INTRAVASCULAR GUIDEWIRE FILTER SYSTEM FOR PULMONARY EMBOLISM PROTECTION AND EMBOLISM REMOVAL OR MACERATION
An intravascular emboli capture and retrieval system for intravascular embolism protection and embolism removal or maceration. Guidewire mounted proximally and distally located multiple opening filters are deployed within the vasculature and used to part, divide and macerate embolic debris and to capture such embolic debris within the confines thereof. A deployable flexible preformed memory shaped capture sleeve is alternatively used to collapse one or more filters and embolic debris therein for subsequent proximal withdrawal from the vasculature.
1 . (canceled)
2 . An intravascular filter system comprising:
a delivery tube;
a positioning tube having a proximal positioning tube end and a distal positioning tube end;
a flexible capture sleeve having mesh coupled with the positioning tube distal end, the flexible capture sleeve includes:
the flexible capture sleeve movable between an expanded capture sleeve conformation having a conical shaped portion and an unexpanded capture sleeve conformation; and
wherein distal movement of the delivery tube compresses the flexible capture sleeve to the unexpanded capture sleeve conformation, and proximal movement of the delivery tube permits the flexible capture sleeve to radially expand to the expanded capture sleeve conformation;
an elongated element having a proximal element end and a distal element end, the elongated element includes:
a flexible preformed memory shaped filter coupled to the elongated element, the flexible preformed memory shaped filter having a proximal conical portion and a distal conical portion;
wherein the elongated element is configured for advancement from the positioning tube such that the flexible preformed memory shaped filter is positioned distal to a thrombus;
wherein the flexible preformed memory shaped filter is moveable between an expanded filter conformation and an unexpanded filter conformation; and
wherein the elongated element is moved distally to pull the flexible preformed memory shaped filter in the expanded filter conformation through the thrombus to engage and pull the thrombus into the flexible capture sleeve in the expanded capture sleeve conformation; and
wherein the conical shaped portion of the flexible capture sleeve corresponds to the proximal conical portion of the flexible preformed memory shaped filter to forcibly compress the flexible preformed memory shaped filter to the unexpanded filter configuration as the flexible preformed memory shaped filter is withdrawn proximally into the positioning tube.
3 . The intravascular filter system of claim 2 , wherein the flexible preformed memory shaped filter is between about 2 mm and about 48 mm in the expanded filter conformation.
4 . The intravascular filter system of claim 2 , wherein the flexible preformed memory shaped filter includes a one-piece slotted tube.
5 . The intravascular filter system of claim 2 , wherein the distal conical portion includes a first plurality of diamond shaped openings and the proximal conical portion includes a second plurality of diamond shaped openings;
wherein the second plurality of diamond shaped openings are larger than the first plurality of diamond shaped openings.
6 . The intravascular filter system of claim 2 , wherein the flexible capture sleeve includes woven nitinol wires.
7 . The intravascular filter system of claim 2 , wherein the elongated element includes a radially projecting element positioned distal to the flexible preformed memory shaped filter.
8 . A method of removing clot from blood vessel, comprising:
advancing distally a delivery tube over at least a portion of a positioning tube and a flexible capture sleeve attached to a distal positioning tube end, wherein distally advancing the delivery tube over the flexible capture sleeve maintains the flexible capture sleeve in an unexpanded capture sleeve conformation;
withdrawing the delivery tube proximally to unsheathe the flexible capture sleeve allowing the flexible capture sleeve to self-expand to an expanded capture sleeve conformation;
advancing distally an introducer sheath over at least a portion of an elongated element having a flexible preformed memory shaped filter positioned on the elongated element, wherein distally advancing the introducer sheath over the flexible preformed memory shaped filter maintains the flexible preformed memory shaped filter in an unexpanded filter conformation;
advancing the introducer sheath and the elongated element through the positioning tube with the flexible preformed memory shaped filter in the unexpanded configuration until the flexible preformed memory shaped filter is positioned distal to a thrombus;
withdrawing the introducer sheath proximally to unsheathe the flexible preformed memory shaped filter allowing the flexible preformed memory shaped filter to expand to an expanded filter conformation; and
retracting the elongated element toward the flexible capture sleeve to engage and pull thrombus toward and into the flexible capture sleeve, wherein the flexible capture sleeve comprises a conical shape corresponding to a proximal conical portion of the flexible preformed memory shaped filter in the expanded filter conformation to forcibly compress the flexible preformed memory shaped filter to the unexpanded filter conformation.
9 . The method of removing clot from blood vessel of claim 8 , further comprising:
applying aspiration to debulk the thrombus with the flexible preformed memory shaped filter is in the expanded filter conformation distal to the thrombus.
10 . The method of removing clot from blood vessel of claim 8 , wherein the flexible preformed memory shaped filter is between about 2 mm and about 48 mm in the expanded filter conformation.
11 . The method of removing clot from blood vessel of claim 8 , wherein the flexible preformed memory shaped filter includes a one-piece slotted tube.
12 . The method of removing clot from blood vessel of claim 8 , wherein a distal conical portion of the flexible preformed memory shaped filter includes a first plurality of diamond shaped openings and the proximal conical portion includes a second plurality of diamond shaped openings;
wherein the second plurality of diamond shaped openings are larger than the first plurality of diamond shaped openings.
13 . The method of removing clot from blood vessel of claim 8 , wherein the flexible capture sleeve includes woven nitinol wires.
14 . The method of removing clot from blood vessel of claim 8 , wherein the elongated element comprises a radially projecting element positioned distal to the flexible preformed memory shaped filter.
15 . A thrombectomy system comprising:
a positioning tube extending between a proximal positioning tube end and a distal positioning tube end, the positioning tube includes:
a flexible capture sleeve coupled with the distal positioning end, the flexible capture sleeve extending between a proximal sleeve end and a distal open sleeve end, the capture sleeve configured to transition between:
an unexpanded sleeve conformation; and
an expanded sleeve conformation, wherein in the expanded sleeve conformation the flexible capture sleeve tapers from the distal open sleeve end toward the proximal sleeve end; and
a filter device including:
an elongated element extending from a proximal element end to a distal element end, the elongated element slidably received in the positioning tube; and
a flexible mesh filter having a proximal filter end and a distal filter end both coupled with the distal element end, wherein at least one of the proximal or distal filter ends is statically fixed to the distal element end; and
wherein the flexible mesh filter includes:
a proximal filter portion having proximal filter openings;
a distal filter portion having distal filter openings, and the proximal filter openings are larger than the distal filter openings;
an intermediate filter portion; and
the proximal filter portion tapers from the filter intermediate portion to the proximal filter end, and the distal filter portion tapers from the filter intermediate portion to the distal filter end.
16 . The thrombectomy system of claim 15 , wherein the elongated element includes a guidewire.
17 . The thrombectomy system of claim 15 comprising a delivery tube slidably coupled along the positioning tube, the delivery tube configured to transition the flexible capture sleeve between expanded sleeve conformations.
18 . The thrombectomy system of claim 15 , wherein the filter device is configured to transition from an entrapment conformation to a capture conformation:
in the entrapment configuration the flexible mesh filter has a filter perimeter spaced from the elongated element and the flexible mesh filter is distally spaced from the flexible capture sleeve; and
in the capture conformation the flexible mesh filter is:
proximally moved into the capture sleeve with proximal movement of the elongated element, thrombus is captured with the flexible mesh filter and the capture sleeve extending over the flexible mesh filter; and
the capture sleeve compresses the thrombus and the flexible mesh filter toward the elongated element.
19 . The thrombectomy system of claim 18 , wherein the capture sleeve includes a tapered profile, and the tapered profile of the capture sleeve compresses the thrombus and the flexible mesh filter toward the elongated element in the capture conformation.
20 . The thrombectomy system of claim 18 , wherein the capture sleeve transitioning from the expanded sleeve conformation to the unexpanded sleeve conformation is configured to compress the thrombus and the flexible mesh filter toward the elongated element in the capture conformation.
21 . The thrombectomy system of claim 15 , wherein the flexible mesh filter is between about 2 mm and about 48 mm in the expanded conformation.
22 . The thrombectomy system of claim 15 , wherein the flexible mesh filter includes a one-piece slotted tube.
23 . The intravascular filter system of claim 15 , wherein the proximal filter openings include proximal diamond shaped openings and the distal filter openings include distal diamond shaped openings, and the proximal diamond shaped openings are larger than the distal diamond shaped openings.
24 . The intravascular filter system of claim 15 , wherein the flexible mesh filter is woven from nitinol wires.
25 . The intravascular filter system of claim 15 , wherein the elongated element comprises a radially projecting element positioned distal to the flexible preformed memory shaped filter.