WO1989000835A1 - Catheter avec couteau annulaire rotatif - Google Patents

Catheter avec couteau annulaire rotatif Download PDF

Info

Publication number
WO1989000835A1
WO1989000835A1 PCT/US1988/001661 US8801661W WO8900835A1 WO 1989000835 A1 WO1989000835 A1 WO 1989000835A1 US 8801661 W US8801661 W US 8801661W WO 8900835 A1 WO8900835 A1 WO 8900835A1
Authority
WO
WIPO (PCT)
Prior art keywords
catheter
flexible
cutter
tube
coil spring
Prior art date
Application number
PCT/US1988/001661
Other languages
English (en)
Inventor
Royce H. Husted
Original Assignee
Husted Royce Hill
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US07/077,981 external-priority patent/US4754755A/en
Application filed by Husted Royce Hill filed Critical Husted Royce Hill
Publication of WO1989000835A1 publication Critical patent/WO1989000835A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B2017/320733—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a flexible cutting or scraping element, e.g. with a whip-like distal filament member

Definitions

  • the present invention is- directed to improvements in a catheter, and more particularly, to an improved catheter provided with a rotatable annular cutter and a method of using same for clearing obstruction in blood vessels, such as human arteries.
  • blood vessels such as human arteries.
  • a large portion of the population develops arterial obstructions formed by fats, fibrous material and calcified deposits, resulting in diminished blood supply to the heart, brain and other organs.
  • obstructions are circumvented surgically by providing a bypass or they are treated with a cath ⁇ eter equipped with a balloon which is inserted into the obstruction area through the arterial system and then inflated to expand the lumen through the obstuc- tion.
  • a problem with the balloon catheter is that it may burst th.e artery and in certain cases- it is in ⁇ effective. Further, it does not remove the obstruction material out of the arterial system.
  • One aim of the present invention is to provide an improved catheter having a rotatable annular cutter, and more specifically, is directed to a catheter for clearing arterial obstructions including flexible tube means adapted to be inserted into an artery ad ⁇ jacent to an obstruction, substantially hollow cutter means comprising a thin-walled annular cutter having a cutting edge at its forward end for rotatably slicing into said obstruction, bearing means for sup ⁇ porting said annular cutter in axial alignment with and at least partially within the forward end of said flexible tube means, thin flexible wire means attached to the wall of said annular cutter for im ⁇ parting an off-center rotational drive force to said annular cutter and providing a substantially obstruction-free passageway through said annular cutter and drive means for rotating said flexible wire means.
  • the present invention is further directed A to a method for clearing an obstruction in an artery comprising the steps of inserting into an artery a flexible tubular catheter having a hollow cutter rotatably supported therein, positioning the tubular catheter with, the hollow cutter adjacent to and in contact with, an obstruction, rotating the hollow cutter by means of an o f-center flexible shaft affixed to a wall of the hollow cutter to provide a substan ⁇ tially obstruction free passageway into the tubular catheter for reception of cut material, applying negative pressure to the other end of the tubular catheter to suck cut material into the catheter, and removing the catheter and its contents from the arter .
  • a thin guide wire is positioned by the surgeon next to an obstruction in a. blood vessel and a catheter tube introduced over the guide wire.
  • the guide wire may he removed before commencing blockage opening procedures.
  • Various well-known f uoroscopy techniques may be utilized .for assisting the position ⁇ ing of the guide wire, the guiding of the catheter to the site of the obstruction and the operation of the obstruction opening device.
  • the cutter tip itself is flexible to permit it to follow the orientation of the obstructed vessel and to negotiate relatively sharp turns therein.
  • the present invention therefore also provides a catheter for opening obstructions in blood vessels including a thin, flexible, cylindrical tube adapted for insertion in a vessel adjacent to an obstruction, an annular cutter positioned at one end of said cylindrical tube and adapted for rotation therein ⁇ said annular cutter having a flexible coil spring body and terminating in a cutting edge, and wire means for imparting an off center rotational driving force to said body.
  • Another aspect of the invention is to provide a self-guiding catheter which preferably, more readily conforms to bends and turns in blood vessels.
  • catheters made in accordance with the invention are much, safer in use.
  • Another feature of the invention is its unitary design of flexible off center drive shaft, flexible cutter body and cutting edge.
  • Fig. 1 shows a general cross sectional view of an embodiment of the invention
  • Fig. 2 shows a cross sectional view of the embodiment along a line 2-2 marked on Fig. 1;
  • Fig. 3 shows " across sectional view of the embodiment along a line 3-3- marked on Fig. 1;
  • Fig. 4 is a simplified representation of a catheter constructed in accordance with a further em ⁇ bodiment of the invention
  • Fig, 5 is an enlarged view of the unitary flexible cutter and guide wire of the catheter of Fig. 4
  • Fig. 6 is an enlarged cutaway portion of a unitary flexible cutter and guide wire constructed in accordance with another form of the invention.
  • Fig. 7 is a partial cutaway section depicting use of the catheter of Fig. 6 to remove obstructions in a curved portion of a blood vessel.
  • Figures 1 - 3 show a catheter 10 insertable into a patient's artery 11 for remotely cutting and removing an obstruction 12 therein, comprising: a flexible-tube 13 having a first opening 14 and a second opening 15.
  • An annular cutter or tubular-blade 16 has a groove 17 which rides on a lip 18 of a hollow bearing 19.
  • the hollow bearing 19 is attached to the first opening 14 and rotatably supports the tubular- blade 16.
  • the first end 21 is coupled to the tubular- blade 16, preferably, by being inserted and affixed in a small hole 23 which is drilled in the tubular- blade's wall. .
  • This offset drive leaves the tubular blade's center open for .freely accepting obstruction material, and as the material enters- the flexible- tube 13 it is continuously agitated and broken down to pieces, by the rotating flexible-shaft 20.
  • a motor (air or electric). 26 is coupled to the second end 22 for rotating the tubular-blade 16 through, the flexible-shaft 20.
  • Suction means 25 for generating negative pressure is connected to the second opening 15, for pulling the obstruction material into and through the flexible-tube 13. The agitating action of the flexible- shaft 20 prevents the obstruction material from forming a solid obstruction in the flexible tube 13 and assists suction means in moving the obstruction material through the flexible-tube 13.
  • a manifold 27 is attached to the motor 26, to the flexible tube 13 and to the suction means 25.
  • the manifold contains an 0-ring seal 28 which seals around the flexible-shaft 20.
  • the process for removing an obstruction 12 from an artery comprises the following steps:
  • Figures 4 - 7 display further embodiments of the invention that are especially designed for op ⁇ erations in very small blood vessels or vessels that include relatively sharp bends or turns.
  • a catheter generally designated by reference numeral 110 includes a small diameter inner flexible tube 112 terminating in a novel hollow flexible coil spring cutter 114 and a fine guide wire 116.
  • Hollow cutter 114 is rotatably driven by a thin, flexible wire drive shaft 134 that extends the length, of tube 112 and is coupled to a motor 118.
  • Hollow cutter 114 is driven in an off center manner by drive shaft 134 in identical fashion to the offset drive of tubular blade 16 in Figures 1 - 3.
  • a source of vacuum 120 is connected to one end of tube 112 to assist cut material (.not shown) being drawn into the other end of catheter 112 through, hollow cutter 114.
  • a similarly configured outer hollow tube 122 may be used in conjunction with, a pump 124 for injecting a saline solution or the like through the annular space between concentric tubes 122 and 112 to the site of the ob ⁇ struction adjacent cutter 114.
  • the end of the outer hollow tube 122 may also serve as a bushing, as at 5 122a, which holds flexible coil spring cutter 114 in axial confinement.
  • Guide wire 116 is very thin and flexible and is used by the surgeon to guide the catheter through a blood vessel and to the site of the obstruction that is to be opened or removed. A rounded 0 end 116a helps guide wire 116 to follow the path of the blood vessel.
  • the motor, pump and vacuum source, enclosed by dashed line box 121 are schematically illustrated only.
  • a slot 123, in outer tube 122 enables tube 122 to be axially 5 moved relative to tube 112, as will be explained.
  • tube 122 is shown in its forward- most position, as- it would be while inserting and guiding the catheter into position adjacent to an obstruction.
  • tube 122 is axially moved to the
  • the end portion of tube 112 may have a thinner wall to promote flexibility and may have a slightly greater diameter than the diameter of coil
  • Tube 112 is seen to have a larger diameter cross section near its end 113 forming a lip or shoulder 112b.
  • the inner surface of end 113 in this embodiment provides a bearing for cutter 114 to rotate in, generally in the 5 direction of the circular arrow A.
  • Guide wire 116 is formed of a fine piano wire or the like and includes a sharp bend to form a rounded tip 116a and has one end 115 securely embedded in the wall of tube 112 by any suitable means, such as by gluing, and its other
  • end.117 extends freely through the central opening of coil spring cutter 114 and terminates inside tube 112.
  • the outer end turn 130 of coil spring cutter 14 is preferably shaped to form a cutting edge 114a and the end turn 131 adjacent shoulder 112b is bent
  • the cutting edge 14a on end turn 130 of the coil spring cutter may be formed in any of a variety of ways, including having the taper oppositely extending to that
  • a separate annular cutting element may be affixed to the end turn of the spring by any suitable means. It is also contemplated that end turn 130 may be flattened to present a cross section that is more readily adapted and shaped into a cutting edge. Any of such constructions would not materially 5 affect the flexibility of the body of cutter 114, which, is a key aspect of the invention.
  • Fig. 7 the flexible coil spring cutter 5 114, tube 112 and guide wire 116 of Fig. 6 are shown in position in a blood vessel 140 that has a partial obstruction or blockage 142.
  • Guide wire 116 and rounded tip 116a enable the tube 112 to follow the bends of the blood vessel 140 and to be positioned
  • guide wire 116 is very flexible and readily conforms to the bends and turns in the blood vessel 140. As the guide wire 116 bends, it forces flexible cutter 114 to follow. Also
  • the surgeon constantly monitors- the position and orientation of the catheter via a fluoro- scope or the like while it is being inserted and adjusts its orientation to keep the outside portion of guide wire 116 adjacent to the large radius side of a
  • cutter 114 is confined by guide wire 116 which, precludes the possibility of inadvertently punc ⁇ turing or cutting through the wall of vessel 140. As cutter 114 is rotated, via the off center rotational

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

Abstract

Un cathéter (10) permettant de déboucher les vaisseaux sanguins obstrués d'un être humain comprend un tube flexible (13) équipé d'un couteau annulaire creux (16) monté en rotation au niveau de sa première extrémité et entraîné par un moteur (26) par l'intermédiaire d'un fil métallique flexible décentré (20), et une pompe d'aspiration (25) à son autre extrémité pour extraire les obstructions coupées par le couteau annulaire. Un cathéter flexible (110) utilisé dans de très petits vaisseaux sanguins est également décrit. Il comprend un ressort hélicoïdal (114) monté en rotation dans l'extrémité d'un tube creux (112). Le ressort est entraîné, décentré par un arbre d'entraînement à fil métallique flexible (134) qui est une extension du ressort hélicoïdal. La spire terminale du ressort hélicoïdal forme un bord coupant. Un guide-fil flexible mince (116) est fixé sur l'extérieur du tube creux adjacent au ressort hélicoïdal et s'étend au devant du bord tranchant. Le guide-fil possède une extrémité libre qui revient pour passer dans le ressort hélicoïdal et le tube creux. Le guide-fil suit l'orientation du vaisseau sanguin et guide le ressort hélicoïdal.
PCT/US1988/001661 1987-07-27 1988-05-17 Catheter avec couteau annulaire rotatif WO1989000835A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US179,069 1980-08-18
US07/077,981 US4754755A (en) 1984-05-14 1987-07-27 Catheter with a rotary blade
US17906988A 1988-04-08 1988-04-08
US077,981 1993-06-15

Publications (1)

Publication Number Publication Date
WO1989000835A1 true WO1989000835A1 (fr) 1989-02-09

Family

ID=26759915

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1988/001661 WO1989000835A1 (fr) 1987-07-27 1988-05-17 Catheter avec couteau annulaire rotatif

Country Status (1)

Country Link
WO (1) WO1989000835A1 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6139557A (en) * 1997-11-07 2000-10-31 Prolifix Medical, Inc. Apparatus for making wire with radial expansible guide section and methods of manufacturing the same
US6371928B1 (en) 1997-11-07 2002-04-16 Prolifix Medical, Inc. Guidewire for positioning a catheter against a lumen wall
US6406442B1 (en) 1996-11-07 2002-06-18 Prolifix Medical, Inc. Guidewire for precision catheter positioning
CN111956876A (zh) * 2020-08-26 2020-11-20 重庆尚业医疗器械有限公司 一种手术防堵吸引管及防堵方法
EP3698740A4 (fr) * 2017-12-26 2021-08-25 Shanghai Bluevascular Medtech Co., Ltd. Cathéter d'extraction de thrombus

Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1630239A (en) * 1924-05-09 1927-05-24 Roy S Binkley Antrum burr
US3565062A (en) * 1968-06-13 1971-02-23 Ultrasonic Systems Ultrasonic method and apparatus for removing cholesterol and other deposits from blood vessels and the like
US3614953A (en) * 1968-01-30 1971-10-26 Nat Res Dev Drills for clearing obstructions in arteries
US3749085A (en) * 1970-06-26 1973-07-31 J Willson Vascular tissue removing device
SU401360A1 (ru) * 1971-12-07 1973-10-12 С. Тарасов В. М. Картащов Свердловский научно исследовательский институт туберкулеза УСТРОЙСТВО дл БИОПСИИ м гких ТКАНЕЙ
SU648219A1 (ru) * 1976-11-15 1979-02-25 Белорусский государственный институт усовершенствования врачей Устройство дл биопсии гортани
DE2804015A1 (de) * 1978-01-31 1979-08-02 Erich Wintermantel Vorrichtung zur lumenerweiterung von gefaessen, insbesondere blutgefaessen im menschlichen kopfbereich
GB2044103A (en) * 1979-03-21 1980-10-15 Ross D N Device for removing material from stenoses
US4243048A (en) * 1976-09-21 1981-01-06 Jim Zegeer Biopsy device
US4445509A (en) * 1982-02-04 1984-05-01 Auth David C Method and apparatus for removal of enclosed abnormal deposits
US4589412A (en) * 1984-01-03 1986-05-20 Intravascular Surgical Instruments, Inc. Method and apparatus for surgically removing remote deposits
US4653496A (en) * 1985-02-01 1987-03-31 Bundy Mark A Transluminal lysing system
US4772258A (en) * 1985-11-22 1988-09-20 Kontron Holding A.G. Angioplasty catheter

Patent Citations (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1630239A (en) * 1924-05-09 1927-05-24 Roy S Binkley Antrum burr
US3614953A (en) * 1968-01-30 1971-10-26 Nat Res Dev Drills for clearing obstructions in arteries
US3565062A (en) * 1968-06-13 1971-02-23 Ultrasonic Systems Ultrasonic method and apparatus for removing cholesterol and other deposits from blood vessels and the like
US3749085A (en) * 1970-06-26 1973-07-31 J Willson Vascular tissue removing device
SU401360A1 (ru) * 1971-12-07 1973-10-12 С. Тарасов В. М. Картащов Свердловский научно исследовательский институт туберкулеза УСТРОЙСТВО дл БИОПСИИ м гких ТКАНЕЙ
US4243048A (en) * 1976-09-21 1981-01-06 Jim Zegeer Biopsy device
SU648219A1 (ru) * 1976-11-15 1979-02-25 Белорусский государственный институт усовершенствования врачей Устройство дл биопсии гортани
DE2804015A1 (de) * 1978-01-31 1979-08-02 Erich Wintermantel Vorrichtung zur lumenerweiterung von gefaessen, insbesondere blutgefaessen im menschlichen kopfbereich
GB2044103A (en) * 1979-03-21 1980-10-15 Ross D N Device for removing material from stenoses
US4445509A (en) * 1982-02-04 1984-05-01 Auth David C Method and apparatus for removal of enclosed abnormal deposits
US4589412A (en) * 1984-01-03 1986-05-20 Intravascular Surgical Instruments, Inc. Method and apparatus for surgically removing remote deposits
US4653496A (en) * 1985-02-01 1987-03-31 Bundy Mark A Transluminal lysing system
US4772258A (en) * 1985-11-22 1988-09-20 Kontron Holding A.G. Angioplasty catheter

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6406442B1 (en) 1996-11-07 2002-06-18 Prolifix Medical, Inc. Guidewire for precision catheter positioning
US6139557A (en) * 1997-11-07 2000-10-31 Prolifix Medical, Inc. Apparatus for making wire with radial expansible guide section and methods of manufacturing the same
US6371928B1 (en) 1997-11-07 2002-04-16 Prolifix Medical, Inc. Guidewire for positioning a catheter against a lumen wall
EP3698740A4 (fr) * 2017-12-26 2021-08-25 Shanghai Bluevascular Medtech Co., Ltd. Cathéter d'extraction de thrombus
CN111956876A (zh) * 2020-08-26 2020-11-20 重庆尚业医疗器械有限公司 一种手术防堵吸引管及防堵方法
CN111956876B (zh) * 2020-08-26 2023-05-12 重庆尚业医疗器械有限公司 一种手术防堵吸引管及防堵方法

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