Methods affecting markers in patients having vascular disease
Marker levels and forms can be modulated in patients having vascular disease when sufficient vascular tissue is removed. The markers can be, e.g., from tissue, blood or lymph. The markers are typically involved in molecular pathways which are in turn modulated. Atherectomy catheters are used for accomplishing sufficient removal of vascular tissue to effect the modulations.
1 . A method of modulating level of a marker in a patient having vascular disease comprising the steps of:
determining a first level of a marker in the patient;
removing sufficient vascular tissue from said patient to modulate level of said marker; and
determining a second level of the marker after removing the vascular tissue.
2 . The method of claim 1 wherein the vascular tissue comprises tissue selected from the group consisting of arterial plaque, vulnerable plaque, inflamed tissue, arterial tissue, calcified tissue, thrombotic tissue, lipid-rich tissue, foam cell tissue, macrophage-rich tissue, hypocellular tissue, fibrotic tissue, and hypercellular tissue.
3 . The method of claim 1 wherein the vascular tissue is removed from a vessel selected from the group consisting of a peripheral artery, a coronary artery, and a carotid artery.
4 . The method of claim 1 wherein the first and second levels are determined in a patient material selected from the group consisting of blood, lymph, saliva, tears, sputum, urine, stool, and sweat.
5 . The method of claim 1 wherein the marker is selected from the group consisting of a protein, a polypeptide, a peptide, a fragment of protein, a nucleic acid, a cell, a fatty acid, and a lipid.
6 . The method of claim 1 wherein the marker is a protein selected from the group consisting of a a hormone, a cytokine, a chemokine, an acute phase reactant protein, a clotting protein, a growth factor, a tissue modeling factor, an antibody, and a plasma protein.
7 . The method of claim 1 wherein the marker is selected from the group consisting of markers listed in FIG. 1 .
8 . The method of claim 1 wherein the marker is LPPLA2.
9 . The method of claim 1 wherein the marker is CRP.
10 . The method of claim 1 wherein the marker is selected from the group consisting of PDGF, PDGF receptor, FGF, VEGF, VCAM-1, and IL-6.
11 . The method of claim 1 wherein the second level is determined between 12 hours and 14 days after said removing.
12 . The method of claim 1 wherein the second level is determined between 6 months and 2 years after said removing.
13 . The method of claim 1 wherein the second level is determined between 1 year and 5 years of said removing.
14 . A method of modulating level of a marker in a patient having vascular disease comprising the steps of:
determining a first level of a marker in the patient;
introducing an atherectomy catheter percutaneously in the patient and directing the catheter to a first site in a vascular lumen containing vascular tissue;
removing sufficient vascular tissue from the vascular lumen to modulate level of said marker; and
determining a second level of the marker after removing the vascular tissue.
15 . The method of claim 14 wherein the atherectomy catheter comprises a rotating cutter, a collection chamber, and a cutting window, the rotating cutter being movable between a stored position and an exposed position; said method further comprising:
exposing the cutter by moving the cutter to the exposed position after introducing the atherectomy catheter to the vascular lumen;
advancing the catheter to move the rotating cutter through the vascular tissue in the first site, the rotating cutter remaining in the exposed position so that the cutter and the window maintain their orientation with respect to one another when advancing, wherein the vascular issue is directed through the cutting window and into the collection chamber as the catheter is advanced, and
removing the vascular tissue from the collection chamber.
16 . The method of claim 16 further comprising:
moving the cutter to the stored position prior to removing the vascular tissue from the collection chamber;
repositioning the catheter at a second site in a vascular lumen;
exposing the cutter by moving the cutter to the exposed position;
advancing the catheter to move the rotating cutter through vascular tissue in the second site, the rotating cutter remaining in the exposed position so that the cutter and the window maintain their orientation with respect to one another when advancing, the vascular tissue cut by the rotating cutter being directed through the cutting window and into the collection chamber as the catheter is advanced.
17 . A method of modifying a marker in a patient having vascular disease comprising the steps of:
determining a first form of a marker in the patient;
removing vascular tissue sufficient to effect a modification of the marker to a second form;
determining the second form of the marker in the patient.
18 . The method of claim 17 wherein the modification is selected from the group consisting of a conform ational change, a structural change, an addition of a moiety, a loss of a moiety, a change in the marker's activity, an increase in binding activity, and a decrease in binding activity.
19 . The method of claim 17 wherein the first form of the marker is determined in a sample selected from the group consisting of blood, lymph, saliva, tears, sputum, urine, stool, and sweat.
20 . The method of claim 17 wherein the marker is selected from the group consisting of markers listed in FIG. 1 .
21 . The method of claim 17 wherein the marker is selected from the group consisting of a protein, a polypeptide, a peptide, a fragment of protein, a nucleic acid, a cell, a fatty acid, and a lipid.
22 . The method of claim 17 wherein the marker is selected from the group consisting of a hormone, a cytokine, a chemokine, an acute phase reactant protein, a clotting protein, a growth factor, a tissue modeling factor, an antibody, and a plasma protein.
23 . The method of claim 17 wherein the vascular tissue comprises tissue selected from the group consisting of arterial plaque, vulnerable plaque, inflamed tissue, arterial tissue, calcified tissue, thrombotic tissue, lipid-rich tissue, foam cell tissue, macrophage-rich tissue, hypocellular tissue, fibrotic tissue, and hypercellular tissue.
24 . The method of claim 18 wherein the vascular tissue is removed from a vessel selected from the group consisting of a peripheral artery, a coronary artery, and a carotid artery.