High capacity debulking catheter with distal driven cutting wheel

1. A catheter for removing tissue comprising:

an elongate body having a proximal end and a distal end and a tubular side wall having an outer surface defining an outer dimension of the elongate body and an inner surface defining a lumen, the elongate body having a distal portion with a window in the side wall, the lumen proximally adjacent the window comprising a material collection chamber;

a rotational tissue cutting element disposed at least partially within the lumen of the elongate body, the tissue cutting element having a distal side and a proximal side, the tissue cutting element having an axis of rotation that extends through the material collection chamber;

a source of rotational power; and

a drive shaft connected between the source of rotational power and the distal side of the rotational tissue cutting element, no portion of the drive shaft being contained within the material collection chamber, such that the material collection chamber is substantially open for collection of tissue.

2. The catheter of claim 1 , wherein the source of rotational power is positioned within the elongate body at a location distal to the tissue cutting element.

3. The catheter of claim 1 , further comprising a handle connected at the proximal end of the elongate body, the source of rotational power being contained within the handle.

4. The catheter of claim 1 , in which the source of rotational power is one of a mechanical coupling to a rotating shaft, an electric motor, a pressure powered turbine, or a chemical powered turbine.

5. The catheter of claim 2 , wherein the drive shaft includes a proximal portion having an axis of rotation that generally coincides with the axis of rotation of the tissue cutting element and a distal portion having an axis of rotation that is radially off-set from the axis of rotation of the tissue cutting element and from the axis of rotation of the proximal portion.

6. The catheter of claim 5 , further comprising a first gear element connected to transfer torque from the proximal portion of the drive shaft to the distal portion of the drive shaft.

7. The catheter of claim 6 , further comprising a second gear element connected to transfer torque from the distal portion of the drive shaft to the distal side of the tissue cutting element.

8. The catheter of claim 1 , wherein the drive shaft has first and second ends positioned within the elongate body distal of the rotational tissue cutting element.

9. The catheter of claim 1 , wherein the elongate body further comprises a deflectable nose region, and a mechanism to allow an operator to deflect the nose region against a body lumen, thereby pushing the window and the rotatable tissue cutting element against an opposite wall of the body lumen, allowing the rotatable cutter to cut material from said body lumen.

10. The catheter of claim 1 , wherein the elongate body contains openings for receiving a guidewire.

11. The catheter of claim 1 , wherein the distal portion of the elongate body further comprises an RF electrode, a laser, or an ultrasound emitter.

12. The catheter of claim 1 , wherein the distal portion of the elongate body further comprises an imaging device.

13. The catheter of claim 12 , in which the imaging device is selected from the group consisting of ultrasound transducer arrays, optical fibers, and coherence tomography devices.

14. The catheter of claim 1 , further comprising a source of ultrasonic vibration operatively coupled to the rotatable tissue cutting element, the source of ultrasonic vibration being configured to ultrasonically vibrate the rotatable tissue cutting element.

15. The catheter of claim 14 , wherein the source of ultrasonic vibration is a piezoelectric ultrasonic vibrator.