US20220378449A1 - Systems and methods for removal of blood and thrombotic material - Google Patents
Systems and methods for removal of blood and thrombotic material Download PDFInfo
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- US20220378449A1 US20220378449A1 US17/886,020 US202217886020A US2022378449A1 US 20220378449 A1 US20220378449 A1 US 20220378449A1 US 202217886020 A US202217886020 A US 202217886020A US 2022378449 A1 US2022378449 A1 US 2022378449A1
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Definitions
- the present disclosure pertains generally to medical devices and methods of their use. More particularly, the present invention pertains to aspiration and thrombectomy devices and methods of use thereof.
- a method for improving a flow condition through a catheter includes providing an aspiration catheter including an elongate shaft configured for placement within a blood vessel of a subject, a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end, and an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid from a first fluid source into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen, providing a sheath including a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough, the sheath further including an extension conduit in fluid communication with the lumen of the she
- a method for identifying a no flow or low flow condition through a catheter includes providing an aspiration catheter including an elongate shaft configured for placement within a blood vessel of a subject, a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end, and an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen, providing a sheath including a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough, the sheath further including an extension conduit in fluid communication with the lumen of the shea
- a method for identifying a no flow or low flow condition through a catheter includes providing an aspiration catheter including an elongate shaft configured for placement within a blood vessel of a subject, a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end, and an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen, providing a sheath including a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough, the sheath further including an extension conduit in fluid communication with the lumen of the she
- a system for aspirating thrombus includes an aspiration catheter including an elongate shaft configured for placement within a blood vessel of a subject, a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end, and an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen, a tubing set including a first conduit having a distal end configured to couple to the aspiration lumen of the aspiration catheter and a proximal end configured to couple to a vacuum source, and a second conduit having a distal end configured to couple to the supply lumen of the aspiration catheter and a proximal end
- a system for aspirating thrombus includes an aspiration catheter including an elongate shaft configured for placement within a blood vessel of a subject, a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end, and an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen, a tubing set including a first conduit having a distal end configured to couple to the aspiration lumen of the aspiration catheter and a proximal end configured to couple to a vacuum source, and a second conduit having a distal end configured to couple to the supply lumen of the aspiration catheter and a proximal end
- FIG. 1 is a plan view of an aspiration system, according to an embodiment of the present disclosure.
- FIG. 2 is a sectional view of the distal end of the aspiration catheter of the system for aspirating thrombus of FIG. 1 .
- FIG. 3 is a perspective view of a modification of the aspiration system having an alternative pinch valve, according to another embodiment of the present disclosure.
- FIG. 4 is plan view of the aspiration system of FIG. 1 , in a second condition.
- FIG. 5 is plan view of the aspiration system of FIG. 1 , in a third condition.
- FIG. 6 is a detail view of the distal end of the guide sheath of FIG. 5 .
- FIG. 7 is a plan view of an alternative aspiration system to the aspiration system of FIG. 1 , according to an embodiment of the present disclosure.
- FIGS. 1 - 3 illustrate a system for aspirating thrombus 2400 , including an aspiration catheter 1930 , a pump base 200 , and a guide sheath 2450 .
- the aspiration catheter 1930 has been inserted through the guide sheath 2450 , which includes a proximally-located hemostasis valve 2452 configured for sealing around the shaft 2454 of the aspiration catheter 1930 .
- the hemostasis valve 2452 instead of being part of the guide sheath 2450 , may be a separate hemostasis valve that is configured to be coupled to the guide sheath 2450 , for example, by a luer fitting or a y-connector.
- Fluid e.g., saline
- Fluid may be injected through the interior lumen 2456 of the guide sheath 2450 , and around the shaft 2454 of the aspiration catheter 1930 by attaching a syringe or pump (not shown) to the luer connector 2458 of an extension tube 2460 .
- a guidewire 1902 can be used to track the aspiration catheter 1930 through a patient's vasculature, for example, a blood vessel 1999 having a thrombus 1995 .
- the distal end 2451 of the guide sheath 2450 and the distal end 1997 of the aspiration catheter 1930 are shown in FIG. 1 within the blood vessel 1999 and in relation to the thrombus 1995 .
- FIG. 2 illustrates the distal end 2451 of the aspiration catheter 1930 and the guidewire 1902 .
- the guidewire 1902 is free to be moved distally or proximally in the longitudinal direction, or to be rotated within the aspiration lumen/guidewire lumen 1932 that extends through the aspiration catheter 1930 .
- the distal end 1901 of the guidewire 1902 may be shapeable, for example, to create a “J”-tip for selectability of vessels or through stenoses or obstructions.
- a high-pressure injection lumen 1934 is contained within a tube 1936 having a large diameter portion 1938 and a small diameter portion 1940 .
- the small diameter portion 1940 may transition from the large diameter portion 1938 via a neckdown or tapered portion 1942 .
- the small diameter portion 1940 is blocked using a blocking material 1944 , which may include a polymer, adhesive, or epoxy adhered to the internal walls of the small diameter portion 1940 .
- a blocking material 1944 may include a polymer, adhesive, or epoxy adhered to the internal walls of the small diameter portion 1940 .
- the small diameter portion 1940 may be crimped, tied off, sealed, or otherwise occluded, without the use of a blocking material 1944 .
- An orifice 1946 in a wall 1948 of the tube 1936 is configured to create a jet from high pressure fluid injected through the high-pressure injection lumen 1934 .
- the jet exiting the high-pressure injection lumen 1934 through the orifice 1946 and entering the aspiration lumen 1932 is configured to impinge on an inner wall 1950 of the aspiration lumen/guidewire lumen 1932 .
- Aspiration may be performed with the guidewire 1902 in place within the aspiration lumen/guidewire lumen 1932 , or may be performed with the guidewire 1902 retracted proximally of the longitudinal location of the orifice 1946 , or even with the guidewire 1902 completely removed from the aspiration lumen/guidewire lumen 1932 .
- the guidewire 1902 may be rotated or otherwise manipulated so that it does not significantly impede the jetting through the orifice 1946 , or in some cases, the jet itself may be sufficient to force the guidewire 1902 into a position that does not impede the jetting against the inner wall 1950 .
- the pump base 200 FIG.
- a cassette 116 which is a component of accessories 2057 (part of a tubing set 1638 ) to pressurize fluid from a fluid source 20 .
- a standard hospital saline bag may be used as fluid source 20 ; such bags are readily available to the physician and provide the necessary volume to perform the procedure, for example 500 ml or 1,000 ml. In other cases, a saline bottle may be used.
- a spike 102 can be placed into a septum of the saline bag and communicates with extension tubing 122 .
- Liquid injectate is pumped downstream at the piston pump 305 (or other pump), which pulls more liquid injectate (for example from a saline bag) through a check valve 126 and through a supply tube 130 , forcing it into a fluid supply line 1646 .
- An injection port 128 may be used in some cases for injecting other materials such as drugs into the system, or for removing air from the system or priming the system.
- the spike 102 may be packaged with a removable protective spike cover. Particular configurations of the aspiration catheter 1930 , pump base 200 , and tubing set 1638 are described in U.S. Pat. No. 9,883,877, issued Feb. 6, 2018, and entitled “Systems and Methods for Removal of Blood and Thrombotic Materials,” which is hereby incorporated by reference in its entirety for all purposes.
- a connector 1642 is coupled to the aspiration catheter 1930 , and includes a female luer sideport 1644 configured to allow injection through the high-pressure injection lumen 1934 of the tube 1936 ( FIG. 2 ) via the fluid supply line 1646 .
- the fluid supply line 1646 includes a male luer 1648 , which is connectable to the sideport 1644 .
- the connector 1642 includes a barbed fitting 1650 (sideport) which is configured for attachment of a vacuum line 1652 having a plastic or elastomeric tubular end 1654 configured for sealingly forcing over the barbed fitting 1650 .
- the barbed fitting 1650 may also include a female luer, so that either the barbed fitting 1650 or the female luer may be chosen as the attachment site.
- the connector 1642 further includes a Touhy-Borst valve 1656 which may be sealed (closed) if a guidewire 1902 is not used, or may be opened to allow the passage of a guidewire 1902 through the connector 1642 and the aspiration lumen 1932 of the aspiration catheter 1930 , and may then be sealed over the guidewire 1902 .
- the Touhy-Borst valve 1656 may include a distal male luer 1657 configured to secure to a female luer 1659 at the proximal end of the connector 1642 . In alternate embodiments, the Touhy-Borst valve 1656 may be permanently connected or formed on the connector 1642 .
- the Touhy-Borst valve 1656 is optional, because in some catheter configurations, the clearance around the guidewire at one or more portions of the connector 1642 may be small enough to create sufficient fluid (blood) flow resistance over a length to allow an acceptable hemostasis with little or no backdrip of blood.
- Accessories 2057 include a syringe 2049 having a plunger 2067 and a barrel 2099 .
- the syringe 2049 is coupled to the vacuum line 1652 via a luer 2065 .
- the syringe 2049 is configured as a vacuum source, to apply a negative pressure on the aspiration lumen 1932 of the aspiration catheter 1930 , for example, to aid in the aspiration of thrombus or other materials from a blood vessel 1999 and into the open distal end 1931 ( FIG. 2 ) of the aspiration lumen 1932 .
- a stopcock 2047 connected between the syringe 2049 and the vacuum line 1652 , may be used to maintain the negative pressure gradient, or, the plunger 2067 may be a locking variety of plunger that is configured to be locked in the retracted (vacuum) position with respect to the barrel 2099 .
- Vacuum bottles may be used in place of the syringe 2049 , or a vacuum canister, syringe, a vacuum pump or other suitable vacuum or negative pressure sources.
- a particular alternative vacuum source is shown in the alternative embodiment of FIG. 7 .
- the system for aspirating thrombus 2400 ′ in FIG. 7 is identical to the system for aspirating thrombus 2400 in FIG.
- the syringe 2049 is replaced by a vacuum pump 2051 .
- the vacuum pump 2051 is coupled to the vacuum line 1652 by a luer 2053 .
- the vacuum pump 2051 may alternatively be used.
- a foot pedal 2021 is configured to operate a pinch valve 1610 for occluding (closing) or opening the vacuum line 1652 .
- the foot pedal 2021 comprises a base 2025 and a pedal 2027 , and is configured to be placed in a non-sterile area, such as on the floor, under the procedure table/bed.
- the user steps on the pedal 2027 causing a signal to be sent along a cable 2029 which is connected via a plug 2041 to an input jack 2037 .
- the input jack 2037 is shown in FIG. 1 remote from the pump base 200 , but alternatively may be located on the pump base 200 .
- a circuit board 304 of the pump FIG.
- the controller 303 of the circuit board 304 may be configured to cause an actuator 2031 of the pinch valve 1610 to move longitudinally to compress and occlude the vacuum line 1652 between an actuator head 2033 (attached to the actuator 2031 ) and an anvil 2035 , also carried by the pinch valve 1610 .
- an actuator 2031 of the pinch valve 1610 By stepping on the pedal 2027 , the user is able to thus occlude the vacuum line 1652 , stopping the application of a negative pressure from the syringe 2049 onto the aspiration lumen 1932 .
- the user may cause the opposite action, wherein the actuator head 2033 opens the vacuum line 1652 , by moving away from the anvil 2035 .
- the anvil 2035 may have a flat (planar) shape, or a U-shape (e.g., semicylindrical), or a V-shape (e.g., a V-block) where it contacts the tubing of the vacuum line 1652 .
- the actuator head 2033 itself may have a flat (planar) shape, or a U-shape (e.g., semi-cylindrical), or a V-shape (e.g., a V-block) where it contacts the vacuum line 1652 .
- the foot pedal 2021 may operate by alternately causing the actuator 2031 to move in a first direction and a second, opposite direction, respectively, with alternate applications of the pedal 2027 .
- the controller 303 may be configured to open the pinch valve 1610 .
- a pressure transducer 2006 is carried within the female luer 1659 of the connector 1642 , but may be alternatively placed at other locations along the aspiration path. The pressure transducer 2006 thus senses a negative pressure and sends a signal to the pump base 200 via a cable 112 , causing the controller 303 to start the motor 302 of the pump base 200 , which is configured to drive the piston pump 305 .
- the cable 112 includes a connector 114 for connecting electrically to the pump base 200 . Because the effect via the electronics is substantially immediate, the motor 302 initiates the piston pump 305 almost immediately after the pedal 2027 is depressed. When the pedal 2027 of the foot pedal 2021 is released, the controller 303 then causes the pinch valve 1610 to close. The pressure transducer 2006 thus senses that no negative pressure is present and causes the motor 302 of the pump base 200 to shut off. Again, the effect via the electronics is substantially immediate, and thus the motor 302 stops operating the piston pump 305 almost immediately after the pedal 2027 is depressed. During sterile procedures, the main interventionalist is usually “scrubbed” such that the user's hands are only intended to touch items in the sterile field.
- the feet/shoes/shoe covers are typically not in the sterile field.
- a single user may operate a switch (via the pedal 2027 ) while also manipulating the aspiration catheter 1930 , guide sheath 2450 , and guidewire 1902 .
- the foot pedal 2021 may comprise two pedals, one configured to command occlusion and one configured to command opening.
- the pedal 2027 may operate a pneumatic line to cause a pressure activated valve or a cuff to occlude or open the vacuum line 1652 , for example, by forcing the actuator head 2033 to move.
- the pedal 2027 may turn, slide, or otherwise move a mechanical element, such as a flexible pull cable or push rod that is coupled to the actuator 2031 , to move the actuator head 2033 .
- the cable 2029 may be supplied sterile and connected to the base 2025 prior to a procedure.
- the occlusion and opening of the vacuum line 1652 thus acts as a on and off switch for the pump base 200 (via the pressure sensor 2006 ), as described in relation to FIG. 1 .
- the on/off function may thus be performed by a user whose hands can focus on manipulating sterile catheters, guidewires, and accessories, and whose foot can turn the motor 302 (and thus pump 305 ) on and off in a non-sterile environment.
- the actuator 2031 may be controlled to compress the vacuum line 1652 against the anvil 2035 with a particular force, and the actuator 2031 may be controlled to move at a particular speed, either when compressing or when removing compression. Speed and force control allows appropriate response time, but may also be able to add durability to the vacuum line 1652 , for example, by eliminating or reducing overcompression of the vacuum line 1652 .
- FIG. 3 A particular configuration for a system for aspirating thrombus 2400 is illustrated in FIG. 3 , and comprises a pump base 200 , a vacuum line 1652 , and a pressure sensor 106 having a cable 112 for connecting to the pump base 200 and carrying signals from the pressure sensor 106 .
- the other elements of the system for aspirating thrombus 2400 are the same as described in relation to FIG. 1 .
- a pinch valve 1610 is operable by a foot pedal (not shown, but similar to the foot pedal 2021 of the system for aspirating thrombus 2400 in FIG. 1 ).
- the foot pedal 2021 may communicate with the pinch valve 1610 via a wired connection through the pump base 200 or may communicate with the pinch valve 1610 wirelessly.
- a pinch valve housing 1609 having an opening 1611 which is configured to hold a portion of the vacuum line 1652 .
- Internal to the pinch valve housing 1609 are components equivalent to the actuator head 2033 , actuator 2031 , and anvil 2035 of the pinch valve 2023 of FIG. 1 , which are configured to compress an external portion of the tubing of the vacuum line 1652 when the foot pedal 2021 is depressed. The foot pedal 2021 may then be depressed a second time to release the compression on (decompress) the vacuum line 1652 .
- the compression of the vacuum line 1652 may be configured to be a complete occlusion of the tubing, thus hydraulically isolating the syringe 2049 from the pressure sensor 106 .
- An input port 1612 to the pressure sensor 106 may include a septum 1614 for adding or removing fluid within the vacuum line 1652 (e.g., via a hypodermic needle), or alternatively may include a luer connector and valve.
- the input port 1612 may also be used to remove air or to allow priming of the system.
- the pressure sensor 106 is thus configured to reside in a non-sterile field, and is capable of detecting the presence of vacuum (or negative pressure) or the lack of vacuum (or negative pressure) when the foot pedal is depressed by the foot of a user.
- fluid such as saline
- the pump base 200 may be configured (via the controller 303 ) to not pump saline when the lack of vacuum or negative pressure in the vacuum line 1652 is determined. Additionally, if vacuum or negative pressure is present, but is suddenly lost, the pump base 200 will shut down. As seen in FIG.
- the pinch valve 1610 is located between the syringe 2049 (or other vacuum source) and the pressure sensor 106 , thus when the pinch valve 1610 shuts off the aspiration catheter 1930 from the syringe 2049 , the pressure sensor 106 is still able to sense the condition within the aspiration lumen 1932 of the aspiration catheter 1930 . In most cases, after the pinch valve 1610 is caused to close, the negative pressure within the aspiration lumen 1932 will rise toward the ambient pressure rather quickly. This change will be sensed by the pressure sensor 106 . However, in cases in which a piece of thrombus causes a temporary or permanent clog in the aspiration lumen 1932 , the pressure sensor 106 is able to sense these occurrences.
- a large moving thrombus will delay the time that the internal pressure of the aspiration lumen 1932 rises to ambient pressure after the pinch valve 1610 is closed.
- a complete occlusion of the aspiration lumen 1932 by a thrombus may cause at least some level of negative pressure to remain in the aspiration lumen.
- Each of these potential occurrences can be identified by the pressure measured by the pressure sensor 106 or by the characteristic of the measured pressure over time.
- the controller 303 may be configured to send an error or to indicate that there is a temporary or permanent clog in the aspiration lumen 1932 , for example, using a display, or a visual, audible, or tactile warning or alarm.
- the user may respond to this indication by removing and unclogging the aspiration catheter 1930 , e.g., by moving a guidewire 1902 back and forth, or may determine that the aspiration catheter 1930 needs to be replaced.
- the ability of the pressure sensor 106 to monitor aspiration lumen pressure offers an important safety control, as well as a general diagnostic of the state of the system (catheter flow status, etc.).
- Another general advantage of using a pinch valve 1610 is that blood only contacts the internal luminal wall of the vacuum line 1652 , and thus is not forced within interstices of rotatable valves or other moving parts that otherwise could begin to stick or foul with biological material.
- the vacuum line 1652 is simply compressed an uncompressed, allowing a robust and durable design.
- the internal volume of the vacuum line 1652 easily maintains sterility. And, as the pinch valve 1610 is isolated from blood/thrombus, it is reusable.
- a push button 1607 may be provided on the pump base 200 , or in a remote component. In a first embodiment, the push button 1607 may simply allow manual opening and closing of the pinch valve 1610 on the vacuum line 1652 .
- the push button 1607 may act as a reset button, and be configured to always open the pinch valve 1610 (when it is closed), or to make no change if the pinch valve 1610 is already open.
- the push button 1607 configured as a reset button, activation of the foot pedal 2021 toggles the pinch valve 1610 open and closed, while activation of the push button 1607 always places or maintains the pinch valve 1610 in the open position.
- the push button 1607 may be a mechanical (doorbell) type button, or may be a touch switch (e.g., capacitive, resistive, or piezo), or in some embodiments may even be a toggle or rocker switch.
- the co-location of two or more of the syringe 2049 , the pinch valve 1610 , the pump base 200 , and the push button 1607 may also be an advantage because it allows a quick assessment by an attending physician or medical personnel in a quick glance, for example, if otherwise focused on catheter manipulation in the sterile field.
- the controller 303 may be configured to cause the piston pump 305 to operate whenever the pinch valve 1610 is in the open condition.
- the piston pump 305 may be configured to cause the piston pump 305 to operate whenever the pinch valve 1610 is in the open condition.
- the plug 2041 contains an identification component 2043 , which may be read by the circuitry (e.g., circuit board 304 ) coupled to the input jack 2037 .
- the identification component 2043 comprises a resistor having a particular value, for example, as part of a Wheatstone bridge.
- the pump base 200 is placed in a “manual” mode, wherein the pump 305 is controllable only by buttons (not shown).
- the identification component 2043 may comprise an RFID (radiofrequency identification) chip, which is read by the circuitry when the plug 2041 is connected to the input jack 2037 .
- a proximity sensor such as a Hall-effect device, may be utilized to determine whether the plug 2041 is or is not connected to the input jack 2037 .
- the pinch valve 1610 and the foot pedal 2021 may be incorporated for on/off operation of the pinch valve 1610 on the vacuum line 1652 , without utilizing the pressure sensor 106 .
- the pressure sensor 106 may even be absent from the system for aspirating thrombus 2400 , the foot pedal 2021 being used as a predominant control means.
- system for aspirating thrombus 2400 further comprises an auxiliary fluid supply system 310 that provides features that improve the efficiency of aspiration procedures performed using the guide sheath 2450 and the aspiration catheter 1930 .
- the auxiliary fluid supply system 310 comprises at least a syringe 312 containing contrast media 314 , either non-dilute, or diluted.
- the contrast media may be diluted 50/50 with normal saline (e.g., heparinized saline), or may be diluted to a ratio of 20% contrast media/80% normal saline.
- the percentage of contrast may be between about 10% and about 75%, or between about 15% and about 40%.
- the syringe 312 comprises a barrel 316 and a plunger 318 , the barrel comprising a luer 320 .
- the luer 320 may be directly coupled to the luer connector 2458 of the extension tube 2460 of the guide sheath 2450 , to allow the interior lumen 2456 of the guide sheath 2450 to have access to the contrast media 314 of the syringe 312 .
- the contrast media 314 allows real-time indication of the status of an aspiration procedure, as will be described.
- FIG. 1 depicts additional optional elements of the auxiliary fluid supply system 310 , including a three-way stopcock 322 and a saline IV bag 324 .
- the saline IV bag 324 may be placed within a pressure bag 326 configured to externally pressurize the internal contents of the saline IV bag 324 , for example, to a pressure of 100 mm Hg or higher, or 150 mm Hg or higher, or 200 mm Hg or higher, or 250 mm Hg or higher, or 300 mm Hg or higher, using, for example, a pressure cuff surrounding the saline IV bag 324 .
- the saline IV bag 324 may have a volume of normal saline or heparinized normal saline of 500 ml or 1,000 ml, in common embodiments.
- the luer 320 of the syringe 312 is coupled to an extension tube 328 having a luer 330 at its distal end.
- the luer 330 is connected to a first luer 332 of the three-way stopcock 322 .
- the saline IV bag 324 includes a port 334 to which a spike 336 of an extension tube 338 is connected.
- the extension tube 338 includes a luer 340 at its opposite end which is connector to a second luer 342 of the threeway stopcock 322 .
- a third luer 344 of the three-way stopcock 322 is connected to the luer connector 2458 of the extension tube 2460 of the guide sheath 2450 .
- the three-way stopcock 322 includes a rotatable valve 346 having a projection 348 that is configured to be manipulated by a user to turn the rotatable valve 346 .
- the projection 348 points toward the luer that will be closed (sealed) in that particular configuration.
- the first luer 332 is closed.
- the second luer 342 and the third luer 344 are open, allowing the interior lumen 2456 of the guide sheath 2450 to have access to saline 350 within the saline IV bag 324 .
- the saline 350 serves also as a lubricating fluid, so that the system 2400 is self-lubricating.
- the spike 336 can include a drip chamber, which also allows certain visual feedback. For example, saline in the drip chamber will drip at a higher frequency when the open distal end 1931 of the aspiration lumen 1932 is located within free flowing blood, and will drip slower when the open distal end 1931 is adjacent to or within thrombus, and actively aspirating and/or macerating thrombus, and will drip very little or not at all when the aspiration lumen 1932 is occluded.
- the distal end 2451 of the guide sheath 2450 in placed within the blood vessel 1999 via an external puncture or cutdown.
- the aspiration catheter 1930 is placed through the guide sheath 2450 and the distal end 1997 of the aspiration catheter 1930 is tracked (e.g., over a guidewire 1902 ) to a location adjacent a thrombus 1995 .
- the guidewire 1902 if used, may be removed from the aspiration catheter 1930 , may be partially retracted, or may be left in place.
- the piston pump 305 is operated to inject high pressure saline through the high-pressure injection lumen 1934 , and aspiration is performed through the aspiration lumen 1932 via the evacuated syringe 2049 .
- the pump 305 delivers the high pressure fluid (e.g., saline) through the high-pressure injection lumen 1934 at an injection flow rate FR 1 .
- the negative pressure P N inside the evacuated syringe 2049 creates, independent of the injection flow rate FR 1 , a potential aspiration flow rate FR 2 (e.g., the intended aspiration capacity from purely negative pressure application). With both the negative pressure P N applied and the injection flow rate FR 1 applied, a total potential flow rate FR 3 is defined by the equation:
- FR 3 FR 1 +FR 2
- the actual flow rate of the blood/thrombus being aspirated from the blood vessel 1999 may likely be less than the total potential flow rate FR 3 . But in certain cases, the total potential flow rate FR 3 is significantly decreased. For example, if the thrombus 1995 creates a significant occlusion within the blood vessel 1999 , and if much or all of the blood or flowable macerated thrombus has been aspirated from the area of interest, there may not be sufficiently enough flowable material adjacent the thrombus 1995 to allow sufficient flow through the aspiration lumen 1932 of the aspiration catheter 1930 , even if the aspiration lumen 1932 is not occluded.
- the injection flow rate FR 1 is configured to be between about 15 ml/min and about 50 ml/min, or between about 20 ml/min and about 40 ml/min, or between about 25 ml/min and about 35 ml/min.
- the potential aspiration flow rate FR 2 is configured to be between about 150 ml/min and about 600 ml/min, or between about 300 ml/min and 600 ml/min. or between about 350 ml/min and about 500 ml/min.
- the interior lumen 2456 of the guide sheath 2450 is capable of allowing additional saline 350 from the saline IV bag 324 to flow into space 1994 adjacent the thrombus 1995 , and adjacent the open distal end 1931 of the aspiration lumen 1932 .
- the new bolus of injected/infused fluid can increase the flowable volume in the space 1994 and can reduce the bulk viscosity of saline/blood/thrombus.
- the initiation of aspiration at the target thrombus site and entry into the aspiration lumen 1932 of the aspiration catheter 1930 is facilitated.
- the aspiration procedure tends to continue, as it is now in a dynamic state, instead of an initially static state.
- changing pressure gradients have caused saline 350 from the saline IV bag 324 to be pulled into the space 1994 automatically, because the pressure inside the saline IV bag 324 is greater than the pressure in the space 1994 .
- the pressure gradient decreases, and less saline 350 from the saline IV bag 324 will be pulled into the space 1994 in the blood vessel 1999 , adjacent the thrombus 1995 , again, automatically.
- the on/off nature of the flow from the saline IV bag 324 and through the interior lumen 2456 of the guide sheath is pressure gradient controlled, and can occur automatically, in order to maintain an active aspiration of thrombus 1995 .
- the actual aspiration flow rate becomes zero. If the actual aspiration flow rate becomes less than the actual injection flow rate, then some injected fluid (saline, etc.) will likely be injected into the blood vessel. This may have negative consequences, such as blood vessel damage, uncontrolled vessel distension, or potentially dangerous thrombus dislodgement.
- the automatic control of additional injected saline serves to create an optimized volume during the procedure, analogous in some manner to the cutting fluid that is used in machining of metals. Viscosity is optimized for efficient jet application on the thrombus and aspiration flow.
- FIG. 4 Additional advantages related to the use of the syringe 312 containing contrast media 314 are described in relation to FIG. 4 .
- the rotatable valve 346 has been turned by the user so that the projection 348 points toward the second luer 342 , thus closing off access of the saline IV bag 324 and opening access to the syringe 312 containing contrast media 314 .
- any changes in pressure gradient or changes in available flowable material that cause fluid to flow from proximal to distal through the interior lumen 2456 of the guide sheath 2450 will now pull contrast media 314 from the syringe 312 into the interior lumen 2456 and deliver it into the space 1994 .
- injected contrast media 1993 upon monitoring the procedure by fluoroscopy (e.g., when stepping on the fluoroscopy pedal), injected contrast media 1993 , because of its radiopacity, is visible to the user when this change in flow characteristics occurs.
- the user thereby receives a visual feedback (e.g., a warning) on fluoroscopy, when key changes to the aspiration process occur.
- a visual feedback e.g., a warning
- the user is also able to see a maceration zone around the distal end 1997 of the aspiration catheter 1930 .
- the contrast media 1993 itself can improve the aspiration as did the saline, by adding flowable volume and decreasing viscosity (in comparison to thrombus or blood, for example, depending on the particular contrast media, and/or any dilution utilized).
- the user may switch the rotatable valve 346 into the position of FIG.
- the plunger 318 of the syringe 312 may be coupled to a mechanical or optical sensor, such as an encoder or linear encoder, that activates an alarm when the plunger 318 moves in relation to the barrel 316 .
- An automated rotating device may even be coupled to the rotatable valve 346 and feedback may be applied by a controller 303 , so that sensed movement of the plunger 318 in relation to the barrel 316 greater than a certain distance, greater than a certain velocity, or greater than a certain acceleration cause the rotatable valve 346 to be rotated from the position in FIG. 1 , to the position in FIG. 4 .
- This feedback may even be used to activate the fluoroscopy unit, so that the flow of contrast media 314 entering the blood vessel 1999 is immediately shown to the user on the fluoroscopy monitor.
- the majority of the contrast media 314 entering the blood vessel 1999 would be expected to very low when the aspiration procedure is correctly functioning (no clogs, sufficient flowable material), because any or most of the contrast media 314 injected into the blood vessel 1999 would be aspirated into the aspiration lumen 1932 .
- the risk of high volumes of contrast added to the blood volume is significantly reduced.
- the attending physician would likely not need to check the area of interest for flow (e.g., using angiograms or venograms) as often, thus, further minimizing contrast media 314 injected into the bloodstream of the patient.
- the method described herein is more efficient and faster than having to stop and “puff” some contrast intermittently.
- the user may also be able to visualize on fluoroscopy the contrast media 314 specifically moving from the interior lumen 2456 of the guide sheath 2450 to the open distal end 1931 of the aspiration lumen 1930 .
- FIG. 5 illustrates the system for aspirating thrombus 2400 with the rotatable valve 346 in the same position as in FIG. 4 , but with the open distal end 1931 of the aspiration lumen 1932 of the aspiration catheter 1930 pulled back to that it is entirely within the interior lumen 2456 of the guide sheath 2450 .
- the guide sheath 2450 may be moved distally in longitudinal relation to the aspiration catheter 2450 , or they both may be adjusted in relative longitudinal relation.
- a diagnostic method for assessment of system operation is described in relation to FIG. 5 .
- the user may pull the distal end 1997 of the aspiration catheter 1930 fully into the guide sheath 2450 in this manner, a bit like a turtle pulls its head into its shell, in order to determine particular diagnostics related to the aspiration procedure.
- the aspiration catheter 1930 is pulled back so that the open distal end 1931 of the aspiration lumen 1932 is at least 1 mm within the guide sheath 2450 , or at least 2 mm, or at least 3 mm, or at least 4 mm, or at least 5 mm, or at least 6 mm, or at least 7 mm, or at least 8 mm, or at least 9 mm, or at least 10 mm.
- the aspiration catheter 1930 is pulled back so that the open distal end 1931 of the aspiration lumen 1932 is between about 1 mm and about 30 mm within the guide sheath 2450 . In some cases, the aspiration catheter 1930 is pulled back so that the open distal end 1931 of the aspiration lumen 1932 is between about 1 mm and about 15 mm within the guide sheath 2450 .
- contrast media 314 will continue being pulled through the interior lumen 2456 of the guide sheath 2450 from proximal to distal, and will be pulled into the open distal end 1931 of the aspiration lumen 1932 (curved arrow, FIG. 6 ) and through the aspiration lumen 1932 proximal to distal.
- the plunger 318 of the syringe 312 will be seen by the user contracting into the barrel 316 of the syringe 312 (right to left in FIG. 5 ).
- the user is notified by the movement or lack of movement of the plunger 318 , and will likely change out the aspiration catheter 1930 for another, or remove the aspiration catheter 1930 and declog the aspiration lumen 1932 , for example by a hand injection with a small bore syringe, retrograde (proximal to distal) through the aspiration lumen 1932 .
- mechanical or optical sensing may be used to automatically determine whether the plunger 318 is moving in relation to the barrel 316 or not, and an alarm or indicator may be broadcast to the user (audible, visual, tactile).
- a significantly empty clot bed can fill itself to allow the thrombus 1995 to move, or come in contact with or be closer to the open distal end 1931 of the aspiration lumen 1932 .
- the blood vessel wall can also be distended somewhat, allowing a larger volume of saline and blood within, the further aid the aspiration of thrombus.
- real-time visualization can be performed during manipulation (positioning/advancement/retraction) of the aspiration catheter 1930 , and of the guide sheath 2450 .
- the plunger 318 can be manually compressed to inject puffs of contrast media 314 .
- Drug may include a lytic agent such as tPA (tissue plasminogen activator) or urokinase.
- tPA tissue plasminogen activator
- urokinase tissue plasminogen activator
- the active use of the lytic agent can actually be more efficient, as less is wasted, and more is delivered to the appropriate target area of action.
- the lytic agent is delivered to a more dynamic surface area of the thrombus 1995 , and is thus more effective in its action on the thrombus 1995 .
- the ability to receive injectate from the guide sheath 2450 can serve to cool down a heated catheter tip. Additionally, the used of the contrast media 314 aids in the delineation of the borders of the thrombus 1995 .
- the constant available supply of fluids from the guide sheath 314 , both contrast media 314 and saline 350 allow the procedure to be optimized and tailored. Blood loss from excessive aspiration of blood and not thrombus can also be reduced.
- any of the embodiments described herein may be used conjunction with the ApolloTM System (Penumbra, Inc., Alameda, Calif., USA).
- the aspiration catheters described herein may be replaced by any standard aspiration catheter having one or more aspiration lumens.
- Aspiration catheters used herein may include the ACETM or INDIGO® catheters produced by Penumbra, Inc. of Alameda, Calif., USA.
- the user may pull the distal end 1997 of the aspiration catheter 1930 fully into the guide sheath 2450 to mimic the separator device used in conjunction with the ACETM or INDIGO® catheters.
- the coaxially placed tubes/shafts of the guide sheath 2450 and the aspiration catheter 1930 can be moved back and forth longitudinally in relation to each other to create additional shearing of any thrombus in the area, to further macerate the thrombus, or to reposition the thrombus in a more strategically aligned location.
- a degree of MRI compatibility may be imparted into parts of the devices described herein.
- MRI Magnetic Resonance Imaging
- Some ferromagnetic materials may not be suitable as they may create artifacts in an MRI image.
- the devices described herein may include materials that the MRI machine can image.
- Some materials that exhibit these characteristics include, for example, tungsten, cobalt-chromium-molybdenum alloys (e.g., UNS: R30003 such as ELGILOY®, PHYNOX®, and the like), nickel-cobaltchromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nitinol, and the like, and others.
- cobalt-chromium-molybdenum alloys e.g., UNS: R30003 such as ELGILOY®, PHYNOX®, and the like
- nickel-cobaltchromium-molybdenum alloys e.g., UNS: R30035 such as MP35-N® and the like
- nitinol and the like, and others.
- some of the devices described herein may include a coating such as a lubricious coating or a hydrophilic coating.
- Hydrophobic coatings such as fluoropolymers provide a dry lubricity.
- Lubricious coatings improve steerability and improve lesion crossing capability.
- Suitable lubricious polymers are well known in the art and may include silicone and the like, hydrophilic polymers such as high-density polyethylene (HDPE), polytetrafluoroethylene (PTFE), polyarylene oxides, polyvinylpyrrolidones, polyvinylalcohols, hydroxy alkyl cellulosics, algins, saccharides, caprolactones, and the like, and mixtures and combinations thereof.
- Hydrophilic polymers may be blended among themselves or with formulated amounts of water insoluble compounds (including some polymers) to yield coatings with suitable lubricity, bonding, and solubility.
- Embodiments of the present disclosure are contemplated to have utility in a variety of blood vessels, including but not limited to coronary arteries, carotid arteries, intracranial/cerebral arteries, inferior and superior vena cavae and other veins (for example, in cases of deep venous thrombosis or pulmonary embolism), peripheral arteries, shunts, grafts, vascular defects, and chambers of the heart. This includes, but is not limited to, any vessel having a diameter of bout two mm or greater.
- An aspiration catheter 1930 outer diameter of about seven French or less is contemplated for many of the applications, though in certain applications, it may be larger. In some embodiments, an aspiration catheter 1930 diameter of about six French or less is contemplated. Embodiments of the present disclosure may even be used in non-vascular applications, for example body lumens or cavities having material accumulations that need to be macerated and/or removed.
- ranges disclosed herein also encompass any and all overlap, sub-ranges, and combinations thereof.
- the terms “approximately”, “about”, and “substantially” may refer to an amount that is within less than 10% of, within less than 5% of, within less than 1% of, within less than 0.1% of, and within less than 0.01% of the stated amount.
Abstract
A system for aspirating thrombus that includes an aspiration catheter, a tubing set connected to the aspiration catheter, a pressurization element configured to couple to the tubing set and further configured to pressurize fluid from a first fluid source or allow pressurized fluid from the first fluid source to be transferred through a supply lumen of the aspiration catheter, and a sheath through which the aspiration catheter can be advanced.
Description
- This application is a continuation of U.S. patent application Ser. No. 16/516,190, filed Jul. 18, 2019, which claims the benefit of priority to U.S. Provisional Patent Application No. 62/700,763, filed on Jul. 19, 2018, which are herein incorporated by reference in their entireties for all purposes. Priority is claimed pursuant to 35 U.S.C. § 119 and 35 U.S.C. § 120.
- The present disclosure pertains generally to medical devices and methods of their use. More particularly, the present invention pertains to aspiration and thrombectomy devices and methods of use thereof.
- Several devices and systems already exist to aid in the removal of thrombotic material. These include simple aspiration tube type devices using vacuum syringes to extract thrombus into the syringe, simple flush-and-aspirate devices, more complex devices with rotating components the pull in, macerate and transport thrombotic material away from the distal tip using a mechanical auger, systems that use very high pressure to macerate the thrombus and create a venturi effect to flush the macerated material away.
- In one embodiment of the present disclosure, a method for improving a flow condition through a catheter includes providing an aspiration catheter including an elongate shaft configured for placement within a blood vessel of a subject, a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end, and an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid from a first fluid source into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen, providing a sheath including a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough, the sheath further including an extension conduit in fluid communication with the lumen of the sheath and extending from the sheath, the extension conduit configured for coupling to a second fluid source, providing a seal associated with the proximal end of the sheath and configured to seal the lumen of the sheath around the elongate shaft of the aspiration catheter when the aspiration catheter is in place within the sheath, providing a tubing set including a first conduit having a distal end configured to couple to the aspiration lumen of the aspiration catheter and a proximal end configured to couple to a vacuum source, and a second conduit having a distal end configured to couple to the supply lumen of the aspiration catheter and a proximal end configured to couple to the first fluid source, wherein the tubing set is configured to couple to a pump configured to pressurize fluid from the first fluid source or allow pressurized fluid from the first fluid source to be transferred to the supply lumen, such that the pressurized fluid is capable of flowing through the supply lumen from the proximal end of the supply lumen to the distal end of the supply lumen, coupling the distal end of the first conduit of the tubing set to the aspiration lumen of the aspiration catheter, coupling the proximal end of the first conduit of the tubing set to the vacuum source, coupling the distal end of the second conduit to the supply lumen of the aspiration catheter, coupling the proximal end of the second conduit to the first fluid source, inserting the distal end of the sheath within the vasculature of a subject, placing the aspiration catheter through the sheath and advancing the aspiration catheter such that the open distal end of the aspiration lumen of the aspiration catheter is distal to the distal end of the sheath and is in proximity to a thrombus within a blood vessel of the subject, coupling the extension conduit to the second fluid source, and activating the pump such that pressurized fluid from the first fluid source is applied to the proximal end of the supply lumen of the aspiration catheter, wherein when sufficient flowable material is present adjacent the open distal end of the aspiration lumen, at least some of the flowable material is caused to flow through the aspiration lumen from the open distal end to the proximal end, and into an interior of the vacuum source, and when insufficient flowable material is present adjacent the open distal end of the aspiration lumen, fluid from the second fluid source is caused to flow through the lumen of the sheath from the proximal end to the distal end, and at least some of the fluid from the second fluid source is delivered into the blood vessel of the subject.
- In another embodiment of the present disclosure, a method for identifying a no flow or low flow condition through a catheter includes providing an aspiration catheter including an elongate shaft configured for placement within a blood vessel of a subject, a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end, and an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen, providing a sheath including a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough, the sheath further including an extension conduit in fluid communication with the lumen of the sheath and extending from the sheath, the extension conduit configured for coupling to a second fluid source, the extension conduit fluidly coupled to a valve having a first position configured to selectively couple the extension conduit to a fluid source containing a contrast agent and a second position configured to selectively couple the extension conduit to a fluid source containing substantially no contrast agent, providing a seal associated with the proximal end of the sheath and configured to seal the lumen of the sheath around the elongate shaft of the aspiration catheter when the aspiration catheter is in place within the sheath, providing a tubing set including a first conduit having a distal end configured to couple to the aspiration lumen of the aspiration catheter and a proximal end configured to couple to a vacuum source, and a second conduit having a distal end configured to couple to the supply lumen of the aspiration catheter and a proximal end configured to couple to a first fluid source, wherein the tubing set is configured to couple to a pressurization element configured to pressurize fluid from the first fluid source or allow pressurized fluid from the first fluid source to be transferred to the supply lumen, such that the pressurized fluid is capable of flowing through the supply lumen from the proximal end of the supply lumen to the distal end of the supply lumen, coupling the distal end of the first conduit of the tubing set to the aspiration lumen of the aspiration catheter, coupling the proximal end of the first conduit of the tubing set to the vacuum source, coupling the distal end of the second conduit to the supply lumen of the aspiration catheter, coupling the proximal end of the second conduit to the first fluid source, inserting the distal end of the sheath within the vasculature of a subject, placing the aspiration catheter through the sheath and advancing the aspiration catheter such that the open distal end of the aspiration lumen of the aspiration catheter is in proximity to a thrombus within a blood vessel of the subject, coupling the extension conduit to at least the fluid source containing a contrast agent, placing or maintaining the valve in the first position, and activating the pressurization element such that pressurized fluid from the first fluid source is applied to the proximal end of the supply lumen of the aspiration catheter, wherein when sufficient flowable material is present adjacent the open distal end of the aspiration lumen, at least some of the flowable material is caused to flow through the aspiration lumen from the open distal end to the proximal end, and into an interior of the vacuum source, and when insufficient flowable material is present adjacent the open distal end of the aspiration lumen, fluid from the fluid source containing a contrast agent is caused to flow through the lumen of the sheath between the proximal end and the distal end, and at least some of the fluid from the fluid source containing a contrast agent is delivered into the blood vessel of the subject.
- In yet another embodiment of the present disclosure, a method for identifying a no flow or low flow condition through a catheter includes providing an aspiration catheter including an elongate shaft configured for placement within a blood vessel of a subject, a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end, and an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen, providing a sheath including a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough, the sheath further including an extension conduit in fluid communication with the lumen of the sheath and extending from the sheath, the extension conduit configured for coupling to a second fluid source, the second fluid source containing a contrast agent, providing a seal associated with the proximal end of the sheath and configured to seal the lumen of the sheath around the elongate shaft of the aspiration catheter when the aspiration catheter is in place within the sheath, providing a tubing set including a first conduit having a distal end configured to couple to the aspiration lumen of the aspiration catheter and a proximal end configured to couple to a vacuum source, and a second conduit having a distal end configured to couple to the supply lumen of the aspiration catheter and a proximal end configured to couple to a first fluid source, wherein the tubing set is configured to couple to a pressurization element configured to pressurize fluid from the first fluid source or allow pressurized fluid from the first fluid source to be transferred to the supply lumen, such that the pressurized fluid is capable of flowing through the supply lumen from the proximal end of the supply lumen to the distal end of the supply lumen, coupling the distal end of the first conduit of the tubing set to the aspiration lumen of the aspiration catheter, coupling the proximal end of the first conduit of the tubing set to the vacuum source, coupling the distal end of the second conduit to the supply lumen of the aspiration catheter, coupling the proximal end of the second conduit to the first fluid source, inserting the distal end of the sheath within the vasculature of a subject, placing the aspiration catheter through the sheath and advancing the aspiration catheter such that the open distal end of the aspiration lumen of the aspiration catheter is in proximity to a thrombus within a blood vessel of the subject, coupling the extension conduit to at least the fluid source containing a contrast agent, and activating the pressurization element such that pressurized fluid from the first fluid source is applied to the proximal end of the supply lumen of the aspiration catheter, wherein when sufficient flowable material is present adjacent the open distal end of the aspiration lumen, at least some of the flowable material is caused to flow through the aspiration lumen from the open distal end to the proximal end, and into an interior of the vacuum source, and when insufficient flowable material is present adjacent the open distal end of the aspiration lumen, fluid from the fluid source containing a contrast agent is caused to flow through the lumen of the sheath between the proximal end and the distal end, and at least some of the fluid from the fluid source containing a contrast agent is delivered into the blood vessel of the subject.
- In still another embodiment of the present disclosure, a system for aspirating thrombus includes an aspiration catheter including an elongate shaft configured for placement within a blood vessel of a subject, a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end, and an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen, a tubing set including a first conduit having a distal end configured to couple to the aspiration lumen of the aspiration catheter and a proximal end configured to couple to a vacuum source, and a second conduit having a distal end configured to couple to the supply lumen of the aspiration catheter and a proximal end configured to couple to a first fluid source, a pressurization element configured to couple to the tubing set and further configured to pressurize fluid from the first fluid source or allow pressurized fluid from the first fluid source to be transferred to the supply lumen, such that the pressurized fluid is capable of flowing through the supply lumen from the proximal end of the supply lumen to the distal end of the supply lumen, a sheath having a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough, the sheath further including an extension conduit in fluid communication with the lumen of the sheath and extending from the sheath, the extension conduit configured for coupling to a second fluid source, a seal associated with the proximal end of the sheath and configured to seal the lumen of the sheath around the elongate shaft of the aspiration catheter when the aspiration catheter is in place within the sheath, and wherein the extension conduit is configured to allow fluid from the second fluid source to flow through the lumen of the sheath from the proximal end of the sheath to the distal end of the sheath when the open distal end of the aspiration lumen of the aspiration catheter is extended outside of the lumen of the sheath in a blood vessel and is in proximity to the distal end of the sheath, and when insufficient flowable material is present adjacent the open distal end of the aspiration lumen, such that a negative pressure gradient supplied by the vacuum source further causes a significant volume of the fluid from the second fluid source to actively flow through the aspiration lumen from the open distal end to the proximal end and into an interior of the vacuum source.
- In yet another embodiment of the present disclosure, a system for aspirating thrombus includes an aspiration catheter including an elongate shaft configured for placement within a blood vessel of a subject, a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end, and an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen, a tubing set including a first conduit having a distal end configured to couple to the aspiration lumen of the aspiration catheter and a proximal end configured to couple to a vacuum source, and a second conduit having a distal end configured to couple to the supply lumen of the aspiration catheter and a proximal end configured to couple to a first fluid source, a pressurization element configured to couple to the tubing set and further configured to pressurize fluid from the first fluid source or allow pressurized fluid from the first fluid source to be transferred to the supply lumen, such that the pressurized fluid is capable of flowing through the supply lumen from the proximal end of the supply lumen to the distal end of the supply lumen, a sheath having a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough, the sheath further including an extension conduit in fluid communication with the lumen of the sheath and extending from the sheath, the extension conduit configured for coupling to a second fluid source, the extension conduit fluidly coupled to a valve having a first position configured to selectively couple the extension conduit to a fluid source containing a contrast agent and a second position configured to selectively couple the extension conduit to a fluid source containing substantially no contrast agent, a seal associated with the proximal end of the sheath and configured to seal the lumen of the sheath around the elongate shaft of the aspiration catheter when the aspiration catheter is in place within the sheath, and wherein the aspiration catheter has a first position within the sheath wherein the open distal end of the aspiration lumen of the aspiration catheter is outside of the lumen of the sheath and distal to the distal end of the sheath, and wherein the aspiration catheter has a second position within the sheath wherein the open distal end of the aspiration lumen of the aspiration catheter is within the lumen of the sheath and proximal to the distal end of the sheath.
-
FIG. 1 is a plan view of an aspiration system, according to an embodiment of the present disclosure. -
FIG. 2 is a sectional view of the distal end of the aspiration catheter of the system for aspirating thrombus ofFIG. 1 . -
FIG. 3 is a perspective view of a modification of the aspiration system having an alternative pinch valve, according to another embodiment of the present disclosure. -
FIG. 4 is plan view of the aspiration system ofFIG. 1 , in a second condition. -
FIG. 5 is plan view of the aspiration system ofFIG. 1 , in a third condition. -
FIG. 6 is a detail view of the distal end of the guide sheath ofFIG. 5 . -
FIG. 7 is a plan view of an alternative aspiration system to the aspiration system ofFIG. 1 , according to an embodiment of the present disclosure. - For the following defined terms, these definitions shall be applied, unless a different definition is given in the claims or elsewhere in this specification.
- As used in this specification and the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise.
- The following detailed description should be read with reference to the drawings in which similar elements in different drawings are numbered the same. The drawings, which are not necessarily to scale, depict illustrative embodiments and are not intended to limit the scope of the invention.
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FIGS. 1-3 illustrate a system for aspiratingthrombus 2400, including anaspiration catheter 1930, apump base 200, and aguide sheath 2450. Theaspiration catheter 1930 has been inserted through theguide sheath 2450, which includes a proximally-locatedhemostasis valve 2452 configured for sealing around theshaft 2454 of theaspiration catheter 1930. Alternatively, thehemostasis valve 2452, instead of being part of theguide sheath 2450, may be a separate hemostasis valve that is configured to be coupled to theguide sheath 2450, for example, by a luer fitting or a y-connector. Fluid (e.g., saline) may be injected through theinterior lumen 2456 of theguide sheath 2450, and around theshaft 2454 of theaspiration catheter 1930 by attaching a syringe or pump (not shown) to theluer connector 2458 of anextension tube 2460. Aguidewire 1902 can be used to track theaspiration catheter 1930 through a patient's vasculature, for example, ablood vessel 1999 having athrombus 1995. Thedistal end 2451 of theguide sheath 2450 and thedistal end 1997 of theaspiration catheter 1930 are shown inFIG. 1 within theblood vessel 1999 and in relation to thethrombus 1995. -
FIG. 2 illustrates thedistal end 2451 of theaspiration catheter 1930 and theguidewire 1902. Theguidewire 1902 is free to be moved distally or proximally in the longitudinal direction, or to be rotated within the aspiration lumen/guidewire lumen 1932 that extends through theaspiration catheter 1930. Thedistal end 1901 of theguidewire 1902 may be shapeable, for example, to create a “J”-tip for selectability of vessels or through stenoses or obstructions. A high-pressure injection lumen 1934 is contained within atube 1936 having alarge diameter portion 1938 and asmall diameter portion 1940. Thesmall diameter portion 1940 may transition from thelarge diameter portion 1938 via a neckdown or taperedportion 1942. Thesmall diameter portion 1940 is blocked using a blockingmaterial 1944, which may include a polymer, adhesive, or epoxy adhered to the internal walls of thesmall diameter portion 1940. Alternatively, thesmall diameter portion 1940 may be crimped, tied off, sealed, or otherwise occluded, without the use of a blockingmaterial 1944. Anorifice 1946 in awall 1948 of thetube 1936 is configured to create a jet from high pressure fluid injected through the high-pressure injection lumen 1934. The jet exiting the high-pressure injection lumen 1934 through theorifice 1946 and entering theaspiration lumen 1932 is configured to impinge on aninner wall 1950 of the aspiration lumen/guidewire lumen 1932. Aspiration may be performed with theguidewire 1902 in place within the aspiration lumen/guidewire lumen 1932, or may be performed with theguidewire 1902 retracted proximally of the longitudinal location of theorifice 1946, or even with theguidewire 1902 completely removed from the aspiration lumen/guidewire lumen 1932. In cases wherein theguidewire 1902 is left in place (as shown inFIG. 2 ), during aspiration, theguidewire 1902 may be rotated or otherwise manipulated so that it does not significantly impede the jetting through theorifice 1946, or in some cases, the jet itself may be sufficient to force theguidewire 1902 into a position that does not impede the jetting against theinner wall 1950. The pump base 200 (FIG. 1 ) is configured to interface with acassette 116 which is a component of accessories 2057 (part of a tubing set 1638) to pressurize fluid from afluid source 20. A standard hospital saline bag may be used asfluid source 20; such bags are readily available to the physician and provide the necessary volume to perform the procedure, for example 500 ml or 1,000 ml. In other cases, a saline bottle may be used. Aspike 102 can be placed into a septum of the saline bag and communicates withextension tubing 122. Liquid injectate is pumped downstream at the piston pump 305 (or other pump), which pulls more liquid injectate (for example from a saline bag) through acheck valve 126 and through asupply tube 130, forcing it into afluid supply line 1646. Aninjection port 128 may be used in some cases for injecting other materials such as drugs into the system, or for removing air from the system or priming the system. Thespike 102 may be packaged with a removable protective spike cover. Particular configurations of theaspiration catheter 1930,pump base 200, and tubing set 1638 are described in U.S. Pat. No. 9,883,877, issued Feb. 6, 2018, and entitled “Systems and Methods for Removal of Blood and Thrombotic Materials,” which is hereby incorporated by reference in its entirety for all purposes. - A
connector 1642 is coupled to theaspiration catheter 1930, and includes a female luer sideport 1644 configured to allow injection through the high-pressure injection lumen 1934 of the tube 1936 (FIG. 2 ) via thefluid supply line 1646. Thefluid supply line 1646 includes amale luer 1648, which is connectable to the sideport 1644. Theconnector 1642 includes a barbed fitting 1650 (sideport) which is configured for attachment of avacuum line 1652 having a plastic or elastomerictubular end 1654 configured for sealingly forcing over thebarbed fitting 1650. In some embodiments, the barbed fitting 1650 may also include a female luer, so that either the barbed fitting 1650 or the female luer may be chosen as the attachment site. Theconnector 1642 further includes a Touhy-Borstvalve 1656 which may be sealed (closed) if aguidewire 1902 is not used, or may be opened to allow the passage of aguidewire 1902 through theconnector 1642 and theaspiration lumen 1932 of theaspiration catheter 1930, and may then be sealed over theguidewire 1902. The Touhy-Borstvalve 1656 may include adistal male luer 1657 configured to secure to afemale luer 1659 at the proximal end of theconnector 1642. In alternate embodiments, the Touhy-Borstvalve 1656 may be permanently connected or formed on theconnector 1642. The Touhy-Borstvalve 1656 is optional, because in some catheter configurations, the clearance around the guidewire at one or more portions of theconnector 1642 may be small enough to create sufficient fluid (blood) flow resistance over a length to allow an acceptable hemostasis with little or no backdrip of blood. -
Accessories 2057 include asyringe 2049 having aplunger 2067 and abarrel 2099. Thesyringe 2049 is coupled to thevacuum line 1652 via aluer 2065. Thesyringe 2049 is configured as a vacuum source, to apply a negative pressure on theaspiration lumen 1932 of theaspiration catheter 1930, for example, to aid in the aspiration of thrombus or other materials from ablood vessel 1999 and into the open distal end 1931 (FIG. 2 ) of theaspiration lumen 1932. Astopcock 2047, connected between thesyringe 2049 and thevacuum line 1652, may be used to maintain the negative pressure gradient, or, theplunger 2067 may be a locking variety of plunger that is configured to be locked in the retracted (vacuum) position with respect to thebarrel 2099. Vacuum bottles may be used in place of thesyringe 2049, or a vacuum canister, syringe, a vacuum pump or other suitable vacuum or negative pressure sources. A particular alternative vacuum source is shown in the alternative embodiment ofFIG. 7 . The system for aspiratingthrombus 2400′ inFIG. 7 is identical to the system for aspiratingthrombus 2400 inFIG. 1 , but thesyringe 2049 is replaced by avacuum pump 2051. Thevacuum pump 2051 is coupled to thevacuum line 1652 by aluer 2053. Thus, in all practicable locations wherein thesyringe 2049 is descried herein, thevacuum pump 2051 may alternatively be used. - Returning to
FIG. 1 , afoot pedal 2021 is configured to operate apinch valve 1610 for occluding (closing) or opening thevacuum line 1652. Thefoot pedal 2021 comprises abase 2025 and apedal 2027, and is configured to be placed in a non-sterile area, such as on the floor, under the procedure table/bed. The user steps on thepedal 2027 causing a signal to be sent along acable 2029 which is connected via aplug 2041 to aninput jack 2037. Theinput jack 2037 is shown inFIG. 1 remote from thepump base 200, but alternatively may be located on thepump base 200. Acircuit board 304 of the pump (FIG. 3 ) may include acontroller 303 configured to receive one or more signals indicating on or off from thefoot pedal 2021, either by a direct electrical connection, or wirelessly (remotely). Thecontroller 303 of thecircuit board 304 may be configured to cause anactuator 2031 of thepinch valve 1610 to move longitudinally to compress and occlude thevacuum line 1652 between an actuator head 2033 (attached to the actuator 2031) and ananvil 2035, also carried by thepinch valve 1610. By stepping on thepedal 2027, the user is able to thus occlude thevacuum line 1652, stopping the application of a negative pressure from thesyringe 2049 onto theaspiration lumen 1932. Also, by stepping on thepedal 2027, the user may cause the opposite action, wherein theactuator head 2033 opens thevacuum line 1652, by moving away from theanvil 2035. Theanvil 2035 may have a flat (planar) shape, or a U-shape (e.g., semicylindrical), or a V-shape (e.g., a V-block) where it contacts the tubing of thevacuum line 1652. Furthermore or alternatively, theactuator head 2033 itself may have a flat (planar) shape, or a U-shape (e.g., semi-cylindrical), or a V-shape (e.g., a V-block) where it contacts thevacuum line 1652. Thefoot pedal 2021 may operate by alternately causing theactuator 2031 to move in a first direction and a second, opposite direction, respectively, with alternate applications of thepedal 2027. In some embodiments, when thepedal 2027 of thefoot pedal 2021 is depressed, thecontroller 303 may be configured to open thepinch valve 1610. Apressure transducer 2006 is carried within thefemale luer 1659 of theconnector 1642, but may be alternatively placed at other locations along the aspiration path. Thepressure transducer 2006 thus senses a negative pressure and sends a signal to thepump base 200 via acable 112, causing thecontroller 303 to start themotor 302 of thepump base 200, which is configured to drive thepiston pump 305. Thecable 112 includes aconnector 114 for connecting electrically to thepump base 200. Because the effect via the electronics is substantially immediate, themotor 302 initiates thepiston pump 305 almost immediately after thepedal 2027 is depressed. When thepedal 2027 of thefoot pedal 2021 is released, thecontroller 303 then causes thepinch valve 1610 to close. Thepressure transducer 2006 thus senses that no negative pressure is present and causes themotor 302 of thepump base 200 to shut off. Again, the effect via the electronics is substantially immediate, and thus themotor 302 stops operating thepiston pump 305 almost immediately after thepedal 2027 is depressed. During sterile procedures, the main interventionalist is usually “scrubbed” such that the user's hands are only intended to touch items in the sterile field. However, the feet/shoes/shoe covers are typically not in the sterile field. Thus, again, a single user may operate a switch (via the pedal 2027) while also manipulating theaspiration catheter 1930,guide sheath 2450, andguidewire 1902. However, this time, it is the sterile field hands and non-sterile field feet that are used. Alternatively, thefoot pedal 2021 may comprise two pedals, one configured to command occlusion and one configured to command opening. In an alternative foot pedal embodiment, thepedal 2027 may operate a pneumatic line to cause a pressure activated valve or a cuff to occlude or open thevacuum line 1652, for example, by forcing theactuator head 2033 to move. In another alternative embodiment, thepedal 2027 may turn, slide, or otherwise move a mechanical element, such as a flexible pull cable or push rod that is coupled to theactuator 2031, to move theactuator head 2033. Thecable 2029 may be supplied sterile and connected to thebase 2025 prior to a procedure. The occlusion and opening of thevacuum line 1652 thus acts as a on and off switch for the pump base 200 (via the pressure sensor 2006), as described in relation toFIG. 1 . The on/off function may thus be performed by a user whose hands can focus on manipulating sterile catheters, guidewires, and accessories, and whose foot can turn the motor 302 (and thus pump 305) on and off in a non-sterile environment. This allows a single user to control the entire operation or the majority of operation of the system for aspiratingthrombus actuator 2031 may be controlled to compress thevacuum line 1652 against theanvil 2035 with a particular force, and theactuator 2031 may be controlled to move at a particular speed, either when compressing or when removing compression. Speed and force control allows appropriate response time, but may also be able to add durability to thevacuum line 1652, for example, by eliminating or reducing overcompression of thevacuum line 1652. - A particular configuration for a system for aspirating
thrombus 2400 is illustrated inFIG. 3 , and comprises apump base 200, avacuum line 1652, and apressure sensor 106 having acable 112 for connecting to thepump base 200 and carrying signals from thepressure sensor 106. The other elements of the system for aspiratingthrombus 2400 are the same as described in relation toFIG. 1 . Apinch valve 1610 is operable by a foot pedal (not shown, but similar to thefoot pedal 2021 of the system for aspiratingthrombus 2400 inFIG. 1 ). Thefoot pedal 2021 may communicate with thepinch valve 1610 via a wired connection through thepump base 200 or may communicate with thepinch valve 1610 wirelessly. Thepinch valve 1610 inFIG. 3 extends from thepump base 200 and includes apinch valve housing 1609 having anopening 1611 which is configured to hold a portion of thevacuum line 1652. Internal to thepinch valve housing 1609 are components equivalent to theactuator head 2033,actuator 2031, andanvil 2035 of the pinch valve 2023 ofFIG. 1 , which are configured to compress an external portion of the tubing of thevacuum line 1652 when thefoot pedal 2021 is depressed. Thefoot pedal 2021 may then be depressed a second time to release the compression on (decompress) thevacuum line 1652. The compression of thevacuum line 1652 may be configured to be a complete occlusion of the tubing, thus hydraulically isolating thesyringe 2049 from thepressure sensor 106. Aninput port 1612 to thepressure sensor 106 may include aseptum 1614 for adding or removing fluid within the vacuum line 1652 (e.g., via a hypodermic needle), or alternatively may include a luer connector and valve. Theinput port 1612 may also be used to remove air or to allow priming of the system. Thepressure sensor 106 is thus configured to reside in a non-sterile field, and is capable of detecting the presence of vacuum (or negative pressure) or the lack of vacuum (or negative pressure) when the foot pedal is depressed by the foot of a user. For example, with thepinch valve 1610 closed via a signal (or resultant mechanical action) from foot pressure on the foot pedal, and thus no vacuum applied within the vacuum line 1606, fluid (such as saline) may be freely injected (proximal to distal) through theaspiration lumen 1932 of theaspiration catheter 1930 connected to thevacuum line 1652, and into theblood vessel 1999 of a patient. Thepump base 200 may be configured (via the controller 303) to not pump saline when the lack of vacuum or negative pressure in thevacuum line 1652 is determined. Additionally, if vacuum or negative pressure is present, but is suddenly lost, thepump base 200 will shut down. As seen inFIG. 3 , thepinch valve 1610 is located between the syringe 2049 (or other vacuum source) and thepressure sensor 106, thus when thepinch valve 1610 shuts off theaspiration catheter 1930 from thesyringe 2049, thepressure sensor 106 is still able to sense the condition within theaspiration lumen 1932 of theaspiration catheter 1930. In most cases, after thepinch valve 1610 is caused to close, the negative pressure within theaspiration lumen 1932 will rise toward the ambient pressure rather quickly. This change will be sensed by thepressure sensor 106. However, in cases in which a piece of thrombus causes a temporary or permanent clog in theaspiration lumen 1932, thepressure sensor 106 is able to sense these occurrences. For example, a large moving thrombus will delay the time that the internal pressure of theaspiration lumen 1932 rises to ambient pressure after thepinch valve 1610 is closed. A complete occlusion of theaspiration lumen 1932 by a thrombus may cause at least some level of negative pressure to remain in the aspiration lumen. Each of these potential occurrences can be identified by the pressure measured by thepressure sensor 106 or by the characteristic of the measured pressure over time. Thecontroller 303 may be configured to send an error or to indicate that there is a temporary or permanent clog in theaspiration lumen 1932, for example, using a display, or a visual, audible, or tactile warning or alarm. The user may respond to this indication by removing and unclogging theaspiration catheter 1930, e.g., by moving aguidewire 1902 back and forth, or may determine that theaspiration catheter 1930 needs to be replaced. Thus, the ability of thepressure sensor 106 to monitor aspiration lumen pressure, regardless of whether thepinch valve 1610 is open or closed, offers an important safety control, as well as a general diagnostic of the state of the system (catheter flow status, etc.). Another general advantage of using apinch valve 1610 is that blood only contacts the internal luminal wall of thevacuum line 1652, and thus is not forced within interstices of rotatable valves or other moving parts that otherwise could begin to stick or foul with biological material. Thevacuum line 1652 is simply compressed an uncompressed, allowing a robust and durable design. The internal volume of thevacuum line 1652 easily maintains sterility. And, as thepinch valve 1610 is isolated from blood/thrombus, it is reusable. As an alternative or in addition to thefoot pedal 2021, apush button 1607 may be provided on thepump base 200, or in a remote component. In a first embodiment, thepush button 1607 may simply allow manual opening and closing of thepinch valve 1610 on thevacuum line 1652. A first push to compress thevacuum line 1652 and isolate thepressure sensor 106 from the syringe 2049 (and its negative pressure), and a second push to decompress thevacuum line 1652. - Alternatively, the
push button 1607 may act as a reset button, and be configured to always open the pinch valve 1610 (when it is closed), or to make no change if thepinch valve 1610 is already open. In an embodiment having both thefoot pedal 2021 and the push button 1067, with thepush button 1607 configured as a reset button, activation of thefoot pedal 2021 toggles thepinch valve 1610 open and closed, while activation of thepush button 1607 always places or maintains thepinch valve 1610 in the open position. Thepush button 1607 may be a mechanical (doorbell) type button, or may be a touch switch (e.g., capacitive, resistive, or piezo), or in some embodiments may even be a toggle or rocker switch. The co-location of two or more of thesyringe 2049, thepinch valve 1610, thepump base 200, and thepush button 1607 may also be an advantage because it allows a quick assessment by an attending physician or medical personnel in a quick glance, for example, if otherwise focused on catheter manipulation in the sterile field. - An additional advantage supplied by the
pinch valve 1610 is that thecontroller 303 may be configured to cause thepiston pump 305 to operate whenever thepinch valve 1610 is in the open condition. Thus, there will always be at least some jet-induced maceration of thrombus while a vacuum is being applied to theaspiration lumen 1932. This minimizes or prevents theaspiration lumen 1932 clogging, which could occur if vacuum or negative pressure is being applied to a large portion of thrombus without any maceration (breaking into smaller pieces). - Returning to
FIG. 1 , theplug 2041 contains anidentification component 2043, which may be read by the circuitry (e.g., circuit board 304) coupled to theinput jack 2037. In some embodiments, theidentification component 2043 comprises a resistor having a particular value, for example, as part of a Wheatstone bridge. When theplug 2041 is connected to theinput jack 2037, the circuitry of theinput jack 2037 sends a current through the resistor, resulting in thepump base 200 being electronically placed into a “foot pedal” mode, wherein thefoot pedal 2021 can be used to control the operation of thepinch valve 1610. Alternatively, when theplug 2041 is detached from theinput jack 2037, and the circuitry is not able to identify the resistor, thepump base 200 is placed in a “manual” mode, wherein thepump 305 is controllable only by buttons (not shown). In other embodiments, instead of a resistor, theidentification component 2043 may comprise an RFID (radiofrequency identification) chip, which is read by the circuitry when theplug 2041 is connected to theinput jack 2037. In other embodiments, a proximity sensor, such as a Hall-effect device, may be utilized to determine whether theplug 2041 is or is not connected to theinput jack 2037. - It should be noted that in certain embodiments, the
pinch valve 1610 and thefoot pedal 2021 may be incorporated for on/off operation of thepinch valve 1610 on thevacuum line 1652, without utilizing thepressure sensor 106. In fact, in some embodiments, thepressure sensor 106 may even be absent from the system for aspiratingthrombus 2400, thefoot pedal 2021 being used as a predominant control means. - Returning to
FIG. 1 , system for aspiratingthrombus 2400 further comprises an auxiliaryfluid supply system 310 that provides features that improve the efficiency of aspiration procedures performed using theguide sheath 2450 and theaspiration catheter 1930. The auxiliaryfluid supply system 310 comprises at least asyringe 312 containingcontrast media 314, either non-dilute, or diluted. The contrast media may be diluted 50/50 with normal saline (e.g., heparinized saline), or may be diluted to a ratio of 20% contrast media/80% normal saline. The percentage of contrast may be between about 10% and about 75%, or between about 15% and about 40%. Thesyringe 312 comprises abarrel 316 and aplunger 318, the barrel comprising aluer 320. Theluer 320 may be directly coupled to theluer connector 2458 of theextension tube 2460 of theguide sheath 2450, to allow theinterior lumen 2456 of theguide sheath 2450 to have access to thecontrast media 314 of thesyringe 312. Thecontrast media 314 allows real-time indication of the status of an aspiration procedure, as will be described.FIG. 1 depicts additional optional elements of the auxiliaryfluid supply system 310, including a three-way stopcock 322 and asaline IV bag 324. Thesaline IV bag 324 may be placed within apressure bag 326 configured to externally pressurize the internal contents of thesaline IV bag 324, for example, to a pressure of 100 mm Hg or higher, or 150 mm Hg or higher, or 200 mm Hg or higher, or 250 mm Hg or higher, or 300 mm Hg or higher, using, for example, a pressure cuff surrounding thesaline IV bag 324. Thesaline IV bag 324 may have a volume of normal saline or heparinized normal saline of 500 ml or 1,000 ml, in common embodiments. Theluer 320 of thesyringe 312 is coupled to anextension tube 328 having aluer 330 at its distal end. Theluer 330 is connected to afirst luer 332 of the three-way stopcock 322. Thesaline IV bag 324 includes aport 334 to which aspike 336 of anextension tube 338 is connected. Theextension tube 338 includes aluer 340 at its opposite end which is connector to asecond luer 342 of thethreeway stopcock 322. Athird luer 344 of the three-way stopcock 322 is connected to theluer connector 2458 of theextension tube 2460 of theguide sheath 2450. The three-way stopcock 322 includes arotatable valve 346 having aprojection 348 that is configured to be manipulated by a user to turn therotatable valve 346. Theprojection 348 points toward the luer that will be closed (sealed) in that particular configuration. As shown inFIG. 1 , thefirst luer 332 is closed. Thus, thesecond luer 342 and thethird luer 344 are open, allowing theinterior lumen 2456 of theguide sheath 2450 to have access tosaline 350 within thesaline IV bag 324. Thesaline 350 serves also as a lubricating fluid, so that thesystem 2400 is self-lubricating. Thespike 336 can include a drip chamber, which also allows certain visual feedback. For example, saline in the drip chamber will drip at a higher frequency when the opendistal end 1931 of theaspiration lumen 1932 is located within free flowing blood, and will drip slower when the opendistal end 1931 is adjacent to or within thrombus, and actively aspirating and/or macerating thrombus, and will drip very little or not at all when theaspiration lumen 1932 is occluded. - In use, the
distal end 2451 of theguide sheath 2450 in placed within theblood vessel 1999 via an external puncture or cutdown. For example, via a femoral artery or radial artery. Theaspiration catheter 1930 is placed through theguide sheath 2450 and thedistal end 1997 of theaspiration catheter 1930 is tracked (e.g., over a guidewire 1902) to a location adjacent athrombus 1995. Theguidewire 1902, if used, may be removed from theaspiration catheter 1930, may be partially retracted, or may be left in place. With the hydraulic connections ofFIG. 1 completed, thepiston pump 305 is operated to inject high pressure saline through the high-pressure injection lumen 1934, and aspiration is performed through theaspiration lumen 1932 via the evacuatedsyringe 2049. Thepump 305 delivers the high pressure fluid (e.g., saline) through the high-pressure injection lumen 1934 at an injection flow rate FR1. The negative pressure PN inside the evacuatedsyringe 2049 creates, independent of the injection flow rate FR1, a potential aspiration flow rate FR2 (e.g., the intended aspiration capacity from purely negative pressure application). With both the negative pressure PN applied and the injection flow rate FR1 applied, a total potential flow rate FR3 is defined by the equation: -
FR 3 =FR 1 +FR 2 - The actual flow rate of the blood/thrombus being aspirated from the
blood vessel 1999 may likely be less than the total potential flow rate FR3. But in certain cases, the total potential flow rate FR3 is significantly decreased. For example, if thethrombus 1995 creates a significant occlusion within theblood vessel 1999, and if much or all of the blood or flowable macerated thrombus has been aspirated from the area of interest, there may not be sufficiently enough flowable material adjacent thethrombus 1995 to allow sufficient flow through theaspiration lumen 1932 of theaspiration catheter 1930, even if theaspiration lumen 1932 is not occluded. Thus, a significantly active flowing condition is not present to the extent that new portions of thethrombus 1995 may be sucked inside the opendistal end 1931 of theaspiration lumen 1932. In some embodiments, the injection flow rate FR1 is configured to be between about 15 ml/min and about 50 ml/min, or between about 20 ml/min and about 40 ml/min, or between about 25 ml/min and about 35 ml/min. In some embodiments, the potential aspiration flow rate FR2 is configured to be between about 150 ml/min and about 600 ml/min, or between about 300 ml/min and 600 ml/min. or between about 350 ml/min and about 500 ml/min. With therotatable valve 346 in the position ofFIG. 1 , theinterior lumen 2456 of theguide sheath 2450 is capable of allowingadditional saline 350 from thesaline IV bag 324 to flow intospace 1994 adjacent thethrombus 1995, and adjacent the opendistal end 1931 of theaspiration lumen 1932. The new bolus of injected/infused fluid can increase the flowable volume in thespace 1994 and can reduce the bulk viscosity of saline/blood/thrombus. The initiation of aspiration at the target thrombus site and entry into theaspiration lumen 1932 of theaspiration catheter 1930 is facilitated. Once the somewhat diluted thrombus begins to flow through theaspiration lumen 1932, the aspiration procedure tends to continue, as it is now in a dynamic state, instead of an initially static state. Thus, changing pressure gradients have causedsaline 350 from thesaline IV bag 324 to be pulled into thespace 1994 automatically, because the pressure inside thesaline IV bag 324 is greater than the pressure in thespace 1994. Once aspiration flow is recovered and the aspiration of thrombus through theaspiration lumen 1932 resumes, the pressure gradient decreases, andless saline 350 from thesaline IV bag 324 will be pulled into thespace 1994 in theblood vessel 1999, adjacent thethrombus 1995, again, automatically. The on/off nature of the flow from thesaline IV bag 324 and through theinterior lumen 2456 of the guide sheath is pressure gradient controlled, and can occur automatically, in order to maintain an active aspiration ofthrombus 1995. In the alternative, in the case of a completely cloggedaspiration lumen 1932, the actual aspiration flow rate becomes zero. If the actual aspiration flow rate becomes less than the actual injection flow rate, then some injected fluid (saline, etc.) will likely be injected into the blood vessel. This may have negative consequences, such as blood vessel damage, uncontrolled vessel distension, or potentially dangerous thrombus dislodgement. The automatic control of additional injected saline, as described, serves to create an optimized volume during the procedure, analogous in some manner to the cutting fluid that is used in machining of metals. Viscosity is optimized for efficient jet application on the thrombus and aspiration flow. - Additional advantages related to the use of the
syringe 312 containingcontrast media 314 are described in relation toFIG. 4 . Therotatable valve 346 has been turned by the user so that theprojection 348 points toward thesecond luer 342, thus closing off access of thesaline IV bag 324 and opening access to thesyringe 312 containingcontrast media 314. Now, when performing the aspiration procedure in the identical manner as that described in relation toFIG. 1 , any changes in pressure gradient or changes in available flowable material that cause fluid to flow from proximal to distal through theinterior lumen 2456 of theguide sheath 2450, will now pullcontrast media 314 from thesyringe 312 into theinterior lumen 2456 and deliver it into thespace 1994. Thus, upon monitoring the procedure by fluoroscopy (e.g., when stepping on the fluoroscopy pedal), injectedcontrast media 1993, because of its radiopacity, is visible to the user when this change in flow characteristics occurs. The user, thereby receives a visual feedback (e.g., a warning) on fluoroscopy, when key changes to the aspiration process occur. Thus, the status of flow is known by the user. The user is also able to see a maceration zone around thedistal end 1997 of theaspiration catheter 1930. Thecontrast media 1993 itself can improve the aspiration as did the saline, by adding flowable volume and decreasing viscosity (in comparison to thrombus or blood, for example, depending on the particular contrast media, and/or any dilution utilized). However, in many cases, it is desired to control the total amount of contrast media injected during a procedure, to protect the patient's kidneys by reducing the burden on them. Thus, the user may switch therotatable valve 346 into the position ofFIG. 1 , to allowsaline 350 to be pulled through theinterior lumen 2456 of theguide sheath 2450 and into theblood vessel 1999 when the system is in the particular pressure or volume change state. The user may choose to change back and forth between therotatable valve 346 position ofFIG. 1 and of therotatable valve 346 position ofFIG. 4 . In alternative embodiments, theplunger 318 of thesyringe 312 may be coupled to a mechanical or optical sensor, such as an encoder or linear encoder, that activates an alarm when theplunger 318 moves in relation to thebarrel 316. An automated rotating device may even be coupled to therotatable valve 346 and feedback may be applied by acontroller 303, so that sensed movement of theplunger 318 in relation to thebarrel 316 greater than a certain distance, greater than a certain velocity, or greater than a certain acceleration cause therotatable valve 346 to be rotated from the position inFIG. 1 , to the position inFIG. 4 . This feedback may even be used to activate the fluoroscopy unit, so that the flow ofcontrast media 314 entering theblood vessel 1999 is immediately shown to the user on the fluoroscopy monitor. The majority of thecontrast media 314 entering theblood vessel 1999 would be expected to very low when the aspiration procedure is correctly functioning (no clogs, sufficient flowable material), because any or most of thecontrast media 314 injected into theblood vessel 1999 would be aspirated into theaspiration lumen 1932. Thus, the risk of high volumes of contrast added to the blood volume is significantly reduced. Also, with this technique the attending physician would likely not need to check the area of interest for flow (e.g., using angiograms or venograms) as often, thus, further minimizingcontrast media 314 injected into the bloodstream of the patient. The method described herein is more efficient and faster than having to stop and “puff” some contrast intermittently. The user may also be able to visualize on fluoroscopy thecontrast media 314 specifically moving from theinterior lumen 2456 of theguide sheath 2450 to the opendistal end 1931 of theaspiration lumen 1930. -
FIG. 5 illustrates the system for aspiratingthrombus 2400 with therotatable valve 346 in the same position as inFIG. 4 , but with the opendistal end 1931 of theaspiration lumen 1932 of theaspiration catheter 1930 pulled back to that it is entirely within theinterior lumen 2456 of theguide sheath 2450. Alternatively, theguide sheath 2450 may be moved distally in longitudinal relation to theaspiration catheter 2450, or they both may be adjusted in relative longitudinal relation. A diagnostic method for assessment of system operation is described in relation toFIG. 5 . The user may pull thedistal end 1997 of theaspiration catheter 1930 fully into theguide sheath 2450 in this manner, a bit like a turtle pulls its head into its shell, in order to determine particular diagnostics related to the aspiration procedure. In some cases, theaspiration catheter 1930 is pulled back so that the opendistal end 1931 of theaspiration lumen 1932 is at least 1 mm within theguide sheath 2450, or at least 2 mm, or at least 3 mm, or at least 4 mm, or at least 5 mm, or at least 6 mm, or at least 7 mm, or at least 8 mm, or at least 9 mm, or at least 10 mm. In some cases, theaspiration catheter 1930 is pulled back so that the opendistal end 1931 of theaspiration lumen 1932 is between about 1 mm and about 30 mm within theguide sheath 2450. In some cases, theaspiration catheter 1930 is pulled back so that the opendistal end 1931 of theaspiration lumen 1932 is between about 1 mm and about 15 mm within theguide sheath 2450. If theaspiration lumen 1932 is patent, and thecontrast media 314 is able to be aspirated through theaspiration lumen 1932, thencontrast media 314 will continue being pulled through theinterior lumen 2456 of theguide sheath 2450 from proximal to distal, and will be pulled into the opendistal end 1931 of the aspiration lumen 1932 (curved arrow,FIG. 6 ) and through theaspiration lumen 1932 proximal to distal. Theplunger 318 of thesyringe 312 will be seen by the user contracting into thebarrel 316 of the syringe 312 (right to left inFIG. 5 ). If, however, theaspiration lumen 1932 of theaspiration catheter 1930 is clogged with relatively hard thrombus or one or more other materials, a non-aspiration condition will be demonstrated. Theplunger 318 of thesyringe 312 will not move in relation to thebarrel 316 of thesyringe 312. If there is an occlusion of theaspiration lumen 1932, the user is notified by the movement or lack of movement of theplunger 318, and will likely change out theaspiration catheter 1930 for another, or remove theaspiration catheter 1930 and declog theaspiration lumen 1932, for example by a hand injection with a small bore syringe, retrograde (proximal to distal) through theaspiration lumen 1932. Again, in other embodiments, mechanical or optical sensing may be used to automatically determine whether theplunger 318 is moving in relation to thebarrel 316 or not, and an alarm or indicator may be broadcast to the user (audible, visual, tactile). - With the advantages of the retrograde flow through the
guide sheath 2450, a significantly empty clot bed can fill itself to allow thethrombus 1995 to move, or come in contact with or be closer to the opendistal end 1931 of theaspiration lumen 1932. The blood vessel wall can also be distended somewhat, allowing a larger volume of saline and blood within, the further aid the aspiration of thrombus. Using thecontrast media 314, real-time visualization can be performed during manipulation (positioning/advancement/retraction) of theaspiration catheter 1930, and of theguide sheath 2450. Theplunger 318 can be manually compressed to inject puffs ofcontrast media 314. Additionally, downstream drug migration can be minimized, if using “clot-busting” drugs injected through or mixed with the saline that is injected through the highpressure injection lumen 1934, because the periods of injection without aspiration (when theaspiration lumen 1932 is blocked) are minimized. Drug may include a lytic agent such as tPA (tissue plasminogen activator) or urokinase. The active use of the lytic agent can actually be more efficient, as less is wasted, and more is delivered to the appropriate target area of action. The lytic agent is delivered to a more dynamic surface area of thethrombus 1995, and is thus more effective in its action on thethrombus 1995. In cases where an active mechanical thrombectomy device is used, the ability to receive injectate from theguide sheath 2450 can serve to cool down a heated catheter tip. Additionally, the used of thecontrast media 314 aids in the delineation of the borders of thethrombus 1995. The constant available supply of fluids from theguide sheath 314, bothcontrast media 314 andsaline 350 allow the procedure to be optimized and tailored. Blood loss from excessive aspiration of blood and not thrombus can also be reduced. - Any of the embodiments described herein may be used conjunction with the Apollo™ System (Penumbra, Inc., Alameda, Calif., USA). The aspiration catheters described herein may be replaced by any standard aspiration catheter having one or more aspiration lumens. Aspiration catheters used herein may include the ACE™ or INDIGO® catheters produced by Penumbra, Inc. of Alameda, Calif., USA. The user may pull the
distal end 1997 of theaspiration catheter 1930 fully into theguide sheath 2450 to mimic the separator device used in conjunction with the ACE™ or INDIGO® catheters. The coaxially placed tubes/shafts of theguide sheath 2450 and theaspiration catheter 1930 can be moved back and forth longitudinally in relation to each other to create additional shearing of any thrombus in the area, to further macerate the thrombus, or to reposition the thrombus in a more strategically aligned location. - In some instances, a degree of MRI compatibility may be imparted into parts of the devices described herein. For example, to enhance compatibility with Magnetic Resonance Imaging (MRI) machines, it may be desirable to make various portions of the devices described herein from materials that do not substantially distort MRI images or cause substantial artifacts (gaps in the images). Some ferromagnetic materials, for example, may not be suitable as they may create artifacts in an MRI image. In some cases, the devices described herein may include materials that the MRI machine can image. Some materials that exhibit these characteristics include, for example, tungsten, cobalt-chromium-molybdenum alloys (e.g., UNS: R30003 such as ELGILOY®, PHYNOX®, and the like), nickel-cobaltchromium-molybdenum alloys (e.g., UNS: R30035 such as MP35-N® and the like), nitinol, and the like, and others.
- In some instances, some of the devices described herein may include a coating such as a lubricious coating or a hydrophilic coating. Hydrophobic coatings such as fluoropolymers provide a dry lubricity. Lubricious coatings improve steerability and improve lesion crossing capability. Suitable lubricious polymers are well known in the art and may include silicone and the like, hydrophilic polymers such as high-density polyethylene (HDPE), polytetrafluoroethylene (PTFE), polyarylene oxides, polyvinylpyrrolidones, polyvinylalcohols, hydroxy alkyl cellulosics, algins, saccharides, caprolactones, and the like, and mixtures and combinations thereof. Hydrophilic polymers may be blended among themselves or with formulated amounts of water insoluble compounds (including some polymers) to yield coatings with suitable lubricity, bonding, and solubility.
- It should be understood that this disclosure is, in many respects, only illustrative. Changes may be made in details, particularly in matters of shape, size, and arrangement of steps without exceeding the scope of the disclosure. The scope of the disclosure is, of course, defined in the language in which the appended claims are expressed.
- While embodiments of the present disclosure have been shown and described, various modifications may be made without departing from the scope of the present disclosure. Embodiments of the present disclosure are contemplated to have utility in a variety of blood vessels, including but not limited to coronary arteries, carotid arteries, intracranial/cerebral arteries, inferior and superior vena cavae and other veins (for example, in cases of deep venous thrombosis or pulmonary embolism), peripheral arteries, shunts, grafts, vascular defects, and chambers of the heart. This includes, but is not limited to, any vessel having a diameter of bout two mm or greater. An
aspiration catheter 1930 outer diameter of about seven French or less is contemplated for many of the applications, though in certain applications, it may be larger. In some embodiments, anaspiration catheter 1930 diameter of about six French or less is contemplated. Embodiments of the present disclosure may even be used in non-vascular applications, for example body lumens or cavities having material accumulations that need to be macerated and/or removed. - It is contemplated that various combinations or subcombinations of the specific features and aspects of the embodiments disclosed above may be made and still fall within one or more of the embodiments. Further, the disclosure herein of any particular feature, aspect, method, property, characteristic, quality, attribute, element, or the like in connection with an embodiment can be used in all other embodiments set forth herein. Accordingly, it should be understood that various features and aspects of the disclosed embodiments can be combined with or substituted for one another in order to form varying modes of the disclosed embodiments. Thus, it is intended that the scope of the present disclosure herein disclosed should not be limited by the particular disclosed embodiments described above. Moreover, while the present disclosure is susceptible to various modifications, and alternative forms, specific examples thereof have been shown in the drawings and are herein described in detail. It should be understood, however, that the present disclosure is not to be limited to the particular forms or methods disclosed, but to the contrary, the present disclosure is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the various embodiments described and the appended claims. Any methods disclosed herein need not be performed in the order recited. The methods disclosed herein include certain actions taken by a practitioner; however, they can also include any third-party instruction of those actions, either expressly or by implication.
- The ranges disclosed herein also encompass any and all overlap, sub-ranges, and combinations thereof. Language such as “up to,” “at least,” “greater than,” “less than,” “between,” and the like includes the number recited. Numbers preceded by a term such as “approximately”, “about”, and “substantially” as used herein include the recited numbers (e.g., about 10%=10%), and also represent an amount close to the stated amount that still performs a desired function or achieves a desired result. For example, the terms “approximately”, “about”, and “substantially” may refer to an amount that is within less than 10% of, within less than 5% of, within less than 1% of, within less than 0.1% of, and within less than 0.01% of the stated amount.
Claims (20)
1. A system for aspirating thrombus, comprising:
an aspiration catheter comprising:
an elongate shaft configured for placement within a blood vessel of a subject;
a supply lumen and an aspiration lumen each extending along the shaft; and
an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen;
a tubing set comprising a first conduit having a distal end configured to couple to the aspiration lumen of the aspiration catheter and a proximal end configured to couple to a vacuum source, and a second conduit having a distal end configured to couple to the supply lumen of the aspiration catheter and a proximal end configured to couple to a first fluid source;
a pressurization element configured to couple to the tubing set and further configured to pressurize fluid from the first fluid source or allow pressurized fluid from the first fluid source to be transferred to the supply lumen, such that the pressurized fluid is capable of flowing through the supply lumen from the proximal end of the supply lumen to the distal end of the supply lumen;
a sheath having a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough.
2. The system of claim 1 , wherein the sheath further comprises an extension conduit in fluid communication with the lumen of the sheath and extending from the sheath, the extension conduit configured for coupling to a second fluid source
3. The system of claim 2 , wherein the second fluid source comprises a contrast agent.
4. The system of claim 2 , wherein the second fluid source further comprises a syringe having a barrel and a plunger longitudinally movable within the barrel, the barrel configured to contain the contrast agent.
5. The system of claim 2 , wherein the second fluid source does not comprise a substantial amount of contrast agent.
6. The system of claim 2 , wherein the extension conduit is hydraulically coupled to a valve having a first position configured to selectively couple the extension conduit to a third fluid source comprising a contrast agent and a second position configured to selectively couple the extension conduit to the second fluid source.
7. The system of claim 6 , wherein the second fluid source comprises a saline bag.
8. The system of claim 6 , wherein the second fluid source comprises a pressure bag configured to compress a saline bag.
9. A system for aspirating thrombus, comprising:
an aspiration catheter comprising:
an elongate shaft configured for placement within a blood vessel of a subject;
a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end; and
an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen;
a tubing set comprising a first conduit having a distal end configured to couple to the aspiration lumen of the aspiration catheter and a proximal end configured to couple to a vacuum source, and a second conduit having a distal end configured to couple to the supply lumen of the aspiration catheter and a proximal end configured to couple to a first fluid source;
a pressurization element configured to couple to the tubing set and further configured to pressurize fluid from the first fluid source or allow pressurized fluid from the first fluid source to be transferred to the supply lumen, such that the pressurized fluid is capable of flowing through the supply lumen from the proximal end of the supply lumen to the distal end of the supply lumen;
a sheath having a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough.
10. The system of claim 9 , wherein the sheath further comprises an extension conduit in fluid communication with the lumen of the sheath and extending from the sheath, the extension conduit configured for coupling to a second fluid source
11. The system of claim 10 , wherein the second fluid source comprises a contrast agent.
12. The system of claim 10 , wherein the second fluid source further comprises a syringe having a barrel and a plunger longitudinally movable within the barrel, the barrel configured to contain the contrast agent.
13. The system of claim 10 , wherein the second fluid source does not comprise a substantial amount of contrast agent.
14. The system of claim 10 , wherein the extension conduit is hydraulically coupled to a valve having a first position configured to selectively couple the extension conduit to a third fluid source comprising a contrast agent and a second position configured to selectively couple the extension conduit to the second fluid source.
15. The system of claim 14 , wherein the second fluid source comprises a saline bag.
16. The system of claim 14 , wherein the second fluid source comprises a pressure bag configured to compress a saline bag.
17. A system for aspirating thrombus, comprising:
an aspiration catheter comprising:
an elongate shaft configured for placement within a blood vessel of a subject;
a supply lumen and an aspiration lumen each extending along the shaft, the supply lumen having a proximal end and a distal end, and the aspiration lumen having a proximal end and an open distal end; and
an opening at or near the distal end of the supply lumen, the opening configured to allow the injection of pressurized fluid into the aspiration lumen at or near the distal end of the aspiration lumen when the pressurized fluid is caused or allowed to flow through the supply lumen;
a tubing set comprising a first conduit having a distal end configured to couple to the aspiration lumen of the aspiration catheter and a proximal end configured to couple to a vacuum source, and a second conduit having a distal end configured to couple to the supply lumen of the aspiration catheter and a proximal end configured to couple to a first fluid source;
a pressurization element configured to couple to the tubing set and further configured to pressurize fluid from the first fluid source or allow pressurized fluid from the first fluid source to be transferred to the supply lumen, such that the pressurized fluid is capable of flowing through the supply lumen from the proximal end of the supply lumen to the distal end of the supply lumen;
a sheath having a proximal end, a distal end and a lumen extending between the proximal end and the distal end, the lumen configured for placement of the aspiration catheter therethrough, the sheath further comprising an extension conduit in fluid communication with the lumen of the sheath and extending from the sheath, the extension conduit configured for coupling to a second fluid source;
a seal associated with the proximal end of the sheath and configured to seal the lumen of the sheath around the elongate shaft of the aspiration catheter when the aspiration catheter is in place within the sheath; and
wherein the extension conduit is configured to allow fluid from the second fluid source to flow through the lumen of the sheath from the proximal end of the sheath to the distal end of the sheath when the open distal end of the aspiration lumen of the aspiration catheter is extended outside of the lumen of the sheath in a blood vessel and is in proximity to the distal end of the sheath, and when insufficient flowable material is present adjacent the open distal end of the aspiration lumen, such that a negative pressure gradient supplied by the vacuum source further causes a significant volume of the fluid from the second fluid source to actively flow through the aspiration lumen from the open distal end to the proximal end and into an interior of the vacuum source.
18. The system of claim 17 , wherein the second fluid source further comprises a syringe having a barrel and a plunger longitudinally movable within the barrel, the barrel configured to contain a contrast agent.
19. The system of claim 17 , wherein the extension conduit is hydraulically coupled to a valve having a first position configured to selectively couple the extension conduit to a third fluid source comprising a contrast agent and a second position configured to selectively couple the extension conduit to the second fluid source.
20. The system of claim 19 , wherein the second fluid source comprises a pressure bag configured to compress a saline bag.
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US17/886,020 US20220378449A1 (en) | 2018-07-19 | 2022-08-11 | Systems and methods for removal of blood and thrombotic material |
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US17/886,020 US20220378449A1 (en) | 2018-07-19 | 2022-08-11 | Systems and methods for removal of blood and thrombotic material |
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US17/886,020 Pending US20220378449A1 (en) | 2018-07-19 | 2022-08-11 | Systems and methods for removal of blood and thrombotic material |
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Families Citing this family (17)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2005094283A2 (en) | 2004-03-25 | 2005-10-13 | Hauser David L | Vascular filter device |
WO2015061365A1 (en) | 2013-10-21 | 2015-04-30 | Inceptus Medical, Llc | Methods and apparatus for treating embolism |
CN113796927A (en) | 2015-10-23 | 2021-12-17 | 伊纳里医疗公司 | Intravascular treatment of vascular occlusions and related devices, systems, and methods |
AU2018328011B2 (en) | 2017-09-06 | 2022-09-15 | Inari Medical, Inc. | Hemostasis valves and methods of use |
US10258357B1 (en) | 2017-10-16 | 2019-04-16 | Michael Bruce Horowitz | Catheter based retrieval device with proximal body having axial freedom of movement |
WO2022082213A1 (en) | 2017-10-16 | 2022-04-21 | Retriever Medical, Inc. | Clot removal methods and devices with multiple independently controllable elements |
US20220104839A1 (en) | 2017-10-16 | 2022-04-07 | Retriever Medical, Inc. | Clot Removal Methods and Devices with Multiple Independently Controllable Elements |
US11154314B2 (en) | 2018-01-26 | 2021-10-26 | Inari Medical, Inc. | Single insertion delivery system for treating embolism and associated systems and methods |
WO2019176171A1 (en) * | 2018-03-16 | 2019-09-19 | オリンパス株式会社 | Endoscope and endoscope system |
AU2019321256B2 (en) | 2018-08-13 | 2023-06-22 | Inari Medical, Inc. | System for treating embolism and associated devices and methods |
WO2020123589A1 (en) * | 2018-12-11 | 2020-06-18 | University Of Washington | Systems and methods for synchronized suction-injection angioscope |
JP2022551992A (en) | 2019-10-16 | 2022-12-14 | イナリ メディカル, インコーポレイテッド | Systems, devices and methods for treating vascular occlusions |
US20210378694A1 (en) * | 2020-06-05 | 2021-12-09 | Inari Medical, Inc. | Recapturable funnel catheters, and associated systems and methods |
CN112674837B (en) * | 2020-12-30 | 2023-01-03 | 上海融脉医疗科技有限公司 | Driving device of thrombus taking-out catheter system |
JP2024506374A (en) * | 2021-02-15 | 2024-02-13 | ウォーク バスキュラー, エルエルシー | System and method for removing blood and thrombotic material |
US20220257268A1 (en) * | 2021-02-15 | 2022-08-18 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
US11679195B2 (en) | 2021-04-27 | 2023-06-20 | Contego Medical, Inc. | Thrombus aspiration system and methods for controlling blood loss |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20130267891A1 (en) * | 2012-01-26 | 2013-10-10 | Covidien Lp | Thrombectomy catheter systems |
Family Cites Families (617)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US1144268A (en) | 1915-06-22 | Frederick William Vickery | Laying-machine. | |
US1114268A (en) | 1913-10-14 | 1914-10-20 | Charles Edmund Kells | Method for surgically cleansing wounds and other surfaces. |
US1148093A (en) | 1915-03-22 | 1915-07-27 | Charles Edmund Kells | Apparatus for surgically cleansing surfaces. |
US2804075A (en) | 1955-11-14 | 1957-08-27 | Ruth O Borden | Non-clogging surgical aspirator |
US3429313A (en) | 1966-02-01 | 1969-02-25 | Ram Domestic Products Co | Medical drainage pump |
US3631847A (en) | 1966-03-04 | 1972-01-04 | James C Hobbs | Method and apparatus for injecting fluid into the vascular system |
NL145136C (en) | 1967-07-25 | 1900-01-01 | ||
US3494363A (en) | 1969-04-01 | 1970-02-10 | Technical Resources Inc | Control for devices used in surgery |
US3620650A (en) | 1969-12-05 | 1971-11-16 | Robert F Shaw | Gas-disabled liquid-pumping apparatus |
US3707967A (en) | 1970-10-01 | 1973-01-02 | Tecna Corp | Steady flow regenerative peritoneal dialysis system and method |
US3693613A (en) | 1970-12-09 | 1972-09-26 | Cavitron Corp | Surgical handpiece and flow control system for use therewith |
US3847140A (en) | 1971-12-16 | 1974-11-12 | Catheter & Instr Corp | Operating handle for spring guides |
US3748435A (en) | 1971-12-16 | 1973-07-24 | Welding Research Inc | Wire attitude control |
US3807401A (en) | 1972-06-21 | 1974-04-30 | Department Of Health Education | Anticoagulating blood suction device |
US3818913A (en) | 1972-08-30 | 1974-06-25 | M Wallach | Surgical apparatus for removal of tissue |
US3916892A (en) | 1974-04-29 | 1975-11-04 | Haemonetics Corp | Phlebotomy needle system incorporating means to add anticoagulant and wash liquid |
US3930505A (en) | 1974-06-24 | 1976-01-06 | Hydro Pulse Corporation | Surgical apparatus for removal of tissue |
US3918453A (en) | 1974-07-01 | 1975-11-11 | Baxter Laboratories Inc | Surgical suction device |
US3955573A (en) | 1974-10-11 | 1976-05-11 | Sorenson Research Co., Inc. | Anticoagulant delivery device and method |
US4030503A (en) | 1975-11-05 | 1977-06-21 | Clark Iii William T | Embolectomy catheter |
US4274411A (en) | 1979-03-30 | 1981-06-23 | Dotson Robert S Jun | Fluid operated ophthalmic irrigation and aspiration device |
US4299221A (en) | 1979-09-28 | 1981-11-10 | Stryker Corporation | Irrigation and suction handpiece |
US4465470A (en) | 1982-06-04 | 1984-08-14 | Kelman Charles D | Apparatus for and method of irrigating and aspirating an eye |
US4573476A (en) | 1983-11-14 | 1986-03-04 | Ruiz Oscar F | Angiographic catheter |
US5197951A (en) | 1983-12-14 | 1993-03-30 | Mahurkar Sakharam D | Simple double lumen catheter |
US4574812A (en) | 1984-04-18 | 1986-03-11 | The Kendall Company | Arterial thrombus detection system and method |
US5306244A (en) | 1984-05-14 | 1994-04-26 | Surgical Systems & Instruments, Inc. | Method of guidewire insertion |
US6440148B1 (en) | 1984-05-14 | 2002-08-27 | Samuel Shiber | Stent unclogging system with stepped spiral |
US5007896A (en) | 1988-12-19 | 1991-04-16 | Surgical Systems & Instruments, Inc. | Rotary-catheter for atherectomy |
US4979939A (en) | 1984-05-14 | 1990-12-25 | Surgical Systems & Instruments, Inc. | Atherectomy system with a guide wire |
US5002553A (en) | 1984-05-14 | 1991-03-26 | Surgical Systems & Instruments, Inc. | Atherectomy system with a clutch |
US4957482A (en) | 1988-12-19 | 1990-09-18 | Surgical Systems & Instruments, Inc. | Atherectomy device with a positive pump means |
US5653696A (en) | 1984-05-14 | 1997-08-05 | Surgical Systems & Instruments, Inc. | Stent unclogging method |
US5135531A (en) | 1984-05-14 | 1992-08-04 | Surgical Systems & Instruments, Inc. | Guided atherectomy system |
US5443443A (en) | 1984-05-14 | 1995-08-22 | Surgical Systems & Instruments, Inc. | Atherectomy system |
US4886490A (en) | 1984-05-14 | 1989-12-12 | Surgical Systems & Instruments, Inc. | Atherectomy catheter system and method of using the same |
US4842579B1 (en) | 1984-05-14 | 1995-10-31 | Surgical Systems & Instr Inc | Atherectomy device |
US5024651A (en) | 1984-05-14 | 1991-06-18 | Surgical Systems & Instruments, Inc. | Atherectomy system with a sleeve |
US5334211A (en) | 1984-05-14 | 1994-08-02 | Surgical System & Instruments, Inc. | Lumen tracking atherectomy system |
US4894051A (en) | 1984-05-14 | 1990-01-16 | Surgical Systems & Instruments, Inc. | Atherectomy system with a biasing sleeve and method of using the same |
US4883458A (en) | 1987-02-24 | 1989-11-28 | Surgical Systems & Instruments, Inc. | Atherectomy system and method of using the same |
US4569344A (en) | 1984-07-23 | 1986-02-11 | Ballard Medical Products | Aspirating/ventilating apparatus and method |
DE8426270U1 (en) | 1984-09-06 | 1985-02-14 | Veltrup, Elmar Michael, Dipl.-Ing., 4150 Krefeld | DEVICE FOR REMOVING SOLID BODIES OR DEPOSITS FROM BODY VESSELS |
US4790813A (en) | 1984-12-17 | 1988-12-13 | Intravascular Surgical Instruments, Inc. | Method and apparatus for surgically removing remote deposits |
US4832685A (en) | 1985-06-05 | 1989-05-23 | Coopervision, Inc. | Fluid flow control system and connecting fitting therefor |
US4700705A (en) | 1985-08-12 | 1987-10-20 | Intravascular Surgical Instruments, Inc. | Catheter based surgical methods and apparatus therefor |
US4770654A (en) | 1985-09-26 | 1988-09-13 | Alcon Laboratories Inc. | Multimedia apparatus for driving powered surgical instruments |
US4702733A (en) | 1985-11-22 | 1987-10-27 | Innovative Surgical Products, Inc. | Foot actuated pinch valve and high vacuum source for irrigation/aspiration handpiece system |
US5135482A (en) | 1985-12-31 | 1992-08-04 | Arnold Neracher | Hydrodynamic device for the elimination of an organic deposit obstructing a vessel of a human body |
GB8602732D0 (en) | 1986-02-04 | 1986-03-12 | Univ Brunel | Taking samples from patients |
US4728319A (en) | 1986-03-20 | 1988-03-01 | Helmut Masch | Intravascular catheter |
DE3715418A1 (en) | 1986-05-08 | 1987-11-12 | Olympus Optical Co | LITHOTOM |
US4740203A (en) | 1986-06-05 | 1988-04-26 | Thomas J. Fogarty | Refillable injection device |
US5527274A (en) | 1986-06-09 | 1996-06-18 | Development Collaborative Corporation | Catheter for chemical contact dissolution of gallstones |
US4715853A (en) | 1986-09-19 | 1987-12-29 | Ideal Instruments, Inc. | Back-fill syringe |
US4747821A (en) | 1986-10-22 | 1988-05-31 | Intravascular Surgical Instruments, Inc. | Catheter with high speed moving working head |
EP0287920B1 (en) | 1987-04-22 | 1991-05-15 | Siemens Aktiengesellschaft | Piston pump for a device for dosing medicaments |
US5057098A (en) | 1987-05-01 | 1991-10-15 | Ophthalmocare, Inc. | Apparatus and method for extracting cataract tissue |
US5011468A (en) | 1987-05-29 | 1991-04-30 | Retroperfusion Systems, Inc. | Retroperfusion and retroinfusion control apparatus, system and method |
US4857046A (en) | 1987-10-21 | 1989-08-15 | Cordis Corporation | Drive catheter having helical pump drive shaft |
DE8714529U1 (en) | 1987-10-31 | 1988-12-08 | Schnepp-Pesch, Wolfram, 7505 Ettlingen, De | |
US4854325A (en) | 1987-11-09 | 1989-08-08 | Stevens Robert C | Reciprocating guidewire method |
US4886507A (en) | 1988-02-01 | 1989-12-12 | Medex, Inc. | Y connector for angioplasty procedure |
US5073168A (en) | 1988-10-05 | 1991-12-17 | Danforth John W | Y-adaptor and percutaneous sheath for intravascular catheters |
SE462414B (en) | 1988-11-15 | 1990-06-25 | Paal Svedman | INSTRUMENTS FOR WEAVING OF WEAVEN |
US5129887A (en) | 1988-12-07 | 1992-07-14 | Scimed Life Systems, Inc. | Adjustable manifold for dilatation catheter |
US5011488A (en) | 1988-12-07 | 1991-04-30 | Robert Ginsburg | Thrombus extraction system |
US5197795A (en) | 1989-06-30 | 1993-03-30 | Gruhn Usa, Inc. | Adjustable-length removably-mountable holder system |
US5318529A (en) | 1989-09-06 | 1994-06-07 | Boston Scientific Corporation | Angioplasty balloon catheter and adaptor |
US5055109A (en) | 1989-10-05 | 1991-10-08 | Advanced Cardiovascular Systems, Inc. | Torque transmitting assembly for intravascular devices |
US5091656A (en) | 1989-10-27 | 1992-02-25 | Storz Instrument Company | Footswitch assembly with electrically engaged detents |
US5163433A (en) | 1989-11-01 | 1992-11-17 | Olympus Optical Co., Ltd. | Ultrasound type treatment apparatus |
US5324263A (en) | 1989-11-02 | 1994-06-28 | Danforth Biomedical, Inc. | Low profile high performance interventional catheters |
US5074841A (en) | 1990-01-30 | 1991-12-24 | Microcision, Inc. | Atherectomy device with helical cutter |
NL9000356A (en) | 1990-02-14 | 1991-09-02 | Cordis Europ | DRAINAGE CATHETER. |
US5158564A (en) | 1990-02-14 | 1992-10-27 | Angiomed Ag | Atherectomy apparatus |
US5125893A (en) | 1990-04-16 | 1992-06-30 | Dryden Gale E | Suction catheter with wall lumen for irrigation |
US5073164A (en) | 1990-05-02 | 1991-12-17 | Hollister William H | Suction catheter |
DE4018736A1 (en) | 1990-06-12 | 1992-01-02 | Wigbert S Prof Dr Med Rau | Aspiration catheter removing blockage from blood vessel - has nozzles at end of suction tube to direct water jets rearwards |
US5195954A (en) | 1990-06-26 | 1993-03-23 | Schnepp Pesch Wolfram | Apparatus for the removal of deposits in vessels and organs of animals |
US5520189A (en) | 1990-07-13 | 1996-05-28 | Coraje, Inc. | Intravascular ultrasound imaging guidewire |
US6007513A (en) | 1990-07-17 | 1999-12-28 | Aziz Yehia Anis | Removal of tissue |
CA2048120A1 (en) | 1990-08-06 | 1992-02-07 | William J. Drasler | Thrombectomy method and device |
US6676627B1 (en) | 1990-08-06 | 2004-01-13 | Possis Medical, Inc. | Crossflow thrombectomy catheter and system |
US6984239B1 (en) | 1990-08-06 | 2006-01-10 | Possis Medical, Inc. | Thrombectomy and tissue removal method |
US5078722A (en) | 1990-08-14 | 1992-01-07 | Cordis Corporation | Method and apparatus for removing deposits from a vessel |
US5064428A (en) | 1990-09-18 | 1991-11-12 | Cook Incorporated | Medical retrieval basket |
CA2093821A1 (en) | 1990-10-09 | 1992-04-10 | Walter R. Pyka | Device or apparatus for manipulating matter |
EP0555362A4 (en) | 1990-10-29 | 1993-09-15 | Scimed Life Systems, Inc. | Guide catheter system for angioplasty balloon catheter |
US5527292A (en) | 1990-10-29 | 1996-06-18 | Scimed Life Systems, Inc. | Intravascular device for coronary heart treatment |
US5496267A (en) | 1990-11-08 | 1996-03-05 | Possis Medical, Inc. | Asymmetric water jet atherectomy |
US5916192A (en) | 1991-01-11 | 1999-06-29 | Advanced Cardiovascular Systems, Inc. | Ultrasonic angioplasty-atherectomy catheter and method of use |
US5234407A (en) | 1991-03-06 | 1993-08-10 | Baxter International Inc. | Method and device for exchanging cardiovascular guide catheter while a previously inserted angioplasty guide wire remains in place |
DE69224636T2 (en) | 1991-04-24 | 1998-11-05 | Advanced Cardiovascular System | INTERCHANGEABLE BALLOON CATHETER WITH INTEGRATED GUIDE WIRE |
US5290247A (en) | 1991-05-21 | 1994-03-01 | C. R. Bard, Inc. | Intracoronary exchange apparatus and method |
US5569275A (en) | 1991-06-11 | 1996-10-29 | Microvena Corporation | Mechanical thrombus maceration device |
US5284486A (en) | 1991-06-11 | 1994-02-08 | Microvena Corporation | Self-centering mechanical medical device |
US5490837A (en) | 1991-07-05 | 1996-02-13 | Scimed Life Systems, Inc. | Single operator exchange catheter having a distal catheter shaft section |
US5584803A (en) | 1991-07-16 | 1996-12-17 | Heartport, Inc. | System for cardiac procedures |
US5261877A (en) | 1991-07-22 | 1993-11-16 | Dow Corning Wright | Method of performing a thrombectomy procedure |
DE4126886A1 (en) | 1991-08-14 | 1993-02-18 | Hp Medica Gmbh | RINSING CATHETER |
US5254085A (en) | 1991-09-19 | 1993-10-19 | Xomed-Treace Inc. | Aspiration system with positive pressure |
US5571087A (en) | 1992-02-10 | 1996-11-05 | Scimed Life Systems, Inc. | Intravascular catheter with distal tip guide wire lumen |
US5242404A (en) | 1992-02-12 | 1993-09-07 | American Cyanamid Company | Aspiration control system |
JP2580816Y2 (en) | 1992-02-26 | 1998-09-17 | 晴夫 高瀬 | Suction tube for sucking tissue such as fat |
US5356375A (en) | 1992-04-06 | 1994-10-18 | Namic U.S.A. Corporation | Positive pressure fluid delivery and waste removal system |
WO1993019679A1 (en) | 1992-04-07 | 1993-10-14 | The Johns Hopkins University | A percutaneous mechanical fragmentation catheter system |
WO1993020876A1 (en) | 1992-04-14 | 1993-10-28 | Du-Med B.V. | Electronic catheter displacement sensor |
US5368566A (en) | 1992-04-29 | 1994-11-29 | Cardiovascular Dynamics, Inc. | Delivery and temporary stent catheter having a reinforced perfusion lumen |
US5322504A (en) | 1992-05-07 | 1994-06-21 | United States Surgical Corporation | Method and apparatus for tissue excision and removal by fluid jet |
US5389072A (en) | 1992-06-05 | 1995-02-14 | Mircor Biomedical, Inc. | Mechanism for manipulating a tool and flexible elongate device using the same |
DE4221931C1 (en) | 1992-07-03 | 1993-07-08 | Harald Dr. 8521 Moehrendorf De Mang | |
US5524180A (en) | 1992-08-10 | 1996-06-04 | Computer Motion, Inc. | Automated endoscope system for optimal positioning |
US5243997A (en) | 1992-09-14 | 1993-09-14 | Interventional Technologies, Inc. | Vibrating device for a guide wire |
US5443078A (en) | 1992-09-14 | 1995-08-22 | Interventional Technologies, Inc. | Method for advancing a guide wire |
US5524635A (en) | 1992-09-14 | 1996-06-11 | Interventional Technologies Inc. | Apparatus for advancing a guide wire |
US5312427A (en) | 1992-10-16 | 1994-05-17 | Shturman Cardiology Systems, Inc. | Device and method for directional rotational atherectomy |
JPH06125915A (en) | 1992-10-21 | 1994-05-10 | Inter Noba Kk | Catheter type medical instrument |
US5368555A (en) | 1992-12-29 | 1994-11-29 | Hepatix, Inc. | Organ support system |
US5626563A (en) | 1993-01-12 | 1997-05-06 | Minnesota Mining And Manufacturing Company | Irrigation system with tubing cassette |
US5910252A (en) | 1993-02-12 | 1999-06-08 | Cobe Laboratories, Inc. | Technique for extracorporeal treatment of blood |
US5403276A (en) | 1993-02-16 | 1995-04-04 | Danek Medical, Inc. | Apparatus for minimally invasive tissue removal |
US5403274A (en) | 1993-03-15 | 1995-04-04 | Cannon; Louis A. | Perfusion catheter and method of use |
US5327906A (en) | 1993-04-28 | 1994-07-12 | Medtronic, Inc. | Steerable stylet handle |
US5325868A (en) | 1993-05-04 | 1994-07-05 | Kimmelstiel Carey D | Self-gripping medical wire torquer |
US5413561A (en) | 1993-05-13 | 1995-05-09 | Cathco, Inc. | Guiding catheter with sealing cap system for reducing blood loss when inserting guiding catheters |
US5342306A (en) | 1993-05-26 | 1994-08-30 | Don Michael T Anthony | Adjustable catheter device |
US5342293A (en) | 1993-06-22 | 1994-08-30 | Allergan, Inc. | Variable vacuum/variable flow phacoemulsification method |
NL9301181A (en) | 1993-07-05 | 1995-02-01 | Cordis Europ | A method of manufacturing a catheter with at least one high pressure lumen and catheter. |
CA2127637C (en) | 1993-07-26 | 2006-01-03 | Scott Bair | Fluid jet surgical cutting tool |
US6113576A (en) | 1993-08-04 | 2000-09-05 | Lake Region Manufacturing, Inc. | Thrombolysis catheter system with fixed length infusion zone |
US5392778A (en) | 1993-08-11 | 1995-02-28 | B. Braun Medical, Inc. | Guidewire torque device for single-hand manipulation |
EP0726466B1 (en) | 1993-08-31 | 2002-04-24 | Aloka Co. Ltd. | Pipetting apparatus equipped with closure detection function |
US5577674A (en) | 1993-09-08 | 1996-11-26 | Somat Corporation | Waste pulping and liquid extraction system and method including automatic bag feeding |
US5419772A (en) | 1993-09-29 | 1995-05-30 | Teitz; Bernard R. | Surgical irrigation apparatus for cleaning and sterilizing wounds and surgical areas during surgery |
US5462529A (en) | 1993-09-29 | 1995-10-31 | Technology Development Center | Adjustable treatment chamber catheter |
US5476450A (en) | 1993-11-04 | 1995-12-19 | Ruggio; Joseph M. | Apparatus and method for aspirating intravascular, pulmonary and cardiac obstructions |
US5605545A (en) | 1994-05-05 | 1997-02-25 | Northgate Technologies Incorporated | Tubing system for delivering fluid to a surgical site |
JPH07299078A (en) | 1994-05-09 | 1995-11-14 | Olympus Optical Co Ltd | Electrotomy device for endoscope |
US5478331A (en) | 1994-05-11 | 1995-12-26 | Localmed, Inc. | Multi-function proximal end adapter for catheter |
EP0954244A1 (en) | 1994-07-01 | 1999-11-10 | SciMed Life Systems, Inc. | Intravascular device utilizing fluid to extract occlusive material |
EP1695673A3 (en) | 1994-07-08 | 2009-07-08 | ev3 Inc. | Intravascular filtering device |
NL9401184A (en) | 1994-07-19 | 1996-03-01 | Cordis Europ | Suction catheter. |
US5507738A (en) | 1994-08-05 | 1996-04-16 | Microsonic Engineering Devices Company, Inc. | Ultrasonic vascular surgical system |
US5634475A (en) | 1994-09-01 | 1997-06-03 | Datascope Investment Corp. | Guidewire delivery assist device and system |
FR2724564B1 (en) | 1994-09-16 | 1997-04-04 | Boussignac Georges | RESPIRATORY ASSISTANCE DEVICE |
US5647847A (en) | 1994-09-16 | 1997-07-15 | Scimed Life Systems, Inc. | Balloon catheter with improved pressure source |
US5785685A (en) | 1994-09-16 | 1998-07-28 | Scimed Life Systems, Inc. | Balloon catheter with improved pressure source |
US5634933A (en) | 1994-09-29 | 1997-06-03 | Stryker Corporation | Powered high speed rotary surgical handpiece chuck and tools therefore |
WO1996010366A1 (en) | 1994-10-03 | 1996-04-11 | Heart Technology, Inc. | Transluminal thrombectomy apparatus |
US5624394A (en) | 1994-10-28 | 1997-04-29 | Iolab Corporation | Vacuum system and a method of operating a vacuum system |
US5520635A (en) | 1994-12-16 | 1996-05-28 | Gelbfish; Gary A. | Method and associated device for removing clot |
JP3735821B2 (en) | 1995-03-28 | 2006-01-18 | シュトラウブ メディカル アーゲー | Catheter for removing abnormal deposits from human blood vessels |
US5795322A (en) | 1995-04-10 | 1998-08-18 | Cordis Corporation | Catheter with filter and thrombus-discharge device |
EP0892651A1 (en) | 1995-05-10 | 1999-01-27 | Cardiogenesis Corporation | System for treating or diagnosing heart tissue |
US5938645A (en) | 1995-05-24 | 1999-08-17 | Boston Scientific Corporation Northwest Technology Center Inc. | Percutaneous aspiration catheter system |
US5827229A (en) | 1995-05-24 | 1998-10-27 | Boston Scientific Corporation Northwest Technology Center, Inc. | Percutaneous aspiration thrombectomy catheter system |
US6216573B1 (en) | 1995-06-07 | 2001-04-17 | Hydrocision, Inc. | Fluid jet cutting system |
US5713878A (en) | 1995-06-07 | 1998-02-03 | Surgi-Jet Corporation | Hand tightenable high pressure connector |
US5871462A (en) | 1995-06-07 | 1999-02-16 | Hydrocision, Inc. | Method for using a fluid jet cutting system |
US5944686A (en) | 1995-06-07 | 1999-08-31 | Hydrocision, Inc. | Instrument for creating a fluid jet |
US6027460A (en) | 1995-09-14 | 2000-02-22 | Shturman Cardiology Systems, Inc. | Rotatable intravascular apparatus |
US5843022A (en) | 1995-10-25 | 1998-12-01 | Scimied Life Systems, Inc. | Intravascular device utilizing fluid to extract occlusive material |
US5642997A (en) | 1996-02-01 | 1997-07-01 | Gregg, Ii; Robert H. | Laser excisional new attachment procedure |
US5895398A (en) | 1996-02-02 | 1999-04-20 | The Regents Of The University Of California | Method of using a clot capture coil |
US5762996A (en) | 1996-04-15 | 1998-06-09 | Lucas; Daniel R. | Silicone balloon catheter |
NL1003056C2 (en) | 1996-05-07 | 1997-11-10 | Cordis Europ | Suction catheter with hemostasis device. |
US6019728A (en) | 1996-05-08 | 2000-02-01 | Kabushiki Kaisha Tokai Rika Denki Seisakusho | Catheter and sensor having pressure detecting function |
US6544276B1 (en) | 1996-05-20 | 2003-04-08 | Medtronic Ave. Inc. | Exchange method for emboli containment |
US6152909A (en) | 1996-05-20 | 2000-11-28 | Percusurge, Inc. | Aspiration system and method |
US6022336A (en) | 1996-05-20 | 2000-02-08 | Percusurge, Inc. | Catheter system for emboli containment |
US6958059B2 (en) | 1996-05-20 | 2005-10-25 | Medtronic Ave, Inc. | Methods and apparatuses for drug delivery to an intravascular occlusion |
US5833644A (en) | 1996-05-20 | 1998-11-10 | Percusurge, Inc. | Method for emboli containment |
US6129698A (en) | 1996-05-24 | 2000-10-10 | Beck; Robert C | Catheter |
US5662671A (en) | 1996-07-17 | 1997-09-02 | Embol-X, Inc. | Atherectomy device having trapping and excising means for removal of plaque from the aorta and other arteries |
US5779721A (en) | 1996-07-26 | 1998-07-14 | Kensey Nash Corporation | System and method of use for revascularizing stenotic bypass grafts and other blood vessels |
US6652546B1 (en) * | 1996-07-26 | 2003-11-25 | Kensey Nash Corporation | System and method of use for revascularizing stenotic bypass grafts and other occluded blood vessels |
US6905505B2 (en) | 1996-07-26 | 2005-06-14 | Kensey Nash Corporation | System and method of use for agent delivery and revascularizing of grafts and vessels |
US6080170A (en) | 1996-07-26 | 2000-06-27 | Kensey Nash Corporation | System and method of use for revascularizing stenotic bypass grafts and other occluded blood vessels |
US6830577B2 (en) | 1996-07-26 | 2004-12-14 | Kensey Nash Corporation | System and method of use for treating occluded vessels and diseased tissue |
US6569147B1 (en) | 1996-07-26 | 2003-05-27 | Kensey Nash Corporation | Systems and methods of use for delivering beneficial agents for revascularizing stenotic bypass grafts and other occluded blood vessels and for other purposes |
US5855567A (en) | 1996-08-22 | 1999-01-05 | Scimed Life Systems, Inc. | Catheter management system |
US5836909A (en) | 1996-09-13 | 1998-11-17 | Cosmescu; Ioan | Automatic fluid control system for use in open and laparoscopic laser surgery and electrosurgery and method therefor |
US5730734A (en) | 1996-11-14 | 1998-03-24 | Scimed Life Systems, Inc. | Catheter systems with interchangeable parts |
US5827243A (en) | 1996-11-29 | 1998-10-27 | Palestrant; Aubrey M. | Collapsible aspiration catheter |
US6165188A (en) | 1996-12-02 | 2000-12-26 | Angiotrax, Inc. | Apparatus for percutaneously performing myocardial revascularization having controlled cutting depth and methods of use |
US5810770A (en) | 1996-12-13 | 1998-09-22 | Stryker Corporation | Fluid management pump system for surgical procedures |
US6146355A (en) | 1996-12-30 | 2000-11-14 | Myelotec, Inc. | Steerable catheter |
US5893857A (en) | 1997-01-21 | 1999-04-13 | Shturman Cardiology Systems, Inc. | Handle for atherectomy device |
CA2322876A1 (en) | 1997-03-06 | 1998-09-11 | Percusurge, Inc. | Intravascular aspiration system |
US5908395A (en) | 1997-03-17 | 1999-06-01 | Advanced Cardiovascular Systems, Inc. | Vibrating guidewire |
US5772674A (en) | 1997-03-31 | 1998-06-30 | Nakhjavan; Fred K. | Catheter for removal of clots in blood vessels |
DE19717790A1 (en) | 1997-04-26 | 1998-10-29 | Convergenza Ag | Device with a therapeutic catheter |
US5885244A (en) | 1997-05-14 | 1999-03-23 | Cordis Corporation & University Of Miami | Synchronous, pulsatile angioplasty system |
US6176844B1 (en) | 1997-05-22 | 2001-01-23 | Peter Y. Lee | Catheter system for the isolation of a segment of blood vessel |
US6090118A (en) | 1998-07-23 | 2000-07-18 | Mcguckin, Jr.; James F. | Rotational thrombectomy apparatus and method with standing wave |
US6554794B1 (en) | 1997-09-24 | 2003-04-29 | Richard L. Mueller | Non-deforming deflectable multi-lumen catheter |
JPH11221229A (en) | 1997-09-24 | 1999-08-17 | Eclipse Surgical Technol Inc | Catheter |
US6179809B1 (en) | 1997-09-24 | 2001-01-30 | Eclipse Surgical Technologies, Inc. | Drug delivery catheter with tip alignment |
US6033366A (en) | 1997-10-14 | 2000-03-07 | Data Sciences International, Inc. | Pressure measurement device |
US5957901A (en) | 1997-10-14 | 1999-09-28 | Merit Medical Systems, Inc. | Catheter with improved spray pattern for pharmaco-mechanical thrombolysis therapy |
US5908435A (en) | 1997-10-23 | 1999-06-01 | Samuels; Shaun L. W. | Expandable lumen device and method of use |
US6156046A (en) | 1997-11-07 | 2000-12-05 | Prolifix Medical, Inc. | Methods and systems for treating obstructions in a body lumen |
US6183432B1 (en) | 1997-11-13 | 2001-02-06 | Lumend, Inc. | Guidewire and catheter with rotating and reciprocating symmetrical or asymmetrical distal tip |
US6050986A (en) | 1997-12-01 | 2000-04-18 | Scimed Life Systems, Inc. | Catheter system for the delivery of a low volume liquid bolus |
US6622367B1 (en) | 1998-02-03 | 2003-09-23 | Salient Interventional Systems, Inc. | Intravascular device and method of manufacture and use |
US6295990B1 (en) | 1998-02-03 | 2001-10-02 | Salient Interventional Systems, Inc. | Methods and systems for treating ischemia |
US7879022B2 (en) | 1998-02-06 | 2011-02-01 | Medrad, Inc. | Rapid exchange fluid jet thrombectomy device and method |
WO2009117663A2 (en) | 2008-03-20 | 2009-09-24 | Medrad, Inc. | Direct stream hydrodynamic catheter system |
US6875193B1 (en) | 1998-02-06 | 2005-04-05 | Possis Medical, Inc. | Rapid exchange fluid jet thrombectomy device and method |
US9586023B2 (en) | 1998-02-06 | 2017-03-07 | Boston Scientific Limited | Direct stream hydrodynamic catheter system |
US6224570B1 (en) | 1998-02-06 | 2001-05-01 | Possis Medical, Inc. | Rheolytic thrombectomy catheter and method of using same |
US5989210A (en) | 1998-02-06 | 1999-11-23 | Possis Medical, Inc. | Rheolytic thrombectomy catheter and method of using same |
US6755803B1 (en) | 1998-02-06 | 2004-06-29 | Possis Medical, Inc. | Single operator exchange fluid jet thrombectomy device |
US6824550B1 (en) | 2000-04-06 | 2004-11-30 | Norbon Medical, Inc. | Guidewire for crossing occlusions or stenosis |
US20070225615A1 (en) | 2006-03-22 | 2007-09-27 | Revascular Therapeutics Inc. | Guidewire controller system |
US20060074442A1 (en) | 2000-04-06 | 2006-04-06 | Revascular Therapeutics, Inc. | Guidewire for crossing occlusions or stenoses |
IL123646A (en) | 1998-03-11 | 2010-05-31 | Refael Beyar | Remote control catheterization |
US6423032B2 (en) | 1998-03-13 | 2002-07-23 | Arteria Medical Science, Inc. | Apparatus and methods for reducing embolization during treatment of carotid artery disease |
US6666874B2 (en) | 1998-04-10 | 2003-12-23 | Endicor Medical, Inc. | Rotational atherectomy system with serrated cutting tip |
US6482217B1 (en) | 1998-04-10 | 2002-11-19 | Endicor Medical, Inc. | Neuro thrombectomy catheter |
US6001112A (en) | 1998-04-10 | 1999-12-14 | Endicor Medical, Inc. | Rotational atherectomy device |
US6190357B1 (en) | 1998-04-21 | 2001-02-20 | Cardiothoracic Systems, Inc. | Expandable cannula for performing cardiopulmonary bypass and method for using same |
US6293960B1 (en) | 1998-05-22 | 2001-09-25 | Micrus Corporation | Catheter with shape memory polymer distal tip for deployment of therapeutic devices |
US6579270B2 (en) | 1998-06-04 | 2003-06-17 | Alcon Manufacturing, Ltd. | Liquefracture handpiece tip |
US6196989B1 (en) | 1998-06-04 | 2001-03-06 | Alcon Laboratories, Inc. | Tip for liquefracture handpiece |
US6331171B1 (en) | 1998-06-04 | 2001-12-18 | Alcon Laboratories, Inc. | Tip for a liquefracture handpiece |
FR2779934B1 (en) | 1998-06-17 | 2001-01-05 | Saphir Medical Sa | PNEUMATICALLY CONTROLLED HANDPIECE FOR SURGICAL AND MEDICAL APPLICATIONS |
US5911722A (en) | 1998-07-23 | 1999-06-15 | Millenium Devices Llc | Leban/Gordon surgical hand driver |
US6231588B1 (en) | 1998-08-04 | 2001-05-15 | Percusurge, Inc. | Low profile catheter for angioplasty and occlusion |
US7193521B2 (en) | 1998-10-29 | 2007-03-20 | Medtronic Minimed, Inc. | Method and apparatus for detecting errors, fluid pressure, and occlusions in an ambulatory infusion pump |
US7621893B2 (en) | 1998-10-29 | 2009-11-24 | Medtronic Minimed, Inc. | Methods and apparatuses for detecting occlusions in an ambulatory infusion pump |
US7766873B2 (en) | 1998-10-29 | 2010-08-03 | Medtronic Minimed, Inc. | Method and apparatus for detecting occlusions in an ambulatory infusion pump |
US6283719B1 (en) | 1998-11-05 | 2001-09-04 | Frantz Medical Development Ltd | Detecting obstructions in enteral/parenteral feeding tubes and automatic removal of clogs therefrom |
US5989271A (en) | 1998-11-09 | 1999-11-23 | Possis Medical, Inc. | Flexible tip rheolytic thrombectomy catheter and method of constructing same |
US6585705B1 (en) | 1999-01-15 | 2003-07-01 | Maginot Catheter Technologies, Inc. | Retractable catheter systems |
US6146396A (en) | 1999-03-05 | 2000-11-14 | Board Of Regents, The University Of Texas System | Declotting method and apparatus |
US6599271B1 (en) | 1999-04-13 | 2003-07-29 | Syntec, Inc. | Ophthalmic flow converter |
US6790215B2 (en) | 1999-04-30 | 2004-09-14 | Edwards Lifesciences Corporation | Method of use for percutaneous material removal device and tip |
US6238405B1 (en) | 1999-04-30 | 2001-05-29 | Edwards Lifesciences Corp. | Percutaneous material removal device and method |
US6918921B2 (en) | 1999-05-07 | 2005-07-19 | Salviac Limited | Support frame for an embolic protection device |
US6350271B1 (en) | 1999-05-17 | 2002-02-26 | Micrus Corporation | Clot retrieval device |
US6375635B1 (en) | 1999-05-18 | 2002-04-23 | Hydrocision, Inc. | Fluid jet surgical instruments |
US6616679B1 (en) | 1999-07-30 | 2003-09-09 | Incept, Llc | Rapid exchange vascular device for emboli and thrombus removal and methods of use |
JP2001070438A (en) | 1999-09-02 | 2001-03-21 | Sentan Kagaku Gijutsu Incubation Center:Kk | Precision screw pump for living body |
US7655016B2 (en) | 1999-09-17 | 2010-02-02 | Covidien | Mechanical pump for removal of fragmented matter and methods of manufacture and use |
US6702830B1 (en) | 1999-09-17 | 2004-03-09 | Bacchus Vascular, Inc. | Mechanical pump for removal of fragmented matter and methods of manufacture and use |
US6454775B1 (en) | 1999-12-06 | 2002-09-24 | Bacchus Vascular Inc. | Systems and methods for clot disruption and retrieval |
US6615835B1 (en) | 1999-09-20 | 2003-09-09 | Ballard Medical Products | Flexible multiple port adaptor |
US6554791B1 (en) | 1999-09-29 | 2003-04-29 | Smisson-Cartledge Biomedical, Llc | Rapid infusion system |
CA2321221A1 (en) | 1999-10-13 | 2001-04-13 | Debra M. Kozak | Crossflow thrombectomy catheter and system |
US8414543B2 (en) | 1999-10-22 | 2013-04-09 | Rex Medical, L.P. | Rotational thrombectomy wire with blocking device |
AU2614901A (en) | 1999-10-22 | 2001-04-30 | Boston Scientific Corporation | Double balloon thrombectomy catheter |
GB9927898D0 (en) | 1999-11-25 | 2000-01-26 | Ssl Int Plc | Irrigation of a hollow body |
US7494484B2 (en) | 1999-12-10 | 2009-02-24 | Beck Robert C | Method of removing particulate debris with an interventional device |
JP2003517870A (en) | 1999-12-22 | 2003-06-03 | ボストン サイエンティフィック リミテッド | Endovascular occlusion irrigation catheter and its use |
US6511493B1 (en) | 2000-01-10 | 2003-01-28 | Hydrocision, Inc. | Liquid jet-powered surgical instruments |
US6451017B1 (en) | 2000-01-10 | 2002-09-17 | Hydrocision, Inc. | Surgical instruments with integrated electrocautery |
US6663613B1 (en) | 2000-01-25 | 2003-12-16 | Bacchus Vascular, Inc. | System and methods for clot dissolution |
US6929633B2 (en) | 2000-01-25 | 2005-08-16 | Bacchus Vascular, Inc. | Apparatus and methods for clot dissolution |
US6808505B2 (en) | 2000-02-01 | 2004-10-26 | Kadan Jeffrey S | Diagnostic needle arthroscopy and lavage system |
US7811250B1 (en) | 2000-02-04 | 2010-10-12 | Boston Scientific Scimed, Inc. | Fluid injectable single operator exchange catheters and methods of use |
US7163504B1 (en) | 2000-02-16 | 2007-01-16 | Advanced Cardiovascular Systems, Inc. | Multi-lumen fluted balloon radiation centering catheter |
US6752800B1 (en) | 2000-02-18 | 2004-06-22 | Intraluminal Therapeutics Inc. | Catheter handle for controlling the advancement of a guide wire |
US6719717B1 (en) | 2000-03-17 | 2004-04-13 | Advanced Research & Technology Institute, Inc. | Thrombectomy treatment system and method |
US20010031981A1 (en) | 2000-03-31 | 2001-10-18 | Evans Michael A. | Method and device for locating guidewire and treating chronic total occlusions |
WO2001076680A1 (en) | 2000-04-05 | 2001-10-18 | Stx Medical, Inc. | Intralumenal material removal systems and methods |
US6533772B1 (en) | 2000-04-07 | 2003-03-18 | Innex Corporation | Guide wire torque device |
US7517352B2 (en) | 2000-04-07 | 2009-04-14 | Bacchus Vascular, Inc. | Devices for percutaneous remote endarterectomy |
US6544231B1 (en) | 2000-05-22 | 2003-04-08 | Medcanica, Inc. | Catch, stop and marker assembly for a medical instrument and medical instrument incorporating the same |
ES2300339T3 (en) | 2000-05-31 | 2008-06-16 | Fox Hollow Technologies, Inc. | PROTECTION SYSTEM AGAINST EMBOLIZATION IN VASCULAR INTERVENTIONS. |
US6824545B2 (en) | 2000-06-29 | 2004-11-30 | Concentric Medical, Inc. | Systems, methods and devices for removing obstructions from a blood vessel |
US7232430B2 (en) | 2000-07-07 | 2007-06-19 | Mack Ventures, Inc. | Air-in-line and pressure detection |
US6572578B1 (en) | 2000-08-25 | 2003-06-03 | Patrick A. Blanchard | Fluid-jet catheter and its application to flexible endoscopy |
US7108674B2 (en) | 2000-08-30 | 2006-09-19 | Radius International Limited Partnership | Catheter |
AU2000277330A1 (en) | 2000-09-28 | 2002-04-08 | Robert C Beck | Catheter system |
US7094216B2 (en) * | 2000-10-18 | 2006-08-22 | Medrad, Inc. | Injection system having a pressure isolation mechanism and/or a handheld controller |
US6758824B1 (en) | 2000-11-06 | 2004-07-06 | Suros Surgical Systems, Inc. | Biopsy apparatus |
US20020058904A1 (en) | 2000-11-08 | 2002-05-16 | Robert Boock | Thrombus removal device |
JP4276834B2 (en) | 2000-12-27 | 2009-06-10 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | Biological information and blood processing apparatus information management system |
US7766894B2 (en) | 2001-02-15 | 2010-08-03 | Hansen Medical, Inc. | Coaxial catheter system |
JP3845857B2 (en) | 2001-03-15 | 2006-11-15 | ニプロ株式会社 | Simple chemical injector |
US7044958B2 (en) | 2001-04-03 | 2006-05-16 | Medtronic Vascular, Inc. | Temporary device for capturing embolic material |
US20030065287A1 (en) | 2001-04-03 | 2003-04-03 | Spohn Michael A. | Encoding and sensing of syringe information |
JP4073313B2 (en) | 2001-04-27 | 2008-04-09 | ハイドロシジョン・インコーポレーテッド | High pressure pumping cartridge for medical and surgical pumping and infusion devices |
US7374560B2 (en) | 2001-05-01 | 2008-05-20 | St. Jude Medical, Cardiology Division, Inc. | Emboli protection devices and related methods of use |
US7422579B2 (en) | 2001-05-01 | 2008-09-09 | St. Jude Medical Cardiology Divison, Inc. | Emboli protection devices and related methods of use |
US7604612B2 (en) | 2001-05-01 | 2009-10-20 | St. Jude Medical, Cardiology Division, Inc. | Emboli protection devices and related methods of use |
US7276044B2 (en) | 2001-05-06 | 2007-10-02 | Stereotaxis, Inc. | System and methods for advancing a catheter |
US7635342B2 (en) | 2001-05-06 | 2009-12-22 | Stereotaxis, Inc. | System and methods for medical device advancement and rotation |
US6623507B2 (en) | 2001-05-07 | 2003-09-23 | Fathy M.A. Saleh | Vascular filtration device |
DE10123278C1 (en) | 2001-05-10 | 2002-06-13 | Univ Hamburg | Breathing device used in intensive care or during anesthesia comprises a respirator, an outlet, an inhalation tube, a twin-channel endotracheal tube, flow meters, pressure meters, and an evaluation device |
US6635070B2 (en) | 2001-05-21 | 2003-10-21 | Bacchus Vascular, Inc. | Apparatus and methods for capturing particulate material within blood vessels |
JP2003010194A (en) | 2001-06-29 | 2003-01-14 | Nippon Clean Engine Lab Co Ltd | Method and device for intravascular operation using catheter adopting reverse injection technology of liquid current |
US20030013986A1 (en) | 2001-07-12 | 2003-01-16 | Vahid Saadat | Device for sensing temperature profile of a hollow body organ |
US20050085769A1 (en) | 2001-07-17 | 2005-04-21 | Kerberos Proximal Solutions | Fluid exchange system for controlled and localized irrigation and aspiration |
AU2002322520A1 (en) | 2001-07-17 | 2003-03-03 | Kerberos Proximal Solutions | Fluid exchange system for controlled and localized irrigation and aspiration |
US20030023263A1 (en) | 2001-07-24 | 2003-01-30 | Incept Llc | Apparatus and methods for aspirating emboli |
CA2493238C (en) | 2001-08-08 | 2007-10-23 | Hydrocision, Inc. | Medical device with high pressure quick disconnect handpiece |
GB2378734A (en) | 2001-08-14 | 2003-02-19 | Carmeli Adahan | Disposable pump with detachable motor |
US6902540B2 (en) | 2001-08-22 | 2005-06-07 | Gerald Dorros | Apparatus and methods for treating stroke and controlling cerebral flow characteristics |
US20030083681A1 (en) | 2001-09-17 | 2003-05-01 | Moutafis Timothy E. | Surgical rotary abrader |
US20030055404A1 (en) | 2001-09-17 | 2003-03-20 | Moutafis Timothy E. | Endoscopic rotary abraders |
JP2003101194A (en) | 2001-09-21 | 2003-04-04 | Hitachi Chem Co Ltd | Production method for printed wiring board |
ES2266626T3 (en) | 2001-10-12 | 2007-03-01 | Coloplast A/S | SHUTTER DEVICE. |
WO2003035142A2 (en) | 2001-10-25 | 2003-05-01 | Emory University | Catheter for modified perfusion |
CA2495911C (en) | 2001-11-21 | 2011-06-07 | Hydrocision, Inc. | Liquid jet surgical instruments incorporating channel openings aligned along the jet beam |
US6755812B2 (en) | 2001-12-11 | 2004-06-29 | Cardiac Pacemakers, Inc. | Deflectable telescoping guide catheter |
GB0130139D0 (en) | 2001-12-18 | 2002-02-06 | Dca Design Int Ltd | Improvements in and relating to a medicament injection apparatus |
DE10202378B4 (en) | 2002-01-23 | 2005-07-21 | Dürr Dental GmbH & Co. KG | Dental treatment device |
US7311690B2 (en) | 2002-02-25 | 2007-12-25 | Novashunt Ag | Implantable fluid management system for the removal of excess fluid |
JP2003260127A (en) | 2002-03-10 | 2003-09-16 | Nippon Clean Engine Lab Co Ltd | Suction method by pressurized reverse jet supply of fluid and apparatus therefor |
JP2003290236A (en) | 2002-04-06 | 2003-10-14 | Nippon Clean Engine Lab Co Ltd | Catheter apparatus for collision/diffusion supply and suction of fluid |
US7179269B2 (en) | 2002-05-20 | 2007-02-20 | Scimed Life Systems, Inc. | Apparatus and system for removing an obstruction from a lumen |
US20030220556A1 (en) | 2002-05-20 | 2003-11-27 | Vespro Ltd. | Method, system and device for tissue characterization |
US20030236533A1 (en) | 2002-06-20 | 2003-12-25 | The Regents Of The University Of California | Shape memory polymer actuator and catheter |
US20030236489A1 (en) | 2002-06-21 | 2003-12-25 | Baxter International, Inc. | Method and apparatus for closed-loop flow control system |
US7831297B2 (en) | 2003-05-24 | 2010-11-09 | Scottsdale Medical Devices, Inc. | Guide wire torque device |
US7232452B2 (en) | 2002-07-12 | 2007-06-19 | Ev3 Inc. | Device to create proximal stasis |
US7166120B2 (en) | 2002-07-12 | 2007-01-23 | Ev3 Inc. | Catheter with occluding cuff |
JP2004049704A (en) | 2002-07-23 | 2004-02-19 | Nipro Corp | Medical aspirator |
US6893414B2 (en) | 2002-08-12 | 2005-05-17 | Breg, Inc. | Integrated infusion and aspiration system and method |
US6991625B1 (en) | 2002-08-23 | 2006-01-31 | Medical Components, Inc. | Shielded tip catheter |
AU2003267147A1 (en) | 2002-09-10 | 2004-04-30 | Placor, Inc. | Method and device for monitoring platelet function |
US20040049225A1 (en) | 2002-09-11 | 2004-03-11 | Denison Andy E. | Aspiration catheter |
US8298161B2 (en) | 2002-09-12 | 2012-10-30 | Intuitive Surgical Operations, Inc. | Shape-transferring cannula system and method of use |
US20070167804A1 (en) | 2002-09-18 | 2007-07-19 | Byong-Ho Park | Tubular compliant mechanisms for ultrasonic imaging systems and intravascular interventional devices |
US7998107B2 (en) | 2002-09-24 | 2011-08-16 | Kensey Nash Corporation | Interventional procedure drive and control system |
US7993108B2 (en) | 2002-10-09 | 2011-08-09 | Abbott Diabetes Care Inc. | Variable volume, shape memory actuated insulin dispensing pump |
AU2003269460A1 (en) | 2002-10-18 | 2004-05-04 | Arieh Sher | Atherectomy system with imaging guidewire |
US8162966B2 (en) | 2002-10-25 | 2012-04-24 | Hydrocision, Inc. | Surgical devices incorporating liquid jet assisted tissue manipulation and methods for their use |
WO2004041343A1 (en) | 2002-11-04 | 2004-05-21 | Lynn Lawrence A D O | Catheter flushing fluid lock system and method |
US7115100B2 (en) | 2002-11-15 | 2006-10-03 | Ethicon, Inc. | Tissue biopsy and processing device |
EP1578281A2 (en) | 2002-11-25 | 2005-09-28 | Boston Scientific Limited | Injection device for treating mammalian body |
US7998114B2 (en) | 2003-01-06 | 2011-08-16 | Maquet Cardiovascular Llc | Method and apparatus for regulating pressure during medical procedures |
US7699804B2 (en) | 2003-01-31 | 2010-04-20 | Creare Inc. | Fluid ejection system |
DE602004003266D1 (en) | 2003-02-07 | 2007-01-04 | Pierpont Family Ltd Partnershi | Catheter system for angioplasty |
US7393339B2 (en) | 2003-02-21 | 2008-07-01 | C. R. Bard, Inc. | Multi-lumen catheter with separate distal tips |
US20040181209A1 (en) | 2003-03-14 | 2004-09-16 | Gross James R. | Multiple port catheter connector |
US7316678B2 (en) | 2003-03-28 | 2008-01-08 | Kensey Nash Corporation | Catheter with associated extension lumen |
US7776005B2 (en) | 2003-03-28 | 2010-08-17 | Covidien Ag | Triple lumen catheter with occlusion resistant tip |
US20040199201A1 (en) | 2003-04-02 | 2004-10-07 | Scimed Life Systems, Inc. | Embolectomy devices |
US20040215222A1 (en) | 2003-04-25 | 2004-10-28 | Michael Krivoruchko | Intravascular material removal device |
US7618434B2 (en) | 2003-05-12 | 2009-11-17 | University Of Florida Research Foundation, Inc. | Devices and methods for disruption and removal of luminal occlusions |
US7862575B2 (en) | 2003-05-21 | 2011-01-04 | Yale University | Vascular ablation apparatus and method |
US20060129091A1 (en) | 2004-12-10 | 2006-06-15 | Possis Medical, Inc. | Enhanced cross stream mechanical thrombectomy catheter with backloading manifold |
JP2005006779A (en) | 2003-06-17 | 2005-01-13 | Terumo Corp | Lumen of living body cleaning device |
US7588033B2 (en) | 2003-06-18 | 2009-09-15 | Breathe Technologies, Inc. | Methods, systems and devices for improving ventilation in a lung area |
US20050004594A1 (en) | 2003-07-02 | 2005-01-06 | Jeffrey Nool | Devices and methods for aspirating from filters |
US20050043682A1 (en) | 2003-08-22 | 2005-02-24 | Cannuflow Incorporated | Flexible inflow/outflow cannula and flexible instrument port |
US6969368B2 (en) | 2003-09-02 | 2005-11-29 | The Anspach Effort, Inc. | Suction and directional irrigation apparatus |
US7220269B1 (en) | 2003-11-06 | 2007-05-22 | Possis Medical, Inc. | Thrombectomy catheter system with occluder and method of using same |
CN104397869B (en) | 2003-11-07 | 2016-06-08 | 美国无烟烟草有限责任公司 | Tobacco compositions |
US7744604B2 (en) | 2003-11-13 | 2010-06-29 | Lawrence Livermore National Security, Llc | Shape memory polymer medical device |
US7887510B2 (en) | 2003-12-08 | 2011-02-15 | Boehringer Laboratories, Inc. | Suction control apparatus and methods for maintaining fluid flow without compromising sterile lines |
CN1859935B (en) | 2003-12-22 | 2011-07-20 | 美德乐控股公司 | Drainage apparatus and method |
US7951073B2 (en) | 2004-01-21 | 2011-05-31 | Boston Scientific Limited | Endoscopic device having spray mechanism and related methods of use |
AU2005207078B2 (en) | 2004-01-26 | 2011-03-17 | Cathrx Ltd | A catheter assembly with an adjustable loop |
EP1720582B1 (en) | 2004-03-05 | 2008-08-06 | Future Medical System S.A. | Cassette for an irrigation or aspiration machine for endoscopy |
US8092483B2 (en) | 2004-03-06 | 2012-01-10 | Medtronic, Inc. | Steerable device having a corewire within a tube and combination with a functional medical component |
US20070118165A1 (en) | 2004-03-08 | 2007-05-24 | Demello Jonathan R | System and method for removal of material from a blood vessel using a small diameter catheter |
US7615032B2 (en) | 2004-03-24 | 2009-11-10 | Windcrest Llc | Vascular guidewire control apparatus |
US7905710B2 (en) | 2004-03-26 | 2011-03-15 | Hospira, Inc. | System and method for improved low flow medical pump delivery |
US20060063973A1 (en) | 2004-04-21 | 2006-03-23 | Acclarent, Inc. | Methods and apparatus for treating disorders of the ear, nose and throat |
US20050240120A1 (en) | 2004-04-26 | 2005-10-27 | Modesitt D B | Vise and method of use |
US7959608B2 (en) | 2004-04-27 | 2011-06-14 | The Spectranetics Corporation | Thrombectomy and soft debris removal device |
US8920402B2 (en) | 2004-04-27 | 2014-12-30 | The Spectranetics Corporation | Thrombectomy and soft debris removal device |
KR100560483B1 (en) | 2004-05-04 | 2006-03-13 | 삼성에스디아이 주식회사 | Secondary battery |
CA2570139C (en) | 2004-05-21 | 2012-04-24 | Ihsan A. Haddad | A system for detecting and removing a gas bubble from a vascular infusion line |
IL162318A (en) | 2004-06-03 | 2011-07-31 | Tal Wenderow | Transmission for a remote catheterization system |
US7662144B2 (en) | 2004-06-22 | 2010-02-16 | Boston Scientific Scimed, Inc. | Catheter shaft with improved manifold bond |
US8366735B2 (en) | 2004-09-10 | 2013-02-05 | Penumbra, Inc. | System and method for treating ischemic stroke |
WO2006034150A2 (en) | 2004-09-17 | 2006-03-30 | Cordis Neurovascular, Inc. | Vascular occlusion device with an embolic mesh ribbon |
JP2006087643A (en) | 2004-09-24 | 2006-04-06 | Terumo Corp | Apparatus for sucking foreign substance from blood vessel |
US7753880B2 (en) | 2004-09-28 | 2010-07-13 | Stryker Corporation | Method of operating a surgical irrigation pump capable of performing a priming operation |
US7479106B2 (en) | 2004-09-30 | 2009-01-20 | Boston Scientific Scimed, Inc. | Automated control of irrigation and aspiration in a single-use endoscope |
US8353860B2 (en) | 2004-09-30 | 2013-01-15 | Boston Scientific Scimed, Inc. | Device for obstruction removal with specific tip structure |
US7819887B2 (en) | 2004-11-17 | 2010-10-26 | Rex Medical, L.P. | Rotational thrombectomy wire |
US20080009784A1 (en) | 2004-11-22 | 2008-01-10 | Leedle John D | Dialysis catheter |
US20060229550A1 (en) | 2004-12-14 | 2006-10-12 | Hydrocision, Incorporated | Liquid jet surgical instrument |
US7691095B2 (en) | 2004-12-28 | 2010-04-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Bi-directional steerable catheter control handle |
US20060142630A1 (en) | 2004-12-29 | 2006-06-29 | Attila Meretei | Systems and methods for treating a thrombus in a blood vessel |
US7491192B2 (en) | 2004-12-30 | 2009-02-17 | C. R. Bard, Inc. | Cardiovascular access catheter with slit valve |
US7740780B2 (en) | 2005-01-20 | 2010-06-22 | Hamboly M Samy Ahmed | Multitube catheter and method for making the same |
CN102525591B (en) | 2005-01-25 | 2014-12-10 | 泰科医疗集团有限合伙公司 | Structures for permanent occlusion of a hollow anatomical structure |
US20060184186A1 (en) | 2005-02-16 | 2006-08-17 | Medtronic Vascular, Inc. | Drilling guidewire for treating chronic total occlusion |
US20060253099A1 (en) | 2005-04-21 | 2006-11-09 | Medtronic Vascular, Inc. | Guiding catheter with resiliently compressible occluder |
US20080097291A1 (en) | 2006-08-23 | 2008-04-24 | Hanson Ian B | Infusion pumps and methods and delivery devices and methods with same |
IL179618A0 (en) | 2006-11-27 | 2007-10-31 | Eyoca Medical Ltd | Device for inducing vibrations |
US7938851B2 (en) | 2005-06-08 | 2011-05-10 | Xtent, Inc. | Devices and methods for operating and controlling interventional apparatus |
EP1909864B1 (en) | 2005-06-13 | 2012-10-17 | Smith & Nephew, Inc. | Surgical fluid management |
US7524299B2 (en) | 2005-06-21 | 2009-04-28 | Alcon, Inc. | Aspiration control |
US8192397B2 (en) | 2005-06-21 | 2012-06-05 | Medrad, Inc. | Medical fluid injection and inflation system |
US20120330196A1 (en) | 2005-06-24 | 2012-12-27 | Penumbra Inc. | Methods and Apparatus for Removing Blood Clots and Tissue from the Patient's Head |
US20070016105A1 (en) | 2005-06-27 | 2007-01-18 | Mamourian Alexander C | Wire torque apparatus, wire insertion devices, improved aneurysm clips and improved aneurysm clip applicators |
US20070078438A1 (en) | 2005-07-05 | 2007-04-05 | Okid Corporation | Catheter assembly and sheath tear assistant tool |
US8221348B2 (en) | 2005-07-07 | 2012-07-17 | St. Jude Medical, Cardiology Division, Inc. | Embolic protection device and methods of use |
US8012766B2 (en) | 2005-08-01 | 2011-09-06 | Ortho-Clinical Diagnostics, Inc. | Prediction of aspirated volume of a liquid |
US8021351B2 (en) | 2005-08-18 | 2011-09-20 | Medtronic Vascular, Inc. | Tracking aspiration catheter |
US7938820B2 (en) | 2005-08-18 | 2011-05-10 | Lumen Biomedical, Inc. | Thrombectomy catheter |
GR20050100452A (en) | 2005-09-02 | 2007-04-25 | Estelle Enterprises Limited | Fluid exchange catheter's system |
US7713240B2 (en) | 2005-09-13 | 2010-05-11 | Medtronic Minimed, Inc. | Modular external infusion device |
US7935077B2 (en) | 2005-09-28 | 2011-05-03 | Medrad, Inc. | Thrombectomy catheter deployment system |
US8202243B2 (en) | 2005-10-27 | 2012-06-19 | Novartis Ag | Fluid pressure sensing chamber |
US8398582B2 (en) | 2005-10-27 | 2013-03-19 | Novartis Ag | Fluid pressure sensing chamber |
US7947039B2 (en) | 2005-12-12 | 2011-05-24 | Covidien Ag | Laparoscopic apparatus for performing electrosurgical procedures |
CA2634683C (en) | 2005-12-22 | 2016-02-02 | The Trustees Of Columbia University In The City Of New York | Systems and methods for intravascular cooling |
EP1976580A2 (en) | 2006-01-24 | 2008-10-08 | HydroCision, Inc. | Liquid jet surgical instrument having a distal end with a selectively controllable shape |
WO2007092637A2 (en) | 2006-02-09 | 2007-08-16 | Deka Products Limited Partnership | Patch-sized fluid delivery systems and methods |
US7608063B2 (en) | 2006-02-23 | 2009-10-27 | Medrad, Inc. | Dual lumen aspiration catheter system |
US7972282B2 (en) | 2006-03-20 | 2011-07-05 | Merit Medical Systems, Inc. | Torque device for a medical guidewire |
US7981073B2 (en) | 2006-03-30 | 2011-07-19 | Moellstam Anders | Method and device for irrigation of body cavities |
US7846175B2 (en) | 2006-04-03 | 2010-12-07 | Medrad, Inc. | Guidewire and collapsable filter system |
US20070239182A1 (en) | 2006-04-03 | 2007-10-11 | Boston Scientific Scimed, Inc. | Thrombus removal device |
EP2030643A1 (en) | 2006-04-06 | 2009-03-04 | Medtronic, Inc. | Systems and methods for identifying catheter malfunctions using pressure sensing |
US20070249990A1 (en) | 2006-04-20 | 2007-10-25 | Ioan Cosmescu | Automatic smoke evacuator and insufflation system for surgical procedures |
WO2007124076A1 (en) | 2006-04-21 | 2007-11-01 | Abbott Laboratories | Guidewire handling device |
CN101460101A (en) | 2006-04-25 | 2009-06-17 | 海德鲁西昂公司 | Electroformed liquid jet surgical instrument |
US8048032B2 (en) | 2006-05-03 | 2011-11-01 | Vascular Solutions, Inc. | Coaxial guide catheter for interventional cardiology procedures |
US7520858B2 (en) | 2006-06-05 | 2009-04-21 | Physical Logic Ag | Catheter with pressure sensor and guidance system |
ES2751017T3 (en) | 2006-06-08 | 2020-03-30 | Hoffmann La Roche | System to detect an occlusion in a tube |
US20070299306A1 (en) | 2006-06-21 | 2007-12-27 | Parasher Vinod K | Probe assembly for endoscopic procedures |
US9314263B2 (en) | 2006-06-30 | 2016-04-19 | Atheromed, Inc. | Atherectomy devices, systems, and methods |
US8007506B2 (en) | 2006-06-30 | 2011-08-30 | Atheromed, Inc. | Atherectomy devices and methods |
US8361094B2 (en) | 2006-06-30 | 2013-01-29 | Atheromed, Inc. | Atherectomy devices and methods |
US8628549B2 (en) | 2006-06-30 | 2014-01-14 | Atheromed, Inc. | Atherectomy devices, systems, and methods |
US20090018566A1 (en) | 2006-06-30 | 2009-01-15 | Artheromed, Inc. | Atherectomy devices, systems, and methods |
US9492192B2 (en) | 2006-06-30 | 2016-11-15 | Atheromed, Inc. | Atherectomy devices, systems, and methods |
US8920448B2 (en) | 2006-06-30 | 2014-12-30 | Atheromed, Inc. | Atherectomy devices and methods |
GB0613981D0 (en) | 2006-07-13 | 2006-08-23 | Shturman Leonid | |
EP2073884B1 (en) | 2006-08-02 | 2018-10-10 | Osprey Medical Inc. | Microvascular obstruction detection and therapy |
US7918835B2 (en) | 2006-08-21 | 2011-04-05 | Tyco Healthcare Group Lp | Compliant guard for use with an aspiration instrument |
EP1891998B1 (en) | 2006-08-24 | 2019-03-13 | Alka Kumar | Surgical aspiration system |
US8876754B2 (en) | 2006-08-31 | 2014-11-04 | Bayer Medical Care Inc. | Catheter with filtering and sensing elements |
US8652086B2 (en) | 2006-09-08 | 2014-02-18 | Abbott Medical Optics Inc. | Systems and methods for power and flow rate control |
US8394078B2 (en) | 2006-10-04 | 2013-03-12 | Medrad, Inc. | Interventional catheters incorporating an active aspiration system |
WO2008042987A2 (en) | 2006-10-04 | 2008-04-10 | Pathway Medical Technologies, Inc. | Interventional catheters |
EP1911474B1 (en) | 2006-10-11 | 2012-07-11 | Alka Kumar | Efficient continuous flow irrigation system |
US9050438B2 (en) | 2006-10-21 | 2015-06-09 | Vesatek, Llc | Guidewire manipulation device |
US8226635B2 (en) | 2006-10-23 | 2012-07-24 | Boston Scientific Scimed, Inc. | Device for circulating heated fluid |
US8414521B2 (en) | 2006-11-06 | 2013-04-09 | Aardvark Medical, Inc. | Irrigation and aspiration devices and methods |
US8152786B2 (en) | 2006-11-07 | 2012-04-10 | Osprey Medical, Inc. | Collection catheter and kit |
US8317773B2 (en) | 2006-11-07 | 2012-11-27 | Angio Dynamics, Inc. | Catheter with open faced sloped end portion |
WO2008057554A1 (en) | 2006-11-08 | 2008-05-15 | Cook Incorporated | Thrombus removal device |
US8337518B2 (en) | 2006-12-20 | 2012-12-25 | Onset Medical Corporation | Expandable trans-septal sheath |
US7591816B2 (en) | 2006-12-28 | 2009-09-22 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Irrigated ablation catheter having a pressure sensor to detect tissue contact |
US7914549B2 (en) | 2007-01-05 | 2011-03-29 | Hesham Morsi | Mechanical embolectomy and suction catheter |
WO2008097993A2 (en) | 2007-02-05 | 2008-08-14 | Boston Scientific Limited | Thrombectomy apparatus and method |
NL1033434C2 (en) | 2007-02-21 | 2008-08-22 | Multilevelcontrol B V | Medical-dental instruments. |
US9254144B2 (en) | 2007-03-30 | 2016-02-09 | Covidien Lp | Methods and apparatus for thrombectomy system |
US8900214B2 (en) | 2007-03-30 | 2014-12-02 | Onset Medical Corporation | Expandable trans-septal sheath |
US20080249501A1 (en) | 2007-04-09 | 2008-10-09 | Medtronic Vascular, Inc. | Methods for Simultaneous Injection and Aspiration of Fluids During a Medical Procedure |
US7951112B2 (en) | 2007-05-16 | 2011-05-31 | Smiths Medical Asd, Inc. | Pump module for use in a medical fluid dispensing system |
JP5128847B2 (en) | 2007-05-22 | 2013-01-23 | オリンパスメディカルシステムズ株式会社 | Endoscope |
US7798999B2 (en) | 2007-06-05 | 2010-09-21 | Cook Incorporated | Adjustable length catheter |
US8974418B2 (en) | 2007-06-12 | 2015-03-10 | Boston Scientific Limited | Forwardly directed fluid jet crossing catheter |
US7914482B2 (en) | 2007-06-13 | 2011-03-29 | Dana Llc | Vacuum surge suppressor for surgical aspiration systems |
EP2494932B1 (en) | 2007-06-22 | 2020-05-20 | Ekos Corporation | Apparatus for treatment of intracranial hemorrhages |
US8858490B2 (en) | 2007-07-18 | 2014-10-14 | Silk Road Medical, Inc. | Systems and methods for treating a carotid artery |
EP2497520B1 (en) | 2007-07-18 | 2022-04-13 | Silk Road Medical, Inc. | Systems for establishing retrograde carotid arterial blood flow |
JP2009039216A (en) | 2007-08-07 | 2009-02-26 | Terumo Corp | Liquid jet flow release tube |
JP4311483B2 (en) | 2007-08-10 | 2009-08-12 | セイコーエプソン株式会社 | Liquid ejecting apparatus and surgical instrument using the same |
JP5115088B2 (en) | 2007-08-10 | 2013-01-09 | セイコーエプソン株式会社 | Surgical tool |
US10342701B2 (en) | 2007-08-13 | 2019-07-09 | Johnson & Johnson Surgical Vision, Inc. | Systems and methods for phacoemulsification with vacuum based pumps |
US7753868B2 (en) | 2007-08-21 | 2010-07-13 | Cook Critical Care Incorporated | Multi-lumen catheter |
US20090082722A1 (en) | 2007-08-21 | 2009-03-26 | Munger Gareth T | Remote navigation advancer devices and methods of use |
US9248253B2 (en) | 2007-08-21 | 2016-02-02 | Cook Medical Technologies Llc | Winged catheter assembly |
US7998020B2 (en) | 2007-08-21 | 2011-08-16 | Stereotaxis, Inc. | Apparatus for selectively rotating and/or advancing an elongate device |
CN201079629Y (en) | 2007-10-15 | 2008-07-02 | 徐加成 | Medical flushing drainage tube |
US8585713B2 (en) | 2007-10-17 | 2013-11-19 | Covidien Lp | Expandable tip assembly for thrombus management |
WO2009052506A1 (en) | 2007-10-19 | 2009-04-23 | Navilyst Medical, Inc. | Recirculation minimizing catheter |
US8500697B2 (en) | 2007-10-19 | 2013-08-06 | Pressure Products Medical Supplies, Inc. | Transseptal guidewire |
US8007490B2 (en) | 2007-10-19 | 2011-08-30 | Cook Medical Technologies Llc | Reduced width dual-lumen catheter |
US8070762B2 (en) | 2007-10-22 | 2011-12-06 | Atheromed Inc. | Atherectomy devices and methods |
US8236016B2 (en) | 2007-10-22 | 2012-08-07 | Atheromed, Inc. | Atherectomy devices and methods |
US8292841B2 (en) | 2007-10-26 | 2012-10-23 | C. R. Bard, Inc. | Solid-body catheter including lateral distal openings |
DE102007053370B3 (en) | 2007-11-09 | 2009-02-26 | Carl Zeiss Surgical Gmbh | Surgical system for controlling fluid |
WO2009067212A1 (en) | 2007-11-19 | 2009-05-28 | Mallinckrodt Inc. | Power injector having patency check with pressure monitoring |
US8262645B2 (en) | 2007-11-21 | 2012-09-11 | Actuated Medical, Inc. | Devices for clearing blockages in in-situ artificial lumens |
US8323268B2 (en) | 2007-12-06 | 2012-12-04 | The Alfred E. Mann Foundation For Scientific Research | Implantable infusion devices including apparatus for confirming fluid flow and systems, apparatus and methods associated with same |
US20090292212A1 (en) | 2008-05-20 | 2009-11-26 | Searete Llc, A Limited Corporation Of The State Of Delaware | Circulatory monitoring systems and methods |
US20090287120A1 (en) | 2007-12-18 | 2009-11-19 | Searete Llc, A Limited Liability Corporation Of The State Of Delaware | Circulatory monitoring systems and methods |
US8734374B2 (en) | 2007-12-20 | 2014-05-27 | Angiodynamics, Inc. | Systems and methods for removing undesirable material within a circulatory system during a surgical procedure |
US8034018B2 (en) | 2007-12-20 | 2011-10-11 | Bausch & Lomb Incorporated | Surgical system having means for stopping vacuum pump |
CN101939405B (en) | 2007-12-21 | 2013-03-27 | 荷兰洛德斯克罗科兰有限公司 | Process for producing a palm oil product |
SG154343A1 (en) | 2008-01-08 | 2009-08-28 | Ting Choon Meng | Method and apparatus for intra-articular injection or aspiration |
US8986246B2 (en) | 2008-01-16 | 2015-03-24 | Catheter Robotics Inc. | Remotely controlled catheter insertion system |
US7867192B2 (en) | 2008-02-29 | 2011-01-11 | The Alfred E. Mann Foundation For Scientific Research | Ambulatory infusion devices and methods with blockage detection |
US8945030B2 (en) | 2008-03-12 | 2015-02-03 | Bluesky Medical Group, Inc. | Negative pressure dressing and method of using same |
US8066677B2 (en) | 2008-03-21 | 2011-11-29 | Medtronic Vascular, Inc | Rapid exchange catheter with tear resistant guidewire shaft |
US9333287B2 (en) | 2008-04-08 | 2016-05-10 | Jet Prep Ltd. | Body passage cleansing device |
WO2009126935A2 (en) | 2008-04-11 | 2009-10-15 | Mindframe, Inc. | Monorail neuro-microcatheter for delivery of medical devices to treat stroke, processes and products thereby |
US9078671B2 (en) | 2008-04-17 | 2015-07-14 | Warsaw Orthopedic, Inc. | Surgical tool |
BRPI0802006B1 (en) | 2008-04-17 | 2020-12-15 | Universidade Federal De Minas Gerais | DEVICE FOR CONTROL AND MONITORING OF VACUUM PRESSURE IN ASPIRATION SYSTEMS FOR BIOLOGICAL SECRETIONS |
US8140146B2 (en) | 2008-05-30 | 2012-03-20 | General Electric Company | Catheter tip device and method for manufacturing same |
DE102009055227B3 (en) | 2009-12-23 | 2011-06-22 | Human Med AG, 19061 | Method for conveying a fluid and device for generating a volume flow |
AU2009266808B2 (en) | 2008-07-03 | 2014-07-10 | Teleflex Life Sciences Limited | Apparatus and methods for treating obstructions within body lumens |
US8070694B2 (en) | 2008-07-14 | 2011-12-06 | Medtronic Vascular, Inc. | Fiber based medical devices and aspiration catheters |
US20100030134A1 (en) | 2008-07-29 | 2010-02-04 | Fitzgerald Matthew J | Precision orifice safety device |
US8465456B2 (en) | 2008-07-31 | 2013-06-18 | Boston Scientific Scimed, Inc. | Extendable aspiration catheter |
EP2158828A1 (en) | 2008-08-25 | 2010-03-03 | Koninklijke Philips Electronics N.V. | Device for frothing milk, comprising means for preventing blockage of an air restriction by milk residue |
US8758364B2 (en) | 2008-08-29 | 2014-06-24 | Rapid Medical Ltd. | Device and method for clot engagement and capture |
US9034008B2 (en) | 2008-08-29 | 2015-05-19 | Rapid Medical Ltd. | Device and method involving stabilization during clot removal |
US9005237B2 (en) | 2008-08-29 | 2015-04-14 | Rapid Medical Ltd. | Device and method for clot capture |
ATE534336T1 (en) | 2008-08-29 | 2011-12-15 | Rapid Medical Ltd | EMBOLECTOMY DEVICE |
US8864792B2 (en) | 2008-08-29 | 2014-10-21 | Rapid Medical, Ltd. | Device and method for clot engagement |
CN102231993A (en) | 2008-10-01 | 2011-11-02 | 阿尔佛雷德·R·扎拉特 | Methods of improving fluid delivery |
US8223028B2 (en) | 2008-10-10 | 2012-07-17 | Deka Products Limited Partnership | Occlusion detection system and method |
US9510854B2 (en) | 2008-10-13 | 2016-12-06 | Boston Scientific Scimed, Inc. | Thrombectomy catheter with control box having pressure/vacuum valve for synchronous aspiration and fluid irrigation |
WO2010045373A1 (en) | 2008-10-14 | 2010-04-22 | The Cleveland Clinic Foundation | Vascular guidewire system and method |
US20110152920A1 (en) | 2008-12-02 | 2011-06-23 | Rapid Medical Ltd. | Embolectomy device |
US8162919B2 (en) | 2008-12-08 | 2012-04-24 | Bausch & Lomb Incorporated | Flow control system based on leakage |
US8267891B2 (en) | 2008-12-18 | 2012-09-18 | Alcon Research, Ltd. | Gilled phacoemulsification irrigation sleeve |
US10226563B2 (en) | 2008-12-23 | 2019-03-12 | Silk Road Medical, Inc. | Methods and systems for treatment of acute ischemic stroke |
EP2385815B1 (en) | 2009-01-07 | 2021-06-23 | Med-Logics, Inc. | Tissue removal devices |
CA2750478C (en) | 2009-01-23 | 2015-04-07 | Endoluminal Sciences Pty Ltd. | Endovascular devices and associated systems and methods |
US8287485B2 (en) | 2009-01-28 | 2012-10-16 | Olympus Medical Systems Corp. | Treatment system for surgery and control method of treatment system for surgery |
US8926529B2 (en) | 2009-02-10 | 2015-01-06 | Vesatek, Llc | Method and apparatus for manipulating a surgical guidewire |
US20100204672A1 (en) | 2009-02-12 | 2010-08-12 | Penumra, Inc. | System and method for treating ischemic stroke |
US8608699B2 (en) | 2009-03-31 | 2013-12-17 | Tandem Diabetes Care, Inc. | Systems and methods to address air, leaks and occlusions in an insulin pump system |
DE102009016859B4 (en) | 2009-04-08 | 2018-06-14 | Erbe Elektromedizin Gmbh | Water jet surgical instrument |
WO2010141752A1 (en) | 2009-06-03 | 2010-12-09 | Silk Road Medical, Inc. | System and methods for controlling retrograde carotid arterial blood flow |
US8353858B2 (en) | 2009-06-03 | 2013-01-15 | Medrad, Inc. | Rapid exchange fluid jet catheter and method |
EP2442843A4 (en) | 2009-06-14 | 2012-11-28 | Medingo Ltd | Devices and methods for malfunctions recognition in a therapeutic dispensing device |
IN2012DN00396A (en) | 2009-07-13 | 2015-05-22 | Nestec Sa | |
CA2921304C (en) | 2009-07-30 | 2018-06-05 | Tandem Diabetes Care, Inc. | Infusion pump system with disposable cartridge having pressure venting and pressure feedback |
JP4655163B1 (en) | 2009-08-26 | 2011-03-23 | セイコーエプソン株式会社 | Fluid ejecting apparatus and method for controlling fluid ejecting apparatus |
AU2010292247B2 (en) * | 2009-09-09 | 2015-05-14 | Abiomed, Inc. | Method for simultaneously delivering fluid to a dual lumen catheter with a single fluid source |
ATE530213T1 (en) | 2009-09-10 | 2011-11-15 | Hoffmann La Roche | MEDICAL INFUSION PUMP AND METHOD FOR DETERMINING THE CAUSE OF A POWER INTERRUPTION IN THE PUMP |
US8291337B2 (en) | 2009-09-22 | 2012-10-16 | Cerner Innovation, Inc. | Infusion management |
WO2011037838A1 (en) | 2009-09-25 | 2011-03-31 | Neuroenterprises, Llc | Regulated gravity-based cerebral spinal fluid drainage device |
US8317786B2 (en) | 2009-09-25 | 2012-11-27 | AthroCare Corporation | System, method and apparatus for electrosurgical instrument with movable suction sheath |
US20110092955A1 (en) | 2009-10-07 | 2011-04-21 | Purdy Phillip D | Pressure-Sensing Medical Devices, Systems and Methods, and Methods of Forming Medical Devices |
US8209060B2 (en) | 2009-11-05 | 2012-06-26 | Smiths Medical Asd, Inc. | Updating syringe profiles for a syringe pump |
WO2011058557A1 (en) | 2009-11-12 | 2011-05-19 | Ramot At Tel-Aviv University Ltd. | Compositions comprising pedf and uses of same in the treatment and prevention of ovary-related syndromes |
US8876757B2 (en) | 2009-11-12 | 2014-11-04 | Abbott Medical Optics Inc. | Fluid level detection system |
US8398579B2 (en) | 2009-12-16 | 2013-03-19 | Medrad, Inc. | Catheter including composite guide and methods for use of the same |
US8337175B2 (en) | 2009-12-22 | 2012-12-25 | Smith & Nephew, Inc. | Disposable pumping system and coupler |
WO2011082272A2 (en) | 2009-12-31 | 2011-07-07 | Deka Products Limited Partnership | Infusion pump assembley |
US10179202B2 (en) | 2010-01-11 | 2019-01-15 | Motus Gi Medical Technologies Ltd. | Systems and methods for cleaning body cavities and for endoscopic steering |
EP2525840A1 (en) | 2010-01-19 | 2012-11-28 | Jeffrey A. Klein | Sterile disposable remote pneumatic actuators |
CN201603160U (en) | 2010-01-24 | 2010-10-13 | 邓仲存 | Improved ventricular drainage tube |
JP2011177407A (en) | 2010-03-03 | 2011-09-15 | Seiko Epson Corp | Fluid injection device |
EP2558005B1 (en) | 2010-04-13 | 2022-03-30 | MIVI Neuroscience, Inc | Embolectomy devices for treatment of acute ischemic stroke condition |
US8246573B2 (en) | 2010-04-27 | 2012-08-21 | Medtronic, Inc. | Detecting empty medical pump reservoir |
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 |
US8764779B2 (en) | 2010-05-13 | 2014-07-01 | Rex Medical, L.P. | Rotational thrombectomy wire |
US8936447B2 (en) | 2010-08-26 | 2015-01-20 | Carefusion 303, Inc. | IV pump dual piston disposable cassette and system |
US9107691B2 (en) | 2010-10-19 | 2015-08-18 | Distal Access, Llc | Apparatus for rotating medical devices, systems including the apparatus, and associated methods |
US9585667B2 (en) | 2010-11-15 | 2017-03-07 | Vascular Insights Llc | Sclerotherapy catheter with lumen having wire rotated by motor and simultaneous withdrawal from vein |
US9180043B2 (en) | 2010-11-15 | 2015-11-10 | Focal Cool, Llc | Apparatus for treatment of reperfusion injury |
US9050398B2 (en) | 2010-12-22 | 2015-06-09 | Smith & Nephew, Inc. | Apparatuses and methods for negative pressure wound therapy |
US9624915B2 (en) | 2011-03-09 | 2017-04-18 | Fresenius Medical Care Holdings, Inc. | Medical fluid delivery sets and related systems and methods |
US9055964B2 (en) | 2011-03-15 | 2015-06-16 | Angio Dynamics, Inc. | Device and method for removing material from a hollow anatomical structure |
US9549753B2 (en) | 2011-04-01 | 2017-01-24 | Christopher Burnside Gordon | Fluid jet cell harvester and cellular delivery system |
US9149546B2 (en) | 2011-05-20 | 2015-10-06 | Nihon Medi-Physics Co., Ltd. | Compound having affinity for amyloid |
WO2012162230A1 (en) | 2011-05-20 | 2012-11-29 | Impulse Biomedical, Inc. | Feeding tube cleaning devices and methods |
WO2012176171A1 (en) | 2011-06-23 | 2012-12-27 | Debiotech S.A. | Vented reservoir for medical pump |
US8702678B2 (en) | 2011-08-03 | 2014-04-22 | Venous Therapy, Inc. | Assemblies, systems, and methods for infusing therapeutic agents into the body |
US10779855B2 (en) | 2011-08-05 | 2020-09-22 | Route 92 Medical, Inc. | Methods and systems for treatment of acute ischemic stroke |
WO2014176121A1 (en) | 2013-04-26 | 2014-10-30 | Medlogics Inc. | Tissue removal devices, systems and methods |
US20130190701A1 (en) | 2012-01-19 | 2013-07-25 | Kirn Medical Design Llc | Medical tube unclogging system and related method |
JP5575281B2 (en) | 2012-01-26 | 2014-08-20 | コヴィディエン リミテッド パートナーシップ | Thrombectomy catheter system |
US9770289B2 (en) | 2012-02-10 | 2017-09-26 | Myromed, Llc | Vacuum powered rotary devices and methods |
JP2013180156A (en) | 2012-03-05 | 2013-09-12 | Sumitomo Bakelite Co Ltd | Medical equipment |
CA2875074A1 (en) | 2012-03-17 | 2013-09-26 | Abbott Medical Optics Inc. | Surgical cassette |
CN102698328B (en) | 2012-06-08 | 2014-12-03 | 李广成 | Double-container balanced lavaging device for hematoma remover |
US9050127B2 (en) | 2012-06-27 | 2015-06-09 | Boston Scientific Limited | Consolidated atherectomy and thrombectomy catheter |
US8454557B1 (en) | 2012-07-19 | 2013-06-04 | Asante Solutions, Inc. | Infusion pump system and method |
US9332999B2 (en) | 2012-08-13 | 2016-05-10 | Covidien Lp | Apparatus and methods for clot disruption and evacuation |
US9332998B2 (en) | 2012-08-13 | 2016-05-10 | Covidien Lp | Apparatus and methods for clot disruption and evacuation |
JP6317751B2 (en) | 2012-11-08 | 2018-04-25 | 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. | System for performing medical procedures |
US8784434B2 (en) | 2012-11-20 | 2014-07-22 | Inceptus Medical, Inc. | Methods and apparatus for treating embolism |
US9539022B2 (en) | 2012-11-28 | 2017-01-10 | Microvention, Inc. | Matter conveyance system |
US9042938B2 (en) | 2012-12-27 | 2015-05-26 | Google Technology Holdings LLC | Method and apparatus for device-to-device communication |
US20140228869A1 (en) | 2013-02-13 | 2014-08-14 | Medrad, Inc. | Thrombectomy catheter |
US20140303658A1 (en) | 2013-02-13 | 2014-10-09 | Bayer Medical Care Inc. | Thrombectomy Catheter System |
US9456872B2 (en) | 2013-03-13 | 2016-10-04 | The Spectranetics Corporation | Laser ablation catheter |
US9883885B2 (en) | 2013-03-13 | 2018-02-06 | The Spectranetics Corporation | System and method of ablative cutting and pulsed vacuum aspiration |
US9283040B2 (en) | 2013-03-13 | 2016-03-15 | The Spectranetics Corporation | Device and method of ablative cutting with helical tip |
US8715314B1 (en) | 2013-03-15 | 2014-05-06 | Insera Therapeutics, Inc. | Vascular treatment measurement methods |
US8690907B1 (en) | 2013-03-15 | 2014-04-08 | Insera Therapeutics, Inc. | Vascular treatment methods |
WO2014144769A1 (en) | 2013-03-15 | 2014-09-18 | Atrium Medical Corporation | Fluid analyzer and associated methods |
WO2014160613A1 (en) | 2013-03-29 | 2014-10-02 | Silk Road Medical, Inc, | Systems and methods for aspirating from a body lumen |
JP2014200617A (en) | 2013-04-10 | 2014-10-27 | セイコーエプソン株式会社 | Fluid injection device and clogging detection method |
US9539402B2 (en) | 2013-06-10 | 2017-01-10 | Guidance Airway Solutions, Llc | Combined laryngo-tracheal anesthetic and stylet device |
US9289575B2 (en) | 2013-06-20 | 2016-03-22 | Philip J. Dye | Catheter |
US9259237B2 (en) | 2013-07-12 | 2016-02-16 | Inceptus Medical, Llc | Methods and apparatus for treating pulmonary embolism |
EP3052156B1 (en) | 2013-10-02 | 2020-12-23 | 3M Innovative Properties Company | Diposable reduced-pressure therapy system with electronic feedback |
US9782195B2 (en) | 2013-11-20 | 2017-10-10 | Board Of Regents Of The University Of Nebraska | Fluid jet arterial surgical device |
US9265512B2 (en) | 2013-12-23 | 2016-02-23 | Silk Road Medical, Inc. | Transcarotid neurovascular catheter |
US20150374391A1 (en) | 2014-03-07 | 2015-12-31 | Inceptus Medical, Llc | Methods and apparatus for treating small vessel thromboembolisms |
DE102014204799A1 (en) | 2014-03-14 | 2015-09-17 | Siemens Aktiengesellschaft | Method and device for displaying a vessel |
US9820761B2 (en) | 2014-03-21 | 2017-11-21 | Route 92 Medical, Inc. | Rapid aspiration thrombectomy system and method |
US9248221B2 (en) | 2014-04-08 | 2016-02-02 | Incuvate, Llc | Aspiration monitoring system and method |
US9433427B2 (en) | 2014-04-08 | 2016-09-06 | Incuvate, Llc | Systems and methods for management of thrombosis |
AU2015253317B2 (en) | 2014-04-28 | 2018-06-14 | Minerva Surgical, Inc. | Tissue resectors with cutting wires, hand-operated tissue resector systems and associated methods |
US9883877B2 (en) | 2014-05-19 | 2018-02-06 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
US9526864B2 (en) | 2014-06-09 | 2016-12-27 | Inceptus Medical, Llc | Retraction and aspiration device for treating embolism and associated systems and methods |
WO2016027198A1 (en) | 2014-08-21 | 2016-02-25 | Koninklijke Philips N.V. | Device and methods for crossing occlusions |
JP6732769B2 (en) | 2015-02-04 | 2020-07-29 | ルート92メディカル・インコーポレイテッドRoute 92 Medical, Inc. | Rapid suction thrombectomy system and method |
CN112220980B (en) | 2015-04-10 | 2023-12-08 | 丝绸之路医药公司 | System for establishing retrograde carotid blood flow |
US10702292B2 (en) | 2015-08-28 | 2020-07-07 | Incuvate, Llc | Aspiration monitoring system and method |
US10561440B2 (en) * | 2015-09-03 | 2020-02-18 | Vesatek, Llc | Systems and methods for manipulating medical devices |
US10226263B2 (en) | 2015-12-23 | 2019-03-12 | Incuvate, Llc | Aspiration monitoring system and method |
JP2019508201A (en) | 2016-02-16 | 2019-03-28 | インセラ セラピューティクス,インク. | Suction device and fixed blood flow bypass device |
US10492805B2 (en) | 2016-04-06 | 2019-12-03 | Walk Vascular, Llc | Systems and methods for thrombolysis and delivery of an agent |
US10492821B2 (en) | 2016-06-24 | 2019-12-03 | Hydrocision, Inc. | Selective tissue removal treatment device |
US9770551B1 (en) | 2017-01-13 | 2017-09-26 | Joel S. Faden | Apparatus and methods of dispensing fluid intravenously and flushing lines of intravenous fluid administration systems |
US20180207397A1 (en) | 2017-01-23 | 2018-07-26 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
CN110650695B (en) | 2017-05-23 | 2023-05-12 | 朝日英达科株式会社 | Assisted jet aspiration thrombectomy catheter and method of use |
US10716880B2 (en) | 2018-06-15 | 2020-07-21 | Incuvate, Llc | Systems and methods for aspiration and monitoring |
US10531883B1 (en) | 2018-07-20 | 2020-01-14 | Syntheon 2.0, LLC | Aspiration thrombectomy system and methods for thrombus removal with aspiration catheter |
EP3806757A4 (en) | 2018-07-24 | 2022-05-25 | Penumbra, Inc. | Apparatus and methods for controlled clot aspiration |
US20200345904A1 (en) | 2019-05-01 | 2020-11-05 | Neuravi Limited | Aspiration control valve |
-
2019
- 2019-07-18 US US16/516,190 patent/US11678905B2/en active Active
-
2022
- 2022-08-11 US US17/886,050 patent/US20220387052A1/en active Pending
- 2022-08-11 US US17/886,020 patent/US20220378449A1/en active Pending
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20130267891A1 (en) * | 2012-01-26 | 2013-10-10 | Covidien Lp | Thrombectomy catheter systems |
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