Systems and methods for manipulating medical devices
A method for treating a patient having thrombus includes providing a manipulation device including a housing configured to be supported by the hand of a user and having a distal and proximal end, a drive system disposed within the housing, and configured to rotate a rotation member, an engagement member coupled to the rotation member and configured to be removably coupled to an elongate medical device, an activation member carried by the housing such that it can be operated by at least a portion of the hand of the user when the housing is supported by the hand of the user, the drive system configured to apply motive force to the engagement member, securing an elongate member to the engagement member, introducing at least the distal end of the elongate member into a blood vessel adjacent a thrombus, operating the activation member to cause at least some rotation of the rotation member, which in turn causes at least some rotation of the distal end of the elongate member at or near the thrombus, and aspirating at least some of the thrombus with an aspiration catheter.
1. A system for treating a patient having thrombus, comprising:
an aspiration catheter having a distal end for placement into a blood vessel, a proximal end, and an aspiration lumen extending between the distal end and the proximal end and configured to be coupled to a vacuum source, the aspiration lumen configured for aspirating thrombus therethrough;
an elongate member having a distal end and a proximal end, the distal end having a straight distal portion such that the elongate member is configured to be inserted through the aspiration lumen of the aspiration catheter such that the distal end extends from the aspiration lumen into a thrombus within the blood vessel;
a manipulation device comprising:
a housing configured to be supported by the hand of a user, the housing having a distal end and a proximal end;
a drive system disposed within the housing, and configured to rotate a rotation member;
an engagement member coupled to the rotation member, and configured to be releasably coupled to the elongate member to transfer rotational movement of the rotation member to rotational movement of the elongate member;
an activation member carried by the housing such that it can be operated by at least a portion of the hand of the user when the housing is supported by the hand of the user; and
wherein the drive system is configured to apply motive force to the engagement member to thereby move the elongate member, wherein the motive force comprises a combination of motive force components comprising an alternating clockwise motion and counter-clockwise motion.
2. The system of claim 1 , wherein the motive force comprises a combination of motive force components comprising a rotational motion and a cyclic longitudinal motion.
3. The system of claim 1 , wherein the elongate member comprises a guidewire.
4. The system of claim 1 , wherein the distal end of the elongate member consists of the straight distal portion.
5. The system of claim 1 , wherein the distal end of the elongate member further comprises a curved portion proximal to the straight distal portion.
6. The system of claim 1 , further comprising a delivery catheter having a proximal end, a distal end, and a delivery lumen extending between the proximal end and the distal end of the delivery catheter, the delivery lumen configured to allow simultaneous placement of the aspiration catheter and the elongate member therein.
7. The system of claim 6 , wherein the delivery catheter comprises a coronary guiding catheter.
8. The system of claim 1 , wherein the elongate member comprises an expandable device.
9. The system of claim 1 , wherein the elongate member comprises a catheter shaft.
10. The system of claim 1 , wherein the elongate member comprises a macerator.
11. The system of claim 1 , wherein the motive force comprises a helical motion.
12. The system of claim 1 , wherein the motive force comprises a jackhammer motion.
13. The system of claim 1 , wherein the elongate member, when rotated, is configured to facilitate movement of at least some thrombus through the aspiration lumen of the aspiration catheter.
14. The system of claim 1 , wherein the aspiration catheter further comprises a distal supply tube having a proximal end configured to be coupled to a fluid source, a distal portion having an orifice, and a lumen, the distal supply tube extending within the aspiration lumen, and the orifice configured to allow fluid injected through the lumen of the distal supply tube to enter the aspiration lumen as a jet.
15. The system of claim 14 , wherein the orifice is at an open distal end of the distal supply tube.
16. The system of claim 14 , wherein a distal end of the distal supply tube is closed, and wherein the orifice is through a wall of the distal supply tube, adjacent to the closed distal end.
17. The system of claim 1 , wherein the elongate member includes a first portion configured to reside within the aspiration lumen and to facilitate the movement of partially or completely macerated thrombus through the aspiration lumen while the elongate member is moved in relation to the aspiration catheter.
18. The system of claim 17 , wherein the first portion of the elongate member is configured to help center or stabilize the elongate member within the aspiration lumen.
19. The system of claim 1 , therein the engagement member comprises a chuck having a collet configured to directly grip the elongate member.