Embolectomy catheters and methods for treating stroke and other small vessel thromboembolic disorders
Embolectomy catheters, rapid exchange microcatheters, systems and methods for removing clots or other obstructive matter (e.g., thrombus, thromboemboli, embolic fragments of atherosclerotic plaque, foreign objects, etc.) from blood vessels. This invention is particularly useable for percutaneous removal of thromboemboli or other obstructive matter from small blood vessels of the brain, during an evolving stroke or period of cerebral ischemia. In some embodiments, the embolectomy catheters of this invention are advanceable with or over a guidewire which has been pre-inserted through or around the clot. Also, in some embodiments, the embolectomy catheters include clot removal devices which are deployable from the catheter after the catheter has been advanced at least partially through the clot. The clot removal device may include a deployable wire nest that is designed to prevent a blood clot from passing therethrough. The delivery catheter may include telescoping inner and outer tubes, with the clot removal device being radially constrained by the outer tube. Retraction of the outer tube removes the constraint on the clot removal device and permits it to expand to its deployed configuration. An infusion guidewire is particularly useful in conjunction with the embolectomy catheter, and permits infusion of medicaments or visualization fluids distal to the clot.
1. An embolism capturing system comprising:
a guide catheter having a proximal obstructive matter retaining member resiliently expandable from a radially compressed configuration to a radially expanded configuration; and
an embolectomy catheter having a matter capturing receptacle resiliently expandable from a radially compressed configuration to a radially expanded configuration;
the embolectomy catheter and matter capturing receptacle advanceable over a guidewire previously passed through a vessel obstruction;
the embolectomy catheter and matter capturing receptacle advanceable through the guide catheter and through the proximal obstructive matter retaining member to the vessel obstruction.
2. The embolism capturing system of claim 1 wherein the matter capturing receptacle is a helical basket.
3. The embolism capturing system of claim 2 wherein the helical basket comprises a plurality of flat ribbons.
4. The embolism capturing system of claim 1 wherein the matter capturing receptacle is an umbrella like structure formed of a plurality of radially splayed wire spokes.
5. The embolism capturing system of claim 1 wherein the matter capturing receptacle comprises a cover.
6. The embolism capturing system of claim 5 wherein the cover comprises polyurethane.
7. The embolism capturing system of claim 5 wherein the cover comprises a material selected from a group consisting of: polyethylene, polytetrafluoroethylene, ethylene vinyl acetate, or silicone.
8. The embolism capturing system of claim 5 wherein the cover is porous.
9. The embolism capturing system of claim 1 wherein the matter capturing receptacle comprises a sac.
10. The embolism capturing system of claim 1 wherein the matter capturing receptacle comprises draw lines that pass through a lumen of the embolectomy catheter and attach to free ends of the matter capturing receptacle.
11. The embolism capturing system of claim 1 wherein the matter capturing receptacle is a football shaped cage.
12. The embolism capturing system of claim 11 wherein the football shaped cage comprises elongated members disposed longitudinally about a longitudinal axis.
13. The embolism capturing system of claim 12 wherein distal ends of the elongated members are attached to a nose cone having a guidewire passage.
14. The embolism capturing system of claim 11 wherein the football shaped cage comprises a cover over a distal portion.
15. The embolism capturing system of claim 11 further comprising an infusion catheter.
16. A method for capturing a clot from a blood vessel, comprising the steps of:
providing a guide catheter having a proximal obstructive matter retaining member resiliently expandable from a radially compressed configuration to a radially expanded configuration;
providing an embolectomy catheter having a matter capturing receptacle biased resiliently expandable from a radially compressed configuration to a radially expanded configuration, the matter capturing receptacle initially disposed in a radially compressed, stowed configuration within an embolectomy catheter;
passing a guidewire through the clot;
advancing the embolectomy catheter and matter capturing receptacle over the guidewire and through a lumen of the guide catheter and through the obstructive matter retaining member;
deploying the matter capturing receptacle to said radially expanded form configuration distally of the guide catheter;
deploying the proximal obstructive matter retaining member to said radially expanded configuration;
capturing the clot between the matter capturing receptacle and the proximal obstructive matter retaining member; and
removing the clot from the blood vessel.
17. The method of claim 16 wherein the step of deploying the matter capturing receptacle to said radially expanded configuration distally of the guide catheter comprises deploying a helically shaped structure.
18. The method of claim 16 wherein the step of deploying the matter capturing receptacle to said radially expanded configuration distally of the guide catheter comprises deploying an umbrella like structure.
19. The method of claim 16 wherein the step of deploying the matter capturing receptacle to said radially expanded configuration distally of the guide catheter comprises deploying a football shaped structure.