Atherectomy devices and methods
This document describes rotational atherectomy devices and systems for removing or reducing stenotic lesions in blood vessels by rotating an abrasive element within the vessel to partially or completely remove the stenotic lesion material.
1. A rotational atherectomy device for removing stenotic lesion material from a blood vessel of a patient, the device comprising:
a rotary actuator:
an elongate flexible drive shaft comprising a torque-transmitting coil having a constant outer diameter and defining a longitudinal axis, the coil configured to transmit a torque from the rotary actuator, the drive shaft being configured to rotate about the longitudinal axis;
multiple spherical abrasive elements that are attached to the drive shaft such that a center of mass of each abrasive element is offset from the longitudinal axis of the drive shaft and that each abrasive element is spaced apart from an adjacent one of the spherical abrasive elements by an element separation distance;
a distal stability element that is fixed to the drive shaft and that has a center of mass aligned with the longitudinal axis of the drive shaft, the distal stability element being distally spaced apart from a distal-most element of the spherical abrasive elements by a distal separation distance, the distal separation distance being greater than the element separation distance; and
a coating along the drive shaft and the distal stability element such that the coating surrounds an outer diameter of at least a portion of drive shaft.
2. The device of claim 1 , wherein the drive shaft has a central lumen extending along the longitudinal axis that is configured to receive a guidewire.
3. The device of claim 1 , wherein the coating surrounds the exterior surfaces of the distal stability element, and an abrasive outer surface of the abrasive element is uncoated and outwardly exposed.
4. The device of claim 1 , wherein the coating comprises a fluid-impermeable material that provides a fluid-impermeable lumen along the drive shaft.
5. The device of claim 1 , wherein the coating has a different durometer at different locations on the drive shaft.
6. The device of claim 1 , further comprising a proximal stability element and a second distal stability element, wherein the proximal stability element is located proximally to the abrasive element and the second distal stability element is located distally to the abrasive element.
7. The device of claim 1 , wherein the multiple abrasive elements comprise three abrasive elements positioned adjacent to one another along the drive shaft.
8. The device of claim 1 , wherein the multiple abrasive elements comprises at least three abrasive elements, and wherein a middle abrasive element has a larger outer diameter than a proximal abrasive element and a larger outer diameter than a distal abrasive element.
9. The device of claim 1 , wherein the distal stability element is spaced apart from the abrasive element by a stability spacing distance.
10. The device of claim 9 , wherein the drive shaft comprises a distal-most extension portion that extends distally of the distal stability element for a distal extension distance.
11. The device of claim 10 , wherein the distal extension distance is substantially greater than the stability spacing distance.
12. The device of claim 1 , wherein the distal stability element comprises a hollow cylinder that surrounds the torque-transmitting coil of the drive shaft.
13. The device of claim 12 , wherein the hollow cylinder has an exterior cylindrical surface that is smoother and different from an abrasive exterior surface of the abrasive element.
14. The device of claim 12 , wherein the hollow cylinder has an axial length that is greater than a maximum exterior diameter of the hollow cylinder.
15. A rotational atherectomy device for removing stenotic lesion material from a blood vessel of a patient, the device comprising:
a rotary actuator;
an elongate flexible drive shaft comprising a torque-transmitting coil having a constant outer diameter and defining a longitudinal axis, the coil configured to transmit a torque from the rotary actuator, the drive shaft being configured to rotate about the longitudinal axis;
multiple abrasive elements attached to the drive shaft such that a center of mass of the abrasive element is offset from the longitudinal axis of the drive shaft, each abrasive element having a spherical shape;
a distal stability element that is fixed to the drive shaft and that has a center of mass aligned with the longitudinal axis of the drive shaft, the distal stability element being distally spaced apart from a distal-most abrasive element by a distal separation distance that is greater than a longitudinal spacing between adjacent spherical abrasive elements of the multiple abrasive elements.
16. The device of claim 15 , further comprising a coating that surrounds the distal stability element.
17. The device of claim 15 , wherein the distal stability element is a hollow cylindrical member having an inner diameter that surrounds a portion of an outer diameter of the drive shaft.
18. The device of claim 15 , wherein the multiple abrasive elements comprises at least three abrasive elements positioned adjacent to one another along the drive shaft.
19. The device of claim 15 , wherein the multiple abrasive elements comprises at least three abrasive elements segments, and wherein a middle abrasive element segment has a larger outer diameter than a proximal abrasive element segment and a larger outer diameter than a distal abrasive element segment.