Atherectomy devices and methods
This document describes rotational atherectomy devices and systems for removing or reducing stenotic lesions in blood vessels by rotating an abrasive element within the vessel to partially or completely remove the stenotic lesion material.
1. A rotational atherectomy device, comprising:
an elongate tube advanceable into a blood vessel and configured to deliver a flush fluid toward a distal opening of the elongate tube;
a torque-transmitting coil rotatable within the elongate tube and extending distally from the distal opening of the elongate tube, wherein the torque-transmitting coil has a constant outer diameter of about 0.020 inches to about 0.100 inches and defines a central lumen configured to slidably receive a guidewire;
a distal metallic concentric element having a center of mass aligned with a longitudinal axis of the torque-transmitting coil and being fixedly mounted to the torque-transmitting coil; and
an array of at least three eccentric abrasive burrs having a spherical or ellipsoid shape with an abrasive outer surface and being fixedly mounted to the torque-transmitting coil at a position spaced proximal from the distal metallic concentric element such that a center of mass of each of the at least three eccentric abrasive burrs is offset from the longitudinal axis while contemporaneously the center of mass of the distal metallic concentric element is aligned with the longitudinal axis,
wherein the array of at least three spherical or ellipsoidal eccentric abrasive burrs comprises at least: a middle abrasive burr having the spherical or ellipsoid shape, a proximal-most abrasive burr having the spherical or ellipsoid shape, and a distal-most abrasive burr having the spherical or ellipsoid shape, wherein the middle abrasive burr in the array has a maximum outer diameter that is greater than both a maximum outer diameter of the proximal-most abrasive burr in the array and a maximum outer diameter of the distal-most abrasive burr in the array.
2. The device of claim 1 , wherein the center of mass of each of the at least three eccentric abrasive burrs is offset from the longitudinal axis such that, in response to rotation of the torque-transmitting coil about an axis of rotation at 20,000 rpm to 160,000 rpm, the array of at least three eccentric abrasive burrs moves in an orbital path that is larger than a maximum diameter of a rotational path of the distal metallic concentric element.
3. The device of claim 2 , wherein in response to the rotation of the torque-transmitting coil about the axis of rotation, the array of at least three eccentric abrasive burrs, the distal metallic concentric element, and a distal tail of the helically wound metallic coil rotate together such that the array of at least three eccentric abrasive burrs moves in the orbital path while the distal tail of the helically wound metallic coil rotates in substantially stable axial alignment with the axis of rotation.
4. The device of claim 1 , wherein the distal metallic concentric element has a cylindrical shape that defines an inner diameter and the distal metallic concentric element is fixed along the inner diameter to helically wound metallic filars of the torque-transmitting coil.
5. The device of claim 1 , wherein the array of at least three eccentric abrasive burrs comprises five eccentric abrasive burrs having the spherical or ellipsoid shape fixedly mounted to the torque-transmitting coil.
6. The device of claim 5 , wherein the at least five eccentric abrasive burrs are positioned adjacent to one another along the torque-transmitting coil.
7. The device of claim 1 , further comprising the guidewire, wherein the central lumen of the torque-transmitting coil is configured to receive the guidewire fully withdrawable into the central lumen.
8. The device of claim 1 , further comprising a fluid-impermeable material along at least a portion of an exterior of the torque-transmitting coil.
9. The device of claim 1 , wherein the distal metallic concentric element comprises a coating along its outer surface.
10. The device of claim 1 , wherein the at least three eccentric abrasive burrs in the array are spaced apart from one another by an element spacing distance, and the distal metallic concentric element is distally spaced apart from the distal-most abrasive burr in the array by a distal separation distance that is greater than the element spacing distance.
11. The device of claim 1 , wherein the proximal-most abrasive burr, the middle abrasive burr and the distal-most abrasive burr are spherical.
12. The device of claim 1 , wherein the torque-transmitting coil comprises a distal-most extension portion that extends distally of the distal metallic concentric element.
13. The device of claim 12 , wherein at least a portion of the distal-most extension portion is defined by helically wound metallic filars of the torque-transmitting coil.
14. The device of claim 1 , wherein the eccentric abrasive burrs in the array of at least three spherical or ellipsoidal eccentric abrasive burrs are positioned adjacent to one another along the torque-transmitting coil.
15. The device of claim 1 , wherein the elongate tube is configured to deliver the flush fluid comprising saline out of the distal opening of the elongate tube while the torque-transmitting coil is driven to rotate within the elongate tube at 20,000 rpm to 160,000 rpm.
16. The device of claim 15 , wherein the elongate tube is configured to increase a column strength for pushing both the torque-transmitting coil and the elongate tube over the guidewire within the blood vessel.
17. The device of claim 16 , wherein in response to rotation of the torque-transmitting coil within the elongate tube, the array of at least three eccentric abrasive burrs, the distal metallic concentric element, and the torque-transmitting coil rotate together such that the array of at least three eccentric abrasive burrs moves in an orbital path at a targeted site distal of the distal opening of the elongate tube while the elongate tube remains stationary.