WO2004002564A1 - Catheter having a funnel-shaped occlusion balloon of uniform thickness and methods of manufacture - Google Patents
Catheter having a funnel-shaped occlusion balloon of uniform thickness and methods of manufacture Download PDFInfo
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- WO2004002564A1 WO2004002564A1 PCT/US2003/019764 US0319764W WO2004002564A1 WO 2004002564 A1 WO2004002564 A1 WO 2004002564A1 US 0319764 W US0319764 W US 0319764W WO 2004002564 A1 WO2004002564 A1 WO 2004002564A1
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- catheter
- occlusion balloon
- polymer cover
- proximal
- exterior
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
-
- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12027—Type of occlusion
- A61B17/1204—Type of occlusion temporary occlusion
- A61B17/12045—Type of occlusion temporary occlusion double occlusion, e.g. during anastomosis
-
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
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- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12136—Balloons
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- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
- A61B17/12172—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/01—Filters implantable into blood vessels
- A61F2/013—Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
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- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
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- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
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- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22065—Functions of balloons
- A61B2017/22067—Blocking; Occlusion
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
- A61B2017/2215—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
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- A61B2217/005—Auxiliary appliance with suction drainage system
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/01—Filters implantable into blood vessels
- A61F2/011—Instruments for their placement or removal
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- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/0006—Rounded shapes, e.g. with rounded corners circular
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- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M2025/0175—Introducing, guiding, advancing, emplacing or holding catheters having telescopic features, interengaging nestable members movable in relations to one another
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- A—HUMAN NECESSITIES
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- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1011—Multiple balloon catheters
- A61M2025/1015—Multiple balloon catheters having two or more independently movable balloons where the distance between the balloons can be adjusted, e.g. two balloon catheters concentric to each other forming an adjustable multiple balloon catheter system
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- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1027—Making of balloon catheters
- A61M25/1029—Production methods of the balloon members, e.g. blow-moulding, extruding, deposition or by wrapping a plurality of layers of balloon material around a mandril
- A61M2025/1031—Surface processing of balloon members, e.g. coating or deposition; Mounting additional parts onto the balloon member's surface
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- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1065—Balloon catheters with special features or adapted for special applications having a balloon which is inversely attached to the shaft at the distal or proximal end
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- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1027—Making of balloon catheters
- A61M25/1029—Production methods of the balloon members, e.g. blow-moulding, extruding, deposition or by wrapping a plurality of layers of balloon material around a mandril
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- A61M25/1034—Joining of shaft and balloon
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- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/104—Balloon catheters used for angioplasty
Definitions
- This invention relates to apparatus and methods for removing emboli during vascular interventions. More particularly, the apparatus and methods of the present invention provide a catheter having an occlusion balloon of uniform thickness that facilitates retrograde flow and removes emboli from a treatment vessel via a funnel- shaped taper of the occlusion balloon.
- occlusion balloons have various drawbacks, including variability in deployment of the balloon to the desired shape, inefficiency in removing emboli, and/or high cost and complicated processes associated with manufacturing the balloon.
- applicant describes the use of a bell or pear- shaped occlusion balloon disposed on the distal end of an arterial catheter.
- the occlusion balloon comprises a compliant material having a variable thickness along its length to provide a bell-shape when inflated.
- the balloon is affixed to distal end of the catheter so that a distal portion of the balloon extends beyond the distal end of the catheter to provide an atraumatic tip or bumper for the catheter.
- the balloon of that catheter may be formed using previously known techniques, such as varying the thickness of the balloon wall to achieve the preferred bell-shape in the deployed position. Such processes, however, can lead to variability in the final product due to the manufacturing process. Because variable thickness balloons present greater difficulties during manufacture than balloons having uniform wall thickness, the cost of such balloons may be higher.
- interventional apparatus comprising a catheter having proximal and distal ends, a working lumen extending therethrough and an occlusion balloon having proximal and distal ends disposed on the distal end of the catheter.
- the occlusion balloon has a contracted state suitable for insertion into a vessel and a deployed state configured to occlude antegrade flow in the vessel .
- the catheter comprises an inner layer covered with a layer of flat stainless steel wire braid and a polymer cover.
- a distal section of the occlusion balloon is melt-bonded to a distalmost end of the inner layer and, optionally, to a distalmost end of the polymer cover to form a substantially seamless transition into the working lumen of the catheter.
- the proximal end of the occlusion balloon is everted and affixed to the polymer cover to form an inflation chamber between the polymer cover and the balloon.
- the occlusion balloon is configured to extend distal of the catheter and provides a funnel-shaped transition into the working lumen of the catheter.
- a distal edge of the occlusion balloon is configured to be in close proximity with an inner wall of a vessel to facilitate retrograde flow into the working lumen of the catheter and efficiently remove emboli. Additionally, because the occlusion balloon of the present invention comprises a uniform thickness, the balloon may be more reliable, easier to manufacture and more cost-effective than an occlusion balloon having a variable thickness along its length. [0015] Preferred methods of making and using the apparatus of the present invention also are disclosed.
- FIGS. 1A-1B are, respectively, side and sectional views of a previously known occlusion balloon in contracted and deployed states;
- FIGS. 2A-2B are, respectively, a schematic view of apparatus in accordance with the present invention and a cross-sectional view along line A- -A of FIG. 2A;
- FIGS. 3A-3B are side sectional views illustrating a preferred configuration of the distal end of the catheter of FIG. 2;
- FIGS. 4A-4B are side sectional views of the occlusion balloon of the present invention in contracted and deployed states, respectively; and [0021] FIG. 5 is a schematic view of apparatus of the present invention being used during an interventional procedure .
- FIGS. 1A-1B a bell-shaped occlusion balloon, as described in applicant's commonly assigned allowed U.S. patent application Serial No. 09/418,727, filed May 8, 2001, which is incorporated herein by reference, is described.
- Occlusion balloon 20 is shown in contracted and deployed states in FIGS. 1A and IB, respectively.
- Balloon 20 is affixed to distal end 26 of catheter 22, for example, by gluing or a melt- bond, so that opening 27 in balloon 20 leads into lumen 28 of catheter 22.
- Balloon 20 preferably is wrapped and heat treated during manufacture so that distal portion 29 of the balloon extends beyond the distal end of catheter 22 and provides an atraumatic tip or bumper for the catheter.
- occlusion balloon 20 comprises a compliant material, such as polyurethane, latex or polyisoprene which has variable thickness along its length to provide a bell-shape when inflated.
- the variable thickness characteristic of occlusion balloon 20, which is used to deploy the balloon to the preferred bell- shape presents certain manufacturing challenges.
- manufacturing a balloon having a variable wall thickness can lead to reduced yield due to variability of the manufacturing process.
- a variable thickness balloon may be difficult to manufacture and may have a higher cost relative to a balloon having a uniform thickness.
- Apparatus 40 comprises catheter 41 having proximal and distal ends and working lumen 58 extending therethrough.
- Catheter 41 comprises occlusion balloon 42 having proximal and distal ends affixed to the distal end of catheter 41, and preferably comprises radiopaque marker band 65 disposed at the distal end of catheter 41 to facilitate positioning of the distal end of the catheter.
- Occlusion balloon 42 comprises a uniform thickness material having a contracted state suitable for insertion into a vessel and a deployed state in which occlusion balloon 42 occludes antegrade flow in the vessel.
- occlusion balloon 42 comprises distal taper 66 that is configured to provide a funnel-shaped transition into working lumen 58 so that blood flows in a non-turbulent fashion from a treated vessel into catheter 41.
- distal edge 68 is configured to be in close proximity with an inner wall of a vessel to facilitate blood flow into catheter 41 and efficiently remove emboli.
- Catheter 41 preferably comprises inner layer 60 of low-friction polymeric material, such as polytetrafluoroethylene (“PTFE”) / covered with a layer of flat stainless steel wire braid 61 and polymer cover 62 (e.g., polyurethane, polyethylene, or PEBAX) , as shown in FIG. 2B.
- Working lumen 58 is defined as a lumen within an interior surface of inner layer 60.
- Inflation lumen 63 preferably is disposed within polymer cover 62 so that the inflation lumen does not substantially increase the overall profile of catheter 41.
- Apparatus 40 preferably further includes proximal hemostatic port 43, e.g., a Touhy-Borst connector, inflation port 44, and blood outlet port 48.
- Inflation port 44 is coupled to inflation lumen 63, which in turn is coupled to occlusion balloon 42.
- Proximal hemostatic port 43 and working lumen 58 of catheter 41 are sized to permit interventional devices, such as angioplasty balloon catheters, atherectomy devices and stent delivery systems to be advanced through the working lumen when a guidewire (not shown) is positioned within the working lumen.
- Blood outlet port 48 which is in fluid communication with working lumen 58, may be coupled to an external aspiration device, e.g., a syringe, to cause blood flow distal of occlusion balloon 42 to flow into working lumen 58.
- blood outlet port 48 may be coupled to a venous return catheter to form an arterial-venous shunt suitable for providing retrograde flow in a treatment vessel.
- This aspiration embodiment comprising an arterial-venous shunt is described in detail in applicant's commonly-assigned, above-incorporated U.S. patent application Serial No. 09/418,727.
- FIG. 3A a preferred configuration of catheter 41 and a preferred method for affixing occlusion balloon 42 to the distal end of catheter 41 are described.
- the distal end of catheter 41 is shown from a side sectional view as comprising inner layer 60 covered with a layer of flat stainless steel wire braid 61 and polymer cover 62.
- Radiopaque marker band 65 preferably is disposed at the distal end of catheter 41 between wire braid 61 and polymer cover 62, as shown in FIG. 3A.
- occlusion balloon 42 comprises a uniform thickness along its length, as illustrated in FIGS. 3A-3B.
- distal end 50 of occlusion balloon 42 is positioned atop polymer cover 62 near the distal end of catheter 41 and just distal of opening 70 of polymer cover 62, as shown in FIG. 3A.
- Distal end 50 of occlusion balloon 42 then is affixed to polymer cover 62, preferably using a melt-bond or, alternatively, using a biocompatible glue.
- proximal end 52 of occlusion balloon 42 extends freely beyond the distal end of catheter 41, as shown in FIG. 3A.
- proximal end 52 of occlusion balloon 42 appears situated distal of distal end 50 in FIG.
- distal section 51 of occlusion balloon 42 which is situated just proximal of distal end 50, is melt-bonded to at least one polymeric layer of catheter 41. Specifically, in a preferred embodiment, distal section 51 of occlusion balloon 42 is melt-bonded to distalmost end 85 of inner layer 60 and, optionally, to distalmost end 87 of polymer cover 62 to form fusion joint 67, as shown in FIG. 3A.
- fusion joint 67 provides substantially seamless transition 72 between occlusion balloon 42 and inner layer 60. Additionally, because fusion joint 67 is formed from a plurality of compliant polymeric materials, fusion joint 67 is capable of achieving a flexible range of motion.
- Proximal end 52 of occlusion balloon 42 then is everted so that it extends proximally and radially outward from catheter 41, as shown in FIGS. 3B and 4A.
- Proximal end 52 is affixed to polymer cover 62, preferably using a melt-bond or, alternatively, using a biocompatible glue, at a distance between about 10-20 mm proximal of the distal end of catheter 41, as shown in FIG. 4A.
- Opening 70 which is disposed in a lateral surface of polymer cover 62, is in fluid communication with inflation lumen 63 and inflation chamber 74, as shown in FIG. 3B.
- Proximal end 52 of occlusion balloon 42 may be stretched while it being affixed to polymer cover 62 so that apparatus 40 may achieve a reduced profile in the contracted state.
- substantially seamless transition 72 into working lumen 58, as shown in FIG. 3B.
- the provision of substantially seamless transition 72 may help reduce flow impedance into working lumen 58 and enhance flow within a treated vessel.
- FIGS. 4A-4B deployment of apparatus 40 within vessel V of a patient is described.
- occlusion balloon 42 is shown in a contracted state suitable for percutaneous and transluminal insertion into a patient's vessel.
- Occlusion balloon 42 is inflated via inflation port 44, inflation lumen 63 and opening 70, and deploys to a predetermined configuration having proximal taper 64 and distal taper 66, as shown in FIG. 4B.
- the predetermined configuration may be determined, for example, using a pre-molding process in accordance with manufacturing techniques that are known in the art.
- Distal edge 68 is defined as a section of occlusion balloon 42 that is formed between central section 75 and distal taper 66. In the deployed state, distal edge 68 is configured to be in close proximity with an inner wall of vessel V to facilitate blood flow into working lumen 58 and efficiently remove emboli.
- Distal taper 66 provides a funnel-shaped flow transition from distal edge 68 into working lumen 58. Additionally, as described hereinabove, fusion joint 67 provides substantially seamless transition 72 from occlusion balloon 42 into working lumen 58 due to the melt-bond between balloon 42 and inner layer 60 of catheter 41. [0037] Referring now to FIG. 5, a preferred method for using apparatus 40 of FIG. 2A during an interventional procedure, such as balloon angioplasty, is described. In a first step, guidewire 83 is inserted into a patient's vasculature and a distal end of guidewire 83 is disposed just proximal of stenosis S, which is located in vessel V.
- a dilator (not shown) that is disposed within catheter 41 then is inserted over guidewire 83 to advance catheter 41 to a desired position proximal of stenosis S.
- catheter 41 When catheter 41 is properly positioned, e.g., as determined under fluoroscopy using radiopaque marker band 65, the dilator may be removed.
- Occlusion balloon 42 then is inflated via inflation port 44 of FIG. 2A, preferably using a radiopaque contrast solution, to occlude antegrade flow in vessel V.
- Aspiration is provided through working lumen 58 of catheter 41 to cause retrograde flow to occur in vessel V distal of occlusion balloon 42, as illustrated by the arrows in FIG. 5.
- Aspiration may be provided through working lumen 58 via blood outlet port 48 using an external aspiration device, e.g., a syringe, or alternatively using a venous return catheter to form an arterial-venous shunt, as described hereinabove.
- An interventional instrument such as conventional angioplasty balloon catheter 80 having balloon 82, may be loaded through hemostatic port 43 and working lumen 58 and positioned within stenosis S, preferably via guidewire 83. Hemostatic port 43 is closed and the angioplasty balloon is actuated to disrupt stenosis S. As seen in FIG. 5, emboli E formed during the interventional procedure are directed into working lumen 58 via the retrograde flow established.
- Occlusion balloon 42 provides a substantially uniform funnel-shaped transition from an inner wall of vessel V into working lumen 58 of catheter 41.
- Distal edge 68 which is configured to be in close proximity with an inner wall of vessel V, facilitates flow into working lumen 58 and efficiently removes emboli.
- the funnel-shaped transition provided by distal taper 66 and substantially seamless transition 72 into the working lumen via fusion joint 67 improves retrograde flow dynamics into working lumen 58.
- a variable thickness occlusion balloon is not required.
Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP03742147A EP1545685B1 (en) | 2002-06-27 | 2003-06-25 | Catheter having a funnel-shaped occlusion balloon of uniform thickness and methods of manufacture |
CA002492020A CA2492020C (en) | 2002-06-27 | 2003-06-25 | Catheter having a funnel-shaped occlusion balloon of uniform thickness and methods of manufacture |
DE60335011T DE60335011D1 (en) | 2002-06-27 | 2003-06-25 | CATHETER WITH HORIZONTAL OCCLUSION BALLOON OF SAME THICKNESS AND MANUFACTURING METHOD |
AU2003280061A AU2003280061B2 (en) | 2002-06-27 | 2003-06-25 | Catheter having a funnel-shaped occlusion balloon of uniform thickness and methods of manufacture |
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US10/187,058 US6960222B2 (en) | 1998-03-13 | 2002-06-27 | Catheter having a funnel-shaped occlusion balloon of uniform thickness and methods of manufacture |
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- 2003-06-25 WO PCT/US2003/019764 patent/WO2004002564A1/en not_active Application Discontinuation
- 2003-06-25 AU AU2003280061A patent/AU2003280061B2/en not_active Ceased
- 2003-06-25 DE DE60335011T patent/DE60335011D1/en not_active Expired - Lifetime
- 2003-06-25 EP EP03742147A patent/EP1545685B1/en not_active Expired - Fee Related
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2005
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Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7654978B2 (en) | 2001-05-01 | 2010-02-02 | St. Jude Medical, Cardiology Division, Inc. | Emboli protection devices and related methods of use |
US8430845B2 (en) | 2001-05-01 | 2013-04-30 | St. Jude Medical, Cardiology Division, Inc. | Emboli protection devices and related methods of use |
US11013523B2 (en) | 2015-01-13 | 2021-05-25 | Anaconda Biomed, S.L. | Thrombectomy device, system and method for extraction of vascular thrombi from a blood vessel |
US11534191B2 (en) | 2019-01-11 | 2022-12-27 | Anaconda Biomed, S.L. | Loading device for loading a medical device into a catheter |
US11771446B2 (en) | 2020-10-19 | 2023-10-03 | Anaconda Biomed, S.L. | Thrombectomy system and method of use |
Also Published As
Publication number | Publication date |
---|---|
US20030023204A1 (en) | 2003-01-30 |
CA2492020A1 (en) | 2004-01-08 |
EP1545685A1 (en) | 2005-06-29 |
US20060041228A1 (en) | 2006-02-23 |
AU2003280061B2 (en) | 2006-11-16 |
EP1545685A4 (en) | 2006-04-19 |
AU2003280061A1 (en) | 2004-01-19 |
CA2492020C (en) | 2008-08-19 |
DE60335011D1 (en) | 2010-12-30 |
US6960222B2 (en) | 2005-11-01 |
EP1545685B1 (en) | 2010-11-17 |
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