Infusion lubricated atherectomy catheter

1. A matter elimination catheter, comprising:

a catheter body extending from a catheter proximal portion to a catheter distal portion, the catheter body including an infusion lumen;

a drive shaft disposed within the infusion lumen, the drive shaft being configured to provide rotation to at least one rotatable cutter coupled to the drive shaft near the catheter distal portion; and

a guide wire liner extending through the drive shaft, the guide wire liner defining a guide wire lumen therein, wherein the drive shaft is rotatable relative to the guide wire liner;

wherein pressurized infusion fluid delivered through the infusion lumen and flowing distally between an outer surface of the guide wire liner and an inner surface of the infusion lumen forms a first guide wire fluid bearing interposed between an outer surface of the guide wire liner and an inner surface of the at least one rotatable cutter, wherein the first guide wire fluid bearing is generated with pressurized infusion fluid delivered through the infusion lumen and flowing distally between the outer surface of the guide wire liner and an inner surface of at least one rotatable cutter.

2. The matter elimination catheter of claim 1 , further comprising a pressurized infusion fluid source in fluid communication with the infusion lumen and configured to provide pressurized infusion fluid delivered to at least one outflow port and delivered through at least one orifice extending through a sidewall of the guide wire liner to form the first guide wire fluid bearing.

3. The matter elimination catheter of claim 2 , wherein the catheter body further comprises an aspiration lumen fluidly isolated from the infusion lumen.

4. The matter elimination catheter of claim 3 , wherein the aspiration lumen terminates with least one inflow port near the catheter distal portion.

5. The matter elimination catheter of claim 4 , wherein the infusion lumen terminates at a point distal of a distalmost at least one inflow port.

6. The matter elimination catheter of claim 3 , further comprising an aspiration source in communication with the aspiration lumen and configured to draw effluent including infusion fluid and entrained particulates into and through the infusion lumen.

7. The matter elimination catheter of claim 6 , wherein the pressurized infusion fluid source and the aspiration source are configured to maintain an isovolumetric treatment site.

8. The matter elimination catheter of claim 6 , wherein the pressurized infusion fluid source and the aspiration source are configured to maintain a pressure differential between the pressurized infusion fluid within the infusion lumen and aspirated infusion fluid and entrained particulates within the infusion lumen.

9. The matter elimination catheter of claim 6 , wherein the pressurized infusion fluid source is configured to deliver infusion fluid through the at least one outflow port sufficient to provide a fluid barrier at the at least one outflow port that prevents ingress of particulates.

10. A matter elimination catheter, comprising:

a catheter body extending from a catheter proximal portion to a catheter distal portion, the catheter body including an infusion lumen and an aspiration lumen; and

a drive shaft disposed within the infusion lumen, the drive shaft being configured to provide rotation to at least one rotatable cutter coupled to the drive shaft near the catheter distal portion; and

a guide wire liner extending through the drive shaft, the guide wire liner defining a guide wire lumen therein, wherein the drive shaft is rotatable relative to the guide wire liner;

wherein pressurized infusion fluid delivered through the infusion lumen and flowing distally between an outer surface of the guide wire liner and an inner surface of the infusion lumen forms a first guide wire fluid bearing interposed between an outer surface of the guide wire liner and an inner surface of the at least one rotatable cutter, wherein the first guide wire fluid bearing is generated with pressurized infusion fluid delivered through the infusion lumen and flowing distally between the outer surface of the guide wire liner and the inner surface of the at least one rotatable cutter,

wherein the infusion lumen is in fluid communication with a pressurized infusion fluid source,

wherein the aspiration lumen is in fluid communication with an aspiration source configured to draw effluent including infusion fluid and entrained particulates into and through the aspiration lumen.

11. The matter elimination catheter of claim 10 , wherein the pressurized infusion fluid source and the aspiration source are configured to maintain an isovolumetric treatment site.

12. The matter elimination catheter of claim 10 , wherein the aspiration lumen terminates with at least one inflow port near the catheter distal portion.

13. The matter elimination catheter of claim 12 , wherein the infusion lumen terminates at a point distal of a distalmost at least one inflow port.

14. The matter elimination catheter of claim 10 , wherein the pressurized infusion fluid source is configured to deliver infusion fluid through at least one outflow port sufficient to provide a fluid barrier at the at least one outflow port that prevents ingress of particulates.

15. A method of using of a matter elimination catheter having catheter body comprising:

an infusion lumen in fluid communication with a pressurized infusion fluid source;

an aspiration lumen in fluid communication with an aspiration source configured to draw effluent including infusion fluid and entrained particulates into and through the aspiration lumen,

wherein the infusion lumen and the aspiration lumen are separated by a fluid barrier;

a drive shaft disposed within the infusion lumen, the drive shaft being configured to provide rotation to at least one rotatable cutter; and

a guide wire liner defining a guide wire lumen,

wherein pressurized infusion fluid delivered to at least one outflow port and through at least one orifice extending through a side wall of the guide wire liner and flowing distally between an outer surface of the guide wire liner and an inner surface of the infusion lumen forms a first guide wire fluid bearing between the guide wire liner and the at least one rotatable cutter, the method comprising:

rotating the drive shaft and the at least one rotatable cutter;

infusing pressurized infusion fluid through the infusion lumen,

through at least one orifice extending through a side wall of the guide wire liner,

between the guide wire liner and the at least one rotatable cutter, and

through at least one outflow port,

lubricating the drive shaft within the infusion lumen;

lubricating the rotatable cutter about the guide wire liner;

preventing ingress of infusion fluid with entrained matter into the infusion lumen with a fluid barrier; and

aspirating in the aspiration lumen.

16. The method of claim 15 , wherein the pressurized infusion fluid source and the aspiration source are configured to maintain a pressure differential between the pressurized infusion fluid within the infusion lumen and aspirated infusion fluid and entrained particulates within the infusion lumen.

17. The method of claim 15 , wherein the infusion lumen terminates at a point distal of a distalmost at least one inflow port.

18. The method of claim 15 , wherein infusing pressurized infusion fluid through the infusion lumen further lubricates a guide wire positioned within the drive shaft.

19. The method of claim 15 , further comprising:

maintaining an isovolumetric treatment site between the at least one outflow port and an inflow port in fluid communication with the aspiration lumen.

20. The method of claim 15 , wherein the at least one rotatable cutter is rotatable relative to the guide wire liner.