Inverting thrombectomy apparatuses and methods of use
Described herein are mechanical inverting tube apparatuses that may be used to remove clot (e.g., thrombectomy), the apparatuses including an inversion support catheter having an expandable funnel-shaped distal end, and a flexible tube that can be continuously rolled over the funnel-shaped distal end and invert into the inner lumen of the inversion support catheter.
1. A thrombectomy system, comprising:
an inversion support catheter having an elongate and flexible catheter body, a catheter lumen, and an expandable funnel disposed at a distal end of the catheter body, wherein a distal end of the funnel defines a distal opening in communication with an interior of the funnel and the catheter lumen, respectively; and
a flexible tube inverting over the distal end of the funnel such that the flexible tube has a first region at least partially disposed within the interior of the funnel and a second region at least partially extending over an exterior of the funnel, wherein the flexible tube is configured to be pulled proximally into the catheter lumen by pulling the first region proximally so that the second region rolls over the distal end of the funnel as the flexible tube is pulled into the catheter lumen.
2. The system of claim 1 , wherein a portion of the second region of the flexible tube extends at least partially over an outer surface the catheter body proximal of the funnel, and wherein an inner diameter of the portion of the second region extending over the outer surface of the catheter body is less than a maximum outer diameter of the funnel when the funnel is in an expanded configuration.
3. The system of claim 1 , wherein a base region of the funnel adjacent to the distal end of the catheter body comprises openings configured to allow fluid to pass therethrough.
4. The system of claim 1 , wherein the funnel comprises a circumferential porous region at a base of the funnel adjacent to the distal end of the catheter body, the porous region configured to allow fluid to pass therethrough.
5. The system of claim 1 , wherein the funnel has a collapsed configuration having a maximum outer diameter of less than 0.3× an outer diameter of the catheter body proximal of the funnel.
6. The system of claim 1 , wherein the funnel has an expanded configuration in which the funnel has a minimum outer diameter of greater than 2× an outer diameter of the catheter body proximal of the funnel.
7. The system of claim 6 , wherein the funnel has an outer diameter of between 2 and 26 mm in the expanded configuration.
8. The system of claim 1 , wherein the flexible tube comprises a knitted tube.
9. The system of claim 8 , wherein the knitted tube has greater than 10 loops per transverse section through the knitted tube along a length of the knitted tube.
10. The system of claim 1 , wherein the funnel is configured assume a jammed configuration when the first region of the flexible tube is pulled proximally and exerts an axial compressive force on the distal end of the funnel.
11. The system of claim 10 , wherein in the jammed configuration, the funnel has a greater column strength than when the funnel is not in the jammed configuration.
12. The system of claim 10 , wherein in the jammed configuration, the funnel is configured to withstand greater than 1200 g of compressive force without collapsing.
13. The system of claim 12 , wherein the funnel comprises a plurality of longitudinal tines that are continuous with the catheter body proximal of the funnel.
14. The system of claim 13 , wherein the funnel further comprises a mesh inverted over itself at the distal end of the funnel such that a first portion of the mesh forms an inner funnel surface and a second portion of the mesh forms an outer funnel surface, and wherein the plurality of longitudinal tines are positioned between the inner funnel surface and the outer funnel surface.
15. The system of claim 1 , further comprising a lubricious sleeve disposed over at least a portion of the funnel.
16. The system of claim 1 , further comprising an intermediate catheter, wherein the inversion support catheter is at least partially slidably disposed in a lumen of the intermediate catheter.
17. The system of claim 16 , further comprising a puller disposed within the catheter lumen, wherein the first region of the flexible tube is coupled to a distal end region of the puller.
18. A thrombectomy system, comprising:
an inversion support catheter having an elongate and flexible catheter body, a catheter lumen, and an expandable funnel disposed at a distal end of the catheter body, wherein a distal end of the funnel defines a distal opening in communication with an interior of the funnel and the catheter lumen, respectively, and wherein at least a proximal portion of the funnel adjacent to the catheter body comprises openings configured to allow fluid to pass therethrough;
a puller disposed within the catheter lumen; and
a flexible tube formed of a knitted or woven material, the flexible tube inverting over the distal end of the funnel and having a first region attached to the puller and a second region at least partially extending over an exterior surface of the funnel, wherein the flexible tube is configured to be pulled proximally into the catheter lumen by pulling the puller proximally so that the second region of the flexible tube passes through the funnel interior and into the catheter lumen, respectively.
19. A thrombectomy system, comprising:
an inversion support catheter having an elongate and flexible catheter body, a catheter lumen, and an expandable funnel disposed at a distal end of the catheter body, wherein a distal end of the funnel defines a distal opening in communication with an interior of the funnel and the catheter lumen, respectively, and wherein at least a proximal end of the funnel adjacent to the catheter body comprises openings configured to allow fluid to pass therethrough; and
a flexible tube that is knitted, the flexible tube inverting over the distal end of the funnel and having a first region at least partially disposed within the interior of the funnel and a second region at least partially extending over an exterior of the funnel, wherein the flexible tube is configured to be pulled proximally into the catheter lumen by pulling the first region of the flexible tube proximally so that the second region of the flexible tube rolls over the distal end of the funnel as it is pulled into the funnel interior and catheter lumen, respectively, and wherein the funnel is configured such that pulling the first region of the flexible tube proximally applies an axial load on the funnel that expands the funnel into an expanded and jammed configuration.