Systems and methods for percutaneous removal of objects from an internal body space
Disclosed are systems, methods, and devices for percutaneous retrieval of objects, such as endovascular devices, from a subject's internal body space. The present inventions have vascular, non-vascular (gastrointestinal), and surgical (laproscopic) applications. The inventions include the use of a retrieval end having one or more compressed states and an expanded state, the retrieval end adopting the expanded state when the retrieval end is deployed into a subject's internal body space, the retrieval end having a mouth through which an object can be passed into an interior space within the retrieval end when the retrieval end is in the expanded state, the mouth being adjustable between an opened state and a closed state so that the object can be enclosed within the interior space after passing through the mouth of the retrieval end.
1. A system for percutaneous retrieval of an endovascular device within a subject's internal body space comprising:
an outer sheath having a lumen and being adapted for insertion into a subject's internal body space;
an inner sheath that is adapted for insertion into the subject's internal body space via the lumen of the outer sheath, the inner sheath comprising
a distal retrieval end comprising a wire weave formed from wires and having one or more compressed states and an expanded state, the retrieval end adopting one of the compressed states when the retrieval end is housed within the lumen of the outer sheath, and adopting the expanded state when the retrieval end is deployed into the subject's internal body space by exiting a distal end of the outer sheath,
the retrieval end having a mouth through which the endovascular device can be passed into an interior space within the retrieval end when the retrieval end is in the expanded state, the mouth being adjustable between an opened state and a closed state so that the endovascular device can be enclosed within the interior space after passing through the mouth of the retrieval end,
the retrieval end comprising a main body portion having a diameter of about 25-35 mm in the expanded state,
the wire weave comprising 11-21 picks per centimeter,
the wires of the wire weave having a diameter of about 100 to about 300 μm, and
a lumen extending from a proximal end of the inner sheath to the retrieval end, the lumen housing a control line that is attached to the retrieval end at least at the mouth and is configured to change a position of the mouth of the retrieval end relative to the endovascular device within the subject's internal body space;
wherein when at least a portion of the retrieval end of the inner sheath is withdrawn into the outer sheath following capture of the endovascular device within the interior space of the retrieval end, the retrieval end exerts an inward force that at least partially collapses or compresses the endovascular device.
2. The system according to claim 1 , further comprising at least one manipulation tool for grips, grasps, grapples, ensnares, moves, captures, changes the orientation, or manipulates the endovascular device, the manipulation tool being deployable into the subject's internal body space via a lumen in the inner sheath.
3. The system according to claim 1 , further comprising a suture line having a loop portion that is positioned around the circumference of the mouth of the retrieval end and that is used to transition the mouth between the opened state and the closed state.
4. The system according to claim 3 wherein said suture line transitions the mouth between the opened state and the closed state independently of whether the retrieval sheath has been at least partially withdrawn into the outer sheath.
5. The system according to claim 3 , wherein the suture line is housed within a lumen in the inner sheath.
6. The system according to claim 1 , wherein the control line also provides longitudinal support for the retrieval end while the object is being drawn into the retrieval end.
7. The system according to claim 1 , wherein the wire weave has a first braiding angle when the retrieval end is in the expanded state and before withdrawal of any portion of the retrieval end into the outer sheath.
8. The system according to claim 7 , wherein the retrieval end elongates and the braiding angle of said wire weave decreases from the first braiding angle to a second braiding angle in response to withdrawal of at least a portion of the retrieval end of the inner sheath into the outer sheath.
9. The system according to claim 1 , wherein the control line is attached to the retrieval end at one or more additional locations on the retrieval end.
10. A method for percutaneously retrieving an endovascular device within a subject's internal body space comprising:
delivering to the subject's internal body space an outer sheath having a lumen;
introducing an inner sheath into the lumen of the outer sheath, the inner sheath comprising
a distal retrieval end comprising a wire weave formed from wires and having one or more compressed states and an expanded state, the retrieval end adopting one of the compressed states when the retrieval end is housed within the lumen of the outer sheath, and adopting the expanded state when the retrieval end is deployed into the subject's internal body space by exiting a distal end of the outer sheath,
the retrieval end having a mouth through which the endovascular device can be passed into an interior space within the retrieval end when the retrieval end is in the expanded state, the mouth being adjustable between an opened state and a closed state so that the endovascular device can be enclosed within the interior space after passing through the mouth of the retrieval end,
the retrieval end comprising a main body portion having a diameter of about 25-35 mm in the expanded state,
the wire weave comprising 11-21 picks per centimeter,
the wires of the wire weave having a diameter of about 100 to about 300 μm, and
a lumen extending from a proximal end of the inner sheath to the retrieval end, the lumen housing a control line that is attached to the retrieval end at least at the mouth and is configured to change a position of the mouth of the retrieval end relative to the endovascular device within the subject's internal body space;
advancing the inner sheath through the lumen of the outer sheath until the retrieval end is deployed into the subject's internal body space by exiting the distal end of the outer sheath;
capturing the endovascular device at least partially within the interior space of the retrieval end;
at least partially closing the mouth of the retrieval end in order to enclose the endovascular device within the interior space of the retrieval end;
withdrawing the inner sheath through the lumen of the outer sheath until the retrieval end exerts an inward force that at least partially collapses or compresses the endovascular device; and,
withdrawing the retrieval end into the lumen of the outer sheath, thereby removing the endovascular device from the subject's internal body space.
11. The method according to claim 10 , wherein the inner sheath is introduced into the lumen of the outer sheath by
introducing the inner sheath into the lumen of a loader tube via a proximal end of the loader tube;
advancing inner sheath through the lumen of the loader tube to a distal end thereof until the inner sheath exits the distal end of the loader tube and enters the lumen of the outer sheath via a proximal end of the outer sheath; and,
advancing the inner sheath until the retrieval end thereof approaches, but does not exit, the distal end of the outer sheath.
12. The method according to claim 10 , further comprising, following deployment of the retrieval end into the subject's internal body space, adjusting the position of the retrieval end relative to the endovascular device by use of the control line, wherein the control line is affixed to the retrieval end.
13. The method according to claim 12 , comprising using the control line to position the retrieval end so that the endovascular device is proximate to the mouth of the retrieval end.
14. The method according to claim 10 , further comprising, following deployment of the retrieval end into the subject's vasculature, advancing through a lumen of the inner sheath a manipulation tool that grips, grasps, grapples, ensnares, moves, captures, changes the orientation, or manipulates the object in order to assist in the step of capturing the endovascular device at least partially within the interior space of the retrieval end.
15. The method according to claim 14 , further comprising adjusting a position of the retrieval end relative to the endovascular device by use of a control line, wherein the control line is affixed to the retrieval end, in order to place the mouth of the retrieval end proximate to the endovascular device at the same time that the manipulation tool grips, grasps, grapples, ensnares, moves, captures, changes the orientation, or manipulates the endovascular device.
16. The method according to claim 10 , wherein the control line is attached to the retrieval end at one or more additional locations on the retrieval end.
17. A device for percutaneously retrieving an endovascular device from a subject's internal body space comprising:
an elongated tube portion that terminates in a distal retrieval end,
the distal retrieval end comprising a wire weave formed from wires having a diameter of about 100 to about 300 μm and comprising 11-21 picks per centimeter, the retrieval end having one or more compressed states and an expanded state, the retrieval end comprising a main body portion having a diameter of about 25-35 mm in the expanded state, the retrieval end adopting one of the compressed states when the retrieval end is housed within the lumen of an outer sheath, and adopting the expanded state when the retrieval end is deployed into the subject's internal body space by exiting a distal end of the outer sheath,
the retrieval end having a mouth through which the endovascular device can be passed into an interior space within the retrieval end when the retrieval end is in the expanded state, the mouth being adjustable between an opened state and a closed state so that the endovascular device can be enclosed within the interior space after passing through the mouth of the retrieval end, and
the elongated tube portion comprising a lumen extending from a proximal end of the elongated tube portion to the retrieval end, the lumen housing a control line that is attached to the retrieval end at least at the mouth and is configured to change a position of the mouth of the retrieval end relative to the endovascular device within the subject's internal body space.
18. The device according to claim 17 further comprising a suture line having a loop portion that is positioned around the circumference of the mouth of the retrieval end and that is used to transition the mouth between the opened state and the closed state.
19. The device according to claim 18 , wherein the suture line is housed within a lumen in the elongated tube portion.
20. The device according to claim 17 , wherein the control line that is affixed to the retrieval end.
21. The device according to claim 17 , wherein the control line also provides longitudinal support for the retrieval end while the endovascular device is being drawn into the retrieval end.
22. The device according to claim 17 , wherein the elongated tube portion comprises two interior lumens.
23. The device according to claim 17 , wherein the elongated tube portion comprises three interior lumens.
24. The device according to claim 17 , wherein the mouth can be transitioned into the closed state independently of whether the retrieval end is being withdrawn into the outer sheath.
25. The device according to claim 17 wherein the wire weave of the retrieval end has a first braiding angle when the retrieval end is in the expanded state and before withdrawal of any portion of the retrieval end into the outer sheath.
26. The device according to claim 25 , wherein the retrieval end elongates and the braiding angle of said wire weave decreases from the first braiding angle to a second braiding angle in response to withdrawal of at least a portion of the retrieval end into the outer sheath.
27. The device according to claim 17 , wherein the control line is attached to the retrieval end at one or more additional locations on the retrieval end.
28. A device for percutaneously retrieving an endovascular device from a subject's internal body space comprising:
an elongated tube for introduction into a subject that terminates in a retrieval end;
the retrieval end comprising a wire weave formed from wires having a diameter of about 100 to about 300 μm and comprising 11-21 picks per centimeter,
the retrieval end being expandable into an expanded state;
the retrieval end comprising a main body portion having a diameter of about 25-35 mm in the expanded state;
the retrieval end further having a mouth through which the endovascular device can be passed into a space within the retrieval end when the retrieval end is in the expanded state;
the mouth being adjustable between an opened state and a substantially closed state so that the endovascular device can be retained within the retrieval end after passing through the mouth of the retrieval end; and,
the elongated tube comprising a lumen extending from a proximal end of the elongated tube to the retrieval end, the lumen housing a control line that is attached to the retrieval end at least at the mouth and is configured to change a position of the mouth of the retrieval end relative to the endovascular device within the subject's internal body space.
29. The device according to claim 28 , wherein the mouth can be transitioned into the substantially closed state independently of whether the retrieval end is being transitioned from the expanded state to an at least partially collapsed state.
30. The device according to claim 28 , wherein the wire weave of the retrieval end has a first braiding angle when the retrieval end is in the expanded state.
31. The device according to claim 30 , wherein the retrieval end elongates and the braiding angle of said wire weave decreases from the first braiding angle to a second braiding angle when the retrieval end is transitioned from the expanded state to an at least partially collapsed state.
32. The device according to claim 28 , wherein the control line is attached to the retrieval end at one or more additional locations on the retrieval end.