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 system for performing rotational atherectomy to remove stenotic lesion material from a blood vessel of a patient the system comprising:
an elongate tube defining a lumen; and
a rotational atherectomy device comprising:
an elongate flexible drive shaft comprising helically wound metallic filars that form a coil having an outer diameter, the drive shaft defining a longitudinal axis;
an array of at least three eccentric spherical abrasive elements being fixed to the drive shaft such that a center of mass of each abrasive element is offset from the longitudinal axis; and
a metallic stability element having a cylindrical shape defining an inner diameter, the metallic stability element being fixed to the helically wound metallic filars of the drive shaft the metallic stability element having a center of mass aligned with the longitudinal axis; and
a distal-most extension portion that extends distally of the metallic stability element to a distal free end;
wherein the drive shaft, the abrasive elements, and the metallic stability element rotate together about the longitudinal axis,
wherein the distal-most extension portion extends distally of the metallic stability element for a distal extension distance,
wherein the distal-most extension portion is distally spaced apart from a distal-most abrasive element of the eccentric spherical abrasive elements by a distal separation distance, and
wherein the center of mass for each eccentric spherical abrasive elements in said array is offset from the longitudinal axis while contemporaneously the center of mass of the metallic stability element is aligned with the longitudinal axis, and
wherein the distal separation distance being greater than an element spacing distance, wherein each abrasive element is spaced apart from an adjacent abrasive element by the element spacing distance.
2. The system of claim 1 , wherein a ratio of the distal extension distance relative to the distal separation distance is about 1:1.
3. The system of claim 1 , wherein a ratio of the distal extension distance relative to the distal separation distance is about 2:1.
4. The system of claim 1 , wherein a ratio of the distal extension distance relative to the distal separation distance is about 3:1.
5. The system of claim 1 , wherein a ratio of the distal extension distance relative to the distal separation distance is higher than 3:1.
6. The system of claim 1 , wherein the distal extension distance and the distal separation distance are unequal.
7. A system for performing rotational atherectomy to remove stenotic lesion material from a blood vessel of a patient, the system comprising:
an elongate tube defining a lumen; and
a rotational atherectomy device comprising:
an elongate flexible drive shaft comprising helically wound metallic filars that form a coil having an outer diameter, the drive shaft defining a longitudinal axis;
an array of at least three eccentric spherical abrasive elements being fixed to the drive shaft such that a center of mass of each abrasive element is offset from the longitudinal axis; and
a metallic stability element having a cylindrical shape defining an inner diameter, the metallic stability element being fixed to the helically wound metallic filars of the drive shaft, the metallic stability element having a center of mass aligned with the longitudinal axis; and
a distal-most extension portion that extends distally of the metallic stability element to a distal free end;
wherein the drive shaft, the abrasive elements, and the metallic stability element rotate together about the longitudinal axis,
wherein the distal-most extension portion is configured to provide a stable rotary motion during rotation of the system.
8. The system of claim 7 , wherein the distal-most extension portion is a portion of the drive shaft.
9. The system of claim 7 , wherein the at least three spherical abrasive elements are positioned adjacent to one another along the coil.
10. The system of claim 7 , wherein at least a portion of the distal-most extension portion is defined by the helically wound metallic filars of the drive shaft that extends distally of the metallic stability element.
11. The system of claim 7 , wherein the spherical abrasive elements are positioned adjacent to one another along the drive shaft.
12. The system of claim 7 , wherein the spherical abrasive elements comprises five spherical abrasive elements positioned along the drive shaft.
13. The system of claim 7 , wherein the drive shaft has a central lumen extending along the longitudinal axis that is configured to receive a guidewire that is fully withdrawable into the central lumen, and wherein the coil formed by the helically wound metallic filars has a constant outer coil diameter.
14. The system of claim 7 , wherein the coil of the drive shaft comprises a torque-transmitting coil and wherein the metallic stability element comprises a hollow metallic cylinder with the inner diameter fixed to an outer diameter of the torque-transmitting coil.
15. The system of claim 7 , wherein the device further comprises a coating covering an outer diameter of the metallic stability element.
16. A system for performing rotational atherectomy to remove stenotic lesion material from a blood vessel of a patient the system comprising:
an elongate tube defining a lumen; and
a rotational atherectomy device comprising;
an elongate flexible drive shaft comprising helically wound metallic filars that form a coil having an outer diameter, the drive shaft defining a longitudinal axis;
an array of at five spherical abrasive elements being fixed to the drive shaft such that a center of mass of each abrasive element is offset from the longitudinal axis; and
a metallic stability element having a cylindrical shape defining an inner diameter, the metallic stability element being fixed to the helically wound metallic filars of the drive shaft the metallic stability element having a center of mass aligned with the longitudinal axis; and
a distal-most extension portion that extends distally of the metallic stability element to a distal free end;
wherein the drive shaft, the abrasive elements, and the metallic stability element rotate together about the longitudinal axis,
and
wherein the array comprises outer spherical abrasive elements and at least one inner spherical abrasive element, wherein an outer diameter of the outer spherical abrasive element is smaller than an outer diameter of the at least one inner spherical abrasive element.
17. The system of claim 16 , wherein the drive shaft has a central lumen extending along the longitudinal axis that is configured to receive a guidewire that is fully withdrawable into the central lumen, and wherein the coil formed by the helically wound metallic filars has a constant outer coil diameter.
18. The system of claim 16 , wherein the coil of the drive shaft comprises a torque-transmitting coil and wherein the metallic stability element comprises a hollow metallic cylinder with the inner diameter fixed to an outer diameter of the torque-transmitting coil.
19. The system of claim 16 , wherein the distal-most extension portion is a portion of the drive shaft.
20. The system of claim 16 , wherein the five spherical abrasive elements are positioned adjacent to one another along the coil.
21. The system of claim 16 , wherein at least a portion of the distal-most extension portion is defined by the helically wound metallic filars of the drive shaft that extends distally of the metallic stability element.
22. The system of claim 16 , wherein the device further comprises a coating covering an outer diameter of the metallic stability element.
23. A system for performing rotational atherectomy to remove stenotic lesion material from a blood vessel of a patient, the system comprising:
an elongate tube defining a lumen; and
a rotational atherectomy device comprising:
an elongate flexible drive shaft comprising helically wound metallic filars that form a coil having an outer diameter, the drive shaft defining a longitudinal axis;
an array of at least three eccentric spherical abrasive elements being fixed to the drive shaft such that a center of mass of each abrasive element is offset from the longitudinal axis; and
a metallic stability element having a cylindrical shape defining an inner diameter, the metallic stability element being fixed to the helically wound metallic filars of the drive shaft, the metallic stability element having a center of mass aligned with the longitudinal axis; and
a distal-most extension portion that extends distally of the metallic stability element to a distal free end;
wherein the drive shaft, the abrasive elements, and the metallic stability element rotate together about the longitudinal axis, and
wherein each spherical abrasive element of the at least three spherical abrasive elements has an abrasive outer surface, wherein a middle spherical abrasive element of the at least three spherical abrasive elements has a larger outer diameter than a proximal-most spherical abrasive element of the at least three spherical abrasive elements and a larger outer diameter than a distal-most spherical abrasive element of the at least three spherical abrasive elements, and wherein the center of mass for each eccentric spherical abrasive elements in said array is offset from the longitudinal axis while contemporaneously the center of mass of the metallic stability element is aligned with the longitudinal axis.
24. The system of claim 23 , wherein the device further comprises a coating covering an outer diameter of the metallic stability element.
25. The system of claim 23 , wherein the drive shaft has a central lumen extending along the longitudinal axis that is configured to receive a guidewire that is fully withdrawable into the central lumen, and wherein the coil formed by the helically wound metallic filars has a constant outer coil diameter.
26. The system of claim 23 , wherein the coil of the drive shaft comprises a torque-transmitting coil and wherein the metallic stability element comprises a hollow metallic cylinder with the inner diameter fixed to an outer diameter of the torque-transmitting coil.
27. The system of claim 23 , wherein the at least three spherical abrasive elements are positioned adjacent to one another along the coil.
28. The system of claim 23 , wherein at least a portion of the distal-most extension portion is defined by the helically wound metallic filars of the drive shaft that extends distally of the metallic stability element.