CA2213571C - Catheter for detaching abnormal deposits in human blood vessels - Google Patents

Catheter for detaching abnormal deposits in human blood vessels Download PDF

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Publication number
CA2213571C
CA2213571C CA002213571A CA2213571A CA2213571C CA 2213571 C CA2213571 C CA 2213571C CA 002213571 A CA002213571 A CA 002213571A CA 2213571 A CA2213571 A CA 2213571A CA 2213571 C CA2213571 C CA 2213571C
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CA
Canada
Prior art keywords
rotor
catheter
drive shaft
catheter according
stator portion
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
CA002213571A
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French (fr)
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CA2213571A1 (en
Inventor
Immanuel Straub
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Straub Medical AG
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Straub Medical AG
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Filing date
Publication date
Application filed by Straub Medical AG filed Critical Straub Medical AG
Priority claimed from PCT/CH1996/000086 external-priority patent/WO1996029942A1/en
Publication of CA2213571A1 publication Critical patent/CA2213571A1/en
Application granted granted Critical
Publication of CA2213571C publication Critical patent/CA2213571C/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3205Excision instruments
    • A61B17/3207Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320783Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681Aspects not otherwise provided for
    • A61B2017/00685Archimedes screw
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements 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
    • A61B2017/22038Implements 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 a guide wire

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Vascular Medicine (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention concerns a catheter (12) which is connected to a rotary drive (20) and has at its front end (12a) a cutting tool comprising a stator (14) and rotor (16). Peripheral blades of the rotor (16) and stator (14) co-operate in scissors-like manner. The detached deposits are conveyed through a tubular casing (22), via a discharge chamber (18), into a collection container (28). The conveying device is a drive shaft which takes the form of a feed screw, is disposed inside the tubular casing (22) and connects the rotary drive (20) to the rotor (16). A rotary catheter of this type is used for gentling removing and discharging thrombi and stenoses in narrowed blood vessels such as arteries and veins.

Description

CATHETER FOR DETACHING ABNORMAL DEPOSITS
FROM BLOOD VESSELS IN HUMANS
The invention relates to a catheter of the type known as a rotary catheter. Rotary catheters for detaching abnormal deposits from blood vessels in humans, such as arteries or veins, generally consist of a cutting tool which is arranged at its front end, and a rotor connected via a flexible drive shaft arranged in a tubular sheath, to a rotary drive mechanism which can be attached at the rear end of the catheter. The flexible drive shaft is designed as a conveyor screw and is wound helically in such a way that when it is being driven, it conveys the dislodged deposits in the direction of the rotary drive mechanism.
A catheter of this kind is used in particular for treating occlusive diseases of the arteries by dislodging stenoses and breaking up blood clots. It is introduced into the artery and is advanced as far as the stenosed area which is to be treated. A cutting tool which can be driven in rotation is arranged at its front or leading end.
In the case of a catheter known from US-A
5269751 and along the lines of that described above, the flexible helical drive shaft, also designed as a conveyor screw, serves as a guide which is introduced into the artery before the catheter and over which the catheter is guided. If this helical drive shaft is introduced into the artery without the protective catheter tube, then it is not possible to rule out the risk of the artery being damaged in the process.
A further known catheter, for example the one from EP-B1-0,267,539, has as its cutting tool a substantially elliptical milling cutter which is provided with abrasive material on its surface and is driven at a speed of up to 160,000 rpm. The milling cutter is connected via a flexible drive shaft to a rotary drive mechanism which is arranged at the other end of the catheter. The drive shaft runs inside a tubular sheath which serves as a catheter tube. A guide wire extending right through the drive shaft is introduced into the artery before introduction of the catheter and is advanced right through the stenosis.
In this known rotary catheter, the particles which are dislodged by the milling cutter are not removed from the body, since they should normally be smaller than the red blood cells by about 7 Vim. If, however, some of the particles which have been dislodged are larger than red blood cells, then there is a considerable risk of their blocking the bloodstream at another location and thereby causing an embolism.
From the literature, it is also known for the particles which have been dislodged to be drawn off through the catheter by suction. Here, however, there is the risk that too many particles will fail to be caught and that these will thus pass into the bloodstream.
The invention is therefore based on the object of providing a catheter which is of the type mentioned at the outset and in which the particles which have been dislodged are removed from the circulation almost in their entirety.
According to the invention, the object set is accomplished by means of a catheter for detaching abnormal deposits from blood vessels in humans, such as arteries or veins, with a cutting tool which is arranged at its front end, has a rotor and can be connected, via a flexible drive shaft arranged in a tubular sheath, to a rotary drive mechanism which can be attached at the rear end of the catheter, the flexible drive shaft being designed as a conveyor screw and being wound helically in such a way that when it is being driven, it conveys the dislodged deposits in the direction of the rotary drive mechanism, characterized in that a guide wire which can be moved independently of the flexible drive shaft and the tubular sheath extends coaxially right through the flexible drive shaft designed as a conveyor screw.
The catheter according to the invention has a conveyor screw with considerably improved efficacy and therefore ensures an immediate and continuous withdrawal of the dislodged or detached particles, so as to reliably prevent these particles from being able to pass into the circulation.
An embodiment having a drive shaft designed as a conveyor screw consisting of a helically wound wire, represents a particularly simple solution from the constructional point of view.
The efficacy can be enhanced still further by use of a helically wound wire that is substantially rectangular in cross-section, since the surface area of a square cross-section affords a higher conveying capacity than, for example, a round wire cross-section.
The use of a coated wire makes it possible, on the one hand, to choose freely a material which is particularly suitable as regards strength, and, on the other hand, to provide an appropriate protection against corrosion and satisfy corresponding requirements in respect of hygiene and tribology.
In a particularly preferred embodiment the cutting tool has at least one slot through which the deposits are conveyed into the inside of the cutting tool when dislodged, and in that the drive shaft extends into the inside of the cutting tool. With this arrangement the particles, immediately after they have been detached, pass through the slot and onto the conveyor screw. This largely avoids detached particles being able to pass into the bloodstream.
In an embodiment of the invention the cutting tool has a stator with a stator portion, and the cutting edges are arranged on the stator portion and on the rotor to interact in a shearing action. The shearing action, in contrast to the use of freely cutting blades, ensures improved control of the dislodging of the deposits and in so doing also reduces the risk of damage to the blood vessel walls. In particular, with such an embodiment it is also easier to ensure that the particles which have been dislodged will in all probability pass through the slot or slots into the region of the conveyor screw and are thus kept from entering the bloodstream.
In a preferred embodiment the stator portion and the rotor are designed at least substantially cylindrical, at least in the region of the cutting edges, in that the rotor surrounds the stator portion as external rotor, and in that the cutting edges are arranged in the circumferential surfaces of the rotor and of the stator portion. In such a configuration, the rotor attacks the deposits radially. This ensures that it is not possible, for example in the area of curves, to drill straight into the vessel wall.
The further dependent claims characterize further preferred embodiments of the invention.
An illustrative embodiment of the invention is explained in greater detail with reference to the drawings, in which:
Figure 1 shows a rotary catheter in a general view, with drive mechanism, guide wire and collection container for the deposit fragments detached from the blood vessel, Figure 2 shows a plan view of the head part of the rotary catheter according to Figure 1, but on a larger scale, Figure 3 shows a longitudinal section through the head part of the rotary catheter according to Figure 2, and Figure 4 shows the guide wire and conveyor screw on a still larger scale.
The catheter 12 shown in Figure 1 has, at its front end 12a, a cutting tool which consists of a stator 14 and rotor 16. At its rear end 12b, the catheter 12 is connected to a rotary drive mechanism 20 via a discharge chamber 18. A flexible drive shaft is mounted in a tubular sheath 22 which serves as catheter tube, said drive shaft connecting the rotor 16 to the rotary drive mechanism 20. A guide wire 24 extends right through the entire length of the catheter 12, and its front e:nd 24a protrudes from the rotor 16 and its rear end 24b from the rotary drive mechanism 20. The guide wire 24 has a nib point 24c at its front end 24a. A collection container 28 is linked to the discharge chamber 18 in the radial direction via a tube or a pipe 26.
When using the catheter 12, the guide wire 24 is introduced, with its front end 24a leading, into the artery or vein which is to be treated, and it is then advanced as far as the stenosed area and manoeuvred through the latter, with radiographic monitoring. The catheter 12 is then passed along the guide wire 2~4. As soon as the front end 12a has reached the area which is to be treated, the rotary drive mechanism 20 is switched on in order to detach the undesired deposits by means of the cutting tool 14, 16 and to convey them out of the bloodstream. The speed of rotation of the rotor 16 preferably lies in the range between 30,000 and 40,000 rpm. The catheter 12 is advanced slowly as the operation proceeds. The deposits which have been dislodged and broken up are carried off through the tubular sheath 22 as far as the discharge chamber 18 and they pass from there into the collection container 28.
Figures 2 and 3 show the front end 12a of the catheter 12 with its stator 14, its rotor 16 designed as external rotor, its tubular sheath 22, and the front end 24a of the guide wire 24. The tubular sheath 22 is shown cut away at 30 in order to reveal the flexible drive shaft 32 whose front end 32a is fixed to the rotor 16 in terms of rotation and tensioning. The guide wire 24 runs through the inside of the drive shaft 32. The drive shaft 32 is designed as a conveyor screw in order to convey the deposits, which have been dislodged by the cutting tool 14, 16, through the tubular sheath 22 to the discharge chamber 18 (Figure 1).
A portion 14a of the stator 14 extends into the rotor 16. It can be seen that the stator portion 14a and the rotor 16 engage one within the other like a bushing.
The stator portion 14a has two shearing slots 14b, 14c which are offset 180° to each other about the circumference. The rotor 16 likewise has two shearing slots 16b, 16c which are offset 180° to each other about the circumference.
The slot 14b of the stator portion 14a is narrower than that 16b of the rotor 16 in the circum-ferential direction. One margin of the rotor slot 16b is designed as cutting edge 16d. The opposite margin of the stator slot 14b is designed as opposite cutting edge 14d.
This opposite cutting edge 14d runs, in the axial direction, in an at least approximately undulating configuration relative to a cylindrical surface.
The cutting edge 16d and the opposite cutting edge 14d interact in a shearing action. Cutting edges of this type are in each case arranged offset 180° t:o one another about the circumference in both slots 14c, 16c which are also referred to as shearing slots.
Towards its tip, the rotor 16 has a front end 16a of diminishing diameter. In this way, the stenosed area of the artery or vein to be treated is widened upon insertion of the catheter 12.
The rotor 16 and stator 14 are preferably made of metal. The guide wire 24 with the nib tip 24c is a steel wire. The drive shaft 32 serving as conveyor screw consists of a coated steel wire, for example. The tubular sheath 22 is made of plastic.
For connecting the stator 14 to the tubular sheath 22 in a rotationally fixed manner, the end 22a of the latter is press-fitted into the stator 14. For securing purposes, holes 14e are arranged in the circumferential surface of the stator 14, and the pressed-in tube material 22b swells with a positive fit into said holes 14e.
Figure 3 shows in particular that the drive shaft 32 extends into the front end 16a of the rotar 16, _ 7 _ and its front end 32a is fixed to the rotor 16 in terms of rotation and tensioning, for example press-fitted into the latter. The figure also shows how the tubular sheath 22 is secured with a positive fit in the stator 14 by means of the holes 14e.
Figure 4 shows the rectangular cross-section of the wire 32c of the helical drive shaft 32 serv_~ng as conveyor screw. The arrangement of the guide wire 24 coaxially inside the drive shaft 32 results in a particularly high degree of efficacy as conveyor screw.
The dislodged fragments of the deposits are conveyed in a virtually linear manner inside the catheter tube 22.

Claims (9)

1. A catheter for detaching abnormal deposits from blood vessels in humans, such as arteries or veins, with a cutting tool which is arranged at its front end, has a rotor and can be connected, via a flexible drive shaft arranged in a tubular sheath, to a rotary drive mechanism which can be attached at the rear end of the catheter, the flexible drive shaft being designed as a conveyor screw and being wound helically in such a way that when it is being driven, it conveys the dislodged deposits in the direction of the rotary drive mechanism, characterized in that a guide wire which can be moved independently of the flexible drive shaft and the tubular sheath extends coaxially right through the flexible drive shaft designed as a conveyor screw.
2. The catheter according to Claim 1 characterized in that the drive shaft designed as a conveyor screw consists of a helically wound wire.
3. The catheter according to Claim 2, characterized in that the wire is substantially rectangular in cross-section.
4. The catheter according to Claim 3, characterized in that the wire is coated.
5. The catheter according to any one of claims 1 through 4, characterized in that the cutting tool has at least one slot through which the deposits are conveyed into the inside of the cutting tool when dislodged, and in that the drive shaft extends into the inside of the cutting tool.
6. The catheter according to Claim 5, characterized in that the cutting tool has a stator with a stator portion, and in that cutting edges are arranged on the stator portion and on the rotor to interact in a shearing action.
7. The catheter according to Claim 6, characterized in that the stator portion and the rotor are designed at least substantially cylindrical, at least in the region of the cutting edges, in that the rotor surrounds the stator portion as external rotor, and in that the cutting edges are arranged in the circumferential surfaces of the rotor and of the stator portion.
8. The catheter according to Claim 7, characterized in that the slots are shearing slots which are arranged in the circumferential surfaces of the stator portion and of the rotor and whose margins are designed as the cutting edges.
9. The catheter according to Claim 8, characterized in that at least two shearing slots are arranged, uniformly distributed about the circumference, in the stator portion and/or in the rotor.
CA002213571A 1995-03-28 1996-03-07 Catheter for detaching abnormal deposits in human blood vessels Expired - Lifetime CA2213571C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
CH87495 1995-03-28
CH00874/95-4 1995-03-28
PCT/CH1996/000086 WO1996029942A1 (en) 1995-03-28 1996-03-07 Catheter for detaching abnormal deposits in human blood vessels

Publications (2)

Publication Number Publication Date
CA2213571A1 CA2213571A1 (en) 1996-10-03
CA2213571C true CA2213571C (en) 2007-01-02

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ID=37603358

Family Applications (1)

Application Number Title Priority Date Filing Date
CA002213571A Expired - Lifetime CA2213571C (en) 1995-03-28 1996-03-07 Catheter for detaching abnormal deposits in human blood vessels

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CA (1) CA2213571C (en)

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Publication number Publication date
CA2213571A1 (en) 1996-10-03

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Effective date: 20160307