WO2014184489A1

WO2014184489A1 - Endovascular surgery device

Info

Publication number: WO2014184489A1
Application number: PCT/FR2014/051114
Authority: WO
Inventors: Antonino MACHI
Original assignee: Machi Antonino
Priority date: 2013-05-13
Filing date: 2014-05-13
Publication date: 2014-11-20
Also published as: FR3005404A1; FR3005404B1

Abstract

The invention relates to an endovascular surgery device (20) which comprises: a catheter (205) comprising a pipe (210) configured to route at least one fluid, a balloon (215) having an inner space which is connected to a pipe of the catheter and configured to be inflated or deflated depending on the pressure of the fluid in the pipe of the catheter. The balloon is provided with at least one radial opening (225) surrounded by a wall (230) in order to fragment at least part of the clot, wherein each of said radial openings receives at least one fragmented part of the clot upon inflation of the balloon and retains at least one fragmented part of the clot when the balloon is at least partially delated. In some embodiments, at least one opening (425) of the small balloon is a radial blind opening.

Description

DEVICE FOR ENDOVASCULAR SURGERY

TECHNICAL FIELD OF THE INVENTION

The present invention relates to a device for endovascular surgery. It is particularly applicable to the field of vascular surgery, interventional neuroradiology, interventional radiology, interventional cardiology, endovascular neurosurgery, endovascular surgery, mechanical thrombectomy, endovascular thrombectomy, and thrombus extraction including endovascular.

STATE OF THE ART

Current systems for treating endovascular thrombosis

(angioplasty, thrombectomy) consist of a deflated angioplasty balloon mounted on a microcatheter. The micro catheter is introduced into the blood vessel with a thrombus so as to place the balloon deflated facing the thrombus. The balloon is then inflated with a liquid introduced into the microcatheter, so as to crush the thrombus against the wall of the blood vessel to restore blood flow into the blood vessel.

One of the drawbacks of these systems is that the blood clot pieces torn by the swelling of the angioplasty balloon are then washed away by the blood flowing into the blood vessel and these pieces of blood clot can become the source of new thromboses. or other vascular problems called thromboembolic complications.

In other current systems, such as the one presented in the patent application EP 2,399,525, the system for treating arterial thrombosis comprises a helical wire which, when compressed on its longitudinal axis, deploys until touching the walls of the blood vessel and forming a blood clot trap displaced along a blood vessel so as to capture the blood clot upon removal from the system. If these systems can recover the main blood clot, they do not prevent blood clots from roaming freely the body, which can lead to a thromboembolic complication. In any case, this type of device is no longer used today because of the low rate of effectiveness and arterial recanalisation and the high rate of complication related to its use.

In other current systems, such as that presented in the WO patent

2009/1 14046, an extractor stent consisting of a metal frame bent around an axis is deployed so that the outer armature matches the contours of the treated blood vessel. Then, in a second step, the expanded stent is pulled to the opening through which the catheter has been inserted to capture an arterial thrombus placed against a wall of the blood vessel. However, these systems are dangerous to use in the case where the thrombosis includes a calcified portion under a soft part, also called plaque thrombosis. Indeed, the tearing that can cause tearing of the calcified part can lead to arterial tearing. For these reasons, an extractor stent can not always be used to perform thrombus extraction. In addition, the surgeon has no control over the interaction between the device and the thrombus.

Moreover, in the treatment of arterial aneurysms, the current balloon assisted remodeling ("balloon-assisted remodeling" in French) systems consist in deploying a catheter opposite an aneurysm, causing the expansion a balloon mounted on the catheter and introducing a secondary catheter into the aneurysm along the inflated balloon. Such systems have the advantage of supporting the embolization material deployed inside the aneurysmal pocket, however they have the disadvantage of blocking the passage of fluids in the blood vessel when the balloon is inflated, which can be the cause of cerebral ischemia.

OBJECT OF THE INVENTION

The present invention aims to remedy all or part of these disadvantages. For this purpose, according to a first aspect, the present invention relates to an endovascular surgical device, which comprises:

a catheter comprising a conduit configured to conduct at least one fluid, a balloon whose internal volume is connected to a conduit of the catheter and configured to be inflated or deflated according to the pressure of the fluid in the catheter duct,

the balloon is provided with at least one radial orifice surrounded by a wall to fragment at least a portion of the clot, each said radial orifice receiving at least a fragmented portion of the clot during the swelling of the balloon and retaining at least a fragmented portion of the clot during deflation, at least partially, of the balloon.

The presence of at least one radial port captures a portion of the blood clot upon deflation of the balloon, wherein the portion of the blood clot is subsequently extracted with the catheter of the treated blood vessel. In addition, since a balloon is used, the risk of damage to the blood vessel is reduced, both when the device is placed in position opposite the endovascular clot and when the balloon is deployed. Finally, the force to be applied is reduced because it is a fluid that conveys the pressure in the balloon. In addition, it is possible to treat thrombosis with a calcified portion by eliminating the risks associated with tearing thrombosis due to the expandable material of the balloon on the one hand, and the capture of the thrombosis by swelling and deflating. the balloon, much less violent for the blood vessel, on the other hand. In comparison with a conventional angioplasty balloon and retrieval stent systems, the present invention allows, beyond compression of the thrombus and reopening of the blood vessel, to capture some or all of the thrombus that has been the cause of endovascular occlusion by improving the hemodynamics of the treated vessel and reducing the risk of embolic migration that can cause a thromboembolic complication.

In embodiments, at least one balloon port is a blind radial port.

These embodiments allow, during balloon inflation, to penetrate part of the blood clot into the blind radial orifice. When deflating the balloon, the portion of the blood clot in the blind radial port is captured and can be removed from the blood vessel with the catheter.

In embodiments, the balloon forms an at least partially inflated hollow volume, at least one balloon port passing through the balloon to connect the hollow volume to the exterior of the balloon. These embodiments retain a fragmented blood clot portion in the hollow volume formed when the balloon is inflated.

In embodiments, the device object of the present invention comprises an axial orifice passing through the balloon to allow the passage of a blood flow.

These embodiments allow the passage of a blood flow through the balloon so as to avoid health risks on a user on which the device object of the present invention is used.

In embodiments, the device of the present invention comprises means for retaining a blood clot in the hollow volume of the balloon when the balloon is inflated, the hollow volume being at least partially formed by the axial orifice.

The advantage of these embodiments is that they prevent a blood clot fragment in the hollow volume from escaping from the hollow volume when the balloon is inflated.

In embodiments, the retention means is a mesh obstructing at least one end of the axial orifice.

These embodiments have the advantage of allowing to retain a blood clot fragment without impairing the passage of blood flow through the axial orifice.

In embodiments, the retention means is a diaphragm positioned on at least one end of the axial orifice.

In embodiments, at least one balloon port is an orifice configured to pass a secondary catheter when the balloon is inflated.

The advantages of these embodiments are that they allow, on the one hand, to allow the blood to flow during the balloon swelling and, on the other hand, to perform another treatment in the blood vessel through a second catheter keeping the blood vessel in position with the inflated balloon.

In embodiments, the balloon is connected to the catheter at the periphery of the balloon.

These embodiments have the advantage, in the case where the balloon has an axial orifice, to allow an optimal size of the light of the axial orifice. In embodiments, the balloon is connected to the catheter at the balloon axis.

The advantage of these embodiments is that they allow a more homogeneous expansion of the balloon during inflation of the balloon.

In embodiments, at least one wall between two radial orifices has an outwardly convex shape of the balloon so as to fragment a clot upon inflation of the balloon.

These embodiments have the advantage of facilitating fragmentation of the blood clot.

BRIEF DESCRIPTION OF THE FIGURES

Other advantages, aims and features of the invention will emerge from the following description of at least one particular embodiment of the endovascular surgical device, with reference to the appended drawings, in which:

FIG. 1 represents, schematically and in perspective, a first particular embodiment of the device that is the subject of the present invention,

FIG. 2 represents, schematically and in perspective, a second particular embodiment of the device that is the subject of the present invention,

FIG. 3 represents, schematically and in perspective, a third particular embodiment of the device that is the subject of the present invention,

FIG. 4 represents, schematically and in perspective, a fourth particular embodiment of the device that is the subject of the present invention,

FIG. 5 represents, schematically and in section, a first view of a seventh particular embodiment of the device that is the subject of the present invention,

FIG. 6 represents, schematically and in section, a second view of the seventh particular embodiment of the device that is the subject of the present invention,

FIG. 7 represents, schematically and in section, a third view of the seventh particular embodiment of the device that is the subject of the present invention, FIG. 8 represents, schematically and in section, a fourth view of the seventh particular embodiment of the device that is the subject of the present invention,

FIG. 9 represents, schematically and in section, a fifth view of the seventh particular embodiment of the device that is the subject of the present invention,

FIG. 10 represents, in the form of a logic diagram, steps of a particular embodiment of a method of endovascular surgery,

FIG. 11 represents, schematically and in section, a fifth particular embodiment of the device that is the subject of the present invention and

FIG. 12 represents, in the form of a logic diagram, steps of a particular embodiment of a method of treating an aneurysm.

DESCRIPTION OF EXAMPLES OF EMBODIMENT OF THE INVENTION

As of now, we note that the figures are not to scale.

The term "orifice" is used both for a cavity in a surface and a gap between reliefs placed on a surface.

FIG. 1 shows a particular embodiment of the device 10 which is the subject of the present invention. This device 10 comprises:

a catheter 105 comprising a conduit 1 10 and

a balloon 1 comprising at least one radial orifice 125.

The conduit 1 10 is configured to conduct at least one fluid, for example a liquid pushed by a syringe, not shown. This conduit 10 is supported by the catheter 105 and the conduit 1 is connected to the balloon 1 on the periphery of the balloon 1 15. The balloon 1 is made of a plastic and elastic material, for example. This balloon 1 comprises at least one radial orifice 125 opening on an outer face of the balloon 1 15. The inner volume of the balloon 1 15 is connected to the conduit 1 10 of the catheter 105 and this balloon 1 15 is configured to be inflated or deflated in This is a function of the fluid pressure in the catheter conduit 105. As the fluid pressure increases, the balloon 1 inflates. Conversely, as the fluid pressure decreases, the balloon 1 deflates. The pressure of the fluid is controlled by the implementation of a syringe with a needle connected to the conduit 1 10. By pushing a piston of the syringe, the The volume containing the fluid decreases and the fluid pressure increases and the balloon 1 inflates. By pulling the plunger of the syringe, the fluid pressure decreases and the balloon 1 deflates.

The balloon 1 forms a hollow volume once at least partially inflated, at least one port 125 of the balloon 1 passing through the balloon 1 to connect the hollow volume to the outside of the balloon 1 15.

The radial orifice 125 is configured to allow the passage of a secondary catheter. In addition, this radial orifice 125 is configured to receive at least a portion of a clot during swelling of the balloon 1 and to retain at least a portion of the clot during the at least partial deflation of the balloon 1 15. At this Indeed, the radial orifice 125 comprises, for example, a honeycomb structure partially obstructing the passage between the two longitudinal ends of the balloon 1 15.

In variants, some radial orifices 125 are blind, that is to say that radial orifices 125 have only one opening on the outside of the balloon 1 15.

At least one orifice 125 is surrounded by a wall 1 to fragment at least a portion 120 of the clot when the balloon 1 is inflated and the wall 120 is pressed against the blood clot adhered to a wall of an artery of a user.

At least one wall 120 between two radial orifices 125 has an outwardly convex shape of the balloon so as to fragment a clot during inflation of the balloon.

In variants, an axial section of the balloon 1 has triangular-shaped walls 120 facing outwardly of the balloon 1, so as to fragment the blood clot by means of a tip of at least one triangle and to retain the fragment through at the flat part of said triangle. In other embodiments, the common walls 120 surrounding at least two ports are oriented toward each other to decrease the pressure surface, between the walls 120, exerted during balloon inflation.

These orifices 125 are configured to receive at least a portion of a blood clot upon inflation of the balloon 1 and to retain at least a portion of the clot upon the at least partial deflation of the balloon 1 15. The balloon 1 is configured to be inflated to a diameter similar to the diameter of the blood vessel in which the device 10 is positioned. When the balloon The opening 125 of the orifices 125 tear the blood clot fixed to the wall of the treated blood vessel and receive pieces of the clot in the radial orifices 125. During deflation of the balloon 1 15, the pieces received by the radial orifices 125 are retained in the radial orifices 125. They are then extracted from the blood vessel to be treated by removal of the catheter 105 carrying the balloon 1 15.

In variants, the walls of the radial ports 125 are configured to facilitate retention of a blood clot. The wall of an orifice 125 comprises, for example, spikes whose tips are oriented in a direction opposite to the opening of said orifice 125. In this way, the spikes do not interfere with the entry of a blood clot into the opening. 125 but allow to retain the blood clot more effectively in the orifice 125.

In alternative embodiments, the balloon 1 has a balloon stretch resistance gradient 1 15 so that the center of the balloon 1 stretches more than the ends of this balloon 1 when the balloon 1 15 is inflated.

FIG. 2 shows a second particular embodiment of the device 20 of the present invention. This device 20 is similar to the device 10 described in FIG. In this configuration, the conduit 210 is connected to the balloon 215 at the center of the balloon 215 when it is deployed.

FIG. 3 shows a third particular embodiment of the device 30 of the present invention. This device 30 is similar to the device 10 described in FIG. This device 30 comprises, in addition to the catheter 305, the conduit 310, the balloon 315 and the radial orifices 325, an axial orifice 320 configured to allow the passage of a secondary catheter. In addition, this axial orifice 320 is configured to receive at least a portion of a clot during swelling of the balloon 315 and to retain at least a portion of the clot during deflation, at least partially, of the balloon 315. For this purpose, the axial orifice 320 comprises, for example, a cellular structure partially obstructing the passage between the two longitudinal ends of the balloon 315.

In variants, the radial orifices 325 are not blind and communicate with the axial orifice 320. In these variants, the blood clot pieces are received and retained by the axial aperture 320. The pieces of blood clot enter the axial orifice 320 through the openings at the longitudinal ends of the balloon 315 or the radial openings 325.

FIG. 4 shows a fourth particular embodiment of the device 40 which is the subject of the present invention. This device 40 is similar to the device 30 described in FIG. 2. This device 40 comprises:

a catheter 405 comprising a duct 410,

a balloon 415 comprising a plurality of radial orifices 425 and an axial orifice 420.

The particularity of the device 40 is that the duct 410 is connected to the balloon 415 at the axis of the balloon 415. For example, this duct 410 is connected to the balloon 415 by eight secondary ducts 430 four of which at each longitudinal opening of the balloon 415 Alternatively, this device 40 has a number of ducts greater than eight, so as to form a mesh in the 420 axial orifice. This mesh allows a better retention of blood clots that are received in the mesh.

In variants, the balloon 315 forms a hollow volume when this balloon 315 is inflated. This hollow volume is at least partially formed by the axial orifice 320 to allow the passage of a blood flow.

The device 40 comprises a means 430 for retaining a blood clot in a hollow volume of the balloon 415 when the balloon is inflated, the hollow volume being at least partially formed by the axial orifice 420.

This retention means 430 is, for example, a mesh obstructing at least one end of the axial orifice or a diaphragm positioned on at least one end of the axial orifice (420).

FIGS. 5 to 9 show a fifth particular embodiment of the device 60 which is the subject of the present invention. In particular, FIG. 5 shows a blood vessel 610 and a blood clot 605 bonded to the wall 610 of the blood vessel.

FIG. 6 shows a fifth particular embodiment of the device 60 which is the subject of the present invention. This device 60 comprises:

a catheter 615 comprising a conduit 620,

a deflated balloon 625 comprising a plurality of radial orifices. The conduit 620 is configured to conduct at least one fluid. This conduit 620 is supported by the catheter 625 and the conduit 620 is connected to the balloon 625 on the periphery of the balloon 625. The balloon 625 is made of a shape memory elastic material, for example. This balloon 625 has a plurality of blind radial ports having an opening on the outside of the balloon 625. The inner volume of the balloon 625 is connected to the conduit 620 of the catheter 625 and this balloon 625 is configured to be inflated or deflated according to the fluid pressure in the conduit 620 of the catheter 625. As the fluid pressure increases, the balloon 625 inflates and, conversely, as the fluid pressure decreases, the balloon 625 deflates. The pressure of the fluid is controlled by the implementation of a syringe (not shown), a needle of which is connected to the conduit 620. By pushing a piston of the syringe, the volume containing the fluid decreases and the fluid pressure increases; which inflates the balloon. By pulling the plunger of the syringe, the fluid pressure decreases, deflating the balloon.

The radial ports are configured to receive at least a portion of a clot upon inflation of balloon 625 and to retain at least a portion of the clot upon at least partial deflation of balloon 625.

During endovascular surgery 605 in a blood vessel, the deflated balloon 625 is placed opposite the clot 605, as seen in FIG.

FIG. 7 shows the balloon 625 inflated to crush the blood clot 605 against the wall 610 of the blood vessel to which the clot 605 is attached. Upon squeezing blood clot 605 against wall 610, clot 605 tears and torn portions are received in the radial ports of balloon 625.

FIG. 8 shows the balloon 625 partially deflated. During deflation of the balloon 625, the portions received in the radial orifices are retained in said radial orifices. In this manner, the blood clot 605 is at least partially removed from the wall 610 of the blood vessel and the removed blood clot pieces 605 do not move freely in the vascular system of the treated patient.

FIG. 9 shows the blood vessel treated after the treatment performed by the device 60. The remaining mass of the blood clot 605 in the vessel blood is low compared to the initial mass of the blood clot 605 shown in FIG.

FIG. 10 shows a particular embodiment of the method 70 of endovascular surgery. This method 70 comprises:

a step 805 of introducing a catheter into a blood vessel comprising a blood clot attached to a wall of the blood vessel,

a step 810 of balloon inflation,

a step 815 for inserting a secondary catheter in order to perform a treatment on another arterial clot,

a step 820 of extraction of the secondary catheter after the treatment is completed,

a step 825 of deflating the balloon and

a step 830 for retracting the catheter.

The step 805 of introducing a catheter is performed, for example, by perforation of a wall of the blood vessel and insertion of the catheter. The catheter includes a conduit configured to conduct at least one fluid, and a balloon having at least one radial port and an axial port. During this step 805, the balloon carried by the catheter is positioned facing the clot, the inner volume of the balloon being connected to the catheter duct.

The balloon inflation step 810 is performed, for example, by increasing the fluid pressure in the catheter conduit to expand at least one axial and radial orifice to receive at least a portion of the clot. The pressure of the fluid is increased, for example, by the actuation of a piston of a syringe connected to the catheter conduit.

The step 815 of inserting a secondary catheter is performed, for example, by a second perforation of the wall of the blood vessel and by the insertion of the secondary catheter. This secondary catheter is inserted into the axial bore of the balloon and the catheter integrally passes through the axial port to effect treatment upstream or downstream of the blood vessel relative to the balloon.

The extraction step 820 is performed, for example, by a user pulling the secondary catheter so that the secondary catheter leaves the treated blood vessel. Step 825 of at least partial deflation of the balloon to retain at least a portion of the clot is achieved, for example, by the actuation of the piston of the syringe, so as to increase the volume containing the fluid. In this way, the pressure in the balloon decreases as desired by the user operating the plunger of the syringe.

The step 830 of retracting the catheter to extract each portion of the clot retained in the at least partially deflated balloon is performed, for example, by a user pulling the catheter so that the catheter leaves the blood vessel through the perforated hole in the catheter. during the introductory step 805.

In variants, the method 70 does not include a step 815 for inserting a secondary catheter or step 820 for extracting the secondary catheter. In these variants, the balloon does not necessarily have an axial orifice but it comprises at least one axial and / or radial orifice.

FIG. 11 shows a particular embodiment of the device 90 which is the subject of the present invention. In this configuration, the device 90 is configured to facilitate the treatment of an endovascular aneurysm. The device 90 comprises:

a first catheter 1 1 15 on which is mounted a balloon 1 125 fed by a conduit 1 120

- A secondary catheter 1 130 configured to release springs 1 135 in the aneurysm 1 105.

The balloon 1125 has an axial port longitudinally extending through the balloon 1125 and allowing the blood flow to continue even when the balloon 1125 is inflated.

To treat the aneurysm 1110, the balloon 1125 is positioned opposite the aneurysm 1 105. The balloon 1 125 is then inflated, as shown in Figure 1 1. Then, a secondary catheter 1 130 is positioned along the balloon 1125 inflated between the wall 11 of the blood vessel and the balloon 1125 so that the longitudinal opening of the catheter is oriented towards the interior of the catheter. Aneurysm 1 105. Springs 1 135 are injected into the aneurysm 1 105 by the application of pressure, by the surgeon, on a syringe containing the springs 1 135 and connected to the catheter 1 130 secondary. The springs 1 135 fill the aneurysm 1 105 so as to reshape the blood vessel. Once the springs 1 135 in Instead, the secondary catheter 110 is removed from the blood vessel, and then the balloon 1125 is deflated. Finally, balloon 1125 is removed from the blood vessel and the blood vessel is closed by the surgeon.

FIG. 12 shows a particular embodiment of the method 80 for treating an aneurysm. This method 80 comprises:

a step 905 for introducing a catheter into a blood vessel comprising an aneurysm,

a step 910 for inflating the balloon,

a step 915 for inserting a secondary catheter so as to pass through a radial orifice and an axial orifice so that an opening of the second catheter is vis-à-vis the aneurysm,

a step 920 of deployment of turns so as to fill the aneurysm,

a step 925 for extracting the secondary catheter,

a step 930 of deflating, at least partially, of the balloon, to retain at least a portion of the clot and

a step 935 of retracting the catheter to extract each part of the clot retained in the at least partially deflated balloon.

The step 905 of introducing a catheter is performed, for example, by the perforation of a wall of the blood vessel and the insertion of the catheter. The catheter includes a conduit configured to conduct at least one fluid, and a balloon having at least one radial port and an axial port. During this step 905, the balloon carried by the catheter is positioned facing an aneurysm, the inner volume of the balloon being connected to the catheter duct.

The balloon inflation step 910 is performed, for example, by increasing the fluid pressure in the catheter conduit to expand at least one axial and radial port to receive at least a portion of the clot. The pressure of the fluid is increased, for example, by the actuation of a piston of a syringe connected to the catheter conduit. The balloon is configured, for example, to act on blood vessels three millimeters in diameter. For example, the ratio between the surface of the radial openings formed in the outer surface of the balloon on this outer surface is, in the inflated position, less than three quarters and, preferably, one half. This allows the retention of a clot while the balloon is being deflated. On the contrary, a spring metallic would have a ratio greater than nine tenths and would tend to shred the clot during its folding.

Finally, unlike systems using a metal spring deformed by longitudinal contraction to fit the walls of a blood vessel, a balloon extends in all directions as it swells. In addition, during deflation, the clot is crushed substantially isotropically and therefore does not tend to tear. On the contrary, the deformation of a metal spring would cause the radial compression of the clot and its longitudinal elongation, which could shred it,

Note that the shape of the radial openings and / or the edges of these openings is, in variants, configured to facilitate the cutting and / or the retention of the clot, whether during the balloon inflation or during a displacement of the balloon.

The step 915 of inserting a secondary catheter is performed, for example, by a second perforation of the wall of the blood vessel and by the insertion of the secondary catheter. This secondary catheter is inserted into the axial bore of the balloon so as to also pass through a radial bore of the balloon.

The coil deployment step 920 is performed, for example, by inserting a syringe needle into a lumen of the catheter. Then, a user actuates a piston of the syringe so as to push the turns into the catheter and, thus, to push the turns out of the opening of the catheter located opposite the aneurysm. These turns are configured to fill the aneurysm.

The extraction step 925 is performed, for example, by a user pulling the secondary catheter so that the secondary catheter leaves the treated blood vessel.

Step 930 of at least partial deflation of the balloon to retain at least a portion of the clot is achieved, for example, by the actuation of the piston of the syringe, so as to increase the volume containing the fluid. In this way, the pressure in the balloon decreases as desired by the user operating the piston.

The step 935 of retracting the catheter to extract each portion of the clot retained in the at least partially deflated balloon is performed, for example, by a user pulling the catheter so that the catheter leaves the blood vessel through the perforated hole in the catheter. during the introductory step 805.

Claims

1. Device (10, 30, 40, 60) for endovascular surgery, which comprises:

a catheter (105, 305, 405, 615) comprising a conduit (1 10, 310, 410, 620) configured to conduct at least one fluid,

a balloon (1, 15, 315, 415, 625) whose interior volume is connected to a catheter duct and configured to be inflated or deflated according to the fluid pressure in the catheter duct,

characterized in that the balloon is provided with at least one radial orifice (125, 325, 425) surrounded by a wall (120, 220, 330, 435, 635) for fragmenting at least a portion of the clot, each said radial orifice receiving at least a fragmented portion of the clot upon inflation of the balloon and retaining at least a fragmented portion of the clot upon at least partial deflation of the balloon.

The device (10, 20, 30, 40, 60) according to claim 1, wherein at least one port (125, 225, 325, 425) of the balloon (115, 215, 315, 415) is a radial orifice. blind.

3. Device (10, 20, 30, 40, 60) according to one of claims 1 or 2, wherein the balloon (1 15, 315, 415, 625) forms a hollow volume once at least partially inflated, at at least one port (125, 325, 425) of the balloon passing through the balloon for connecting the hollow volume to the outside of the balloon.

4. Device (30, 40, 60, 90) according to one of claims 1 to 3, which comprises an axial orifice (320, 420) passing through the balloon to allow the passage of a blood flow.

5. Device (40) according to claims 3 and 4, which comprises means (430) for retaining a blood clot in the hollow volume of the balloon (415) when the balloon is inflated, the hollow volume being at least partially formed through the axial orifice (420).

6. Device (40) according to claim 5, wherein the means (430) of retention is a mesh obstructing at least one end of the axial orifice (420).

7. Device (30, 40, 60) according to claim 5, wherein the means (415) of retention is a diaphragm positioned on at least one end of the axial orifice

(420).

The device (30, 40) according to one of claims 1 to 7, wherein at least one port (320, 325, 420, 425) of the balloon is an orifice configured to pass a secondary catheter when the balloon (315 , 415) is inflated.

9. Device (10, 30, 60) according to one of claims 1 to 8, wherein the balloon (1 15, 315, 625) is connected to the catheter (105, 305, 615) at the axis of the balloon.

The device (20, 40, 90) according to one of claims 1 to 9, wherein the balloon (215, 415, 115) is connected to the catheter (205, 405, 1115) at the periphery. of the balloon.

1 1. Device (10, 20, 30, 40, 60) according to one of claims 1 to 10, wherein at least one wall (120, 220, 330, 435, 635) between two radial orifices (125, 225, 325, 425) has an outwardly convex shape of the balloon so as to fragment a clot during inflation of the balloon.