Pre-loaded inverting tractor thrombectomy apparatuses and methods
Mechanical thrombectomy apparatuses including an inverting, rolling conveyor region (“tractor”) at the distal end that are configured to grab and remove thrombus material. In particular, described herein are mechanical thrombectomy apparatuses that are adapted to prevent premature deployment of the tractor, e.g., by including a tractor hold (e.g., a housing, a lock, a clamp, etc.) or the like to secure the outer end of the tractor against and/or relative to the elongate inversion support.
1. A mechanical thrombectomy apparatus for removing a clot from a vessel, the apparatus comprising:
a catheter having a proximal end, a distal end, and a distal end opening;
a tractor comprising a flexible tube that extends in a proximal direction within the catheter, inverts over the distal end opening of the catheter, and extends in a proximal direction over the distal end of the catheter, wherein the tractor is configured to invert by rolling over the distal end opening of the catheter when a first end of the tractor is pulled proximally within the catheter;
a puller having a proximal end and a distal end, wherein the first end of the tractor is coupled to the puller at a location that is at least 2 mm proximal to the puller distal end, further wherein the puller extends within the catheter to the proximal end of the catheter; and
a guidewire lumen extending through the respective catheter, puller and tractor, wherein the guidewire lumen is configured to pass a guidewire therethrough.
2. The apparatus of claim 1 , further comprising a stop between the distal end of the puller and the distal end opening of the catheter.
3. The apparatus of claim 1 , further comprising a stop on the puller between the distal end of the puller and the first end of the tractor, wherein first end of the tractor is coupled to a sliding ring configured to slide over the puller until it engages the stop.
4. The apparatus of claim 1 , wherein the proximal end of the puller is configured to be connected to a vacuum source.
5. The apparatus of claim 1 , wherein the proximal end of the puller comprises a Tuohy-Borst valve/rotating hemostasis valve (RHV).
6. A mechanical thrombectomy apparatus for removing a clot from a vessel, the apparatus comprising:
a catheter having a proximal end, a distal end, and a distal end opening;
a tractor comprising a flexible tube that extends in a proximal direction within the catheter, inverts over the distal end opening of the catheter, and extends in a proximal direction over the distal end of the catheter, wherein the tractor is configured to invert by rolling over the distal end opening of the catheter when a first end of the tractor is pulled proximally within the catheter;
a puller having a proximal end and a distal end, wherein the first end of the tractor is coupled to the puller, further wherein the puller extends within the catheter to the proximal end of the catheter;
a guidewire lumen extending through the respective catheter, puller and tractor, wherein the guidewire lumen is configured to pass a guidewire therethrough; and
a stop on the puller between the distal end of the puller and the first end of the tractor, wherein first end of the tractor is coupled to a sliding ring configured to slide over the puller until it engages the stop.
7. The apparatus of claim 6 , wherein the proximal end of the puller is configured to be connected to a vacuum source.
8. The apparatus of claim 6 , wherein the proximal end of the puller comprises a Tuohy-Borst valve/rotating hemostasis valve (RHV).