CN113827311A - 具有可扩展凝块接合框架的凝块取回系统 - Google Patents

具有可扩展凝块接合框架的凝块取回系统 Download PDF

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CN113827311A
CN113827311A CN202110690003.2A CN202110690003A CN113827311A CN 113827311 A CN113827311 A CN 113827311A CN 202110690003 A CN202110690003 A CN 202110690003A CN 113827311 A CN113827311 A CN 113827311A
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S·惠兰
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Neuravi Ltd
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Abstract

本发明题为“具有可扩展凝块接合框架的凝块取回系统”。本发明呈现了一种用于从身体血管移除凝块的凝块移除装置。该装置可通过以在显著表面区域上接合凝块的方式扩展来促进凝块取回。该凝块可具有至少一个坚固部分和至少一个柔软部分。在提取时，该凝块的至少一个坚固部分可由该装置的近侧部分夹紧，而该凝块的至少一个柔软部分可由该装置的远侧部分保持。然而，该凝块的分离和移除可使该凝块的较柔软部分经受剪切或破裂，从而在该血管中产生不再附接到主凝块的小漂浮凝块碎片。该装置在从血管移除凝块时还可捕获并且保持凝块的剪切或扩展远侧部分。

Description

具有可扩展凝块接合框架的凝块取回系统
技术领域
本公开整体涉及用于在血管内医学治疗期间从血管移除堵塞物的装置和方法。
背景技术
本发明涉及用于从血管中移除急性堵塞物的装置。急性阻塞物可包括凝块、错位装置、迁移装置、大栓塞等。当部分或全部血栓从血管壁脱离时，发生血栓栓塞。这种凝块(现在称为栓塞)随后沿血流方向运送。如果凝块起源于静脉系统或心脏右侧并滞留在肺动脉或其分支中，则可能导致缺血性卒中。凝块也可不以栓塞的形式释放，而是在局部形成并堵塞血管，这种机制在冠状动脉堵塞形成中较为常见。
凝块通常可在从容器中移除时经受剪切或破损。本发明特别适于整体移除凝块，而不剪切凝块和/或留下凝块的残余部分。装置可用于患有急性缺血性卒中(AIS)的患者体内的脑动脉、患有心肌梗塞(MI)的患者体内的冠状天生或移植血管和患有肺栓塞(PE)的患者体内的肺动脉以及凝块造成闭塞的其他外周动脉和静脉血管中。
发明内容
本文呈现了一种用于从身体血管移除凝块的凝块移除装置。该装置可通过以在显著表面区域上接合凝块的方式扩展来促进凝块取回。该凝块可具有至少一个坚固部分和至少一个柔软部分。在提取时，该凝块的至少一个坚固部分可由该装置的近侧部分夹紧，而凝块的至少一个柔软部分可由该装置的远侧部分保持。该夹紧可通过将微导管或中间导管推进到该装置上方直到凝块的一部分被压缩在该导管的末端和该装置上的冠部或撑条之间来实现。然而，该凝块的分离和移除可使该凝块的较柔软部分经受剪切或破裂，从而在该血管中产生不再附接到主凝块的小漂浮凝块碎片。该装置还旨在在从血管移除该凝块时捕获或保持该凝块的剪切或扩展远侧部分。
在本文所呈现的一些示例中，微导管和导丝可经由取回导管插入患者的脉管系统中并且跨凝块推进。当该微导管就位时，可移除该导丝以允许凝块取回装置推进穿过该微导管到达该凝块。该装置可以塌缩构型推进。然后，可回缩微导管，同时维持装置的位置，以将装置跨凝块部署。
在一些示例中，该装置可包括凝块接合框架、海波管和远侧栓塞保护系统。该接合框架可具有塌缩递送构型、凝块接合部署构型和凝块夹紧构型。该接合框架还可具有近侧端部、远侧端部和远侧末端。该海波管可包括远侧端部，该远侧端部以螺旋构型至少部分地由该凝块接合框架围绕。该远侧栓塞保护系统可从在该海波管内的塌缩递送构型扩展到在该海波管的远侧端部远侧的部署构型。
在一些示例中，在该装置跨凝块部署之后，可将该微导管朝远侧推进到该接合框架中，以将该接合框架移动为该凝块夹紧构型。在该凝块夹紧构型中，该接合框架的该近侧端部的这些撑条可被压缩以夹紧凝块。然后，该远侧栓塞保护系统可在塌缩递送构型中推进穿过该海波管，并且部署为在该海波管的该远侧端部远侧的扩展构型。处于部署构型的接合框架的撑条可具有凝块夹持表面，以接合凝块并固持到凝块的坚固部分上。一旦该装置处于该夹紧构型并且该远侧栓塞保护系统已部署，该微导管和该装置就可朝取回导管回缩。在回缩期间，可能的是，该凝块的小的较柔软部分可能从较坚固的较大凝块质量块破裂或剪切开。该远侧栓塞保护系统可用作全捕获机构，以在移除该装置时保持该凝块的这些较柔软部分。该装置可通过该取回导管移除。
在本文所述的一些示例中，该装置可包括牵拉线和支架取栓器。该牵拉线可靠近该支架取栓器的远侧端部附连。该支架取栓器可包括近侧螺旋区段、远侧圆柱形主体区段和远侧锥。该螺旋区段的至少一部分可环绕该牵拉线。如前所述，在回缩微导管时，该支架取栓器可从塌缩递送构型扩展到夹紧构型，然后进一步扩展为扩展构型。在该夹紧构型中，该远侧圆柱形主体区段可具有第一直径，并且该微导管可朝该近侧螺旋区段朝远侧推进，以使该近侧螺旋部分的开口塌缩，从而将凝块的坚固部分夹紧在该微导管的远侧端部和该近侧螺旋区段之间。一旦该支架取栓器处于该夹紧构型，该牵拉线就可回缩以使该支架取栓器扩展为扩展构型。在该扩展构型中，该远侧圆柱形主体区段可径向扩展至更大的第二直径，并且接合该凝块的原本在移除该装置时可能易受剪切或破损影响的任何柔软部分。在该支架取栓器处于该扩展构型之后，该微导管和该装置可通过该脉管系统回缩到取回导管中以从该患者体内移除。
用于治疗具有闭塞血管的患者的示例性方法可包括以非特定次序呈现的以下步骤中的一者或多者，并且该方法可包括此处未包括的附加步骤。可将定位在微导管内的凝块接合框架递送到目标闭塞血管。可用该凝块接合框架将具有远侧栓塞保护系统的海波管递送到该闭塞血管。可部署该凝块接合框架以接触凝块的至少一部分。可将该海波管跨凝块推进。可将该微导管推进到该凝块接合框架的近侧部分上方，从而夹紧该凝块。可部署该远侧栓塞保护系统。然后，可将该凝块接合框架、该远侧栓塞保护系统和凝块从该患者体内抽回。该方法还可包括用该海波管的外表面夹持该凝块。该方法还可包括用该远侧栓塞保护系统捕获凝块碎片。
用于治疗具有闭塞血管的患者的另一示例性方法可包括以非特定次序呈现的以下步骤中的一者或多者，并且该方法可包括此处未包括的附加步骤。可通过微导管将包括支架取栓器和牵拉线的装置递送到该闭塞血管。可部署该支架取栓器，以接触该凝块的至少一部分，使得该支架取栓器的近侧螺旋部分形成螺旋，并且该支架取栓器的远侧圆柱形部分形成圆柱形主体。可用该支架取栓器的该螺旋部分将该凝块的至少一部分夹紧。可回缩该牵拉线以使该支架取栓器的该圆柱形部分径向扩展。可将该微导管和该装置从血管一起抽回。然后可将该装置、该微导管和该凝块从该患者体内移除。该方法还可包括将该凝块的至少一部分收集在该支架取栓器的远侧锥内。该方法还可包括将该装置定位成使得该螺旋区段的至少一部分环绕该牵拉线。
附图说明
参考附图，根据下文对本发明仅以举例的方式给出的一些实施方案的描述，将更清楚地理解本发明，其中：
图1A至图1B示出了根据本发明的方面将凝块取回装置递送到血管内的目标位置；
图2A至图2C示出了根据本发明的方面的凝块取回装置的各种机械部件；
图3A至图3E示出了使用根据本发明的方面的凝块取回装置从血管移除凝块；
图4A至图4B示出了根据本发明的方面将凝块取回装置递送到血管内的目标位置；
图5A和图5B示出了根据本发明的方面的凝块取回装置的各种机械部件；
图6A至图6C示出了使用根据本发明的方面的凝块取回装置从血管移除凝块；
图7为根据本发明的方面的描绘治疗具有闭塞血管的患者的方法的流程图；并且
图8为根据本发明的方面的描绘治疗具有闭塞血管的患者的方法的流程图。
具体实施方式
现在参考附图详细描述本发明的具体实施方案，其中相同的参考标号表示相同或功能类似的元件。术语“远侧”和“近侧”用于下文有关相对于治疗医师的位置或方向的描述。“远侧”或“朝远侧”为远离医师的位置或在远离医师方向上。“近侧”或“朝近侧”或“在近侧”为靠近医师的位置或在朝向医师方向上。
进入脑血管、冠状血管和肺血管涉及使用多种可商购获得的产品和常规的程序步骤。进入产品诸如导丝、引导导管、血管造影导管和微导管在别处描述，并且常用于导管实验室程序中。在下文的描述中假定这些产品和方法与本发明的装置和方法结合使用，并且不需要详细描述。
以下具体实施方式本质上仅为说明性的，并不旨在限制本发明或本发明的应用和用途。虽然本发明的描述在许多情况下是在治疗颅内动脉的背景下，但本发明也可用于如前所述的其他身体通道中。
所公开设计的可扩展构件期望由一旦从高度应变递送构型释放后就能够自动恢复其形状的材料制成。超弹性材料诸如镍钛诺或类似性质的合金是特别合适的。该材料可为多种形式，诸如线状或条状或片状或管状。特别合适的制造工艺是激光切割镍钛诺管，然后对所得结构进行热定形和电抛光，以形成撑条和连接元件的框架。该框架可为如本文所公开的大范围形状中的任一种，并且可通过添加合金元素(诸如铂)或者通过多种其他涂层或标记带而在荧光镜透视检查下可见。
当在本文中使用时，术语“管状”和“管”应广义地理解，并且不限于为正圆柱体的或横截面为完全圆周的或在其整个长度上具有均匀横截面的结构。例如，管状结构或系统通常被示出为基本上呈正圆柱体的结构。然而，在不脱离本发明范围的情况下，管状系统可具有锥形或弯曲外表面。
这种装置旨在通过以在显著表面区域上接合凝块的方式扩展来促进凝块取回。凝块的一部分可夹紧在导管的末端和装置的镍钛诺撑条之间。凝块可具有至少一个坚固部分和至少一个柔软部分。在提取时，凝块的至少一个坚固部分可由装置的近侧部分夹紧，而凝块的至少一个柔软部分可由装置的远侧部分保持。该夹紧可通过将微导管或中间导管推进到该装置上方直到凝块的一部分被压缩在该导管的末端和该装置上的冠部或撑条之间来实现。这种夹紧有利于移除凝块，因为其增加了装置对凝块(尤其是富含纤维蛋白的凝块)的夹持。该夹紧还可通过在分离过程期间将凝块拉离血管壁来拉长凝块，从而减小分离力。然而，凝块的分离和移除可导致凝块的柔软部分剪切或破裂，从而在该血管中产生不再附接到主凝块的小漂浮凝块碎片。该装置还旨在在从血管移除凝块时捕获并保持凝块的柔软的剪切或扩展的远侧部分。
图1A和图1B示出了将用于从血管100移除凝块101的凝块取回装置110递送到目标位置。如图1A所示，微导管103和导丝可经由取回导管104插入脉管系统100中，并且使用常规已知的技术跨凝块101推进。当微导管103定位在凝块101远侧时，导丝可从脉管系统移除，以允许凝块取回装置110被推进穿过微导管102。装置110可以塌缩构型推进，直到装置110的远侧末端到达微导管103的远侧端部。
在图1B中，可回缩微导管103，同时维持装置110的位置，以将凝块取回装置跨凝块101部署，其方式使得装置110的远侧端部定位在凝块101远侧。
如图2A至图2C进一步所示，装置110可包括凝块接合框架112、海波管111和远侧栓塞保护系统115。接合框架112可具有塌缩递送构型、凝块接合部署构型和凝块夹紧构型。接合框架还可具有近侧端部112a、远侧端部112b和远侧末端162。在凝块夹紧构型中，凝块接合框架112的至少一部分可被构造成能够在部署构型中接合凝块101的坚固部分，并且在从部署构型移动到凝块夹紧构型时夹紧凝块101。海波管111可包括近侧端部和远侧端部，该远侧端部至少部分地由靠近海波管111远侧端部的凝块接合框架112围绕。海波管111还可具有凝块夹持外表面。远侧栓塞保护系统115可从在海波管111内的塌缩递送构型移动到在海波管的远侧端部远侧的扩展部署构型。远侧栓塞保护系统115还可具有近侧边缘115a。
在图2A中，装置110以部署构型示出。如图2A所见，凝块接合部分112的至少一部分以螺旋构型环绕海波管111。如图2B所示，当微导管103朝远侧推进到接合框架112中时，接合框架可移动到凝块夹紧构型，该凝块夹紧构型压缩接合框架的近侧端部112a的撑条，以便夹紧凝块以从血管提取。这种夹紧效应可通过图2A和图2B所示的箭头看到。当装置110完全部署时，该区段中的单元是打开的。当装置110被微导管103压缩时，单元将凝块101紧密“夹紧”在它们之间，以更牢固地夹持凝块101以便移除。如图2C进一步所示，远侧栓塞保护系统115可在塌缩递送构型中推进穿过海波管111，并且部署到在海波管111外部的扩展构型。栓塞保护系统115可部署在海波管111的远侧端部远侧。栓塞保护系统115可部署在接合框架112的远侧末端162远侧。
在图3A至图3E中，示出了使用凝块取回装置110从血管移除凝块101。装置110可跨凝块101推进，如先前在图1A和图1B中所示。如图3A所示，在微导管103回缩时，接合框架112可扩展为部署构型。处于部署构型的接合框架112的撑条可具有凝块夹持表面，以接合凝块101a并固持到凝块101a的坚固部分上，从而有助于移除凝块101。在接合框架处于部署构型之后，远侧栓塞保护系统115可部署到在接合框架112的远侧末端162远侧的部署构型。然后，如图3B所示，可推进微导管103以将凝块的坚固部分夹紧在微导管和接合框架112之间，如前所述。图3E提供了装置110的构型的近距离视图，其中接合框架112处于夹紧构型以夹紧凝块101a的坚固近侧端部并且保护系统115已部署。在实现夹紧之后，微导管和装置可通过脉管系统朝取回导管104回缩，如图3C所示。在回缩期间，可能的是，凝块101b的小的较柔软部分可能从较坚固的较大凝块质量块101破裂或剪切开。远侧栓塞保护系统115可用作全捕获机构，以在移除装置时保持凝块的这些较柔软部分。保护系统115可在柔软凝块碎片101b和血管的远侧部分之间形成屏障，以防止凝块碎片101b重新进入血管并确保它们与凝块101的其余部分一起被移除。
在图3D中，通过取回导管104移除装置110。处于扩展部署构型的远侧栓塞保护系统115的尺寸可被设定成行进穿过取回导管104。
图4A和图4B示出了将用于从血管100移除凝块101的凝块取回装置200递送到目标位置，这类似于图1A和图1B。如图4A所示，微导管103和导丝可经由取回导管104插入脉管系统100中，并且使用常规已知的技术跨凝块101推进。凝块101可具有至少一个坚固部分和至少一个柔软部分，如前所述。当微导管103定位在凝块101远侧时，导丝可从脉管系统移除，以允许凝块取回装置200被推进穿过微导管103。装置200以塌缩构型推进，直到装置200的远侧末端到达微导管103的远侧端部。
在图4B中，可回缩微导管103，同时维持装置200的位置，以将凝块取回装置跨凝块101部署，其方式使得装置200的远侧端部定位在凝块101远侧。装置200可包括牵拉线204和支架取栓器202。牵拉线204可靠近支架取栓器202的远侧端部附连到支架取栓器202。支架取栓器202可包括近侧螺旋区段206、远侧圆柱形主体区段208和远侧锥体210。螺旋区段206的至少一部分可环绕牵拉线204。支架取栓器202可被构造成从塌缩递送构型扩展为夹紧构型，然后进一步扩展为扩展构型。在塌缩递送构型中，支架取栓器202和牵拉线204可位于导管103内部。装置还可包括类似于前述附图中所述的远侧保护系统的远侧保护系统115。
如图5A所示，在夹紧构型中，牵拉线204的一部分和支架取栓器202可位于导管103外部。在夹紧构型中，远侧圆柱形主体区段208可具有第一直径D1。在图5B中，微导管103可朝近侧螺旋区段206朝远侧推进，以将凝块的坚固部分夹紧在微导管的远侧端部103a和近侧螺旋区段206之间。当导管103朝远侧移动时，支架取栓器202的近侧螺旋部分206的开口塌缩，从而夹紧凝块，使得凝块的近侧端部由导管103和近侧螺旋区段206固持。如图5B中进一步所示，一旦支架取栓器202已离开微导管103进入夹紧构型，牵拉线104就可相对于支架取栓器202回缩以使支架取栓器202扩展为扩展构型。在扩展构型中，在牵拉线204相对于支架取栓器202移动时，远侧圆柱形主体区段208可扩展到第二直径D2。在扩展构型中，圆柱形主体区段208可接合凝块的原本可能在移除装置200时易受剪切或破损影响的任何柔软部分。当牵拉线204相对于支架取栓器202朝近侧回缩时，圆柱形主体区段208的直径D2可径向扩展至大于处于夹紧构型的圆柱形主体区段208的直径D1。
在图6A至图6C中，示出了使用凝块取回装置200从血管移除凝块101。在图6A中，可将装置200跨凝块101推进，如先前图4A和图4B所述。如图6A所示，在微导管103回缩时，支架取栓器202可扩展到部署构型。处于部署构型的支架取栓器202的撑条可具有凝块夹持表面，以接合凝块101并固持到凝块101上，从而有助于移除凝块101。在支架取栓器202处于部署构型之后，如图6B所示，支架取栓器202可扩展为扩展构型。然后，可推进微导管103以将凝块101a的坚固部分夹紧在微导管和近侧螺旋区段206之间，如前所述。在实现夹紧之后，微导管和装置200可朝取回导管104回缩，如图6C所示。在装置200回缩期间，圆柱形主体区段208可接合凝块101的原本在移除装置200时可能易受剪切或破损影响的任何柔软部分，以确保移除整个凝块101。
其他示例可包括远侧栓塞保护系统，如先前所示。远侧栓塞保护系统115可用作全捕获机构以在移除装置时保持这些凝块。保护系统115可在凝块碎片101b和血管的远侧部分之间形成屏障，以防止凝块碎片101b重新进入血管并确保它们与凝块101的其余部分一起被移除。然而，需注意，该示例可在具有或不具有远侧栓塞保护系统115的情况下捕获杂散栓塞101b。
图7是示出治疗具有闭塞血管的患者的方法300的流程图。该方法可包括：递送定位在微导管内的凝块接合框架(310)；用凝块接合框架将其中包含远侧栓塞保护系统的海波管递送到闭塞血管(320)；部署凝块接合框架以接触凝块的至少一部分(330)；用海波管穿过凝块(340)；将微导管推进到凝块接合框架的近侧部分上方，从而夹紧凝块(350)；部署远侧栓塞保护系统(360)；以及将接合框架、远侧栓塞保护系统和凝块从患者体内抽回抽回。(390)
在方法300中，凝块接合部分可以螺旋构型至少部分地环绕海波管。方法300还可包括：将凝块接合框架和远侧栓塞保护系统抽回到微导管中，并且将凝块接合框架、远侧栓塞保护系统和凝块从患者体内移除。方法300还可包括：将凝块、凝块接合框架和远侧栓塞保护系统一起抽回。方法300还可包括：用海波管的外表面夹持凝块(370)。方法300还可包括：用远侧栓塞保护系统捕获凝块碎片(380)。
图8是示出治疗具有闭塞血管的患者的方法400的流程图。闭塞可包括凝块。方法400可涉及：通过微导管递送装置(410)，该装置具有支架取栓器和通向闭塞血管的牵拉线；部署支架取栓器以接触凝块的至少一部分，使得支架取栓器的近侧螺旋部分形成螺旋，并且支架取栓器的远侧圆柱形部分形成圆柱形主体(420)；用支架取栓器的螺旋部分夹紧凝块的至少一部分(430)；回缩牵拉线以使支架取栓器的圆柱形部分径向扩展(440)；将微导管和装置从血管一起抽回(450)；以及从患者体内移除装置、微导管和凝块(470)。
用螺旋部分夹紧凝块的至少一部分的步骤430还可包括：使螺旋部分的第一部分朝微导管朝近侧移动，从而导致螺旋部分的第二部分塌缩并且夹紧凝块。方法400还可包括：将凝块的至少一部分收集在支架取栓器的远侧锥内(460)。将凝块的至少一部分收集在远侧锥内的步骤460还可包括：回缩牵拉线以使远侧锥径向扩展。方法400还可包括：将装置定位成使得螺旋区段的至少一部分环绕牵拉线。
本文所包含的描述是本发明的实施方案的示例，并且不旨在以任何方式限制本发明的范围。本领域普通技术人员根据本公开的以下教导内容显而易见的修改旨在落入以下权利要求的范围内。

Claims (20)

1.一种用于从身体血管移除凝块的凝块移除装置，所述凝块移除装置包括：
凝块接合框架，所述凝块接合框架包括塌缩递送构型、凝块接合部署构型和凝块夹紧构型，使得所述凝块接合框架的至少一部分被构造成在所述部署构型中接合凝块，并且在从所述部署构型移动到所述凝块夹紧构型时夹紧凝块；
海波管，所述海波管包括近侧端部和远侧端部，所述远侧端部至少部分地由靠近所述海波管的远侧端部的所述凝块接合框架围绕；以及
远侧栓塞保护系统，所述远侧栓塞保护系统能够从在所述海波管内的塌缩递送构型移动到在所述海波管的远侧端部远侧的扩展部署构型。
2.根据权利要求1所述的装置，其中所述海波管还包括凝块夹持外表面。
3.根据权利要求1所述的装置，其中凝块接合部分的至少一部分以螺旋构型环绕所述海波管。
4.根据权利要求1所述的装置，其中所述海波管被构造成穿过所述凝块。
5.根据权利要求1所述的装置，其中处于所述扩展部署构型的所述远侧栓塞保护系统被设定尺寸成行进穿过取回导管。
6. 一种用于从身体血管移除凝块的凝块移除装置，所述凝块移除装置经由导管递送到所述血管并且包括：
牵拉线；以及
支架取栓器，所述支架取栓器包括近侧螺旋区段和远侧圆柱形主体区段，所述远侧圆柱形主体区段被构造成从塌缩递送构型扩展到夹紧构型和扩展构型，
在所述塌缩递送构型中，所述支架取栓器和所述牵拉线位于所述导管内部，
在所述夹紧构型中，所述牵拉线的一部分和所述支架取栓器位于所述导管外部，并且所述支架取栓器具有第一直径，并且
在所述扩展构型中，所述凝块的近侧端部接触导管的远侧端部，并且在所述牵拉线相对于所述支架取栓器移动时，所述支架取栓器运动到第二直径。
7.根据权利要求6所述的装置，其中当所述牵拉线相对于所述支架取栓器朝近侧回缩时，所述圆柱形主体区段的直径径向扩展至大于处于所述夹紧构型的所述圆柱形主体区段的直径。
8.根据权利要求6所述的装置，其中所述牵拉线靠近所述支架取栓器的远侧端部附连到所述支架取栓器。
9.根据权利要求6所述的装置，其中所述螺旋区段的至少一部分环绕所述牵拉线。
10.一种治疗具有闭塞血管的患者的方法，所述闭塞物包括凝块，并且所述方法包括以下步骤：
递送定位在微导管内的凝块接合框架；
用所述凝块接合框架将其中包括远侧栓塞保护系统的海波管递送到所述闭塞血管；
部署所述凝块接合框架以接触所述凝块的至少一部分；
用所述海波管穿过所述凝块；
将所述微导管推进到所述凝块接合框架的近侧部分上方，从而夹紧所述凝块；
部署所述远侧栓塞保护系统；以及
将所述凝块接合框架、所述远侧栓塞保护系统和所述凝块从所述患者体内抽回。
11. 根据权利要求10所述的方法，还包括：
将所述凝块接合框架和所述远侧栓塞保护系统抽回到所述微导管中；以及
将所述凝块接合框架、所述远侧栓塞保护系统和所述凝块从所述患者体内移除。
12.根据权利要求10所述的方法，还包括：
将所述凝块、所述凝块接合框架和所述远侧栓塞保护系统一起抽回。
13.根据权利要求10所述的方法，还包括：
用所述海波管的外表面夹持所述凝块。
14.根据权利要求10所述的方法，还包括：
用所述远侧栓塞保护系统捕获凝块碎片。
15.根据权利要求10所述的方法，其中凝块接合部分以螺旋构型至少部分地环绕所述海波管。
16.一种治疗具有闭塞血管的患者的方法，所述闭塞物包括凝块，并且所述方法包括以下步骤：
通过微导管将包括支架取栓器和牵拉线的装置递送到所述闭塞血管；
部署所述支架取栓器以接触所述凝块的至少一部分，使得所述支架取栓器的近侧螺旋部分形成螺旋，并且所述支架取栓器的远侧圆柱形部分形成圆柱形主体；
用所述支架取栓器的所述螺旋部分夹紧所述凝块的至少一部分；
回缩所述牵拉线以使所述支架取栓器的所述圆柱形部分径向扩展；
将所述微导管和所述装置从所述血管一起抽回；以及
将所述装置、所述微导管和所述凝块从所述患者体内移除。
17.根据权利要求16所述的方法，其中用所述螺旋部分夹紧所述凝块的至少一部分的所述步骤还包括：将所述螺旋部分的第一部分朝所述微导管朝近侧移动，从而使所述螺旋部分的第二部分塌缩并且夹紧所述凝块。
18.根据权利要求16所述的方法，还包括：将所述凝块的至少一部分收集在所述支架取栓器的远侧锥内。
19.根据权利要求18所述的方法，还包括：
回缩所述牵拉线以使所述远侧锥径向扩展。
20.根据权利要求16所述的方法，还包括：
将所述装置定位成使得所述螺旋区段的至少一部分环绕所述牵拉线。
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