Surgery – Instruments – Internal pressure applicator
Reexamination Certificate
1999-12-23
2001-04-10
Jackson, Gary (Department: 3731)
Surgery
Instruments
Internal pressure applicator
C604S104000
Reexamination Certificate
active
06214026
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to apparatus and methods for filtering or removing matter from within a vascular system. More particularly, the present invention provides a delivery system for a low profile, self-expanding vascular device useful for capturing emboli generated during interventional procedures, and for thrombectomy and embolectomy.
BACKGROUND OF THE INVENTION
Percutaneous interventional procedures to treat occlusive vascular disease, such as angioplasty, atherectomy, and stenting, often dislodge material from the vessel walls. This dislodged material, known as emboli, enters the bloodstream, and may be large enough to occlude smaller downstream vessels, potentially blocking blood flow to tissue. The resulting ischemia poses a serious threat to the health or life of a patient if the blockage occurs in critical tissue, such as the heart, lungs, or brain.
The deployment of stents and stent-grafts to treat vascular disease, such as aneurysms, also involves the introduction of foreign objects into the bloodstream, and also may result in the formation of clots or release of emboli. Such particulate matter, if released into the bloodstream, also may cause infarction or stroke.
Numerous previously known methods and apparatus have been proposed to reduce the risk of embolism. U.S. Pat. No. 5,833,644 to Zadno-Azizi et al., for example, describes the use of balloon-tipped catheter to temporarily occlude flow through a vessel from which a stenosis is to be removed. Stenotic material removed during a treatment procedure is evacuated from the vessel before the flow of blood is restored. A drawback of such previously known systems, however, is that occlusion of antegrade flow through the vessel may result in damage to the tissue normally fed by the blocked vessel.
U.S. Pat. No. 5,814,064 to Daniel et al. describes an emboli filter system having a radially expandable mesh filter disposed on the distal end of a guide wire. The filter is deployed distal to a region of stenosis, and any interventional devices, such as an angioplasty balloon or stent delivery system are advanced along the guide wire. The filter is designed to capture emboli generated during treatment of the stenosis while permitting blood to flow through the filter. Similar filter systems are described in Wholey et al. U.S. Pat. No. 4,723,549 and Cassell et al. U.S. Pat. No. 5,827,324.
One disadvantage of radially expandable filter systems such as described in the foregoing patents is the relative complexity of the devices, which typically comprise numerous parts. Connecting more than a minimal number of such parts to a guide wire generally increases delivery complications. The ability of the guide wire to negotiate tortuous anatomy diminishes, and the profile of the device in its delivery configuration increases. Consequently, it may be difficult or impossible to use such devices in small diameter vessels such as are commonly found in the carotid artery and cerebral vasculature. Moreover, such filter devices are generally incapable of preventing material from escaping from the filter during the process of collapsing the filter for removal.
International Publication No. WO 98/39053 describes a filter system comprising an elongated member, a radially expandable hoop and a cone-shaped basket. The hoop is affixed to the elongated member, and the cone-shaped basket is attached to the hoop and the elongated member so that the hoop forms the mouth of the basket. The filter system includes a specially configured delivery catheter that retains the mouth of the basket in a radially retracted position during delivery.
While the filter system described in the foregoing International Publication reduces the number of components used to deploy the cone-shaped basket, compared to the radial strut-type filter elements described hereinabove, it too has drawbacks. Chief among these, it is expected that it will be difficult to reduce the diameter of the radially expandable hoop to its retracted position. In particular, as the hoop is contracted through smaller radii of curvature, the stiffness of the hoop is expected to increase dramatically. This increased stiffness prevents the hoop from being contracted more tightly and is expected to result in a delivery profile too large to permit use of the device in critical regions of the body, such as the smaller coronary arteries, carotid arteries, and cerebral vasculature.
In view of the foregoing disadvantages of previously known apparatus and methods, a need still exists for a vascular device with a reliable and multi-functional delivery system, e.g., for use as a vascular filter. It would therefore be desirable to provide a delivery system for a vascular device that overcomes the foregoing disadvantages.
It further would be desirable to provide a delivery system for a vascular device that integrates multiple delivery functions of previously known devices into a single device.
It further would be desirable to provide a delivery system for a vascular device that facilitates positioning of the vascular device in a bifurcated vessel.
It still further would be desirable to provide a delivery system for a vascular device that facilitates the addition or removal of fluids from the operative site.
It further would be desirable to provide a delivery system for a vascular device that provides precise control over the deployment and retrieval of the vascular device.
SUMMARY OF THE INVENTION
In view of the foregoing, it is an object of the present invention to provide a delivery system for a vascular device that overcomes disadvantages associated with previously known vascular filters and thrombectomy/embolectomy systems.
It is also an object of this invention to provide a delivery system for a vascular device that integrates multiple delivery functions of previously known devices into a single device.
It is another object of this invention to provide a delivery system for a vascular device that facilitates positioning of the vascular device in a bifurcated vessel.
It is yet another object of this invention to provide a delivery system for a vascular device that facilitates the addition or removal of fluids from the operative site.
It is further an object of this invention to provide a delivery system for a vascular device that provides precise control over the deployment and retrieval of the vascular device.
These and other objects of the present invention are accomplished by providing a delivery system for a vascular device, suitable for use as a vascular filter or thrombectomy/embolectomy device. The delivery system integrates the functions of a Touhy Borst, a torquer, and a pusher into a single device, and is configured for use with the vascular device described in commonly assigned, co-pending U.S. patent application Ser. No. 09/364,064 filed Jul. 30, 1999, which is incorporated herein by reference.
In a preferred embodiment, the vascular device comprises a blood permeable sac affixed at its perimeter to a support hoop having an articulation region. The reduced-thickness articulation region enables contraction of the support hoop to very small radii of curvature without increased stiffness and kinking. The hoop is attached in a distal region of an elongated member, such as a guide wire, and supports a proximally-oriented mouth of the sac when the device is deployed in a vessel. The sides of the support hoop fold inwards towards one-another when the vascular device is collapsed into a sheath for removal. This in turn closes the mouth of the sac and reduces the potential for emboli or thrombus to be released from the vascular device during removal.
The delivery system of the present invention facilitates introduction and retrieval of the vascular device. The torqueing function allows the vascular device to navigate tortuous anatomy. For example, the distal end of the guide wire may be rotated to selectively orient the vascular device in a selected branch of a bifurcated vessel. The Touhy-Borst adapter permits liquid to be introduced or withdrawn through the lumen of the va
Khosravi Farhad
Lepak Jonah
Salahieh Amr
Fish & Neave
Incept LLC
Jackson Gary
Michlitsch Kenneth J.
Pisano Nicola A.
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