WO2002026289A1 - Catheter system - Google Patents
Catheter system Download PDFInfo
- Publication number
- WO2002026289A1 WO2002026289A1 PCT/US2000/026770 US0026770W WO0226289A1 WO 2002026289 A1 WO2002026289 A1 WO 2002026289A1 US 0026770 W US0026770 W US 0026770W WO 0226289 A1 WO0226289 A1 WO 0226289A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- catheter
- jet
- ablation catheter
- fluid
- barrier wall
- Prior art date
Links
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
- A61B17/3203—Fluid jet cutting instruments
- A61B17/32037—Fluid jet cutting instruments for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
-
- 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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
- A61B2017/22039—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire eccentric
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
- A61B2017/22042—Details of the tip of the guide wire
-
- 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
- A61B2017/320775—Morcellators, impeller or propeller like means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/007—Auxiliary appliance with irrigation system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/84—Drainage tubes; Aspiration tips
- A61M1/85—Drainage tubes; Aspiration tips with gas or fluid supply means, e.g. for supplying rinsing fluids or anticoagulants
Definitions
- the present invention is a catheter system for removing occlusive material from the body.
- Hydraulic catheter devices for the removal of occlusive material from the body are widely known. In general these devices use a small free jet of fluid to remove material from the body.
- Veltrup device shown in US Patent 4,690,672 ejects a conical free stream of fluid in a retrograde direction. Occlusive material, which comes into contact with the jet, is macerated and forced into a low-pressure discharge lumen.
- the ablation catheter of the present invention uses a ring shaped substantially annular jet which flows along the exterior surface of the catheter body.
- the jet is thin and it is issued next to a barrier surface.
- a pressure difference builds across the jet so that it "attaches" to the barrier wall.
- the fluid jet adheres to the catheter body barrier by generating a low-pressure zone or area between the catheter body and the "interior" surface of the jet.
- the jet may be ejected in the same direction as the barrier surface or the initial jet direction and barrier surface may diverge.
- the geometric axis of the jet orifice may direct the jet away from or along the axis of the catheter body.
- the ablation catheter provides a high-energy jet film of fluid surrounding the exterior of the catheter body and this energetic sheet of fluid interacts directly with the occlusive material and emulsifies the occlusive material.
- the ablation catheter operates within a sheath and creates a strong suction at the mouth of the sheath to pull occlusive material into the sheath. It is preferred to have the sheath and catheter separately movable so that both modes may be practiced in a single procedure. However separate sheath and fixed sheath versions are taught as well.
- Additional structures may be incorporated into the ablation catheter. Distal and proximal balloons are described.
- the jet may direct fluid flow either proximally or distally and multiple jets may be incorporated in a single device.
- the ablation catheter may be delivered via a guidewire in "monorail”; “rapid exchange” or over the wire fashion.
- the ablation catheter may be delivered through a sheath and the sheath may include a guide wire passage as well.
- Fig 1 shows the catheter system connected to a power injector and collection bag
- Fig. 2 shows a representative ablation catheter in a sheath
- Fig. 3 shows a schematic device including an impeller
- Fig. 4 shows device including a remote energy source
- Fig. 5 shows an embodiment of the ablation catheter
- Fig. 6 shows an embodiment of the ablation catheter
- Fig. 7 shows an embodiment of the ablation catheter
- Fig. 8 shows an embodiment of the ablation catheter
- Fig. 9 shows an embodiment of the ablation catheter
- Fig. 10 shows a cross-section of a jet.
- Fig. 1 shows the connections to the ablation catheter 10 and sheath 12 assembly.
- the sheath is connected to a collection bag 13.
- fluid is forced by the injector 14 into the high-pressure portion of the system.
- Saline and C02 loaded saline are acceptable fluids.
- Other examples of fluid include contrast agent and therapeutic drug solutions such as lytic drug solution.
- a guidewire 16 may be inserted through the catheter or the sheath to help position the system in the patient.
- the distal section 18 is shown in exaggerated scale in Fig. 2.
- Fig. 2 shows that the ablation catheter 10 is moveable with respect to the sheath in this embodiment.
- the high-pressure fluid emerges 26 from the nozzle assembly 22 and "attaches" to the barrier wall 28.
- the primary stream mixes with and entrains blood and other material 24 from the body and propels the combined flow 30 into the low-pressure lumen 25.
- hypo tube 32 may be used to form a conduit for a guidewire.
- the sheath 12 may also have a short lumen 34 to carry a guide wire 36.
- Fig. 3 shows the ablation catheter used in connection with a mechanical propeller 40, which is turned by a remote motor 42.
- the jet 44 emerging from the nozzle entrains material from the body.
- the ablation catheter and impeller are carried in a sheath 12.
- the sheath may have one or more ports 48 to accept and recirculate occlusive material.
- Fig. 4 shows a remote energy source 52 such as an ultrasound generator or laser coupled to a wave guide 54.
- a remote energy source 52 such as an ultrasound generator or laser coupled to a wave guide 54.
- the fluid passing through the ablation catheter 10 inside the sheath 12 will cool the wave-guide 54.
- Occlusive material dislodged by the radiating tip 50 energy source will be transported by the ablation catheter 10 and sheath to a location outside the body.
- Fig. 5 shows a construction of an ablation catheter that is "unitary" and ports or slots 60 are cut in the catheter tip to allow fluid to emerge.
- a ring like step 62 separates the slot 60 from the inclined barrier surface 64. It has been found that this step can encourage the attachment of the jet to the barrier surface 64 and promote turning of the jet 68.
- inclined surfaces and cylindrical surfaces for the barrier wall as easy to fabricate and operable it may be preferable to use more complex surfaces including the parabolic and spherical surfaces depicted in the figure for some applications.
- the unitary structure can be fabricated enitly of a metal such as NITINOL and the device can act as a guide wire. If used with a sheath 12 a short lumen 34 can be used to deliver a guidewire 36.
- Fig. 6 shows a multiple nozzle assembly that can be used inside or outside a sheath 12 having a first jet annulus 70 and one or more "booster" jets 72.
- the high-pressure fluid from the injector 14 enters the nozzle though the hypo tube 74where it enters a plenum 76.
- the fluid feeds the annular gap 70 generating primary streams depicted as jet 80 and jet 82.
- Booster jet 84 is directed at an acute angle in the proximal direction of about sixty degrees and the jet 84 attaches to wall 88 and the several jets operate together to discharge material into the low pressure lumen 25.
- Fig. 7 is a schematic view showing the flow path for an ablation catheter that has a concave barrier surface 70.
- the free space flow direction of the jet issuing from the nozzle is shown by dotted line 72.
- the jet is one hundred and eighty degrees from the axis of the catheter body and is therefore parallel to it.
- the inclined concave surface meets the jet aperture at an angle shown by dotted line 74.
- the fat arrow 76 is a somewhat exaggerated direction of flow for the augmented stream.
- This concave surface 70 has several features of the step seen ion Fig. 5 and also shows the ability of the combined stream to follow a rapidly changing barrier wall shape.
- Fig. 8 is a schematic diagram that shows that the barrier surface need not be rigid.
- an elastic spherical balloon 80 forms the barrier surface.
- the free jet direction 72 and the tangent to the barrier surface at the location of the connection between the barrier and the aperture are essentially the same.
- Fig. 9 shows the barrier surface as a set of stepped cones.
- the free stream direction of the jets 72 and the angle that the conical surfaces meet the aperture depicted by tangent 74 are essentially the same.
- the wall attachment effects require that the jet emerge into a fluid. However during testing it is common to squirt fluid into the air.
- the direction of fluid flow in air is the free stream direction of flow.
- the geometric direction of the "jet” may form an angle with respect to the catheter axis of from approximately 90 degrees (or right angle to the axis) to 180 degrees in the examples (or parallel to the axis).
- a broad range of angles can be used for the free stream direction of the jet.
- the barrier surface may form an angle with the geometric axis of the initial jet direction of between about zero degrees and sixty degrees or more in the figures.
- steps 62 provides an example of a wall barrier to jet aperture angle of 180 degrees. In use the pressure difference across the jet causes the fluid stream to run next to the barrier surface and this allows the barrier surface to turn through a greater or lesser degree of turning.
- FIG. 10 is a cross section or slice out of a device that shows the operation of the jet in more detail.
- the aperture or slit 100 has a geometric direction shown as dotted line 102. When operated in air the fluid will generally follow this free stream direction or path.
- the barrier wall 104 is at an angle to the free stream direction shown in the figure. In practice this angle can vary from about 0 degrees up to about 60 degrees. Small steps of up to 90 degrees can be used to promote adhesion of the jet. However typically 45 degrees is a usable value for the inclination of the jet to the barrier wall.
- the jet When the jet first issues from the aperture 100 it has a small cross section area and a very high stream velocity. As this jet 99 begins to exchange momentum with the surrounding fluid s the jet become broader but move at lower speed this is depicted as jet cross section 98. This momentum exchange process is minimized on the barrier side of the jet near the barrier wall 104. In fact a recirculation bubble 106 occurs in most instances although it is very difficult to detect directly.
- the arrow loop depicts the bubble in the figure. The effect takes place within of a variety of wall shapes.
- the free jet direction 102 may be inclined with respect to the catheter body from an angle of more than ninety degrees to about one hundred and eighty degrees.
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Vascular Medicine (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/US2000/026770 WO2002026289A1 (en) | 2000-09-28 | 2000-09-28 | Catheter system |
AU2000277330A AU2000277330A1 (en) | 2000-09-28 | 2000-09-28 | Catheter system |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
PCT/US2000/026770 WO2002026289A1 (en) | 2000-09-28 | 2000-09-28 | Catheter system |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2002026289A1 true WO2002026289A1 (en) | 2002-04-04 |
Family
ID=21741821
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2000/026770 WO2002026289A1 (en) | 2000-09-28 | 2000-09-28 | Catheter system |
Country Status (2)
Country | Link |
---|---|
AU (1) | AU2000277330A1 (en) |
WO (1) | WO2002026289A1 (en) |
Cited By (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2005084561A1 (en) * | 2004-02-28 | 2005-09-15 | David Hoyle | Vascular descaler |
NL1034242C2 (en) * | 2007-02-16 | 2008-08-19 | T M H Beheer B V | Catheter for removing blood clots, has radially oriented outlet openings for cleaning agent located in its head |
EP2913012A1 (en) * | 2014-03-01 | 2015-09-02 | Rex Medical, L.P. | Atherectomy device |
US10307175B2 (en) | 2016-03-26 | 2019-06-04 | Rex Medical, L.P | Atherectomy device |
US10433868B2 (en) | 2014-12-27 | 2019-10-08 | Rex Medical, L.P. | Artherectomy device |
US10463389B2 (en) | 2014-12-27 | 2019-11-05 | Rex Medical, L.P. | Atherectomy device |
EP3689274A1 (en) * | 2007-02-05 | 2020-08-05 | Boston Scientific Limited | Thrombectomy system |
US11051832B2 (en) | 2015-12-23 | 2021-07-06 | Incuvate, Llc | Aspiration monitoring system and method |
US11253292B2 (en) | 2015-09-13 | 2022-02-22 | Rex Medical, L.P. | Atherectomy device |
US11490909B2 (en) | 2014-05-19 | 2022-11-08 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
US11497521B2 (en) | 2008-10-13 | 2022-11-15 | Walk Vascular, Llc | Assisted aspiration catheter system |
US11510689B2 (en) | 2016-04-06 | 2022-11-29 | Walk Vascular, Llc | Systems and methods for thrombolysis and delivery of an agent |
US11672561B2 (en) | 2015-09-03 | 2023-06-13 | Walk Vascular, Llc | Systems and methods for manipulating medical devices |
US11678905B2 (en) | 2018-07-19 | 2023-06-20 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
US11826064B2 (en) | 2018-06-15 | 2023-11-28 | Incuvate, Llc | Systems and methods for aspiration and monitoring |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5273526A (en) * | 1991-06-21 | 1993-12-28 | Lake Region Manufacturing Company, Inc. | Vascular occulusion removal devices and method |
-
2000
- 2000-09-28 WO PCT/US2000/026770 patent/WO2002026289A1/en active Application Filing
- 2000-09-28 AU AU2000277330A patent/AU2000277330A1/en not_active Abandoned
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5273526A (en) * | 1991-06-21 | 1993-12-28 | Lake Region Manufacturing Company, Inc. | Vascular occulusion removal devices and method |
Cited By (23)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2005084561A1 (en) * | 2004-02-28 | 2005-09-15 | David Hoyle | Vascular descaler |
EP3689274A1 (en) * | 2007-02-05 | 2020-08-05 | Boston Scientific Limited | Thrombectomy system |
US11653945B2 (en) | 2007-02-05 | 2023-05-23 | Walk Vascular, Llc | Thrombectomy apparatus and method |
NL1034242C2 (en) * | 2007-02-16 | 2008-08-19 | T M H Beheer B V | Catheter for removing blood clots, has radially oriented outlet openings for cleaning agent located in its head |
US11497521B2 (en) | 2008-10-13 | 2022-11-15 | Walk Vascular, Llc | Assisted aspiration catheter system |
US10271869B2 (en) | 2014-03-01 | 2019-04-30 | Rex Medical, L.P. | Atherectomy device |
US10751083B2 (en) | 2014-03-01 | 2020-08-25 | Rex Medical L.P. | Atherectomy device |
EP2913012A1 (en) * | 2014-03-01 | 2015-09-02 | Rex Medical, L.P. | Atherectomy device |
US11490909B2 (en) | 2014-05-19 | 2022-11-08 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
US10463389B2 (en) | 2014-12-27 | 2019-11-05 | Rex Medical, L.P. | Atherectomy device |
US10433868B2 (en) | 2014-12-27 | 2019-10-08 | Rex Medical, L.P. | Artherectomy device |
US11547434B2 (en) | 2014-12-27 | 2023-01-10 | Rex Medical L.P. | Atherectomy device |
US11426194B2 (en) | 2014-12-27 | 2022-08-30 | Rex Medical L.P. | Atherectomy device |
US11672561B2 (en) | 2015-09-03 | 2023-06-13 | Walk Vascular, Llc | Systems and methods for manipulating medical devices |
US11253292B2 (en) | 2015-09-13 | 2022-02-22 | Rex Medical, L.P. | Atherectomy device |
US11051832B2 (en) | 2015-12-23 | 2021-07-06 | Incuvate, Llc | Aspiration monitoring system and method |
US11771445B2 (en) | 2015-12-23 | 2023-10-03 | Incuvate, Llc | Aspiration monitoring system and method |
US11020134B2 (en) | 2016-03-26 | 2021-06-01 | Rex Meddical L.P. | Atherectomy device |
US10307175B2 (en) | 2016-03-26 | 2019-06-04 | Rex Medical, L.P | Atherectomy device |
US11864780B2 (en) | 2016-03-26 | 2024-01-09 | Rex Medical, L.P. | Atherectomy device |
US11510689B2 (en) | 2016-04-06 | 2022-11-29 | Walk Vascular, Llc | Systems and methods for thrombolysis and delivery of an agent |
US11826064B2 (en) | 2018-06-15 | 2023-11-28 | Incuvate, Llc | Systems and methods for aspiration and monitoring |
US11678905B2 (en) | 2018-07-19 | 2023-06-20 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
Also Published As
Publication number | Publication date |
---|---|
AU2000277330A1 (en) | 2002-04-08 |
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