Clot-engulfing mechanical thrombectomy apparatuses
Mechanical thrombectomy systems including an elongate catheter configured as an elongate inversion support, a flexible tractor configured to roll and invert over the distal end of the elongate inversion support, and a clot engaging member on the distal end of an elongate manipulator are described herein. These systems may capture a clot using the clot engaging member and draw the clot and clot engaging member and roll the flexible tractor into the catheter to remove the clot and clot engaging member from a vessel.
1. A method of removing a clot from within a vessel using a mechanical thrombectomy apparatus, the method comprising:
positioning a distal end of the mechanical thrombectomy apparatus adjacent to the clot within the vessel, wherein the mechanical thrombectomy apparatus includes a tractor region that extends along a distal region of a catheter and inverts over a distal end of the catheter so that a first end of the tractor extends proximally within the catheter;
pulling the first end of the tractor proximally within the catheter to roll the tractor over the distal end of the catheter so that the tractor inverts over the distal end of the catheter and pulls the clot into the catheter with the inverting tractor;
withdrawing the catheter proximally away from the tractor and clot when the tractor jams on the distal end of the catheter;
pulling the first end of the tractor proximally so that the tractor inverts over the clot within the vessel without rolling over the distal end opening of the catheter; and
withdrawing the tractor and clot proximally from the vessel.
2. The method of claim 1 , further comprising disengaging a second end of the tractor from a tractor hold that secures the second end of the tractor to an outer surface of the catheter by pulling the tractor proximally with a force greater than a deployment force and expanding the tractor against the vessel wall, wherein the second end of the tractor is disengaged before pulling the first end of the tractor proximally.
3. The method of claim 1 , further comprising pulling proximally on the tractor to draw the tractor and clot into the catheter.
4. The method of claim 1 , wherein pulling the first end of the tractor proximally within the catheter to roll the tractor over the distal end of the catheter comprises advancing the catheter while pulling the first end of the tractor.
5. The method of claim 1 , wherein pulling the first end of the tractor proximally so that the tractor inverts over the clot further comprises pulling the catheter proximally with the first end of the tractor.
6. The method of claim 1 , wherein pulling the first end of the tractor proximally so that the tractor inverts over the clot comprises pulling a puller at the proximal end of the mechanical thrombectomy apparatus proximally.
7. The method of claim 1 , wherein pulling the first end of the tractor proximally within the catheter to roll the tractor over the distal end of the catheter comprises engaging the clot with the tractor.
8. The method of claim 1 , wherein withdrawing the catheter proximally away from the tractor comprises pulling the catheter proximally beyond a second end of the tractor that is outside of the catheter.
9. The method of claim 1 , wherein pulling the first end of the tractor proximally so that the tractor inverts over the clot comprises pulling the first end of the tractor when the tractor has expanded to contact the vessel wall.
10. The method of claim 1 , further wherein positioning the distal end of the mechanical thrombectomy apparatus adjacent to the clot comprises sliding the mechanical thrombectomy apparatus over a guidewire or catheter passing through a lumen in the mechanical thrombectomy apparatus.
11. A method of removing a clot from within a vessel using a mechanical thrombectomy apparatus, the method comprising:
positioning a distal end of the mechanical thrombectomy apparatus adjacent to the clot within the vessel, wherein the mechanical thrombectomy apparatus includes a tractor region that extends along a distal region of a catheter and inverts over a distal end of the catheter so that a first end of the tractor extends proximally within the catheter;
disengaging a second end of the tractor from a tractor hold that secures the second end of the tractor to an outer surface of the catheter by pulling the tractor proximally with a force greater than a deployment force and expanding the tractor against the vessel wall;
pulling the first end of the tractor proximally within the catheter to roll the tractor over the distal end of the catheter so that the tractor inverts over the distal end of the catheter and pulls the clot into the catheter with the inverting tractor;
withdrawing the catheter proximally away from the tractor and clot when the tractor jams on the distal end of the catheter;
pulling the tractor and clot proximally so that the tractor inverts over the clot within the vessel without rolling over the distal end opening of the catheter;
pulling proximally on the tractor to draw the tractor and clot into the catheter; and
withdrawing the tractor and clot proximally from the vessel.
12. The method of claim 11 , wherein pulling the first end of the tractor proximally within the catheter to roll the tractor over the distal end of the catheter comprises advancing the catheter while pulling the first end of the tractor.
13. The method of claim 11 , wherein pulling the first end of the tractor proximally so that the tractor inverts over the clot further comprises pulling the catheter proximally with the first end of the tractor.
14. The method of claim 11 , wherein pulling the first end of the tractor proximally so that the tractor inverts over the clot comprises pulling a puller at the proximal end of the mechanical thrombectomy apparatus proximally.
15. The method of claim 11 , wherein withdrawing the catheter proximally away from the tractor comprises pulling the catheter proximally beyond a second end of the tractor that is outside of the catheter.
16. The method of claim 11 , wherein pulling the first end of the tractor proximally so that the tractor inverts over the clot comprises pulling the first end of the tractor when the tractor has expanded to contact the vessel wall.
17. The method of claim 11 , further wherein positioning the distal end of the mechanical thrombectomy apparatus adjacent to the clot comprises sliding the mechanical thrombectomy apparatus over a guidewire or catheter passing through a lumen in the mechanical thrombectomy apparatus.