation bun according to the present invention. The ablation burr 300 includes a drive tube 302 into which the distal end of the drive shaft 24 is inserted and secured.
The drive tube 302 is generally cylindrical except for a stepped semi-circular section 304 at the distal end of the tube, whereby half the circumference of the tube is removed. The drive tube 302 also includes a serpentine channel 306 disposed about the outer surface of the tube proximal to the stepped section 304. The serpentine channel306 operates to control the maximum diameter of the ablation burr in a manner described below.
Disposed over a proximal end of the drive tube 302 is a spring 310. The spring abuts a ring 311 that is formed around the perimeter of the drive tube 302 to prevent the spring from moving forward on the drive tube. Also disposed over the proximal end of the drive tube 302 behind the spring 310 is a proximal locking tube 312. At its proximal rim, the proximal locking tube 312 includes a notch into which a pin 316 that extends radially outward from the proximal end of the drive tube 302 is inserted. The pin 316 operates to transfer rotation energy of the drive tube 302 to the proximal locking tube 312 while allowing the locking tube 312 some axial motion along the drive tube.
Positioned distal to and axially aligned with the drive tube 302 is a distal locking tube 320. The distal locking tube 320 is generally circular with a stepped semi-circular section 322 that mates with the stepped section 304 on the drive tube 302. At the distal end of the burr are a set of blades 330 that extend outwardly from a ring 332 and are held in place at the distal end of the burr by a nose cone 334 and a retaining ring {not shown). The retaining ring is secured within the distal end of the distal locking tube 320. As with the indexable burrs described above, an elastomeric liner is preferably positioned inside the blade to prevent excessive turbulence of the blood in a lumen.
Extending over the drive tube 302 and the distal locking tube 320 is a traveling tube 340. At its proximal end, the traveling tube 340 includes a larger diameter flange 342 with a proximally extending tab 344 secured thereto.
Extending radially inward from the end of the tab 344 is a follower pin 346.
As shown in FIGURE 7B, the tab 344 and follower pin 346 operate as a cam within the serpentine track 306 that is formed around the outer surface of the drive tube 302. The track 306 includes a number of alternating bends 308, 310 that open towards the distal and proximal ends of the drive tube 302, respectively. Each of the bends 308 that open towards the distal end of the drive tube 302 are located at a different position along the length of the drive tube 302.
The depth of the channel 306 varies as the channel proceeds around the drive tube 302. Positioned in the channel near each of the bends 308, 310 is a step 354. At each step, the depth of the channel increases. The depth then decreases in the channel until the next bend where the depth again increases with a step. This pattern continues around the circumference of the drive tube 302.
As the ablation burr 300 is pulled into a catheter having a distal end which prevents the collapse or bending of the blades 330, a pull on the drive coil causes retraction of the drive tube 302. This causes a relative movement of the traveling tube 340 in a distal direction (relative to the drive tube). The follower pin 346 will move to a distal end of the slot in the serpentine channel 306. Releasing the drive coil will allow spring 310 to move the drive tube 302 distal which will result in the traveling tube pin moving into a proximal end of the slot in the serpentine channel 306. As the pin 346 moves back and forth in the channel, it is forced to move in one direction due to a series of ramps in the channel. As the pin 346 moves to the distal end of a slot, it moves over a ramp which prevents it from returning back down that slot. It is forced to return at an angle down to the adjacent slot.
Before reaching the bottom of the adjacent slot, it again travels over a ramp, which prevents it from returning up the slot it had just traveled down. The pin is now in an analogous position to the position in which it started. Because the proximal end of each slot is at a slightly different position (along a proximal/distal line on the drive tube), the overall length of the burr is therefore adjusted with each proximal/distal movement of the pin.
As can be seen from the above description, the present invention provides various mechanisms for selectively controlling the diameter of an ablation burr. By controlling the diameter of the burr, it is not necessary to remove the bun, drive shaft and catheter in order to ablate a larger diameter lumen in a patient.
While the preferred embodiments of the invention has been illustrated and described, it will be appreciated that various changes can be made therein without departing from the spirit and scope of the invention. The scope of the invention should therefore be determined from the following claims and equivalents thereto.
Claims (24)
1. An atherectomy device for ablating an occlusion in a patient's blood vessel, comprising:
a drive shaft;
an ablation burr secured to the drive shaft, the burr including a polymeric balloon having an unexpanded state with a first diameter and an expanded state with a second larger diameter, the polymeric balloon further including an abrasive coating disposed on at least a portion of its exterior surface to ablate an occlusion in a patient's vessel; and a lumen extending through the drive shaft and ablation burr for receiving a guide wire.
a drive shaft;
an ablation burr secured to the drive shaft, the burr including a polymeric balloon having an unexpanded state with a first diameter and an expanded state with a second larger diameter, the polymeric balloon further including an abrasive coating disposed on at least a portion of its exterior surface to ablate an occlusion in a patient's vessel; and a lumen extending through the drive shaft and ablation burr for receiving a guide wire.
2. The atherectomy device of Claim 1, wherein the ablation burr further comprises:
a tube including one or more holes disposed at the distal end of the drive shaft, wherein the polymeric balloon is disposed over the tube.
a tube including one or more holes disposed at the distal end of the drive shaft, wherein the polymeric balloon is disposed over the tube.
3. The atherectomy device of Claim 2, wherein the tube includes one or more holes disposed on an outer surface thereof for passage of a fluid into and out of the polymeric balloon.
4. The atherectomy device of Claim 1, wherein the polymeric balloon is made of a non-stretchable plastic.
5. The atherectomy device of Claim 1, wherein the polymeric balloon assumes the expanded state when rotated by the drive shaft.
6. An atherectomy device for ablating an occlusion in a patient's blood vessel, comprising:
a drive shaft;
an ablation burr secured to the drive shaft, the burr including a nose section having a fixed maximum diameter and a polymeric section having an abrasive disposed on at least a portion thereof, the polymeric section having a diameter that increases as the burr is rotated by the drive shaft; and a lumen extending through the drive shaft and ablation burr for receiving a guide wire.
a drive shaft;
an ablation burr secured to the drive shaft, the burr including a nose section having a fixed maximum diameter and a polymeric section having an abrasive disposed on at least a portion thereof, the polymeric section having a diameter that increases as the burr is rotated by the drive shaft; and a lumen extending through the drive shaft and ablation burr for receiving a guide wire.
7. The atherectomy device of Claim 6, wherein the ablation burr comprises a core with the nose section having a maximum diameter approximately midway along a length of the burr and tapering toward a distal end of the burr and a stepped section of a substantially constant diameter that is smaller than the maximum diameter of the nose section, wherein the polymeric section comprises a polymeric tube disposed over the stepped section.
8. The atherectomy device of Claim 7, wherein an end of the polymeric tube is spaced from the drive shaft.
9. The atherectomy device of Claim 7, wherein the polymeric tube engages the drive shaft.
10. The atherectomy device of Claim 9, wherein the polymeric tube includes one or more holes disposed around a circumference thereof.
11. An atherectomy device for ablating an occlusion in a patient's blood vessel, comprising:
a drive shaft;
a mandrel coupled to the drive shaft;
a compressible strip wound around the mandrel, the compressible strip including an abrasive disposed on at least a portion thereof for ablating an occlusion, the strip having a first diameter when the strip is tightly coiled around the mandrel and a second, larger diameter when not tightly coiled around the mandrel; and a lumen extending through the drive shaft and mandrel for receiving a guide wire.
a drive shaft;
a mandrel coupled to the drive shaft;
a compressible strip wound around the mandrel, the compressible strip including an abrasive disposed on at least a portion thereof for ablating an occlusion, the strip having a first diameter when the strip is tightly coiled around the mandrel and a second, larger diameter when not tightly coiled around the mandrel; and a lumen extending through the drive shaft and mandrel for receiving a guide wire.
12. The atherectomy device of Claim 11, wherein the ablation burr has a diameter at its proximal and distal ends that is smaller than a diameter at a midpoint of the burr.
13. The atherectomy device of Claim 11, wherein the mandrel includes a slot and the expandable strip includes a tab that cooperates with the slot to secure the metallic strip to the mandrel.
14. The atherectomy device of Claim 11, wherein the expandable strip is made of a superelastic metal.
15. An atherectomy device for ablating an occlusion in a patient's blood vessel, comprising:
a drive shaft;
a drive tube coupled to the distal end of the drive shaft;
a nose cone that slides within a lumen at a distal end of the drive tube; and a wire spring having a first end coupled to a proximal end of the drive tube a second end coupled to the nose cone, the wire spring having an outer diameter that increases as the drive shaft is rotated, the outer diameter of the wire spring being limited by a length of travel of the nose cone and an abrasive disposed on an outer surface thereof, in the lumen at the distal end of the drive tube.
a drive shaft;
a drive tube coupled to the distal end of the drive shaft;
a nose cone that slides within a lumen at a distal end of the drive tube; and a wire spring having a first end coupled to a proximal end of the drive tube a second end coupled to the nose cone, the wire spring having an outer diameter that increases as the drive shaft is rotated, the outer diameter of the wire spring being limited by a length of travel of the nose cone and an abrasive disposed on an outer surface thereof, in the lumen at the distal end of the drive tube.
16. The atherectomy device of Claim 15, wherein the nose cone and the lumen at the distal end of the drive tube have a cooperating shape such that they can slide axially with respect to one another but cannot rotate with respect to one another.
17. An atherectomy device for ablating an occlusion from a patient's vessel, comprising:
a drive shaft;
an ablation bun coupled to the drive shaft that includes a number of cutting blades having an abrasive disposed therein, the cutting blades including a first end coupled to a distal end of the burr and a second end coupled to a proximal end of the burr, the burr further including an indexing mechanism for selectively changing a maximum outer diameter of the burr, and a lumen extending through the drive shaft and ablation burr for receiving a guide wire.
a drive shaft;
an ablation bun coupled to the drive shaft that includes a number of cutting blades having an abrasive disposed therein, the cutting blades including a first end coupled to a distal end of the burr and a second end coupled to a proximal end of the burr, the burr further including an indexing mechanism for selectively changing a maximum outer diameter of the burr, and a lumen extending through the drive shaft and ablation burr for receiving a guide wire.
18. The atherectomy device of Claim 17, wherein the indexing mechanism changes a length between the distal and proximal ends of the bun in order to change the maximum outer diameter of the burr.
19. The atherectomy device of Claim 18, wherein the indexing mechanism comprises:
an indexing ring disposed on a distal tube, the indexing ring having a number of slots having varying depths, each slot including an edge that is canted with respect to the longitudinal axis of the distal tube and an edge that is substantially parallel with respect to the longitudinal axis of the distal tube;
a proximal drive tube attached to a drive shaft and is slidably secured to the proximal end of the distal tube, the proximal drive tube including a distal rim having a number of teeth disposed thereon; and a slide washer that fits over the indexing ring, the slide washer including a proximal rim with a number of teeth that engage the teeth on the proximal drive tube, the slide washer also including a pin that rides along the edges of the slots on the indexing ring, the pin seating in one of the slots to change the distance between the proximal and distal ends of the burr in order to change the maximum outer diameter of the ablation burr.
an indexing ring disposed on a distal tube, the indexing ring having a number of slots having varying depths, each slot including an edge that is canted with respect to the longitudinal axis of the distal tube and an edge that is substantially parallel with respect to the longitudinal axis of the distal tube;
a proximal drive tube attached to a drive shaft and is slidably secured to the proximal end of the distal tube, the proximal drive tube including a distal rim having a number of teeth disposed thereon; and a slide washer that fits over the indexing ring, the slide washer including a proximal rim with a number of teeth that engage the teeth on the proximal drive tube, the slide washer also including a pin that rides along the edges of the slots on the indexing ring, the pin seating in one of the slots to change the distance between the proximal and distal ends of the burr in order to change the maximum outer diameter of the ablation burr.
20. The atherectomy device of Claim 19, wherein the pin on the slide washer rotates around the indexing ring to seat in each of the slots.
21. The atherectomy device of Claim 18, wherein the indexing mechanism comprises:
a drive tube disposed at the distal end of the drive shaft, the drive tube including a race that extends around the perimeter of the drive tube and is centered with respect to a longitudinal axis of the drive tube and a number of ratchet teeth that extend around the perimeter of the drive tube;
a traveling ball disposed in the race;
a proximal locking tube that extends over the drive tube including a hole through which a portion of the traveling ball extends and a ratchet tab that engages the ratchet teeth on the drive tube;
a distal locking tube that is coupled to the distal end of the burr, the distal locking tube being slidably aligned with the proximal locking tube; and a traveling tube positioned over the distal and proximal locking tubes, the traveling tube including a hole that receives the traveling ball, and a distal rim that limits the travel of the distal locking tube with respect to the proximal locking tube wherein the traveling ball moves in the race and moves the traveling tube along the length of the drive tube in order to change a maximum outer diameter of the burr; and
a drive tube disposed at the distal end of the drive shaft, the drive tube including a race that extends around the perimeter of the drive tube and is centered with respect to a longitudinal axis of the drive tube and a number of ratchet teeth that extend around the perimeter of the drive tube;
a traveling ball disposed in the race;
a proximal locking tube that extends over the drive tube including a hole through which a portion of the traveling ball extends and a ratchet tab that engages the ratchet teeth on the drive tube;
a distal locking tube that is coupled to the distal end of the burr, the distal locking tube being slidably aligned with the proximal locking tube; and a traveling tube positioned over the distal and proximal locking tubes, the traveling tube including a hole that receives the traveling ball, and a distal rim that limits the travel of the distal locking tube with respect to the proximal locking tube wherein the traveling ball moves in the race and moves the traveling tube along the length of the drive tube in order to change a maximum outer diameter of the burr; and
22. The atherectomy device of Claim 18, wherein the indexing mechanism comprises:
a drive tube disposed at the end of the drive shaft, the drive tube including a serpentine channel that extends around the drive tube, the channel including a number of bends that are located at varying positions along the drive tube;
a distal locking tube that is coupled to the distal end of the burr and is slidably aligned with the drive tube; and a traveling tube disposed over the drive tube and the distal locking tube, the traveling tube including a pin that moves in the serpentine channel and rests in one of the number of bends to move the traveling tube along the length of the drive tube in order to change a maximum outer diameter of the burr.
a drive tube disposed at the end of the drive shaft, the drive tube including a serpentine channel that extends around the drive tube, the channel including a number of bends that are located at varying positions along the drive tube;
a distal locking tube that is coupled to the distal end of the burr and is slidably aligned with the drive tube; and a traveling tube disposed over the drive tube and the distal locking tube, the traveling tube including a pin that moves in the serpentine channel and rests in one of the number of bends to move the traveling tube along the length of the drive tube in order to change a maximum outer diameter of the burr.
23. The atherectomy device of Claim 19, wherein the serpentine channel includes a number of steps that direct the pin in a predefined direction within the channel.
24. The atherectomy device of Claim 17, wherein the cutting blades extend radially outward from a ring at the distal end of the burr and are folded over the burr and secured at the proximal end of the burr.
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
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US7696398P | 1998-03-05 | 1998-03-05 | |
US60/076,963 | 1998-03-05 | ||
US09/178,449 US6096054A (en) | 1998-03-05 | 1998-10-23 | Expandable atherectomy burr and method of ablating an occlusion from a patient's blood vessel |
US09/178,449 | 1998-10-23 | ||
PCT/US1999/003851 WO1999044513A2 (en) | 1998-03-05 | 1999-02-22 | Expandable atherectomy burr |
Publications (1)
Publication Number | Publication Date |
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CA2322651A1 true CA2322651A1 (en) | 1999-09-10 |
Family
ID=26758701
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002322651A Abandoned CA2322651A1 (en) | 1998-03-05 | 1999-02-22 | Expandable atherectomy burr |
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US (4) | US6096054A (en) |
EP (1) | EP1059885A2 (en) |
JP (1) | JP2003504090A (en) |
CA (1) | CA2322651A1 (en) |
WO (1) | WO1999044513A2 (en) |
Families Citing this family (221)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6183487B1 (en) * | 1997-03-06 | 2001-02-06 | Scimed Life Systems, Inc. | Ablation device for reducing damage to vessels and/or in-vivo stents |
US6096054A (en) * | 1998-03-05 | 2000-08-01 | Scimed Life Systems, Inc. | Expandable atherectomy burr and method of ablating an occlusion from a patient's blood vessel |
US6146395A (en) * | 1998-03-05 | 2000-11-14 | Scimed Life Systems, Inc. | Ablation burr |
US20040215235A1 (en) | 1999-11-16 | 2004-10-28 | Barrx, Inc. | Methods and systems for determining physiologic characteristics for treatment of the esophagus |
CA2388861C (en) | 1999-11-16 | 2013-09-03 | Robert A. Ganz | System and method of treating abnormal tissue in the human esophagus |
US20060095032A1 (en) | 1999-11-16 | 2006-05-04 | Jerome Jackson | Methods and systems for determining physiologic characteristics for treatment of the esophagus |
JP3519656B2 (en) * | 2000-01-31 | 2004-04-19 | 株式会社シーアイメディック | Medical guidewire and balloon catheter |
US6579299B2 (en) | 2000-01-31 | 2003-06-17 | Rex Medical, L.P. | Atherectomy device |
US6572630B1 (en) | 2000-01-31 | 2003-06-03 | Rex Medical, L.P | Atherectomy device |
US6579298B1 (en) * | 2000-02-29 | 2003-06-17 | Scimed Life Systems, Inc. | Method and apparatus for treating vein graft lesions |
US6565588B1 (en) | 2000-04-05 | 2003-05-20 | Pathway Medical Technologies, Inc. | Intralumenal material removal using an expandable cutting device |
CA2403925C (en) * | 2000-04-05 | 2008-09-16 | Stx Medical, Inc. | Intralumenal material removal systems and methods |
US7517352B2 (en) * | 2000-04-07 | 2009-04-14 | Bacchus Vascular, Inc. | Devices for percutaneous remote endarterectomy |
US7555333B2 (en) | 2000-06-19 | 2009-06-30 | University Of Washington | Integrated optical scanning image acquisition and display |
EP1169970A1 (en) * | 2000-07-04 | 2002-01-09 | Transgene S.A. | Device for the administration of a composition in a conduit of a human or animal body |
US20050113798A1 (en) * | 2000-07-21 | 2005-05-26 | Slater Charles R. | Methods and apparatus for treating the interior of a blood vessel |
US7077836B2 (en) * | 2000-07-21 | 2006-07-18 | Vein Rx, Inc. | Methods and apparatus for sclerosing the wall of a varicose vein |
US20050107738A1 (en) * | 2000-07-21 | 2005-05-19 | Slater Charles R. | Occludable intravascular catheter for drug delivery and method of using the same |
US20030120256A1 (en) * | 2001-07-03 | 2003-06-26 | Syntheon, Llc | Methods and apparatus for sclerosing the wall of a varicose vein |
EP1304965A2 (en) * | 2000-07-31 | 2003-05-02 | Boston Scientific Limited | Expandable atherectomy burr |
US6451037B1 (en) | 2000-11-22 | 2002-09-17 | Scimed Life Systems, Inc. | Expandable atherectomy burr with metal reinforcement |
US6436111B1 (en) | 2000-12-19 | 2002-08-20 | Scimed Life Systems, Inc. | Expandable atherectomy burr |
US6569177B1 (en) | 2001-01-19 | 2003-05-27 | Scimed Life Systems, Inc. | Ablation atherectomy burr |
US6491660B2 (en) * | 2001-01-23 | 2002-12-10 | Scimed Life Systems, Inc. | Frontal infusion system for intravenous burrs |
US6800083B2 (en) | 2001-04-09 | 2004-10-05 | Scimed Life Systems, Inc. | Compressible atherectomy burr |
US6616676B2 (en) * | 2001-04-10 | 2003-09-09 | Scimed Life Systems, Inc. | Devices and methods for removing occlusions in vessels |
US6500186B2 (en) * | 2001-04-17 | 2002-12-31 | Scimed Life Systems, Inc. | In-stent ablative tool |
US6746451B2 (en) * | 2001-06-01 | 2004-06-08 | Lance M. Middleton | Tissue cavitation device and method |
US8061006B2 (en) * | 2001-07-26 | 2011-11-22 | Powderject Research Limited | Particle cassette, method and kit therefor |
US7150723B2 (en) * | 2001-11-29 | 2006-12-19 | C-I-Medic Co., Ltd. | Medical device including guide wire and balloon catheter for curing a coronary artery |
US20040082859A1 (en) | 2002-07-01 | 2004-04-29 | Alan Schaer | Method and apparatus employing ultrasound energy to treat body sphincters |
US7189229B2 (en) * | 2002-09-16 | 2007-03-13 | Prorhythm, Inc. | Balloon alignment and collapsing system |
US6808524B2 (en) * | 2002-09-16 | 2004-10-26 | Prorhythm, Inc. | Balloon alignment and collapsing system |
US7037319B2 (en) * | 2002-10-15 | 2006-05-02 | Scimed Life Systems, Inc. | Nanotube paper-based medical device |
AU2003230740B2 (en) * | 2002-11-08 | 2008-10-09 | Warsaw Orthopedic, Inc. | Transpedicular intervertebral disk access methods and devices |
US6746463B1 (en) * | 2003-01-27 | 2004-06-08 | Scimed Life Systems, Inc | Device for percutaneous cutting and dilating a stenosis of the aortic valve |
WO2004073505A2 (en) | 2003-02-20 | 2004-09-02 | Prorhythm, Inc. | Cardiac ablation devices |
JP2004297166A (en) * | 2003-03-25 | 2004-10-21 | Murata Mfg Co Ltd | Temperature-compensated piezoelectric oscillator and electronic equipment using the same |
US6964661B2 (en) * | 2003-04-02 | 2005-11-15 | Boston Scientific Scimed, Inc. | Endovenous ablation mechanism with feedback control |
US7279002B2 (en) * | 2003-04-25 | 2007-10-09 | Boston Scientific Scimed, Inc. | Cutting stent and balloon |
US20050059993A1 (en) * | 2003-09-17 | 2005-03-17 | Kamal Ramzipoor | Embolectomy device |
US7955384B2 (en) * | 2003-11-12 | 2011-06-07 | Medtronic Vascular, Inc. | Coronary sinus approach for repair of mitral valve regurgitation |
US7901348B2 (en) | 2003-12-12 | 2011-03-08 | University Of Washington | Catheterscope 3D guidance and interface system |
US8048093B2 (en) * | 2003-12-19 | 2011-11-01 | Boston Scientific Scimed, Inc. | Textured balloons |
US8043311B2 (en) * | 2003-12-22 | 2011-10-25 | Boston Scientific Scimed, Inc. | Medical device systems |
US7150745B2 (en) | 2004-01-09 | 2006-12-19 | Barrx Medical, Inc. | Devices and methods for treatment of luminal tissue |
IL160074A (en) * | 2004-01-26 | 2009-07-20 | Redent Nova Ltd | Self adjusting instrument |
US8784421B2 (en) * | 2004-03-03 | 2014-07-22 | Boston Scientific Scimed, Inc. | Apparatus and methods for removing vertebral bone and disc tissue |
US20050197661A1 (en) * | 2004-03-03 | 2005-09-08 | Scimed Life Systems, Inc. | Tissue removal probe with sliding burr in cutting window |
US8142462B2 (en) | 2004-05-28 | 2012-03-27 | Cavitech, Llc | Instruments and methods for reducing and stabilizing bone fractures |
US7976557B2 (en) * | 2004-06-23 | 2011-07-12 | Boston Scientific Scimed, Inc. | Cutting balloon and process |
AU2005277797A1 (en) * | 2004-08-19 | 2006-03-02 | Vein Rx, Inc. | An occludable intravascular catheter for drug delivery and method of using the same |
US8066726B2 (en) * | 2004-11-23 | 2011-11-29 | Boston Scientific Scimed, Inc. | Serpentine cutting blade for cutting balloon |
US20060116700A1 (en) * | 2004-11-29 | 2006-06-01 | Crow Loren M | Aortic stenosis cutting balloon blade |
US7736375B2 (en) * | 2004-11-29 | 2010-06-15 | Boston Scientific Scimed, Inc. | Balloon catheter with controller depth incising blade |
KR20060072734A (en) * | 2004-12-23 | 2006-06-28 | 두산인프라코어 주식회사 | Appareatus for supplying compressed air of construction heavy equipments |
US7530948B2 (en) | 2005-02-28 | 2009-05-12 | University Of Washington | Tethered capsule endoscope for Barrett's Esophagus screening |
US20060247674A1 (en) * | 2005-04-29 | 2006-11-02 | Roman Ricardo D | String cutting balloon |
GB2426455A (en) * | 2005-05-26 | 2006-11-29 | Leonid Shturman | A rotational atherectomy device with supports on the drive shaft |
GB2426458A (en) | 2005-05-26 | 2006-11-29 | Leonid Shturman | Atherectomy device |
GB2426456B (en) * | 2005-05-26 | 2010-10-27 | Leonid Shturman | Rotational device with eccentric abrasive element and method of use |
US20070032808A1 (en) * | 2005-08-03 | 2007-02-08 | Azam Anwar | System and method for addressing total occlusion in a vascular environment |
EP1932462A4 (en) | 2005-10-05 | 2013-02-27 | Olympus Medical Systems Corp | Capsule type medical device, its guidance system and guidance method and examinee insertion device |
EP1956991A1 (en) * | 2005-11-15 | 2008-08-20 | Aoi Medical, Inc. | Inflatable device for restoring anatomy of fractured bone |
US7959627B2 (en) | 2005-11-23 | 2011-06-14 | Barrx Medical, Inc. | Precision ablating device |
WO2007067163A1 (en) * | 2005-11-23 | 2007-06-14 | University Of Washington | Scanning beam with variable sequential framing using interrupted scanning resonance |
US8702694B2 (en) | 2005-11-23 | 2014-04-22 | Covidien Lp | Auto-aligning ablating device and method of use |
US7997278B2 (en) | 2005-11-23 | 2011-08-16 | Barrx Medical, Inc. | Precision ablating method |
US8137256B2 (en) * | 2005-12-16 | 2012-03-20 | Portola Medical, Inc. | Brachytherapy apparatus |
US20070270627A1 (en) * | 2005-12-16 | 2007-11-22 | North American Scientific | Brachytherapy apparatus for asymmetrical body cavities |
JP2009528128A (en) | 2006-03-03 | 2009-08-06 | ユニヴァーシティ オブ ワシントン | Multi-clad optical fiber scanner |
US10499937B2 (en) | 2006-05-19 | 2019-12-10 | Recor Medical, Inc. | Ablation device with optimized input power profile and method of using the same |
GB0623366D0 (en) | 2006-11-23 | 2007-01-03 | Shturman Leonid | Rotational atherectomy device with fluid inflatable support elements and distal protection capability |
GB0613979D0 (en) | 2006-07-13 | 2006-08-23 | Shturman Leonid | Rotational atherectomy device with solid support elements supported by fluid bearings |
GB0613980D0 (en) | 2006-07-13 | 2006-08-23 | Shturman Leonid | Rotational Atherectomy Device with Fluid Inflatable Elements supported by Fluid Bearings |
GB0613981D0 (en) | 2006-07-13 | 2006-08-23 | Shturman Leonid | |
GB0613982D0 (en) * | 2006-07-13 | 2006-08-23 | Shturman Leonid | Rotational atherectomy device with fluid inflatable support elements and two torque transmitting coils |
US20080058629A1 (en) * | 2006-08-21 | 2008-03-06 | University Of Washington | Optical fiber scope with both non-resonant illumination and resonant collection/imaging for multiple modes of operation |
US7985228B2 (en) * | 2006-08-25 | 2011-07-26 | Kyphon Sarl | Apparatus and methods for use of expandable members in surgical applications |
TR200605770A2 (en) * | 2006-10-16 | 2007-10-22 | Ykk Saglik Hizmetleri Anonim Sirketi | Flexible and rigid catheter resector balloon |
WO2008058089A2 (en) * | 2006-11-03 | 2008-05-15 | North American Scientific, Inc. | Brachytherapy device having seed tubes with individually-settable tissue spacings |
US20080132834A1 (en) * | 2006-12-04 | 2008-06-05 | University Of Washington | Flexible endoscope tip bending mechanism using optical fibers as tension members |
WO2008095052A2 (en) * | 2007-01-30 | 2008-08-07 | Loma Vista Medical, Inc., | Biological navigation device |
US20080200873A1 (en) * | 2007-02-16 | 2008-08-21 | Alejandro Espinosa | Methods and Apparatus for Infusing the Interior of a Blood Vessel |
JP2010518988A (en) * | 2007-02-22 | 2010-06-03 | スパイン ビュー, インコーポレイテッド | Expandable rotation device and method for tissue aspiration |
US20080221388A1 (en) * | 2007-03-09 | 2008-09-11 | University Of Washington | Side viewing optical fiber endoscope |
US8840566B2 (en) * | 2007-04-02 | 2014-09-23 | University Of Washington | Catheter with imaging capability acts as guidewire for cannula tools |
WO2008121145A1 (en) * | 2007-04-02 | 2008-10-09 | University Of Washington | Multifunction cannula tools |
US20080243030A1 (en) * | 2007-04-02 | 2008-10-02 | University Of Washington | Multifunction cannula tools |
US7952718B2 (en) | 2007-05-03 | 2011-05-31 | University Of Washington | High resolution optical coherence tomography based imaging for intraluminal and interstitial use implemented with a reduced form factor |
US8641711B2 (en) | 2007-05-04 | 2014-02-04 | Covidien Lp | Method and apparatus for gastrointestinal tract ablation for treatment of obesity |
CA2692002A1 (en) | 2007-05-21 | 2008-11-27 | Aoi Medical Inc. | Articulating cavitation device |
US8597313B2 (en) * | 2007-06-11 | 2013-12-03 | Cardiovascular Systems, Inc. | Eccentric abrading head for high-speed rotational atherectomy devices |
US8784338B2 (en) | 2007-06-22 | 2014-07-22 | Covidien Lp | Electrical means to normalize ablational energy transmission to a luminal tissue surface of varying size |
US8475478B2 (en) | 2007-07-05 | 2013-07-02 | Cardiovascular Systems, Inc. | Cleaning apparatus and method for high-speed rotational atherectomy devices |
CN102688092B (en) | 2007-07-06 | 2015-04-22 | 柯惠有限合伙公司 | Ablation in the gastrointestinal tract to achieve hemostasis and eradicate lesions with a propensity for bleeding |
US8251992B2 (en) | 2007-07-06 | 2012-08-28 | Tyco Healthcare Group Lp | Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight-loss operation |
US8273012B2 (en) | 2007-07-30 | 2012-09-25 | Tyco Healthcare Group, Lp | Cleaning device and methods |
US8646460B2 (en) | 2007-07-30 | 2014-02-11 | Covidien Lp | Cleaning device and methods |
WO2009029639A1 (en) * | 2007-08-27 | 2009-03-05 | Spine View, Inc. | Balloon cannula system for accessing and visualizing spine and related methods |
US7879056B2 (en) * | 2007-10-11 | 2011-02-01 | Keith Butterfield | Pleurabrade device |
GB0722990D0 (en) | 2007-11-23 | 2008-01-02 | Shturman Leonid | Rotational atherectomy system with enhanced distal protection capability and method of use |
US20090137893A1 (en) * | 2007-11-27 | 2009-05-28 | University Of Washington | Adding imaging capability to distal tips of medical tools, catheters, and conduits |
US8157747B2 (en) | 2008-02-15 | 2012-04-17 | Lary Research & Development, Llc | Single-use indicator for a surgical instrument and a surgical instrument incorporating same |
US8323243B2 (en) | 2008-03-21 | 2012-12-04 | Innovasc Llc | Device and method for opening blood vessels by pre-angioplasty serration and dilatation of atherosclerotic plaque |
US11219750B2 (en) | 2008-03-21 | 2022-01-11 | Cagent Vascular, Inc. | System and method for plaque serration |
US9480826B2 (en) | 2008-03-21 | 2016-11-01 | Cagent Vascular, Llc | Intravascular device |
US8758377B2 (en) * | 2008-05-30 | 2014-06-24 | Cardiovascular Systems, Inc. | Eccentric abrading and cutting head for high-speed rotational atherectomy devices |
EP2644225B1 (en) * | 2008-06-02 | 2020-12-23 | Loma Vista Medical, Inc. | Inflatable medical devices |
US9186170B2 (en) * | 2008-06-05 | 2015-11-17 | Cardiovascular Systems, Inc. | Bidirectional expandable head for rotational atherectomy device |
US20090306690A1 (en) * | 2008-06-05 | 2009-12-10 | Cardiovascular Systems, Inc. | Abrasive nose cone with expandable cutting and sanding region for rotational atherectomy device |
US8192451B2 (en) * | 2008-06-05 | 2012-06-05 | Cardiovascular Systems, Inc. | Cutting and coring atherectomy device and method |
WO2009155319A1 (en) * | 2008-06-17 | 2009-12-23 | Soteira, Inc. | Devices and methods for fracture reduction |
WO2010041258A1 (en) * | 2008-10-10 | 2010-04-15 | Safend Ltd. | System and method for validating and controlling applications |
WO2010080886A1 (en) | 2009-01-09 | 2010-07-15 | Recor Medical, Inc. | Methods and apparatus for treatment of mitral valve in insufficiency |
US8795303B2 (en) | 2009-02-02 | 2014-08-05 | Cardiovascular Systems, Inc. | Multi-material abrading head for atherectomy devices having laterally displaced center of mass |
JP5693471B2 (en) | 2009-02-11 | 2015-04-01 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Insulated ablation catheter device and use thereof |
WO2010094032A2 (en) | 2009-02-16 | 2010-08-19 | Aoi Medical Inc. | Trauma nail accumulator |
GB0905748D0 (en) | 2009-04-03 | 2009-05-20 | Shturman Leonid | Rotational atherectomy device with eccentric abrasive element and method of use |
GB0905751D0 (en) | 2009-04-03 | 2009-05-20 | Shturman Leonid | Rotational atherectomy device with distal embolic protection and method of use |
US8795304B2 (en) * | 2009-06-18 | 2014-08-05 | Cardiovascular Systems, Inc. | Atherectomy device, system and method having a bi-directional distal expandable ablation element |
US20120046599A1 (en) * | 2010-02-18 | 2012-02-23 | Cardiovascular Systems, Inc. | Therapeutic agent delivery system, device and method for localized application of therapeutic substances to a biological conduit |
DE102010009723A1 (en) * | 2010-03-01 | 2011-09-01 | Andramed Gmbh | Guidewire / catheter guided valvulotome |
US8764779B2 (en) | 2010-05-13 | 2014-07-01 | Rex Medical, L.P. | Rotational thrombectomy wire |
US8663259B2 (en) | 2010-05-13 | 2014-03-04 | Rex Medical L.P. | Rotational thrombectomy wire |
US9795406B2 (en) | 2010-05-13 | 2017-10-24 | Rex Medical, L.P. | Rotational thrombectomy wire |
US9023070B2 (en) | 2010-05-13 | 2015-05-05 | Rex Medical, L.P. | Rotational thrombectomy wire coupler |
US9789293B2 (en) * | 2010-06-24 | 2017-10-17 | Boston Scientific Scimed, Inc. | Stents with bladder retention members |
EP2593171B1 (en) | 2010-07-13 | 2019-08-28 | Loma Vista Medical, Inc. | Inflatable medical devices |
US9943668B2 (en) | 2010-07-16 | 2018-04-17 | Sub3 Vascular, Llc | Guidewire and catheter system and method for treating a blood clot |
US8685050B2 (en) | 2010-10-06 | 2014-04-01 | Rex Medical L.P. | Cutting wire assembly for use with a catheter |
US9282991B2 (en) | 2010-10-06 | 2016-03-15 | Rex Medical, L.P. | Cutting wire assembly with coating for use with a catheter |
US8685049B2 (en) | 2010-11-18 | 2014-04-01 | Rex Medical L.P. | Cutting wire assembly for use with a catheter |
US10188436B2 (en) | 2010-11-09 | 2019-01-29 | Loma Vista Medical, Inc. | Inflatable medical devices |
US8702736B2 (en) | 2010-11-22 | 2014-04-22 | Rex Medical L.P. | Cutting wire assembly for use with a catheter |
US10278774B2 (en) | 2011-03-18 | 2019-05-07 | Covidien Lp | Selectively expandable operative element support structure and methods of use |
US8834544B2 (en) * | 2011-04-08 | 2014-09-16 | Sanovas Inc. | Photodynamic therapy for tumors with localized delivery |
US9055951B2 (en) | 2011-05-23 | 2015-06-16 | Covidien Lp | Endovascular tissue removal device |
ES2665307T3 (en) * | 2011-05-26 | 2018-04-25 | Adn International, Llc | Expandable device for tissue collection of an aerodigestive body light |
US8956376B2 (en) | 2011-06-30 | 2015-02-17 | The Spectranetics Corporation | Reentry catheter and method thereof |
WO2013003757A2 (en) | 2011-06-30 | 2013-01-03 | The Spectranetics Corporation | Reentry catheter and method thereof |
US8998936B2 (en) | 2011-06-30 | 2015-04-07 | The Spectranetics Corporation | Reentry catheter and method thereof |
US9603659B2 (en) | 2011-09-14 | 2017-03-28 | Boston Scientific Scimed Inc. | Ablation device with ionically conductive balloon |
CN103987336A (en) | 2011-09-14 | 2014-08-13 | 波士顿科学西美德公司 | Ablation device with multiple ablation modes |
US9861444B2 (en) | 2011-11-01 | 2018-01-09 | The Johns Hopkins University | Method and device for endoscopic abrasion |
AU2013207994B2 (en) | 2012-01-10 | 2015-05-07 | Boston Scientific Scimed, Inc. | Electrophysiology system |
WO2013115941A1 (en) | 2012-01-31 | 2013-08-08 | Boston Scientific Scimed, Inc. | Ablation probe with fluid-based acoustic coupling for ultrasonic tissue imaging |
JP5912685B2 (en) * | 2012-03-08 | 2016-04-27 | 株式会社東海メディカルプロダクツ | Balloon for IABP balloon catheter |
US9056191B2 (en) | 2012-04-11 | 2015-06-16 | Covidien Lp | Apparatus and method for removing occlusive tissue |
CA2917350C (en) | 2012-07-10 | 2019-02-12 | Valorisation Recherche Hscm, Limited Partnership | Method and device for infusion of pharmacologic agents and thrombus aspiration in artery |
US9456842B2 (en) * | 2012-07-13 | 2016-10-04 | Boston Scientific Scimed, Inc. | Wire-guided recanalization system |
WO2014020590A1 (en) * | 2012-07-29 | 2014-02-06 | V.V.T. Med Ltd. | Ablation catheter for blood vessel ablation and methods of using thereof |
US9320502B2 (en) | 2013-03-12 | 2016-04-26 | Cook Medical Technologies Llc | Cytology balloon |
US9119609B2 (en) | 2013-03-13 | 2015-09-01 | Cook Medical Technologies Llc | Rotating cell collection device |
US9095330B2 (en) | 2013-03-13 | 2015-08-04 | Cook Medical Technologies Llc | Perforated tube for cell collection |
US9039637B2 (en) | 2013-03-13 | 2015-05-26 | Cook Medical Technologies Llc | Flexible cytology coil |
US9936970B2 (en) * | 2013-03-14 | 2018-04-10 | Cardiovascular Systems, Inc. | Devices, systems and methods for an oscillating crown drive for rotational atherectomy |
US9750525B2 (en) * | 2013-03-14 | 2017-09-05 | Cardiovascular Systems, Inc. | Devices, systems and methods for an oscillating crown drive for rotational atherectomy |
US20140316447A1 (en) * | 2013-03-14 | 2014-10-23 | Cardiovascular Systems, Inc. | Devices, systems and methods for a piloting tip bushing for rotational atherectomy |
GB2519057A (en) * | 2013-08-02 | 2015-04-15 | Martin Sabado | Minimally invasive device and method for treating vascular disorders |
US9468457B2 (en) | 2013-09-30 | 2016-10-18 | Cardiovascular Systems, Inc. | Atherectomy device with eccentric crown |
US9763733B2 (en) | 2013-10-25 | 2017-09-19 | Covidien Lp | Unfurling electrode devices with the multiple longitudinal electrode segments |
US9918789B2 (en) | 2013-10-25 | 2018-03-20 | Covidien Lp | Unfurling electrode devices with the protection element |
USD766433S1 (en) | 2013-11-04 | 2016-09-13 | Cardiovascular Systems, Inc. | Eccentric crown |
US9788853B2 (en) | 2014-01-15 | 2017-10-17 | Cardio Flow, Inc. | Atherectomy devices and methods |
US10271869B2 (en) | 2014-03-01 | 2019-04-30 | Rex Medical, L.P. | Atherectomy device |
US10463842B2 (en) | 2014-06-04 | 2019-11-05 | Cagent Vascular, Llc | Cage for medical balloon |
US20160030068A1 (en) * | 2014-07-31 | 2016-02-04 | Terumo Kabushiki Kaisha | Method for treating varicose veins and intraluminal device used in such method |
US10524684B2 (en) | 2014-10-13 | 2020-01-07 | Boston Scientific Scimed Inc | Tissue diagnosis and treatment using mini-electrodes |
US10603105B2 (en) | 2014-10-24 | 2020-03-31 | Boston Scientific Scimed Inc | Medical devices with a flexible electrode assembly coupled to an ablation tip |
US10471238B2 (en) | 2014-11-03 | 2019-11-12 | Cagent Vascular, Llc | Serration balloon |
WO2016072107A1 (en) * | 2014-11-04 | 2016-05-12 | テルモ株式会社 | Medical device |
US11096715B2 (en) | 2014-11-04 | 2021-08-24 | Terumo Kabushiki Kaisha | Medical device and treatment method |
US9743854B2 (en) | 2014-12-18 | 2017-08-29 | Boston Scientific Scimed, Inc. | Real-time morphology analysis for lesion assessment |
US20160175516A1 (en) * | 2014-12-22 | 2016-06-23 | Boston Scientific Scimed, Inc. | Apparatus for increased dye flow |
EP3037050B1 (en) | 2014-12-27 | 2023-04-12 | Rex Medical, L.P. | Atherectomy device |
JP6781703B2 (en) * | 2014-12-30 | 2020-11-04 | バード・ペリフェラル・バスキュラー・インコーポレーテッド | Abrasive elements for rotary atherectomy system |
US10368934B2 (en) | 2015-01-14 | 2019-08-06 | Covidien Lp | Arrangement of multi-channel bipolar electrode zones to minimize leakage and edge effects |
US10149716B2 (en) | 2015-02-02 | 2018-12-11 | Covidien Lp | Self-sizing catheter features to prevent over-tightening of the electrode |
JP2016221081A (en) | 2015-06-02 | 2016-12-28 | テルモ株式会社 | Medical device |
WO2016194551A1 (en) | 2015-06-02 | 2016-12-08 | テルモ株式会社 | Medical device |
US10478213B2 (en) | 2015-06-25 | 2019-11-19 | Covidien Lp | Tissue-removing catheter with adjustable cross-sectional dimension |
US11253292B2 (en) | 2015-09-13 | 2022-02-22 | Rex Medical, L.P. | Atherectomy device |
EP3799919A1 (en) | 2015-09-17 | 2021-04-07 | Cagent Vascular, LLC | Wedge dissectors for a medical ballon |
US10898221B2 (en) | 2015-10-30 | 2021-01-26 | Terumo Kabushiki Kaisha | Device handle for a medical device |
US10869688B2 (en) | 2015-10-30 | 2020-12-22 | Terumo Kabushiki Kaisha | Device handle for a medical device |
AU2016353345B2 (en) | 2015-11-12 | 2021-12-23 | University Of Virginia Patent Foundation | Compositions and methods for vas-occlusive contraception and reversal thereof |
WO2017164119A1 (en) * | 2016-03-23 | 2017-09-28 | テルモ株式会社 | Medical device and treatment method |
US10307175B2 (en) | 2016-03-26 | 2019-06-04 | Rex Medical, L.P | Atherectomy device |
US10905457B2 (en) * | 2016-06-06 | 2021-02-02 | Terumo Kabushiki Kaisha | Device handle for a medical device |
US10966749B2 (en) | 2016-06-13 | 2021-04-06 | Terumo Kabushiki Kaisha | Medical device and treatment method |
US10980555B2 (en) * | 2016-07-12 | 2021-04-20 | Cardioprolific Inc. | Methods and devices for clots and tissue removal |
US10905863B2 (en) | 2016-11-16 | 2021-02-02 | Cagent Vascular, Llc | Systems and methods of depositing drug into tissue through serrations |
JP6836894B2 (en) * | 2016-12-22 | 2021-03-03 | テルモ株式会社 | Medical device |
USD825756S1 (en) * | 2016-12-23 | 2018-08-14 | Derek T. Denton | Manual debridement implement |
US10953204B2 (en) | 2017-01-09 | 2021-03-23 | Boston Scientific Scimed, Inc. | Guidewire with tactile feel |
US10441312B2 (en) | 2017-02-23 | 2019-10-15 | Cardio Flow, Inc. | Atherectomy devices and methods |
JP6993404B2 (en) * | 2017-03-28 | 2022-01-13 | テルモ株式会社 | Medical device |
CN114948106A (en) | 2017-05-03 | 2022-08-30 | 美敦力瓦斯科尔勒公司 | Tissue removal catheter with guidewire isolation bushing |
US11690645B2 (en) | 2017-05-03 | 2023-07-04 | Medtronic Vascular, Inc. | Tissue-removing catheter |
EP3634528B1 (en) | 2017-06-07 | 2023-06-07 | Shifamed Holdings, LLC | Intravascular fluid movement devices, systems, and methods of use |
WO2019018546A1 (en) * | 2017-07-18 | 2019-01-24 | President And Fellows Of Harvard College | Deployable kiriform flexures |
CN111556763B (en) | 2017-11-13 | 2023-09-01 | 施菲姆德控股有限责任公司 | Intravascular fluid movement device and system |
US10732051B2 (en) | 2018-01-22 | 2020-08-04 | Google Llc | Passive infrared sensor device |
JP7410034B2 (en) | 2018-02-01 | 2024-01-09 | シファメド・ホールディングス・エルエルシー | Intravascular blood pump and methods of use and manufacture |
WO2019188655A1 (en) | 2018-03-29 | 2019-10-03 | テルモ株式会社 | Medical device |
US10463390B1 (en) | 2018-05-24 | 2019-11-05 | Cardio Flow, Inc. | Atherectomy devices and methods |
US11147582B2 (en) | 2018-06-14 | 2021-10-19 | Cardio Flow, Inc. | Atherectomy devices and methods |
CN112739406A (en) | 2018-07-25 | 2021-04-30 | 开金血管有限公司 | Medical balloon catheter with enhanced pushability |
WO2020033260A1 (en) | 2018-08-07 | 2020-02-13 | Cardio Flow, Inc. | Atherectomy devices and methods |
EP3880096A1 (en) | 2018-11-16 | 2021-09-22 | Medtronic Vascular Inc. | Tissue-removing catheter |
JP6681453B2 (en) * | 2018-11-16 | 2020-04-15 | バード・ペリフェラル・バスキュラー・インコーポレーテッド | Abrasive elements for a rotary atherectomy system |
US11622786B2 (en) | 2019-03-27 | 2023-04-11 | Gyrus Acmi, Inc. | Planar alignment for asymmetric cutting members |
US11819236B2 (en) | 2019-05-17 | 2023-11-21 | Medtronic Vascular, Inc. | Tissue-removing catheter |
WO2021016372A1 (en) | 2019-07-22 | 2021-01-28 | Shifamed Holdings, Llc | Intravascular blood pumps with struts and methods of use and manufacture |
CN111012448A (en) * | 2019-08-20 | 2020-04-17 | 上海微创医疗器械(集团)有限公司 | Rotary grinding device |
JP2022548877A (en) * | 2019-09-12 | 2022-11-22 | フリー フロー メディカル インコーポレイテッド | Devices, methods and systems for treating chronic bronchitis |
EP4034192A4 (en) | 2019-09-25 | 2023-11-29 | Shifamed Holdings, LLC | Intravascular blood pump systems and methods of use and control thereof |
EP4096539A1 (en) | 2020-01-30 | 2022-12-07 | Julier Medical AG | Apparatus and method for neurovascular endoluminal intervention |
WO2021243046A1 (en) * | 2020-05-28 | 2021-12-02 | Contraline, Inc. | Systems and methods for removing biomaterial implants |
US11737767B2 (en) | 2022-01-21 | 2023-08-29 | Julier Medical AG | Neurovascular catheter and method of use |
Family Cites Families (80)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US33569A (en) * | 1861-10-29 | Improvement in braiding-machines | ||
DE823320C (en) * | 1950-08-15 | 1951-12-03 | Willy Ruesch | Catheters, in particular intratracheal catheters and processes for their manufacture |
US2701559A (en) * | 1951-08-02 | 1955-02-08 | William A Cooper | Apparatus for exfoliating and collecting diagnostic material from inner walls of hollow viscera |
GB1235321A (en) * | 1968-01-30 | 1971-06-09 | Nat Res Dev | Improvements in or relating to drills for clearing obstructions |
US3896815A (en) * | 1974-06-06 | 1975-07-29 | Shiley Lab Inc | Expansible tip catheters |
US4273128A (en) * | 1980-01-14 | 1981-06-16 | Lary Banning G | Coronary cutting and dilating instrument |
US4445509A (en) * | 1982-02-04 | 1984-05-01 | Auth David C | Method and apparatus for removal of enclosed abnormal deposits |
US4465072A (en) * | 1983-02-22 | 1984-08-14 | Taheri Syde A | Needle catheter |
US4589412A (en) * | 1984-01-03 | 1986-05-20 | Intravascular Surgical Instruments, Inc. | Method and apparatus for surgically removing remote deposits |
US4631052A (en) * | 1984-01-03 | 1986-12-23 | Intravascular Surgical Instruments, Inc. | Method and apparatus for surgically removing remote deposits |
US4685458A (en) * | 1984-03-01 | 1987-08-11 | Vaser, Inc. | Angioplasty catheter and method for use thereof |
US4842579B1 (en) | 1984-05-14 | 1995-10-31 | Surgical Systems & Instr Inc | Atherectomy device |
US5653696A (en) * | 1984-05-14 | 1997-08-05 | Surgical Systems & Instruments, Inc. | Stent unclogging method |
US4926858A (en) * | 1984-05-30 | 1990-05-22 | Devices For Vascular Intervention, Inc. | Atherectomy device for severe occlusions |
US4781186A (en) * | 1984-05-30 | 1988-11-01 | Devices For Vascular Intervention, Inc. | Atherectomy device having a flexible housing |
US4653496A (en) * | 1985-02-01 | 1987-03-31 | Bundy Mark A | Transluminal lysing system |
DE3519626A1 (en) * | 1985-05-31 | 1986-12-04 | Stöckert Instrumente GmbH, 8000 München | BALLOON CATHETER |
US4706670A (en) | 1985-11-26 | 1987-11-17 | Meadox Surgimed A/S | Dilatation catheter |
CA1293663C (en) | 1986-01-06 | 1991-12-31 | David Christopher Auth | Transluminal microdissection device |
US4794931A (en) * | 1986-02-28 | 1989-01-03 | Cardiovascular Imaging Systems, Inc. | Catheter apparatus, system and method for intravascular two-dimensional ultrasonography |
USRE33569E (en) | 1986-02-28 | 1991-04-09 | Devices For Vascular Intervention, Inc. | Single lumen atherectomy catheter device |
US4728319A (en) * | 1986-03-20 | 1988-03-01 | Helmut Masch | Intravascular catheter |
US4696667A (en) * | 1986-03-20 | 1987-09-29 | Helmut Masch | Intravascular catheter and method |
DE3715418A1 (en) * | 1986-05-08 | 1987-11-12 | Olympus Optical Co | LITHOTOM |
US4765332A (en) * | 1986-07-14 | 1988-08-23 | Medinnovations, Inc. | Pullback atherectomy catheter system |
US4747821A (en) * | 1986-10-22 | 1988-05-31 | Intravascular Surgical Instruments, Inc. | Catheter with high speed moving working head |
US4857045A (en) * | 1987-04-30 | 1989-08-15 | Schneider (Usa) Inc., A Pfizer Company | Atherectomy catheter |
US4784636A (en) * | 1987-04-30 | 1988-11-15 | Schneider-Shiley (U.S.A.) Inc. | Balloon atheroectomy catheter |
US4794928A (en) * | 1987-06-10 | 1989-01-03 | Kletschka Harold D | Angioplasty device and method of using the same |
US4886061A (en) * | 1988-02-09 | 1989-12-12 | Medinnovations, Inc. | Expandable pullback atherectomy catheter system |
US4950238A (en) * | 1988-07-07 | 1990-08-21 | Clarence E. Sikes | Hydro-rotary vascular catheter |
US4921484A (en) * | 1988-07-25 | 1990-05-01 | Cordis Corporation | Mesh balloon catheter device |
US5749914A (en) * | 1989-01-06 | 1998-05-12 | Advanced Coronary Intervention | Catheter for obstructed stent |
US4966604A (en) * | 1989-01-23 | 1990-10-30 | Interventional Technologies Inc. | Expandable atherectomy cutter with flexibly bowed blades |
US5147302A (en) | 1989-04-21 | 1992-09-15 | Scimed Life Systems, Inc. | Method of shaping a balloon of a balloon catheter |
US5571169A (en) * | 1993-06-07 | 1996-11-05 | Endovascular Instruments, Inc. | Anti-stenotic method and product for occluded and partially occluded arteries |
US5100425A (en) * | 1989-09-14 | 1992-03-31 | Medintec R&D Limited Partnership | Expandable transluminal atherectomy catheter system and method for the treatment of arterial stenoses |
US5030201A (en) * | 1989-11-24 | 1991-07-09 | Aubrey Palestrant | Expandable atherectomy catheter device |
US5158564A (en) * | 1990-02-14 | 1992-10-27 | Angiomed Ag | Atherectomy apparatus |
US5154724A (en) * | 1990-05-14 | 1992-10-13 | Andrews Winston A | Atherectomy catheter |
US5395311A (en) * | 1990-05-14 | 1995-03-07 | Andrews; Winston A. | Atherectomy catheter |
US5100424A (en) * | 1990-05-21 | 1992-03-31 | Cardiovascular Imaging Systems, Inc. | Intravascular catheter having combined imaging abrasion head |
US5196024A (en) * | 1990-07-03 | 1993-03-23 | Cedars-Sinai Medical Center | Balloon catheter with cutting edge |
US5217474A (en) * | 1991-07-15 | 1993-06-08 | Zacca Nadim M | Expandable tip atherectomy method and apparatus |
FR2685190B1 (en) * | 1991-12-23 | 1998-08-07 | Jean Marie Lefebvre | ROTARY ATHERECTOMY OR THROMBECTOMY DEVICE WITH CENTRIFUGAL TRANSVERSE DEVELOPMENT. |
US5224945A (en) * | 1992-01-13 | 1993-07-06 | Interventional Technologies, Inc. | Compressible/expandable atherectomy cutter |
US5192291A (en) * | 1992-01-13 | 1993-03-09 | Interventional Technologies, Inc. | Rotationally expandable atherectomy cutter assembly |
US5176693A (en) * | 1992-05-11 | 1993-01-05 | Interventional Technologies, Inc. | Balloon expandable atherectomy cutter |
US5250060A (en) * | 1992-06-26 | 1993-10-05 | Carbo Paul L | Angioplasty apparatus |
US5356418A (en) * | 1992-10-28 | 1994-10-18 | Shturman Cardiology Systems, Inc. | Apparatus and method for rotational atherectomy |
US5312427A (en) * | 1992-10-16 | 1994-05-17 | Shturman Cardiology Systems, Inc. | Device and method for directional rotational atherectomy |
US5360432A (en) * | 1992-10-16 | 1994-11-01 | Shturman Cardiology Systems, Inc. | Abrasive drive shaft device for directional rotational atherectomy |
US5336178A (en) * | 1992-11-02 | 1994-08-09 | Localmed, Inc. | Intravascular catheter with infusion array |
US5571122A (en) * | 1992-11-09 | 1996-11-05 | Endovascular Instruments, Inc. | Unitary removal of plaque |
US5490859A (en) * | 1992-11-13 | 1996-02-13 | Scimed Life Systems, Inc. | Expandable intravascular occlusion material removal devices and methods of use |
US5318576A (en) * | 1992-12-16 | 1994-06-07 | Plassche Jr Walter M | Endovascular surgery systems |
JP2585939B2 (en) * | 1993-01-26 | 1997-02-26 | 大淀小松株式会社 | Crushing equipment |
DE4307642C1 (en) * | 1993-03-11 | 1994-06-09 | Redha Falah | Medical instrument for dispersal of deposits in arteries and/or veins - has partly hollow body with basic body to which cutters are attached having cutting edges pointing in draw direction |
EP0794734B1 (en) * | 1993-04-29 | 2002-08-28 | SciMed Life Systems, Inc. | Expandable intravascular occlusion material removal device |
US5897567A (en) * | 1993-04-29 | 1999-04-27 | Scimed Life Systems, Inc. | Expandable intravascular occlusion material removal devices and methods of use |
CA2118886C (en) * | 1993-05-07 | 1998-12-08 | Dennis Vigil | Method and apparatus for dilatation of a stenotic vessel |
US5456666A (en) | 1994-04-26 | 1995-10-10 | Boston Scientific Corp | Medical balloon folding into predetermined shapes and method |
US5836957A (en) * | 1994-12-22 | 1998-11-17 | Devices For Vascular Intervention, Inc. | Large volume atherectomy device |
CA2157697C (en) * | 1995-01-10 | 2007-03-13 | Banning Gray Lary | Vascular incisor/dilator |
US5702754A (en) | 1995-02-22 | 1997-12-30 | Meadox Medicals, Inc. | Method of providing a substrate with a hydrophilic coating and substrates, particularly medical devices, provided with such coatings |
US5728123A (en) * | 1995-04-26 | 1998-03-17 | Lemelson; Jerome H. | Balloon actuated catheter |
US5556408A (en) * | 1995-04-27 | 1996-09-17 | Interventional Technologies Inc. | Expandable and compressible atherectomy cutter |
US5554163A (en) * | 1995-04-27 | 1996-09-10 | Shturman Cardiology Systems, Inc. | Atherectomy device |
US5725568A (en) * | 1995-06-27 | 1998-03-10 | Scimed Life Systems, Inc. | Method and device for recanalizing and grafting arteries |
US5681336A (en) * | 1995-09-07 | 1997-10-28 | Boston Scientific Corporation | Therapeutic device for treating vien graft lesions |
US5556405A (en) * | 1995-10-13 | 1996-09-17 | Interventional Technologies Inc. | Universal dilator with reciprocal incisor |
US5766192A (en) * | 1995-10-20 | 1998-06-16 | Zacca; Nadim M. | Atherectomy, angioplasty and stent method and apparatus |
US5697944A (en) * | 1995-11-15 | 1997-12-16 | Interventional Technologies Inc. | Universal dilator with expandable incisor |
US5792158A (en) * | 1995-11-15 | 1998-08-11 | Lary; Banning Gray | University dilator with expandable incisor |
US5897566A (en) * | 1996-07-15 | 1999-04-27 | Shturman Cardiology Systems, Inc. | Rotational atherectomy device |
US5882329A (en) * | 1997-02-12 | 1999-03-16 | Prolifix Medical, Inc. | Apparatus and method for removing stenotic material from stents |
US5868708A (en) * | 1997-05-07 | 1999-02-09 | Applied Medical Resources Corporation | Balloon catheter apparatus and method |
US6096054A (en) | 1998-03-05 | 2000-08-01 | Scimed Life Systems, Inc. | Expandable atherectomy burr and method of ablating an occlusion from a patient's blood vessel |
DE19811364C2 (en) | 1998-03-16 | 2000-01-27 | Gerhard Benker | Balloon dilatation catheter with antithrombotic filter screen and balloon dilatation catheter fastened in a resection instrument |
US5919200A (en) * | 1998-10-09 | 1999-07-06 | Hearten Medical, Inc. | Balloon catheter for abrading a patent foramen ovale and method of using the balloon catheter |
-
1998
- 1998-10-23 US US09/178,449 patent/US6096054A/en not_active Expired - Fee Related
-
1999
- 1999-02-22 WO PCT/US1999/003851 patent/WO1999044513A2/en not_active Application Discontinuation
- 1999-02-22 CA CA002322651A patent/CA2322651A1/en not_active Abandoned
- 1999-02-22 EP EP99937862A patent/EP1059885A2/en not_active Withdrawn
- 1999-02-22 JP JP2000534125A patent/JP2003504090A/en active Pending
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2000
- 2000-06-08 US US09/589,861 patent/US6416526B1/en not_active Expired - Fee Related
- 2000-07-31 US US09/629,771 patent/US6685718B1/en not_active Expired - Fee Related
-
2004
- 2004-02-02 US US10/770,336 patent/US7252674B2/en not_active Expired - Fee Related
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US6096054A (en) | 2000-08-01 |
WO1999044513A2 (en) | 1999-09-10 |
US6685718B1 (en) | 2004-02-03 |
WO1999044513A3 (en) | 1999-11-04 |
JP2003504090A (en) | 2003-02-04 |
US20040158270A1 (en) | 2004-08-12 |
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FZDE | Discontinued |