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 system for performing rotational atherectomy to remove stenotic lesion material from a blood vessel of a patient, the system comprising:
an elongate tube defining a lumen; and
a rotational atherectomy device comprising:
an elongate flexible drive shaft comprising helically wound metallic filars that form a coil having an outer diameter, the drive shaft defining a longitudinal axis;
an array of at least three spherical eccentric abrasive elements being fixed to the drive shaft such that a center of mass of each abrasive element is offset from the longitudinal axis, each abrasive element being spaced apart from an adjacent abrasive element by an element spacing distance; and
a metallic stability element having a cylindrical shape defining an inner diameter, the metallic stability element being fixed along the inner diameter to the helically wound metallic filars of the drive shaft, the metallic stability element having a center of mass aligned with the longitudinal axis;
wherein the drive shaft, the spherical eccentric abrasive elements, and the metallic stability element rotate together about the longitudinal axis,
wherein the stability element being distally spaced apart from a distal-most abrasive element of the spherical eccentric abrasive elements by a distal separation distance, and
wherein the distal separation distance being greater than the element spacing distance.
2. The system of claim 1 , wherein the at least three spherical eccentric abrasive elements are positioned adjacent to one another along the coil.
3. The system of claim 1 , further comprising a guidewire configured to be slidably disposed within a fluid-impermeable lumen of the drive shaft.
4. The system of claim 1 , wherein the drive shaft has a central lumen extending along the longitudinal axis that is configured to receive a guidewire, and wherein the coil formed by the helically wound metallic filars has a constant outer coil diameter.
5. The system of claim 1 , wherein the coil of the drive shaft comprises a torque-transmitting coil and wherein the metallic stability element comprises a hollow metallic cylinder with the inner diameter that is fixed to an outer diameter of the torque-transmitting coil.
6. A system for performing rotational atherectomy to remove stenotic lesion material from a blood vessel of a patient, the system comprising:
an elongate tube defining a lumen; and
a rotational atherectomy device comprising:
an elongate flexible drive shaft comprising helically wound metallic filars that form a coil having an outer diameter, the drive shaft defining a longitudinal axis;
an array of at least three spherical eccentric abrasive elements being fixed to the drive shaft such that a center of mass of each abrasive element is offset from the longitudinal axis, each abrasive elements being spaced apart from an adjacent abrasive element by an element spacing distance; and
a metallic stability element having a cylindrical shape defining an inner diameter, the metallic stability element being fixed along the inner diameter to the helically wound metallic filars of the drive shaft, the metallic stability element having a center of mass aligned with the longitudinal axis;
wherein the drive shaft, the spherical eccentric abrasive elements, and the metallic stability element rotate together about the longitudinal axis,
the system further comprising a second stability element fixed to the drive shaft.
7. The system of claim 6 , wherein the metallic stability element being distally spaced apart from a distal-most abrasive element of the spherical eccentric abrasive elements by a distal separation distance.
8. The system of claim 6 , wherein the second stability element is located proximally of the abrasive elements.
9. The system of claim 6 , further comprising a guidewire configured to be slidably disposed within a fluid-impermeable lumen of the drive shaft.
10. The system of claim 6 , wherein the spherical eccentric abrasive elements are positioned adjacent to one another along the drive shaft.
11. The system of claim 6 , wherein the abrasive elements comprises five spherical eccentric abrasive elements positioned along the drive shaft.
12. The system of claim 6 , wherein the drive shaft has a central lumen extending along the longitudinal axis that is configured to receive a guidewire, and wherein the coil formed by the helically wound metallic filars has a constant outer coil diameter.
13. The system of claim 6 , wherein the coil of the drive shaft comprises a torque-transmitting coil and wherein the metallic stability element comprises a hollow metallic cylinder with the inner diameter that is fixed to an outer diameter of the torque-transmitting coil.
14. The system of claim 13 , wherein the hollow metallic cylinder has an axial length that is greater than a maximum exterior diameter of the hollow metallic cylinder.
15. A system for performing rotational atherectomy to remove stenotic lesion material from a blood vessel of a patient, the system comprising:
an elongate tube defining a lumen; and
a rotational atherectomy device comprising:
an elongate flexible drive shaft comprising helically wound metallic filars that form a coil having an outer diameter, the drive shaft defining a longitudinal axis;
an array of five spherical eccentric abrasive elements being fixed to the drive shaft such that a center of mass of each abrasive element is offset from the longitudinal axis,
each abrasive element being spaced apart from an adjacent abrasive element by an element spacing distance; and
a metallic stability element having a cylindrical shape defining an inner diameter, the metallic stability element being fixed along the inner diameter to the helically wound metallic filars of the drive shaft, the metallic stability element having a center of mass aligned with the longitudinal axis;
wherein the drive shaft, the spherical eccentric abrasive elements, and the metallic stability element rotate together about the longitudinal axis, and
wherein the array comprises outer spherical eccentric abrasive elements and at least one inner spherical eccentric abrasive element, wherein an outer diameter of each of the outer spherical eccentric abrasive element is smaller than an outer diameter of the at least one inner spherical eccentric abrasive element.
16. The system of claim 15 , wherein the drive shaft has a central lumen extending along the longitudinal axis that is configured to receive a guidewire, and wherein the coil formed by the helically wound metallic filars has a constant outer coil diameter.
17. The system of claim 15 , further comprising a guidewire configured to be slidably disposed within a fluid-impermeable lumen of the drive shaft.
18. The system of claim 15 , wherein the spherical eccentric abrasive elements are positioned adjacent to one another along the drive shaft.
19. The system of claim 15 , wherein the metallic stability element comprises a hollow metallic cylinder with an exterior cylindrical surface.
20. The system of claim 15 , wherein the coil of the drive shaft comprises a torque-transmitting coil and wherein the metallic stability element comprises a hollow metallic cylinder with the inner diameter fixed to an outer diameter of the torque-transmitting coil.
21. The system of claim 20 , wherein the hollow metallic cylinder has an axial length that is greater than a maximum exterior diameter of the hollow metallic cylinder.
22. A system for performing rotational atherectomy to remove stenotic lesion material from a blood vessel of a patient, the system comprising:
an elongate tube defining a lumen; and
a rotational atherectomy device comprising:
an elongate flexible drive shaft comprising helically wound metallic filars that form a coil having an outer diameter, the drive shaft defining a longitudinal axis;
an array of at least three spherical eccentric abrasive elements being fixed to the drive shaft such that a center of mass of each abrasive element is offset from the longitudinal axis, each abrasive elements being spaced apart from an adjacent abrasive element by an element spacing distance; and
a metallic stability element having a cylindrical shape defining an inner diameter, the metallic stability element being fixed along the inner diameter to the helically wound metallic filars of the drive shaft, the metallic stability element having a center of mass aligned with the longitudinal axis;
wherein the drive shaft, the spherical eccentric abrasive elements, and the metallic stability element rotate together about the longitudinal axis, and
wherein each spherical eccentric abrasive element of the at least three spherical eccentric abrasive elements has an abrasive outer surface, and wherein a middle spherical eccentric abrasive element of the at least three spherical eccentric abrasive elements has a larger outer diameter than a proximal spherical eccentric abrasive element of the at least three spherical eccentric abrasive elements and a larger outer diameter than a distal spherical eccentric abrasive element of the at least three spherical abrasive elements.
23. The system of claim 22 , wherein the metallic stability element comprises a hollow metallic cylinder with an exterior cylindrical surface.
24. The system of claim 22 , wherein the system includes a means for stabilizing a portion of the drive shaft that is proximal of the abrasive elements.
25. The system of claim 22 , wherein the drive shaft has a central lumen extending along the longitudinal axis that is configured to receive a guidewire, and wherein the coil formed by the helically wound metallic filars has a constant outer coil diameter.
26. The system of claim 22 , wherein the coil of the drive shaft comprises a torque-transmitting coil and wherein the metallic stability element comprises a hollow metallic cylinder with the inner diameter that is fixed to an outer diameter of the torque-transmitting coil.
27. The system of claim 22 , wherein the spherical eccentric abrasive elements are positioned adjacent to one another along the drive shaft.
28. The system of claim 22 , wherein the system includes an inflatable balloon member attached to and surrounding an outer diameter of a distal end portion of the elongate tube, the balloon member is in fluid communication with the lumen, and the balloon member is configured to contact a blood vessel wall when the balloon member is in an inflated configuration.
29. The system of claim 28 , wherein an outer surface of the balloon member defines channel spaces configured to allow blood flow past the balloon member when the balloon member is in the inflated configuration and in contact with the blood vessel wall.
30. The system of claim 22 , wherein the drive shaft has an outer diameter covered by a flexible polymer coating.
31. The system of claim 30 , wherein the flexible polymer coating comprises a fluid-impermeable material that provides a fluid-impermeable lumen along the drive shaft.