CATHETERS HAVING STEERABLE DISTAL PORTIONS, AND ASSOCIATED SYSTEMS AND METHODS
Disclosed herein are clot removal systems including steerable catheters, and associated systems and methods. In some embodiments, a clot removal system includes (i) an aspiration catheter having a proximal region and a distal region and (ii) a handle coupled to the proximal region of the catheter and having an actuator. The distal region of the catheter can include a deflectable member, and the clot removal system can include a pull wire extending between the actuator and the deflectable member. Actuation of the actuator is configured to pull the pull wire to deflect the deflectable member to deflect the distal region relative to the proximal region. The deflection can facilitate steering of the catheter to hard-to-reach (e.g., tortuous) portions of the anatomy of a patient.
1 . An aspiration catheter, comprising:
a proximal region; and
a distal region including a deflectable member, wherein the deflectable member includes—
a proximal ring;
a distal ring configured to be fixedly attached to a pull wire; and
a tube portion extending between the proximal and distal rings, wherein the tube portion includes a plurality of openings extending therethrough to define a plurality of ribs, and wherein the ribs are configured to flex away from each other when the pull wire is pulled proximally.
2 . The aspiration guide catheter of claim 1 wherein the tube portion includes a spine extending in a direction between the proximal and distal rings, wherein the ribs extend away from the spine, and wherein the spine is configured to extend generally parallel to and over the pull wire.
3 . The aspiration catheter of claim 1 wherein the proximal region and the distal region define a lumen having a diameter of 20 French or greater.
4 . The aspiration catheter of claim 1 , further comprising an intermediate region between the proximal and distal regions, wherein the proximal region and the intermediate region include a braid of wires extending therethrough.
5 . The aspiration catheter of claim 4 wherein the intermediate region includes a wire coiled around the braid.
6 . The aspiration catheter of claim 1 wherein the tube portion extends along a longitudinal axis in a relaxed state, and wherein the openings extend circumferentially about the longitudinal axis and generally parallel to one another in the relaxed state.
7 . The aspiration catheter of claim 1 wherein the proximal ring includes an annular member configured to slidably receive the pull wire therethrough.
8 . A clot removal system, comprising:
an aspiration catheter including a proximal region and a distal region, wherein the distal region includes a deflectable member;
a handle coupled to the proximal region of the aspiration catheter, wherein the handle includes an actuator; and
a pull wire extending between the actuator and the deflectable member, wherein actuation of the actuator is configured to pull the pull wire to deflect the deflectable member to deflect the distal region of the aspiration catheter relative to the proximal region.
9 . The clot removal system of claim 8 wherein the aspiration catheter extends along an axis, and wherein the actuation of the actuator is configured to deflect the distal region of the aspiration catheter away from the axis by about 90 degrees or greater.
10 . The clot removal system of claim 8 wherein the aspiration guide catheter has a size of 20 French or greater.
11 . The clot removal system of claim 8 wherein the deflectable member has a tubular shape that extends along a longitudinal axis, and wherein the deflectable member includes (a) a spine extending parallel to the longitudinal axis and (b) a plurality of ribs extending from the spine and circumferentially about the longitudinal axis.
12 . The clot removal system of claim 11 wherein the deflectable member has a distal portion and a proximal portion, and wherein the pull wire is attached to the distal portion of the deflectable member.
13 . The clot removal system of claim 12 wherein the actuation of the actuator is configured pull the distal portion proximally relative to the proximal portion.
14 . The clot removal system of claim 12 wherein the ribs define a plurality of openings therebetween, and wherein the actuation of the actuator is configured pull the distal portion of the deflectable member proximally relative to the proximal portion to bend the spine and increase a size of the openings.
15 . The clot removal system of claim 8 wherein the aspiration catheter further includes—
an intermediate region between the proximal and distal regions;
an inner liner extending through the proximal, intermediate, and distal regions;
a braid of wires extending through the proximal and intermediate regions over the inner liner;
a wire extending through the intermediate region and coiled around the braid; and
an outer liner extending through the proximal, intermediate, and distal regions over the inner liner, the braid, and the wire, wherein the deflectable member is positioned between the inner and outer liners in the distal region.
16 . The clot removal system of claim 15 wherein—
the distal region further includes a proximal transition region, a distal tip region, and a deflectable region between the proximal transition region and the distal tip region;
the deflectable member is positioned in the deflectable region;
the outer liner has a first hardness in the proximal transition region, a second hardness in the deflectable region, and a third hardness in the distal tip region; and
the second hardness is less than the first hardness and less than the third hardness.
17 . A method of removing clot material from a blood vessel, the method comprising:
advancing an aspiration catheter through the blood vessel, wherein the aspiration catheter includes a distal portion and a proximal portion;
actuating a handle coupled to the aspiration catheter to deflect the distal portion of the aspiration catheter away from a longitudinal axis of the proximal portion;
positioning a distal tip of the aspiration catheter proximate to the clot material;
activating a pressure source coupled to the aspiration catheter via a fluid control device, while the fluid control device is closed, to generate a vacuum in the pressure source; and
opening the fluid control device to apply the vacuum to the aspiration catheter to thereby aspirate at least a portion of the clot material into the aspiration catheter.
18 . The method of claim 17 wherein actuating the handle to deflect the distal portion of the aspiration catheter includes deflecting the distal portion of the aspiration catheter away from the longitudinal axis in a deflection direction, and wherein the method further comprises rotating the aspiration catheter such that the deflection direction is at least partially aligned with a bend in the blood vessel.
19 . The method of claim 17 wherein the aspiration catheter has a size of 20 French or greater.
20 . The method of claim 17 wherein the aspiration catheter includes a deflectable member positioned in the distal portion, and wherein actuating the handle includes rotating an actuator of the handle to pull a pull wire coupled to the deflectable portion proximally to deflect the deflectable member to deflect the distal portion of the aspiration catheter.