WO2021097215A1 - Dispositifs, systèmes et procédés pour éliminer des caillots sanguins - Google Patents

Dispositifs, systèmes et procédés pour éliminer des caillots sanguins Download PDF

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Publication number
WO2021097215A1
WO2021097215A1 PCT/US2020/060426 US2020060426W WO2021097215A1 WO 2021097215 A1 WO2021097215 A1 WO 2021097215A1 US 2020060426 W US2020060426 W US 2020060426W WO 2021097215 A1 WO2021097215 A1 WO 2021097215A1
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WO
WIPO (PCT)
Prior art keywords
clot
blood vessel
distal
catheter
distal end
Prior art date
Application number
PCT/US2020/060426
Other languages
English (en)
Inventor
Paul KRELL
Original Assignee
Ischemicure Ltd
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
Application filed by Ischemicure Ltd filed Critical Ischemicure Ltd
Publication of WO2021097215A1 publication Critical patent/WO2021097215A1/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
    • A61B17/22—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
    • 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
    • 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
    • A61B2017/22079—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 suction of debris
    • 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
    • A61B2017/22082—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 after introduction of a substance
    • A61B2017/22089—Gas-bubbles
    • 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
    • A61B2017/22094—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 for crossing total occlusions, i.e. piercing
    • 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
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2215—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
    • 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0194—Tunnelling catheters

Definitions

  • the present invention relates generally to medical and surgical devices and, more particularly, to devices, systems, and methods for removing blood clots during a catheter procedure.
  • Stroke is a sudden and often severely debilitating medical event for many people. Stroke can cause sudden death, and even survivors can lose the ability to speak, walk, feed, and care for themselves. These patients frequently need long term care and have limited life expectancy.
  • the most common cause of a stroke is an obstruction of an artery in the brain caused by lodgment of a blood clot.
  • the clot or embolus dislodges from a source such as the heart or an artery in the neck, and travels into a brain artery. As the artery narrows, the clot eventually becomes fixed or stuck in position. Flow ceases to the region of the brain beyond the obstruction and severe damage often occurs.
  • the brain is very unforgiving of lost blood flow. Many regions are supplied by only one source of blood, and the function of the brain is not replicated. Once a motor or speech area is lost, there is limited ability for other segments of the brain to take over the lost function.
  • the typical treatment for stroke was conservative, watchful therapy. With this approach the outcome was often unsatisfactory.
  • Another form of therapy involves the use of clot dissolving agents. However, these agents can only provide limited benefit.
  • the present disclosure contemplates that previously developed mechanical thrombectomy techniques have been shown to be effective in treating clots lodged in a relatively large blood vessels (e.g., “large vessel occlusions”). Generally, these relatively larger blood vessels are considerably larger than the catheters and associated devices used to access and remove the clots. [0009] The present disclosure contemplates that it may be advantageous to mechanically remove clots that are lodged in relatively smaller blood vessels, such as at further distal positions in a patient’s vascular system. These relatively smaller vessels may be too small to utilize some techniques developed for treating large vessel occlusions because they are narrow and/or because they taper rapidly in the vicinity of the clot.
  • some smaller or tapered vessels may not be large enough for a catheter carrying an expandable seal or similar structure to be advanced to a position distal to the clot. Further, some smaller or tapered vessels may be so small that accessing the clot with an aspiration catheter or a catheter carrying a stent may not be practical.
  • a device for removing a blood clot from a blood vessel comprises an elongate intravascular element having a non- expandable distal end portion disposed at a distal end. At least one hole is in fluid communication between an interior lumen of the elongate intravascular element and an exterior of the elongate intravascular element. The at least one hole is located proximal to the distal end portion. The distal end portion is configured to sealingly engage an interior wall surface of the blood vessel, thereby occluding the blood vessel.
  • the device may include various optional features as well.
  • the distal end portion may be at least one of: inwardly tapering, substantially the same diameter as the elongate intravascular element, and generally bulbous.
  • the elongate intravascular element may be configured to advance along a guidewire, and a distal interface between the elongate intravascular element and the guidewire may be fluidically sealed.
  • the distal interface between the elongate intravascular element and the guidewire may include at least one of (1) an internally tapering internal distal seal disposed on the distal end portion of the elongate intravascular element and (2) a negatively tapered distal end portion of the guidewire.
  • a system for removing a blood clot from a blood vessel of a patient, with the system including a device such a summarized above, and a guidewire.
  • the system may further include a first catheter disposed about the elongate intravascular element.
  • the system may further include a delivery catheter disposed about the first catheter.
  • a method of removing a clot from a blood vessel comprises: engaging an interior wall surface of the blood vessel with a non-expandable distal end portion of a positive pressure catheter to occlude the blood vessel distal to the clot; moving the clot in a proximal direction by directing a fluid at a positive pressure sufficient to move the clot into the vessel distal to the clot through the positive pressure catheter; and capturing the clot and removing the clot from the blood vessel.
  • the method may include various optional features.
  • a guidewire before the engaging the interior wall surface of the blood vessel operation, a guidewire may be advanced from proximal to the clot to a position distal to the clot; and engaging the interior wall surface of the blood vessel comprises advancing the positive pressure catheter along the guidewire.
  • the method may further comprise, before the advancing the guidewire operation, positioning an elongate intravascular element in the blood vessel on the proximal side of the blood clot; and the advancing the guidewire operation includes advancing the guidewire through the elongate intravascular element.
  • Positioning the elongate intravascular element operation may further comprise occluding the blood vessel proximal to the clot by expanding a radially expandable proximal seal extending from the elongate intravascular element.
  • Positioning the elongate intravascular element may further comprise advancing a delivery catheter into the blood vessel and advancing the elongate intravascular element through the delivery catheter.
  • the method may further comprise applying suction in the blood vessel proximal to the clot.
  • FIG. 1 is a schematic representation of a patient illustrating the use of an example clot removal system to remove a clot from a blood vessel in the patient’s brain.
  • FIGS. 2A through 2C are longitudinal cross-sectional views schematically illustrating a clot removal system in accordance with one illustrative embodiment being used to dislodge and remove a blood clot.
  • FIG. 3A is a longitudinal cross-sectional view illustrating the embodiment of FIGS. 2A through 2C in more detail.
  • FIG. 3B is a longitudinal cross-sectional view similar to FIG. 3A but illustrating another alternative embodiment.
  • FIG. 3C is a longitudinal cross-sectional view similar to FIGS. 3A and 3B but illustrating another alternative embodiment.
  • FIG. 4 is a longitudinal cross-sectional view schematically illustrating a clot removal system according to another illustrative embodiment.
  • FIG. 1 is a schematic representation of a patient and portions of the vascular system of the patient, partially cross sectioned, and further illustrating a manner of using an example clot removal system 100 to remove a clot from a blood vessel in the patient’s brain. It will be appreciated that although exemplary embodiments are described herein in connection with removing clots from blood vessels in brains, some embodiments according to at least some aspects of the present disclosure may be used in procedures for removing obstructions from vessels in other body parts.
  • FIGS. 2A-2C are cross-sectional schematic views of a blood vessel 12 showing an example procedure for removing a clot 10 using the illustrative clot removal system 100.
  • the clot 10 is lodged in the vessel 12, which includes a proximal portion 11 and a distal portion 13.
  • the internal size (e.g., diameter) of the vessel 12 tapers narrower from the proximal portion 11 to the distal portion 13.
  • the shape and taper of the vessel 12 shown in the drawings is intended to facilitate understanding of the construction and operation of the illustrative embodiment and that the shape and/or taper of actual vessels may differ.
  • the clot removal system 100 includes an elongate intravascular element, such as a delivery catheter 8, which may be utilized to direct other components of the system 100 into the vicinity of the clot 10.
  • the clot removal system includes an elongate intravascular element, such as a first catheter 14, that is advanced through the delivery catheter 8 and out of the distal end opening 8a of the delivery catheter 8.
  • the first catheter 14 includes a proximal seal 16 disposed at distal end portion 15 of the first catheter 14.
  • the proximal seal 16 is partially funnel shaped and comprises an open distal end forming a mouth 16a.
  • the proximal seal 16 is be constructed of a thin, flexible, generally impermeable membrane that is selectively deployable, such as by radially self-expanding (e.g., by a stent-like structure 16b) as it is advanced through and beyond the distal end opening 8a of the delivery catheter 8. This relative motion may be accomplished by advancing the first catheter 14 through the stationary delivery catheter 8, withdrawing the delivery catheter 8 from the stationary first catheter 14, or by moving both the first catheter 14 and the delivery catheter 8.
  • the proximal seal 16 may be disposed on a proximal seal wire (see generally FIG. 4 and corresponding description below). In some such embodiments, the proximal seal 16 may be deployed by being advanced distally from the distal end portion 15 of the first catheter 14.
  • the proximal seal 16 has a length that is several times its expanded diameter and/or that is longer than the clot 10. As shown in FIG. 2C, this elongated shape of proximal seal 16 may facilitate capture and/or containment of the clot 10 substantially within the proximal seal 16, which may be particularly advantageous while the clot removal system 100 and clot 10 are being withdrawn from the vessel 12.
  • the proximal seal 16 expands radially to engage the interior wall surface 12a of the vessel 12 in a substantially fluid-tight manner.
  • the delivery catheter 8, the first catheter 14, and the proximal seal 16 may be positioned proximal to the clot 10.
  • the proximal seal 16 may substantially occlude the vessel 12.
  • proximal seals may be utilized instead of or in addition to the radially self-expanding proximal seal 16 of the illustrative embodiment.
  • an alternative proximal seal may comprise an inflatable balloon, which may be disposed on the first catheter 14 and/or the delivery catheter 8.
  • the clot removal system 100 includes an elongate intravascular element, such as a guidewire 36, which is advanced through the delivery catheter 8 (e.g., through the first catheter 14), adjacent to and/or through the clot 10, and to a position distal to the clot 10.
  • suction may be applied, such as via the first catheter 14, while the guidewire 36 is advanced past the clot 10.
  • the clot removal system 100 includes an elongate intravascular element, such as a positive pressure catheter 27 (e.g., a microcatheter), that is advanced along the guidewire 36 to a position distal to the clot 10.
  • a positive pressure catheter 27 e.g., a microcatheter
  • the positive pressure catheter 27 is advanced until its distal end portion 27a engages the interior wall surface 12a of the vessel 12, thereby occluding the vessel 12 distal to the clot 10 (FIG. 2B).
  • FIG. 3A is a detailed cross-sectional schematic view of the distal portion of the guidewire 36 and the positive pressure catheter 27 in the vessel 12.
  • the outer diameter of the distal end portion 27a of the positive pressure catheter 27 tapers inward (e.g., narrows) in the distal direction, which generally corresponds to the narrowing of the vessel 12 from proximal to distal.
  • FIG. 3B is a detailed cross-sectional schematic view of the distal portion of an alternative guide wire 136 and an alternative positive pressure catheter 127. It will be appreciated that any of the features illustrated in FIG. 3B may be utilized in any embodiment according to at least some aspects of the present disclosure.
  • the outer diameter of the distal end portion 127a of the positive pressure catheter 127 is substantially the same as the diameter of the main body portion and is substantially constant over the distal end portion 127a.
  • FIG. 3C is a detailed cross-sectional schematic view of the distal portion of an alternative positive pressure catheter 227. It will be appreciated that any of the features illustrated in FIG. 3C may be utilized in any embodiment according to at least some aspects of the present disclosure.
  • at least a portion of the outer diameter of the distal end portion 227a is wider than the diameter of the main body portion of the positive pressure catheter 227.
  • the distal end portion 227a is generally bulbous (e.g., enlarged and rounded).
  • the illustrated bulbous distal end portion 227a comprises a substantially circumferentially uniform, rounded, and enlarged shape
  • other alternative embodiments may include distal end portions comprising projections that are circumferentially non-uniform, are not generally rounded (e.g., include one or more distinct corners), and/or are otherwise shaped in any desired manner.
  • the positive pressure catheter 27, 127, 227 is advanced distally (e.g., over the guidewire 36, 136) until the distal end portion 27a, 127a, 227a achieves a substantially sealed engagement with the interior wall surface 12a of the vessel 12, thereby occluding the vessel 12 distal to the clot 10.
  • These example distal end portions 27a, 127a, 227a are non-expandable and utilize distal advancement to engage their outer diameters with the inner diameter of the vessel 12 to achieve the occluding seal distal to the clot 10.
  • the vessel 12 may be occluded distal to the clot without using an expandable seal distal to the clot.
  • occluding the vessel 12 distal to the clot 10 using the distal end portion 27a, 127a, 227a of the positive pressure catheter 27, 127, 227 may facilitate mechanical clot 10 removal in vessels 12 that are too small or too tapered to accommodate larger distal occlusion devices, such as expandable distal seals. Accordingly, some clot removal systems according to at least some aspects of the present disclosure may be used to remove clots that would not be mechanically removable using other devices.
  • the clot removal system 100 includes a pressure source/control 22, which may be configured to provide and/or control suction and/or positive fluid pressure to various components of the system 100.
  • the pressure source/control 22 may be configured to supply a pressurized fluid (e.g., a liquid, a gas, or a combination of liquid and gas), such as any biocompatible liquids (e.g., saline) and/or biocompatible gasses (e.g., carbon dioxide, air, oxygen, or anesthetic gasses).
  • Fluids may include medications, which may aid in dilating the vessel 12 and/or dissolving the clot, and/or may protect the brain, for example.
  • the internal diameter of the positive pressure catheter 27 is larger than the external diameter of the guidewire 36 so that a generally annular flow channel is created therebetween.
  • the positive pressure catheter 27 includes one or more perforations or holes 23 connecting the interior lumen of the positive pressure catheter 27 (e.g., the generally annular flow channel) to the surrounding environment (e.g., the interior of the vessel 12).
  • the holes 23 are positioned proximal to the distal end portion 27a so that they are within the occluded volume of the vessel 12 (e.g., between the distal seal formed by the distal end portion 27a of the positive pressure catheter 27 and the proximal seal 16 of the first catheter 14).
  • the positive pressure catheter 27 is positioned relative to the clot 10 so that the holes 23 are distal to the clot 10.
  • the holes 23 may be generally radially oriented.
  • the positive pressure catheter 27 comprises an internal distal seal 27b, which may be operative to fluidically seal the distal interface between the positive pressure catheter 27 and the guidewire 36.
  • the positive pressure catheter 27 comprises an inwardly projecting internal distal seal 27b.
  • the internal distal seal 27b comprises an inwardly tapering (e.g., internally narrowing) portion that sealingly engages the radially exterior surface of the guidewire 36 extending therethrough. Accordingly, the interior lumen of the positive pressure catheter 27 is fluidically separated from the interior volume of the vessel 12 distal to the distal end portion 27a of the positive pressure catheter 27.
  • the internal distal seal 27b may comprise a radially inwardly facing projection having a shape other than a gradual, elongated taper.
  • the guidewire 136 and positive pressure catheter 127 comprise an alternative distal sealed interface therebetween.
  • the internal diameter of the positive pressure catheter 127 is substantially constant over the main body portion and the distal end portion 127a.
  • the guidewire 136 comprises an outwardly tapering distal portion 136a that tapers from narrower to wider in the distal direction (a “negative taper”).
  • the pressure source/control 22 supplies carbon dioxide 19 (or any other suitable gas, liquid, or mixture thereof) at a positive pressure to the positive pressure catheter 27, which directs the carbon dioxide 19 into the into the vessel 12 distal to the clot 10 through the holes 23.
  • the pressure source/control 22 may apply suction pressure, such as via the first catheter 14.
  • suction may be applied via the first catheter 14 when the guidewire 36 and/or the positive pressure catheter 27 are being advanced past the clot 10 and/or when positive pressure is being applied distal to the clot 10 via the holes 23.
  • the positive pressure delivered through the holes 23 and/or the suction applied via the first catheter 14 may be continuous (constant) or pulsed (cycled) at one or more desired frequencies and amplitudes of pressure, such as controlled by the pressure source/control 22.
  • Some example embodiments may utilize suction only, positive pressure only, or both suction and positive pressure.
  • the pressure source/control 22 may comprise an electronically controlled pump, which may be configured with various control algorithms.
  • the pressure source/control 22 may be configured to avoid suction of blood beyond a predetermined amount.
  • the pressure source/control 22 may be configured to recognize when a clot 10 has been captured in the proximal seal 16.
  • the pressure source/control 22 may be configured to limit positive pressure and/or suction within predetermined limits.
  • the pressure source/control 22 may be configured to minimize the introduction of air into the clot removal system 2.
  • the carbon dioxide 19 supplied via the positive pressure catheter 27 (creating a relatively higher pressure distal to the clot 10) and/or the suction applied via the first catheter 14 (creating a relatively lower pressure proximal to the clot 10) has detached the clot 10 from the interior wall surface 12a of the vessel and has moved the clot 10 proximally at least partially into the proximal seal 16 and/or the first catheter 14, thereby capturing the clot 10.
  • the clot removal system 100 may be withdrawn with the clot 10 at least partially intact, or the clot 10 may be fragmented and aspirated, such as via the first catheter 14, thereby removing the clot 10 from the vessel 12.
  • FIG. 4 is a cross-sectional schematic view of the blood vessel 12 showing the proximal portion of an alternative illustrative clot removal system 200.
  • the clot removal system 200 is generally similar to clot removal system 100, includes similar components (unless explicitly stated otherwise), and is used in a generally similar manner.
  • the clot removal system 200 may be particularly useful for relatively smaller vessels 12 that may not be accessible by some of the potentially larger components of the clot removal system 100, such as the delivery catheter 8 and/or the first catheter 14.
  • the clot removal system 200 comprises the guidewire 36, positive pressure catheter 27, proximal seal 16, and/or pressure source/control 22 of the clot removal system 100.
  • an elongate intravascular element such as a microcatheter 327, is advanced into the vessel 12 to a position proximal to the clot 10 so that the proximal seal 16 will engage the interior wall surface 12a of the vessel 12 proximal to the clot 10 in a substantially fluid-tight manner when the proximal seal 16 is deployed.
  • the proximal seal 16 is disposed at the distal end of an elongate intravascular element, such as a proximal seal wire 114, which is advanced through the microcatheter 327.
  • the proximal seal 16 is deployed from the distal end of the microcatheter 227 by relative motion of the proximal seal 16 in the distal direction.
  • the proximal seal wire 114 and proximal seal 16 may be advanced distally through the stationary microcatheter 227, the microcatheter 227 may be withdrawn from the stationary proximal seal wire 114 and proximal seal 16, or both the microcatheter 227 and the proximal seal wire 114 may be moved in opposite directions.
  • positive fluid pressure distal to the clot 10 may be sufficient to dislodge and/or move the clot 10 proximally (e.g., without applying suction on the proximal side of the clot 10).
  • blood clot means any obstruction or clot material impeding the flow of blood in a blood vessel, regardless of the material forming the obstruction or the origin of the material.
  • elongate intravascular element means a wire, guidewire, catheter or microcatheter, or other similar device configured for insertion into and use within the vascular system of a patient.
  • catheter and microcatheter mean an elongate intravascular element having a longitudinal lumen extending therethrough, which may be used to convey fluid and/or other elongate intravascular elements, regardless of diameter.
  • positive pressure refers to a pressure that is greater than the pressure at the relevant location.
  • suction refers to a pressure that is less than the pressure at the relevant location. Accordingly, “positive pressure” and “suction” are relative terms that should be considered in the context of the pressure at the relevant location immediately before the “positive pressure” or “suction” is applied.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Orthopedic Medicine & 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

L'invention concerne un dispositif ou un système (100) pour retirer un caillot sanguin (10) d'un vaisseau sanguin (12), lequel comprend un élément intravasculaire allongé (27) ayant une partie d'extrémité distale non extensible (27a). Au moins un trou (23) relie fluidiquement une lumière intérieure (27b) de l'élément intravasculaire allongé (27) à l'extérieur de l'élément intravasculaire allongé (27). Ledit au moins un trou (23) est situé à proximité de la partie d'extrémité distale (27a). La partie d'extrémité distale (27a) est conçue pour venir en prise de manière étanche avec une surface de paroi intérieure (12a) du vaisseau sanguin (12) et assurer l'occlusion du vaisseau sanguin (12).
PCT/US2020/060426 2019-11-14 2020-11-13 Dispositifs, systèmes et procédés pour éliminer des caillots sanguins WO2021097215A1 (fr)

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US201962935466P 2019-11-14 2019-11-14
US62/935,466 2019-11-14

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11793532B2 (en) 2018-01-25 2023-10-24 Ischemicure Ltd. Devices, systems and methods to remove blood clots

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5989271A (en) * 1998-11-09 1999-11-23 Possis Medical, Inc. Flexible tip rheolytic thrombectomy catheter and method of constructing same
US20060064074A1 (en) * 2004-09-21 2006-03-23 Scimed Life Systems, Inc. Rapid exchange catheters having a sealed guidewire lumen and methods of making the same
US8057497B1 (en) * 2009-07-28 2011-11-15 Seshadri Raju Thrombectomy removal device kit
US20140276602A1 (en) * 2013-03-13 2014-09-18 Medrad, Inc. Catheter system
US20170189654A1 (en) * 2016-01-04 2017-07-06 ReFlow Therapeutics AG System and methods for treating mvo

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5989271A (en) * 1998-11-09 1999-11-23 Possis Medical, Inc. Flexible tip rheolytic thrombectomy catheter and method of constructing same
US20060064074A1 (en) * 2004-09-21 2006-03-23 Scimed Life Systems, Inc. Rapid exchange catheters having a sealed guidewire lumen and methods of making the same
US8057497B1 (en) * 2009-07-28 2011-11-15 Seshadri Raju Thrombectomy removal device kit
US20140276602A1 (en) * 2013-03-13 2014-09-18 Medrad, Inc. Catheter system
US20170189654A1 (en) * 2016-01-04 2017-07-06 ReFlow Therapeutics AG System and methods for treating mvo

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11793532B2 (en) 2018-01-25 2023-10-24 Ischemicure Ltd. Devices, systems and methods to remove blood clots
US11950795B1 (en) 2018-01-25 2024-04-09 Ischemicure Ltd. Devices, systems and methods to image blood clots

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