Methods and systems for treatment of acute ischemic stroke
A system of devices for treating an artery includes an arterial access sheath adapted to introduce an interventional catheter into an artery and an elongated dilator positionable within the internal lumen of the sheath body. The system also includes a catheter formed of an elongated catheter body sized and shaped to be introduced via a carotid artery access site into a common carotid artery through the internal lumen of the arterial access sheath. The catheter has an overall length and a distal most section length such that the distal most section can be positioned in an intracranial artery and at least a portion of the proximal most section is positioned in the common carotid artery during use.
1. An aspiration catheter system comprising:
an access sheath comprising a tubular sheath body with a central lumen having an inner diameter, a proximal end and a distal opening,
and a connector operably connected with the sheath body and attachable to an aspiration line that connects to an aspiration source via the connector; and
a catheter comprising a distal portion and a proximal tether extending proximally from a point of attachment between the proximal tether and the distal portion, wherein the distal portion has an inner lumen, and wherein the catheter is configured to extend from a femoral access site to a carotid artery,
wherein the catheter is configured to slide within the central lumen of the sheath body to change the relative position of the catheter within the central lumen and provide for at least a portion of the distal portion to extend outward from the distal opening of the sheath body such that an overlap region is formed between the catheter and the access sheath,
wherein an effective seal is formed in the overlap region by a tight fit between a cylindrical outer surface of the catheter and a cylindrical inner surface of the central lumen of the sheath body, and
wherein an aspiration lumen is collectively formed by the inner lumen of the catheter and the central lumen of the access sheath and aspiration is enabled via the effective seal.
2. The aspiration catheter system of claim 1 , wherein the access sheath has an outer diameter ranging from about 6 Fr to about 8 Fr.
3. The aspiration catheter system of claim 1 , wherein the inner diameter of the catheter is between about 0.058″ and about 0.072″ and wherein the inner diameter of the central lumen of the sheath body is between about 0.074″ and about 0.088″.
4. The aspiration catheter system of claim 1 , wherein the sheath body of the access sheath has a length from about 90 cm to about 120 cm.
5. The aspiration catheter system of claim 1 , wherein the aspiration source is a syringe having a volume of at least 30 cc, and wherein a flow rate of at least about 321 mL/min is established when an aspiration pressure through the aspiration lumen is applied by the syringe.
6. The aspiration catheter system of claim 1 , wherein the distal portion of the catheter has a first outer diameter and the cylindrical outer surface of the catheter has a second outer diameter that is larger than the first outer diameter.
7. The aspiration catheter system of claim 1 , wherein the distal portion of the catheter comprises a step up from a first outer diameter to a larger, second outer diameter located proximal of the first outer diameter.
8. The aspiration catheter system of claim 7 , wherein the step up is over a transition section.
9. The aspiration catheter system of claim 8 , wherein the transition section is between 3 mm and 10 mm in length.
10. The aspiration catheter system of claim 7 , wherein the first outer diameter extends along a distal 10-25 cm and wherein the second outer diameter extends along a remainder of a working length of the distal portion.
11. A method for treating a stroke in a cerebral blood vessel using an aspiration catheter system comprising an access sheath and a catheter slidably engaged with the access sheath, the catheter comprising a proximal end configured to remain in a central lumen of the access sheath and a distal end extending in a distal direction from the proximal end, the catheter further including a proximal tether extending proximally from a point of attachment between the proximal tether and a distal portion of the catheter, wherein the distal portion has an inner lumen the method comprising:
advancing the access sheath into an internal carotid artery via a transfemoral access site of a patient
tracking the distal end of the catheter to a desired location within the cerebral blood vessel by sliding the catheter relative to the access sheath via the transfemoral access site;
forming a seal by a tight fit in an overlap region between a cylindrical outer surface of a region of the catheter and a cylindrical inner surface of the central lumen of the sheath body so as to define an aspiration lumen collectively formed by the central lumen of the access sheath and an inner lumen of the catheter; and
aspirating via the aspiration lumen wherein aspiration through the aspiration lumen is at least partially enabled by the seal.
12. The method of claim 11 , wherein the tracking is performed by directing the catheter over a guidewire.
13. The method of claim 11 , further comprising deploying a mechanical thrombectomy device extending in a distal direction from the distal end of the catheter.
14. The method of claim 11 , wherein the distal portion of the catheter has a first outer diameter and the cylindrical outer surface of the catheter has a second outer diameter that is larger than the first outer diameter.
15. The method of claim 11 , wherein the distal portion of the catheter comprises a step up from a first outer diameter to a larger, second outer diameter located proximal of the first outer diameter.
16. The method of claim 15 , wherein the step up is over a transition section.
17. The method of claim 16 , wherein the transition section is between 3 mm and 10 mm in length.
18. The method of claim 15 , wherein the first outer diameter extends along a distal 10-25 cm and wherein the second outer diameter extends along a remainder of a working length of the distal portion.