Atherectomy catheter with shapeable distal tip

1. An atherectomy catheter for use in a vessel comprising:

an annular cutter; and

an elongate catheter body including:

a curved portion including a frame having a plurality of annular spines connected together by a longitudinal proximal spine and a longitudinal distal spine, the longitudinal proximal spine positioned approximately 180 degrees away from the longitudinal distal spine, wherein the longitudinal proximal spine and the longitudinal distal spine bend in opposite directions to give the curved portion an s-shape; and

a nosecone attached to the elongate catheter body, the nosecone configured to pivot away from the elongate catheter body to expose the cutter, wherein an engagement surface between a distal-most annular spine of the plurality of spines and the nosecone is beveled to provide space for the nosecone to pivot.

2. The atherectomy catheter of claim 1 , wherein the plurality of annular spines includes a first annular spine, a second annular spine, and a third annular spine, the longitudinal proximal spine connecting the first annular spine and the second annular spine, and the longitudinal distal spine connecting the second annular spine and the third annular spine.

3. The atherectomy catheter of claim 1 , further comprising a cutting window through which the annular cutter extends, the cutting window positioned distal of curved portion and on an outer circumference of the curved portion so as to urge the cutter into the vessel.

4. The atherectomy catheter of claim 1 , wherein the curved portion is configured to be activated by pulling or pushing on a shaft of the atherectomy catheter.

5. The atherectomy catheter of claim 1 , further comprising at least one laminating layer positioned over or under the frame.

6. The atherectomy catheter of claim 5 , wherein the at least one laminating layer is made of a polymer.

7. The atherectomy catheter of claim 1 , wherein the frame is made of metal.

8. The atherectomy catheter of claim 1 , wherein the distal longitudinal spine is positioned adjacent to an exposed portion of the cutter.

9. The atherectomy catheter of claim 8 , wherein the distal longitudinal spine is on a same side of the elongate catheter body as the exposed portion of the cutter.

10. The atherectomy catheter of claim 1 , wherein the longitudinal proximal spine forms a first angle, and wherein the longitudinal distal spine forms a second angle, the first and second angles extending in opposite directions, and wherein the first angle is between 140 and 160 degrees and the second angle is between 140 and 160 degrees.

11. The atherectomy catheter of claim 1 , wherein the distal-most annular spine of the plurality of spines includes a beveled distal edge.

12. A method of performing atherectomy comprising:

inserting an atherectomy catheter into a vessel, the atherectomy catheter including:

an elongated catheter body, the elongated catheter body comprising a curved portion, the curved portion including a frame having a plurality of annular spines connected together by a longitudinal proximal spine and a longitudinal distal spine, the longitudinal proximal spine positioned approximately 180 degrees away from the longitudinal distal spine, wherein the longitudinal proximal spine and the longitudinal distal spine bend in opposite directions to give the curved portion an s-shape;

an annular cutter; and

a nosecone pivotably coupled to the elongated catheter body;

pulling proximally on a driveshaft to pivot the nosecone with respect to the elongated catheter body and expose the cutter, wherein an engagement surface between a distal-most annular spine of the plurality of spines and the nosecone is beveled to provide space for the nosecone to pivot;

pushing the curved portion of the elongate catheter body against a first portion of a wall of the vessel to urge the annular cutter against a second portion of the wall of the vessel; and

rotating the annular cutter against the second portion of the wall of the vessel.

13. The method of claim 12 , wherein the plurality of annular spines includes a first annular spine, a second annular spine, and a third annular spine, the longitudinal proximal spine connecting the first annular spine and the second annular spine, and the longitudinal distal spine connecting the second annular spine and the third annular spine.

14. The method of claim 12 , wherein the catheter further comprises a cutting window through which the annular cutter extends, the cutting window positioned distal of the curved portion and on an outer circumference of the curved portion, the method further comprising extending the annular cutter out of the cutting window.

15. The method of claim 12 , wherein activating the curved portion comprises pulling or pushing on a shaft of the atherectomy catheter.

16. The method of claim 12 , wherein the distal longitudinal spine is positioned adjacent to an exposed portion of the cutter.

17. The method of claim 16 , wherein the distal longitudinal spine is on a same side of the elongate catheter body as the exposed portion of the cutter.

18. The method of claim 12 , wherein activating the curved portion causes the longitudinal proximal spine to form a first angle and the longitudinal distal spine to form a second angle, the first and second angles extending in opposite directions, and wherein the first angle is between 140 and 160 degrees and the second angle is between 140 and 160 degrees.

19. The method of claim 12 , wherein the distal-most annular spine of the plurality of spines includes a beveled distal edge.

20. An atherectomy catheter for use in a vessel comprising:

an elongate catheter body;

an annular cutter; and

a curved portion in the elongate catheter body, the curved portion including a frame having a plurality of annular spines connected together by a longitudinal proximal spine and a longitudinal distal spine, the longitudinal proximal spine positioned approximately 180 degrees away from the longitudinal distal spine, wherein the longitudinal proximal spine and the longitudinal distal spine are fixedly bent in opposite directions to give the curved portion a fixed s-shape.

21. The atherectomy catheter of claim 20 , further comprising a cutting window through which the annular cutter extends, the cutting window positioned distal of the curved portion and on an outer circumference of the fixed s-shape.

22. The atherectomy catheter of claim 20 , wherein the longitudinal distal spine is positioned adjacent to and on a same side of the elongate catheter body as an exposed portion of the annular cutter.

23. The atherectomy catheter of claim 20 , wherein the frame is made of metal.

24. The atherectomy catheter of claim 20 , wherein the longitudinal proximal spine forms a first angle, and wherein the longitudinal distal spine forms a second angle, the first and second angles extending in opposite directions, and wherein the first angle is between 140 and 160 degrees and the second angle is between 140 and 160 degrees.

25. The atherectomy catheter of claim 20 , further comprising a nosecone configured to pivot away from the elongate catheter body to expose the cutter, wherein the elongate catheter body has a bevel distal edge configured to provide space for the nosecone to pivot.

26. The atherectomy catheter of claim 25 , wherein a distal-most spine of the plurality of annular spines includes the beveled distal edge.

27. The atherectomy catheter of claim 20 , wherein at least a portion of the frame is heat-set in the fixed s-shape.

28. The atherectomy catheter of claim 20 , wherein the curved portion is laminated.