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. An apparatus for removing a clot from a vessel, the apparatus comprising:
an inversion support catheter having a proximal end, a distal end, and a distal end opening, wherein the distal end of the inversion support catheter is expandable to assume a funnel shape;
a tractor comprising a flexible tube that extends within the inversion support catheter, inverts over the distal end opening of the inversion support catheter, and extends over an outer surface of the inversion support catheter, wherein the tractor is configured to invert by rolling over the distal end opening of the inversion support catheter when a first end of the tractor is pulled proximally within the inversion support catheter; and
a puller having a distal end coupled to the first end of the tractor, wherein the puller extends proximally within the inversion support catheter.
2. The apparatus of claim 1 , wherein the distal end of the inversion support catheter is configured to expand to assume the funnel shape when the puller is pulled proximally to roll the tractor over the distal end opening.
3. The apparatus of claim 1 , further comprising a sleeve disposed on the distal end of the inversion support catheter, wherein the sleeve is expandable to assume the funnel shape.
4. The apparatus of claim 1 , wherein the distal end of the inversion support catheter comprises a plurality of rods extending in a proximal-to-distal axis, and wherein the rods are configured to expand outwards to cause the distal end of the inversion support catheter to assume the funnel shape.
5. The apparatus of claim 4 , further comprising one or more strands or rings connecting the rods.
6. The apparatus of claim 1 , further comprising a plurality of slots formed in the distal end of the inversion support catheter.
7. The apparatus of claim 1 , further comprising a guidewire lumen extending through the respective inversion support catheter, puller and tractor.
8. The apparatus of claim 1 , wherein the tractor comprises a knitted material.
9. The apparatus of claim 1 , wherein the distal end of the inversion support catheter is configured to be elastically deformable in a radial direction, while resisting deformation along a proximal-to-distal axis.
10. A method of removing a clot from a vessel, the method comprising:
positioning a distal portion of the apparatus of claim 1 adjacent to the clot within the vessel;
expanding the distal end of the inversion support catheter into the funnel shape by pulling the puller proximally to roll the tractor over the distal end of the catheter so that the tractor inverts over the distal end of the catheter; and
drawing the clot into the catheter with the inverting tractor.
11. The method of claim 10 , further comprising compressing the clot as it is drawn into the catheter through the funnel shaped distal end.
12. The method of claim 10 , wherein puling the puller proximally to roll the tractor over the distal end of the catheter comprises rolling the catheter over a sleeve at least partially covering the funnel shaped distal end.
13. The method of claim 10 , wherein expanding the distal end of the inversion support catheter comprises expanding a plurality of slots or slits extending proximally to distally in the distal end of the inversion support catheter to form the funnel shape.
14. An apparatus for removing a clot from a vessel, the apparatus comprising:
an inversion support catheter having a proximal end, a distal end, and a distal end opening, wherein the distal end of the inversion support catheter is expandable to assume a funnel shape;
a tractor comprising a flexible tube that extends within the inversion support catheter, inverts over the distal end opening of the inversion support catheter, and extends over an outer surface of the inversion support catheter, wherein the tractor is configured to invert by rolling over the distal end opening of the inversion support catheter when a first end of the tractor is pulled proximally within the inversion support catheter;
a sleeve disposed on the distal end of the inversion support catheter, wherein the sleeve is expandable to assume the funnel shape; and
a puller having a proximal end and a distal end, wherein the first end of the tractor is coupled to the puller, and wherein the distal end of the inversion support catheter is configured to expand to assume the funnel shape when the puller is pulled proximally to roll the tractor over the distal end opening.
15. The apparatus of claim 14 , wherein the distal end of the inversion support catheter comprises a plurality of rods extending in a proximal-to-distal axis, and wherein the rods are configured to expand outwards to cause the distal end of the inversion support catheter to assume the funnel shape.
16. The apparatus of claim 15 , further comprising one or more strands or rings connecting the rods.
17. The apparatus of claim 15 , further comprising a plurality of slots formed in the distal end of the inversion support catheter.
18. The apparatus of claim 15 , further comprising a guidewire lumen extending through the respective inversion support catheter, puller and tractor.
19. The apparatus of claim 14 , wherein the tractor comprises a knitted material.
20. The apparatus of claim 14 , wherein the distal end of the inversion support catheter is configured to be elastically deformable in a radial direction, while resisting deformation along a proximal-to-distal axis.