Devices and methods for removal of acute blockages from blood vessels
A rapid exchange (RX) catheter may provide a proximal seal against a guide catheter inner lumen so that aspiration may be applied through a guide catheter. The catheter may include an exit port that defines a transfer port for aspiration and may enable minimal frictional engagement with the guide catheter proximal of the exit port. Aspiration can be applied to the lumen of the guide catheter and may be directed to and effective at the tip of the RX aspiration catheter. A tip of the RX catheter may facilitate aspiration and retrieval of the clot by expanding under load and can also partially or fully occlude the vessel.
1. A system for removing a clot from a vessel, the system comprising:
an expandable clot retrieval device having a collapsed delivery configuration and an expanded deployed configuration;
a microcatheter having a proximal end and a distal end and defining a lumen therein, the expandable clot retrieval device being positioned within the lumen of the microcatheter in the collapsed delivery configuration;
a second catheter having a proximal end and a distal end and defining a lumen therein, the second catheter being an aspiration catheter comprising an expansile distal tip comprising a constricted delivery configuration and an expanded deployed configuration comprising a larger diameter than a diameter of the second catheter proximal thereof;
a self-expandable clot receptor device comprising:
a plurality of struts distally connected at crowns formed with atraumatic ends and proximally terminating at a proximal shaft integrally formed therewith,
the proximal shaft extending proximally in the second catheter and having a sheathed configuration within the lumen of the second catheter and expanded configuration extending distally of the second catheter caused by distally advancing the proximal shaft,
wherein, in the expanded configuration, a distal end of the clot receptor device includes a larger diameter than a diameter of a proximal end of the clot receptor device and being larger than the diameter of the expansile distal end of the second catheter.
2. The system of claim 1 , wherein the clot receptor device further includes a non-porous cover positioned over a self-expanding frame.
3. The system of claim 2 , wherein the non-porous cover is a membrane that comprises a polymeric material.
4. The system of claim 1 , wherein, in the expanded configuration, the distal end of the clot receptor device includes diameter that is between 50% and 500% larger than the diameter of the proximal end of the clot receptor device.
5. The system of claim 1 , wherein, in the expanded configuration, the distal end of the clot receptor device is capable of sealing against the vessel.
6. The system of claim 1 , wherein the microcatheter is configured to be distally advanced so the distal end of the microcatheter extends distally of or within the clot.
7. The system of claim 1 , wherein the self-expandable clot receptor device further comprises an unsheathed configuration distal of the lumen of the second catheter in the expanded configuration caused by retracting proximally the second catheter.
8. The system of claim 1 , wherein following deployment, the clot receptor device is capable of being retracted into the lumen of the second catheter.
9. The system of claim 1 , wherein following deployment, the clot engaging device is capable of being retracted towards the clot receptor device in the expanded configuration.
10. The system of claim 9 , wherein the clot engaging device is retracted toward the clot receptor device by retracting the clot engaging device through the distal end of the clot receptor device and into a lumen defined by the clot receptor device.
11. The system of claim 1 , wherein the second catheter is capable of aspirating through the lumen of the second catheter to the distal end of the clot receptor device.
12. The system of claim 11 , wherein the clot receptor device together are configured to maintain the vessel in an open state during aspiration, via the distal end of the clot receptor device.
13. The system of claim 1 , wherein the clot receptor device comprises a self-expanding frame and a non-porous cover positioned over the self-expanding frame.
14. The system of claim 1 , wherein the clot receptor device comprises a first tubular section tapered to a second tubular section of the larger diameter, the second section being disposed on the distal end of the clot receptor device.
15. The system of claim 1 , wherein of the atraumatic ends comprise a higher radius of curvature the proximal crowns of the clot receptor device.
16. A system for removing a clot from a vessel, the system comprising:
an expandable clot retrieval device having a collapsed delivery configuration and an expanded deployed configuration, the clot retrieval device comprising a framework of struts forming a mesh-like porous body comprising a collapsed delivery configuration capable of being stored in a microcatheter and an expanded deployed configuration when delivered to an occlusion and distal of the microcatheter;
a microcatheter having a proximal end and a distal end and defining a lumen therein, the expandable clot retrieval device being positioned within the lumen of the microcatheter in the collapsed delivery configuration;
an aspiration catheter having a proximal end and a distal end and defining a lumen therein;
a self-expandable clot receptor device comprising:
a plurality of struts distally connected at crowns formed with atraumatic ends and proximally terminating at a proximal shaft integrally formed therewith,
the proximal shaft extending proximally in the aspiration catheter and having a sheathed configuration within the lumen of the aspiration catheter and expanded configuration extending distally of the aspiration catheter caused by distally advancing the proximal shaft,
wherein, in the expanded configuration, a distal end of the clot receptor device includes a larger diameter than a diameter of a proximal end of the clot receptor device and being larger than a diameter of the distal end of the aspiration catheter.