Atherectomy catheters with longitudinally displaceable drive shafts
Described herein are atherectomy catheters, systems and methods that include longitudinally displaceable drive shafts that drive actuation of one or more cutters at the distal end of the catheter. The catheters described herein may include one or more imaging sensors for imaging before, during or after cutting tissue. In some variations the imaging sensor may be rotated around the perimeter of the catheter independently of the rotation of the cutter. Also describe herein are imaging catheters that may be used without cutters.
1. An atherectomy catheter device configured to visualize and to cut tissue, the device comprising:
an elongate catheter body;
a distal tip attached to the elongate catheter body;
a cutter having a distal cutting edge, the cutter configured to rotate relative to the elongate catheter body;
a cutter drive shaft within the elongate catheter body and connected to the cutter, the cutter drive shaft configured to rotate the cutter, wherein the cutter drive shaft is further configured to be longitudinally displaced proximally or distally to deflect the distal tip to expose the cutting edge of the cutter; and
an optical fiber within the cutter drive shaft extending a length of the elongate catheter body, a distal end of the optical fiber forming an imaging sensor;
wherein the distal end of the optical fiber is rotationally fixed to the cutter and configured to rotate therewith during imaging, a proximal end of the optical fiber is rotationally fixed to a portion of the catheter device, and an area between the proximal end of the optical fiber and the distal end of the optical fiber is free to rotate within the cutter drive shaft.
2. The device of claim 1 , further comprising a ramped slide surface between the distal tip and a region within the elongate body proximal to the cutter, wherein the ramped slide surface is configured to guide deflection of the distal tip as the cutter drive shaft is moved longitudinally.
3. The device of claim 1 , wherein the imaging sensor comprises an OCT imaging sensor.
4. The device of claim 1 , wherein the cutter comprises a ring cutter.
5. The device of claim 1 , wherein the distal tip is configured to collect tissue cut by the cutter.
6. The device of claim 1 , further comprising a proximal handle having a first driver for driving rotation of the cutter and a second driver for driving rotation of the imaging sensor.
7. The device of claim 1 , further comprising a proximal handle having a first driver for driving rotation of the cutter between 100 and 4000 rpm, and a second driver for driving rotation of the imaging sensor at less than 100 rpm.
8. The device of claim 1 , further comprising a proximal handle having a first driver for driving rotation of the cutter in a first direction and a second driver for alternately driving rotation of the imaging sensor in a first rotational direction and a second rotational direction.
9. The device of claim 1 , wherein the portion of the catheter device is the handle.
10. The device of claim 1 , wherein the cutter drive shaft is configured to be moved longitudinally to pack tissue into the distal tip.
11. The device of claim 1 , wherein the area of the optical fiber between the proximal end and the distal end is not fixed to any portion of the device.