Method and apparatus for avulsion of varicose veins
View Patent ↗Apparatuses and methods for removing veins, usually varicose veins, rely on endoluminal capture of a distal end of the vein segment to be removed. In the illustrated embodiments, a shaft having reciprocatable penetrating elements is used to engage and capture the distal end of the vein. After rotating the shaft to pull the distal segment of the vein away from the connecting tissue, the shaft is withdrawn proximally, invaginating the segment back to the point of insertion.
1. A method for removing a blood vessel having a vessel wall from tissue, said method comprising:
introducing a shaft having retracted penetrating elements into a lumen of the vessel at a proximal location;
advancing a distal end of the shaft to a distal location within the vessel lumen; exposing the penetrating elements and capturing the vessel wall at the distal location within the lumen with the distal end of the shaft; and
manipulating the shaft to remove the vessel from the tissue while the vessel wall remains captured by the penetrating elements;
wherein exposing and capturing comprise advancing at least one penetrating element from the shaft into the vessel wall and rotating the shaft to separate the vessel wall from surrounding tissue;
wherein the at least one penetrating element is deformable and advancing comprises advancing the element over a ramp which deflects the element radially outwardly.
2. A method as in claim 1 , wherein capturing the vessel wall is effected without external tissue penetration in the region of the distal location.
3. A method as in claim 1 , further comprising intraluminally generating a signal at the distal location and externally observing the signal to confirm the position of the shaft distal end prior to exposing the penetrating elements and capturing the vessel.
4. A method as in claim 1 , wherein the at least one penetrating element is resilient and preshaped to diverge radially outwardly as the element is advanced from the shaft.
5. A method as in claim 1 , wherein the introducing is performed while the penetrating elements are retracted toward a longitudinal axis of the shaft, and the exposing is performed by extending the penetrating elements away from the longitudinal axis.
6. A method as in claim 1 , wherein manipulating the shaft comprises retracting the shaft proximally to invaginate the vessel.
7. A method as in claim 1 , wherein manipulation of the shaft comprises rotating the shaft to draw down at least a distal portion of the vessel onto the shaft.
8. A method as in claim 1 , further comprising severing the vessel at the distal location prior to retracting the shaft.
9. A method as in claim 1 , further comprising disrupting the connective tissue mechanically or by introduction of tumescent anesthesia prior to shaft retraction.
10. A method as in claim 1 , further comprising applying manual pressure over the distal location to facilitate penetration of the vessel wall by the at least one penetrating element.
11. A method as in claim 1 , further comprising severing the vessel wall at the proximal location after the shaft has been retracted back to the proximal location.