Devices and methods for preventing distal embolization from the vertebrobasilar artery using flow reversal
The invention provides a medical device having a catheter and one or more expandable constricting/occluding members. The catheter has a lumen communicating with a port at its distal end. The lumen and port are adapted for introduction of therapeutic or diagnostic devices, including an angioplasty/stent catheter and an atherectomy catheter, into a vertebral or basilar artery. The constrictor/occluder is mounted proximal to the port of the catheter. Manometers may be mounted distal to one or more constrictors for measuring pressure distal to the constrictor(s). Methods of using the devices for preventing distal embolization during vertebral and/or basilar procedures by reversing blood flow in the vertebral artery toward the subclavian artery are disclosed.
1. A method for treating a vertebral artery lesion, comprising the steps of:
inserting a distal end of a catheter into a subclavian artery, the catheter having a proximal end, the distal end of the catheter having a constricting member;
locating the constricting member in the subclavian artery upstream a vertebral artery having a lesion;
expanding the constricting member to constrict the subclavian artery, wherein blood flow in the vertebral artery is reversed to pass over the lesion and toward the subclavian artery; and
advancing a therapeutic instrument into the vertebral artery to treat the lesion.
2. The method of claim 1 , wherein the lesion is an occlusion or stenosis.
3. The method of claim 1 , wherein the lesion is a dissection.
4. The method of claim 1 , wherein the distal end of the catheter is inserted into the subclavian artery in an antegrade direction.
5. The method of claim 1 , wherein the vertebral artery is the right vertebral artery and the subclavian artery is the right subclavian artery.
6. The method of claim 1 , wherein the vertebral artery is the left vertebral artery and the subclavian artery is the left subclavian artery.
7. The method of claim 1 , wherein the occlusion partially occludes the vertebral artery.
8. The method of claim 1 , wherein the occlusion is a stenosis.
9. The method of claim 1 , wherein the occlusion is an embolus.
10. The method of claim 1 , wherein the occlusion is an atheroma.
11. The method of claim 1 , wherein the constricting member is expanded to occlude the subclavian artery.
12. The method of claim 1 , wherein the constricting member is expanded to partially occlude the subclavian artery.
13. The method of claim 1 , wherein the constricting member is a balloon that communicates with an inflation lumen that extends to the proximal end of the catheter.
14. The method of claim 13 , wherein the balloon is a toroidal balloon.
15. The method of claim 1 , wherein the therapeutic instrument is an angioplasty catheter.
16. The method of claim 1 , wherein the therapeutic instrument is a stent.
17. The method of claim 1 , wherein the therapeutic instrument is an atherectomy catheter.
18. The method of claim 1 , wherein the catheter has a lumen adapted to pass the therapeutic instrument.
19. The method of claim 1 , further comprising the step of locating a second constricting member in the subclavian artery downstream the vertebral artery having an occlusion.
20. The method of claim 19 , further comprising the step of expanding the second constricting member to partially occlude the subclavian artery.
21. The method of claim 1 , further comprising the step of infusing angiographic dye to confirm the reversal of blood flow.
22. The method of claim 1 , wherein the distal end of the catheter further comprises a radiopaque marker.
23. The method of claim 1 , wherein a manometer is mounted distal the constricting member.