Aspiration catheter systems and methods of use
Described are methods, systems, devices for facilitation of intraluminal medical procedures within the neurovasculature. A catheter advancement device includes a flexible elongate body having a proximal end, a distal end, and a single lumen extending therebetween. The flexible elongate body has a proximal segment, an intermediate segment, and a tip segment. The proximal segment includes a hypotube coated with a polymer. The intermediate segment includes an unreinforced polymer having a durometer of no more than 72D. The tip segment is formed of a polymer different from the intermediate segment and has a durometer of no more than about 35D and a length of at least 5 cm. The tip segment has a tapered portion that tapers distally from a first outer diameter to a second outer diameter over a length of between 1 and 3 cm.
1 . An intravascular catheter advancement device comprising:
a flexible elongate body having a proximal end with a proximal opening, a distal end with a distal opening, and a single lumen extending from the proximal opening to the distal opening, the single lumen having an inner diameter at the distal end and at the proximal end that is about 0.30 mm to about 0.66 mm, the flexible elongate body comprising:
a proximal segment;
an intermediate segment distal to the proximal segment formed of an unreinforced polymer having a first durometer;
a material transition between the intermediate segment and the proximal segment; and
a tip segment formed of a polymer having a second durometer less than the first durometer and comprising a radiopaque marker,
wherein the tip segment has a tapered portion that tapers from a first outer diameter to a second outer diameter over a taper length between 0.5 cm and 4.0 cm, the first outer diameter being about 1.57 mm to about 2.08 mm and the second outer diameter being smaller than the first outer diameter,
wherein the proximal segment is less flexible than the intermediate segment and is suitable for bi-directional movement of the tip segment through tortuous anatomy to reach an occlusion within an intracranial vessel,
wherein the catheter advancement device has a working length between the proximal opening and the distal opening sufficient to position the proximal opening outside a patient's body through a point of insertion in a peripheral artery and position the distal opening at the occlusion.
2 . The device of claim 1 , wherein a taper angle of a wall of the tapered portion relative to a center line of the tapered portion is about 0.9 degrees to about 1.6 degrees.
3 . The device of claim 1 , wherein the radiopaque marker comprises radiopaque material embedded in or disposed on a portion of the tip segment.
4 . The device of claim 1 , wherein the radiopaque marker comprises extruded polymer loaded with radiopaque material.
5 . The device of claim 1 , wherein the proximal segment comprises a polymer reinforced with a coil, wherein the coil terminates a distance from a distal-most terminus of the flexible elongate body, the distance being about 4-15 cm.
6 . The device of claim 1 , wherein the proximal segment comprises a polymer reinforced with a coil, wherein the coil terminates a distance from the tip segment, the distance being about 4-15 cm.
7 . The device of claim 1 , wherein the flexible elongate body has no inner liner along the intermediate segment and the tip segment.
8 . The device of claim 7 , wherein the proximal segment comprises a lubricious layer.
9 . The device of claim 8 , wherein the lubricious layer is polytetrafluoroethylene (PTFE).
10 . The device of claim 1 , wherein the point of insertion of the catheter advancement device is one of a femoral artery, a radial artery, an ulnar artery, or a brachial artery of an arm.
11 . The device of claim 1 , wherein the second outer diameter is about 65% of the first outer diameter.
12 . The device of claim 1 , wherein the radiopaque marker is positioned to identify the tapered portion of the tip segment.
13 . The device of claim 1 , wherein the radiopaque marker is positioned to identify a maximum outer diameter of the flexible elongate body.
14 . The device of claim 1 , further comprising a second radiopaque marker positioned to identify the distal end of the flexible elongate body.
15 . A catheter system comprising:
a neurovascular catheter comprising a catheter lumen and a proximal hub; and
a catheter advancement device having a proximal end with a proximal opening, a distal end with a distal opening, and a single lumen extending between the proximal opening and the distal opening, the single lumen having an inner diameter at the distal opening that is about 0.30 mm up to about 0.66 mm, the catheter advancement device comprising:
a flexible elongate body comprising:
a proximal segment, the proximal segment being capable of moving the catheter advancement device bi-directionally;
an intermediate segment distal to the proximal segment comprising an unreinforced polymer having a first durometer; and
a tip segment formed of a polymer different from the unreinforced polymer of the intermediate segment, the polymer of the tip segment having a second durometer less than the first durometer and comprising a radiopaque marker,
wherein the tip segment has a tapered portion that tapers distally from a first outer diameter of about 1.57 mm to about 2.08 mm to a second outer diameter that is smaller than the first outer diameter over a taper length,
wherein the catheter advancement device has a working length sized to extend from outside a patient's body, through a femoral artery, and to an intracranial vessel, and
wherein the first outer diameter of the tip segment is sized to insert through the catheter lumen of the neurovascular catheter, and
wherein a flexibility of the tip segment is greater than a flexibility of a distal end of the neurovascular catheter.
16 . The system of claim 15 , wherein a taper angle of a wall of the tapered portion relative to horizontal is about 0.9 degrees to about 1.6 degrees.
17 . The system of claim 15 , wherein the intermediate segment includes a first segment having a material hardness of no more than 55D and a second segment located proximal to the first segment having a material hardness of no more than 72D.
18 . The system of claim 15 , wherein the polymer of the tip segment has a material hardness of no more than 45D.
19 . He system of claim 15 , wherein the radiopaque marker comprises radiopaque material embedded in or disposed on a portion of the tip segment.
20 . The system of claim 15 , wherein the radiopaque marker comprises extruded polymer loaded with radiopaque material.
21 . The system of claim 15 , wherein the proximal segment comprises a polymer reinforced with a coil, wherein the coil terminates a distance from a distal-most terminus of the flexible elongate body, the distance being about 4-15 cm.
22 . The system of claim 15 , wherein the flexible elongate body has no inner liner along the tip segment.
23 . The system of claim 22 , wherein the proximal segment comprises a lubricious layer.
24 . The system of claim 15 , wherein the second outer diameter is about 65% of the first outer diameter.
25 . The system of claim 15 , wherein the tapered portion is a constant taper from the first outer diameter to the distal end of the flexible elongate body.
26 . The system of claim 15 , wherein the flexible elongate body is sized to be positioned within the catheter lumen such that the tapered portion of the tip segment extends distally beyond the distal end of the neurovascular catheter and at least a portion of the proximal segment is positioned within the catheter lumen.
27 . The system of claim 26 , wherein a difference between a diameter of the catheter lumen and an outer diameter of the flexible elongate body along a majority of a length of the flexible elongate body is sized to minimize a lip at the distal end of the catheter.
28 . The system of claim 15 , wherein the radiopaque marker is positioned to identify the tapered portion of the tip segment.
29 . The system of claim 15 , wherein the radiopaque marker is positioned to identify a maximum outer diameter of the flexible elongate body.
30 . The system of claim 15 , further comprising a second radiopaque marker positioned to identify the distal end of the flexible elongate body.
31 . The system of claim 27 , wherein the difference is about 0.076 mm-0.254 mm.
32 . A system for performing a medical procedure at a treatment site within a cerebral vessel of a patient, the system comprising:
a neurovascular catheter comprising a catheter lumen, a proximal hub, and a radiopaque marker near a distal end of the neurovascular catheter, the neurovascular catheter having a working length greater than 130 cm; and
a catheter advancement device comprising:
a flexible elongate body having a proximal end, a distal end, and a single lumen extending therebetween, the flexible elongate body comprising:
a proximal segment capable of moving the catheter advancement device bi-directionally within the catheter lumen;
an intermediate segment comprising an unreinforced polymer having a first durometer; and
a tip segment formed of a polymer different from the unreinforced polymer of the intermediate segment, the polymer of the tip segment having a second durometer less than the first durometer,
wherein the tip segment has a tapered portion that tapers distally from a first outer diameter to a second outer diameter over a taper length, wherein a taper angle of a wall of the tapered portion relative to horizontal is 0.9-1.6 degrees,
wherein the catheter advancement device has a working length sized to extend from outside a patient's body, through a femoral artery, and to the cerebral vessel, and
wherein the flexible elongate body of the catheter advancement device is sized to insert through the proximal hub into the catheter lumen and beyond the distal end of the neurovascular catheter.
33 . The system of claim 32 , wherein the first outer diameter is about 1.57 mm to about 2.08 mm and the second outer diameter is about 65% of the first outer diameter.
34 . The system of claim 32 , wherein the proximal segment comprises a polymer reinforced with a coil, wherein the coil terminates a distance from a distal-most terminus of the flexible elongate body, the distance being about 4-15 cm.
35 . The system of claim 32 , wherein the flexible elongate body has no inner liner along the tip segment.
36 . The system of claim 35 , wherein the proximal segment comprises a lubricious layer.
37 . The system of claim 32 , wherein the tip segment comprises a radiopaque marker positioned to identify the tapered portion of the tip segment.
38 . The system of claim 32 , wherein the tip segment comprises a radiopaque marker positioned to identify a maximum outer diameter of the flexible elongate body.
39 . The system of claim 38 , further comprising a second radiopaque marker positioned to identify the distal end of the flexible elongate body.