Self-rolling thrombectomy apparatuses and methods
Self-rolling mechanical atherectomy aka thrombectomy apparatuses for removing a clot from a vessel include a tractor tube portion that rolls and inverts over itself in a continuous motion, tractor-like, to draw material into the tractor tube, wherein the tractor tube rolls over itself without requiring any additional internal support at the distal-facing region of the tractor tube.
1. A self-rolling apparatus, comprising:
an outer tractor pusher comprising a catheter having a distal end and a distal end opening;
a tractor tube comprising an outer tractor tube portion that extends distally in an un-inverted configuration and inverts into itself at a distal-facing region to form an inner tractor tube portion,
wherein the tractor tube is configured such that pulling the inner tractor tube portion proximally (i) compresses the outer tractor tube portion into a configuration having a column strength that resists collapsing, and (ii) causes a region of the outer tractor tube portion at the distal-facing region to roll over itself, unsupported, and invert into the inner tractor tube portion,
the tractor tube comprising a braided material, wherein the outer tractor tube portion has a braid angle in a proximal to distal axis in a compressed configuration that is between 80 and 170 degrees, and the inner tractor tube portion has a braid angle in the proximal to distal axis under tension of less than 80 degrees; and
an inner tractor puller coupled to the inner tractor tube portion and extending proximally within the outer tractor pusher.
2. The apparatus of claim 1 , wherein the outer tractor pusher is coupled to a proximal end of the outer tractor tube portion of the tractor tube.
3. The apparatus of claim 1 , further comprising a distal access catheter, wherein the outer tractor pusher, the tractor tube, and inner tractor puller are held within the distal access catheter in an un-deployed configuration, and wherein the tractor tube is configured to be deployed by being pushed distally out of the distal access catheter so that the outer tractor tube portion expands to a diameter that is greater than an outer diameter of the distal access catheter in a deployed configuration.
4. The apparatus of claim 1 , wherein the outer tractor pusher is configured as a distal access catheter in which the tractor tube and inner tractor puller are held within the outer tractor pusher in an un-deployed configuration, and wherein the tractor tube is configured to be deployed by being pushed distally out of the outer tractor pusher so that the outer tractor tube portion expands to an outer diameter that is greater than an outer diameter of the outer tractor pusher.
5. The apparatus of claim 1 , wherein the tractor tube is configured so that pulling the inner tractor tube proximally compresses the outer tractor tube portion into a configuration in which the column strength of the outer tractor tube portion resists collapsing up to at least 500 g of compression.
6. The apparatus of claim 1 , wherein the outer tractor tube portion of the tractor tube is configured to expand to between about +/−30% of an outer diameter of the outer tractor pusher.
7. The apparatus of claim 1 , wherein the tractor tube is formed of between 24-48 filaments.
8. The apparatus of claim 1 , wherein the tractor tube is formed of a plurality of filaments, each having a diameter of greater than 0.003 inches.
9. The apparatus of claim 1 , wherein the proximal end of the outer tractor tube portion is configured to have a tapered shape when the outer tractor tube portion is expanded radially outward.
10. The apparatus of claim 1 , wherein the distal-facing region of the tractor tube is unsupported over at least 1 cm proximally from the distal-facing region of the tractor tube.
11. The apparatus of claim 1 , wherein the tractor tube has a porosity of 60% or greater.
12. The apparatus of claim 1 , wherein the inner tractor puller comprises an inner lumen configured to pass a guidewire out of a distal end of the apparatus.
13. The apparatus of claim 1 , further comprising a vacuum source coupled to the tractor tube and configured to apply a vacuum therethrough.
14. A self-rolling apparatus, comprising:
an outer tractor pusher comprising a catheter having a distal end and a distal end opening;
a tractor tube comprising an outer tractor tube portion that extends distally in an un-inverted configuration and inverts into itself at a distal-facing region to form an inner tractor tube portion, wherein the tractor tube is configured so that pulling the inner tractor tube portion proximally (i) compresses the outer tractor tube portion into a configuration having a column strength that resists collapsing up to at least 500 g of compression, and (ii) causes a region of the outer tractor tube portion at the distal-facing region to roll over itself, unsupported, and invert into the inner tractor tube portion; and
an inner tractor puller coupled to the inner tractor tube portion and extending proximally within the outer tractor pusher.
15. The apparatus of claim 14 , wherein the outer tractor pusher is coupled to a proximal end of the outer tractor tube portion of the tractor tube.
16. The apparatus of claim 14 , further comprising a distal access catheter, wherein the outer tractor pusher, the tractor tube, and inner tractor puller are held within the distal access catheter in an un-deployed configuration, and wherein the tractor tube is configured to be deployed by being pushed distally out of the distal access catheter so that the outer tractor tube portion expands to a diameter that is greater than an outer diameter of the distal access catheter in a deployed configuration.
17. The apparatus of claim 14 , wherein the outer tractor pusher is configured as a distal access catheter in which the tractor tube and inner tractor puller are held within the outer tractor pusher in an un-deployed configuration, and wherein the tractor tube is configured to be deployed by being pushed distally out of the outer tractor pusher so that the outer tractor tube portion expands to an outer diameter that is greater than an outer diameter of the outer tractor pusher.
18. The apparatus of claim 14 , wherein the tractor tube comprises a braided material.
19. The apparatus of claim 18 , wherein the outer tractor tube portion has a braid angle in a proximal to distal axis in a compressed configuration that is between 80 and 170 degrees, and the inner tractor tube portion has a braid angle in the proximal to distal axis under tension of less than 80 degrees.
20. The apparatus of claim 14 , wherein the outer tractor tube portion of the tractor tube is configured to expand to between about +/−30% of an outer diameter of the outer tractor pusher.
21. The apparatus of claim 14 , wherein the tractor tube is formed of between 24-48 filaments.
22. The apparatus of claim 14 , wherein the tractor tube is formed of a plurality of filaments, each having a diameter of greater than 0.003 inches.
23. The apparatus of claim 14 , wherein the proximal end of the outer tractor tube portion is configured to have a tapered shape when the outer tractor tube portion is expanded radially outward.
24. The apparatus of claim 14 , wherein the distal-facing region of the tractor tube is unsupported over at least 1 cm proximally from the distal-facing region of the tractor tube.
25. The apparatus of claim 14 , wherein the tractor tube has a porosity of 60% or greater.
26. The apparatus of claim 14 , wherein the inner tractor puller comprises an inner lumen configured to pass a guidewire out of a distal end of the apparatus.
27. The apparatus of claim 14 , further comprising a vacuum source coupled to the tractor tube and configured to apply a vacuum therethrough.
28. A self-rolling apparatus, comprising:
an outer tractor pusher comprising a catheter having a distal end and a distal end opening;
a tractor tube formed from 10 or more strands, the tractor tube comprising an outer tractor tube portion that extends distally in an un-inverted configuration and inverts into itself at a distal-facing region to form an inner tractor tube portion, wherein the tractor tube is configured such that pulling the inner tractor tube portion proximally (i) compresses the outer tractor tube portion into a configuration having a column strength that resists collapsing, and (ii) causes a region of the outer tractor tube portion at the distal-facing region to roll over itself, unsupported, and invert into the inner tractor tube portion,
wherein the outer tractor tube portion has an expanded configuration with a distal-to-proximal facing braid angle for the expanded configuration of between about 80 and about 170 degrees; and wherein the outer tractor tube portion of the tractor tube is configured to expand to between about +/−30% of an outer diameter of the outer tractor pusher; and
an inner tractor puller coupled to the inner tractor tube portion and extending proximally within the outer tractor pusher.