Catheter systems enabling improved aspiration from cerebral arteries

1 . An endovascular method for gaining access to cervical and cerebral arteries, the endovascular method for placing a catheter system within a human vasculature between a distal entry point (DEP) and cerebral arteries and aspirating a cerebral clot in one of the cerebral arteries, the method comprising the steps of:

a) introducing a catheter system including a D2BA catheter, guide wire (GW) and diagnostic catheter (DC) through a DEP;

b) advancing the catheter system to an aortic arch;

c) advancing the GW and DC to a desired cervical artery and manipulating the GW into a desired cervical artery;

d) advancing the D2BA catheter to a desired carotid artery over the DC and GW;

e) removing the DC and GW;

f) introducing an internal support catheter (ISC) having a tapered distal section for supporting a distal end of the D2BA catheter and adapted to facilitate movement of the distal end through tight curves in the cerebral vasculature and an ISC microwire (ISC MW);

g) advancing the ISC and ISC MW to the cerebral artery with the clot;

h) advancing the D2BA catheter to a proximal face of the clot and withdrawing the ISC and ISC MW; and,

i) applying suction to the clot through the D2BA catheter;

j) comparing a pre-determined pressure pulse against a measured response pressure at a suction pump and adjusting subsequent pressure pulses based on the measured response pressure;

where step i includes applying one or more first pressure pulses through the D2BA catheter to assist in engaging a distal tip of the D2BA catheter against the clot followed by at least one second aspiration pulse to aspirate the clot;

wherein the step of adjusting subsequent pressure pulses considers pressure response data from a plurality of patients collected and analysed from similar procedures;

wherein suction is applied via a suction pump operatively connected to the internet and a central computer system and wherein pressure response data from different pumps is received and analysed by the central computer system and wherein pump pressure algorithms are updated via the internet to the different pumps.

2 . The method as in claim 1 further comprising the steps of:

k) after applying suction to withdraw a clot in step i, conducting a check angiogram to determine if the entire clot has been withdrawn and if one or more distal emboli are present and if present:

l) advancing a second D2BA catheter sized for co-axial movement within the D2BA catheter together with a second ISC and second ISC MW to a proximal face of the distal emboli; and,

m) applying suction to the second D2BA catheter to withdraw the distal emboli via aspiration or by withdrawing the second D2BA catheter.

3 . The method as in claim 1 where step i includes applying one or more first pressure pulses through the D2BA catheter to assist in engaging a distal tip of the D2BA catheter against the clot followed by at least one second aspiration pulse to aspirate the clot.

4 . The method as in claim 3 wherein pump pressure algorithms consider catheter materials, brand and/or size.

5 . The method as in claim 1 wherein if aspiration has been unsuccessful further comprising the step of introducing a cooling catheter into the D2BA catheter and advancing the cooling catheter to the distal tip of the D2BA catheter and flushing a cooling solution through the cooling catheter to affect cooling of brain tissue.

6 . The method as in claim 5 further comprising the step of flushing the cooling solution through the cooling catheter.

7 . The method as in claim 6 wherein the cooling catheter further having proximal insulation and where after the ISC has been withdrawn and aspiration has been completed, the ISC is re-introduced and cooling solution is flushed through the ISC.

8 . A method for gaining access to cervical and cerebral arteries, comprising:

advancing a catheter system to an aortic arch, the catheter system comprising an aspiration catheter, a guide wire, and a diagnostic catheter;

advancing the guide wire and the diagnostic catheter to a desired cervical artery;

advancing the aspiration catheter to a desired carotid artery over the diagnostic catheter and the guide wire;

removing the diagnostic catheter and the guide wire;

advancing an integrated support and cooling catheter to a clot within a cerebral artery, the integrated support and cooling catheter comprising a cooling lumen and a tapered distal section;

advancing the aspiration catheter to the clot and withdrawing the integrated support and cooling catheter;

aspirating the clot with the aspiration catheter;

reintroducing the integrated support and cooling catheter to a previous location of the clot after the clot has been aspirated;

cooling the previous location of the clot by flushing a cooling solution through the integrated support and cooling catheter.

9 . The method of claim 8 , wherein the integrated support and cooling catheter comprises a length greater than the aspiration catheter.

10 . The method of claim 8 , further comprising the step of introducing an integrated support and cooling catheter microwire.

11 . The method of claim 10 , further comprising advancing the integrated support and cooling catheter microwire to the cerebral artery with the integrated support and cooling catheter.

12 . The method of claim 8 , further comprising applying a first pressure pulse through the aspiration catheter to assist in engaging a distal tip of the aspiration catheter against the clot.