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 rotational atherectomy device for removing stenotic lesion material from a blood vessel of a patient, the device comprising:
an elongate flexible drive shaft comprising helically wound metallic filars that form a coil having a constant outer diameter and a longitudinal axis;
a distal metallic concentric cylindrical element having a center of mass aligned with the longitudinal axis and being fixed to a distal tip portion of the drive shaft; and
an array of at least three spherical eccentric abrasive burrs being fixed to the drive shaft at a position spaced proximal from the distal metallic concentric cylindrical element such that a center of mass of each of the at least three spherical eccentric abrasive burrs is offset from the longitudinal axis while contemporaneously the center of mass of the distal metallic concentric cylindrical element is aligned with the longitudinal axis,
wherein when the drive shaft is configured to be driven to rotate about an axis of rotation at 20,000 rpm to 160,000 rpm, the array of at least three spherical eccentric abrasive burrs and the distal metallic concentric cylindrical element rotate together with the drive shaft such that the array of at least three spherical eccentric abrasive burrs move in an orbital path offset from the axis of rotation while the distal metallic concentric cylindrical element simultaneously rotates at a position generally axially aligned with the axis of rotation.
2. The device of claim 1 , wherein each spherical eccentric abrasive burr in the array of at least three spherical eccentric abrasive burrs has an abrasive outer surface, wherein a middle spherical abrasive burr in the array of at least three spherical eccentric abrasive burrs has a maximum outer diameter that is greater than a maximum outer diameter of a proximal-most spherical abrasive burr in the array of at least three spherical eccentric abrasive burrs and that is greater than a maximum outer diameter of a distal-most spherical abrasive burr in the array of at least three spherical eccentric abrasive burrs, and wherein the center of mass of each of the at least three spherical eccentric abrasive burrs is offset from the longitudinal axis such that said orbital path of the array of at least three spherical eccentric abrasive burrs is larger than a maximum diameter of a rotational path of the distal metallic concentric cylindrical element.
3. The device of claim 2 , wherein the distal metallic concentric cylindrical element is distally spaced apart from the distal-most abrasive burr in the array of at least three spherical eccentric abrasive burrs by a distal separation distance.
4. The device of claim 3 , wherein each abrasive burrs in the array of at least three spherical eccentric abrasive burrs is spaced apart from an adjacent abrasive burr by an element spacing distance, and the distal separation distance is greater than the element spacing distance.
5. The device of claim 1 , wherein the distal metallic concentric cylindrical element defines an inner diameter and the distal metallic concentric cylindrical element is fixed along the inner diameter to the helically wound metallic filars of the drive shaft.
6. The device of claim 1 , wherein the array of at least three spherical eccentric abrasive burrs comprises five spherical eccentric abrasive burrs positioned along the drive shaft, each of the five spherical eccentric abrasive burrs having an abrasive outer surface.
7. The device of claim 6 , wherein a proximal-most spherical abrasive burr in the array has a maximum outer diameter smaller than an intermediate spherical abrasive burr in the array.
8. The device of claim 7 , wherein a distal-most spherical abrasive burr in the array has a maximum outer diameter smaller than the intermediate spherical abrasive burr in the array.
9. The device of claim 1 , wherein the coil of the drive shaft defines a central lumen extending along the longitudinal axis that is configured to receive a guidewire fully withdrawable into the central lumen.
10. The device of claim 1 , wherein the drive shaft comprises a fluid-impermeable coating.
11. The device of claim 1 , wherein the coil of the drive shaft comprises a distal-most extension portion that extends distally of the distal metallic concentric cylindrical element.
12. The device of claim 1 , wherein the distal metallic concentric cylindrical element comprises a coating along its outer cylindrical surface.
13. A rotational atherectomy device for removing stenotic lesion material, the device comprising:
an elongate flexible drive shaft comprising helically wound metallic filars that form a coil having a constant outer diameter and a longitudinal axis;
a distal metallic concentric cylindrical element having a center of mass aligned with the longitudinal axis and being fixed to a distal tip portion of the drive shaft; and
an array of at least three eccentric abrasive burrs having a same shape and being fixed to the drive shaft at a position spaced proximal from the distal metallic concentric cylindrical element such that a center of mass of each of the at least three eccentric abrasive burrs is offset from the longitudinal axis while contemporaneously the center of mass of the distal metallic concentric cylindrical element is aligned with the longitudinal axis,
wherein when the drive shaft is configured to be driven to rotate about an axis of rotation at 20,000 rpm to 160,000 rpm, the array of at least three eccentric abrasive burrs and the distal metallic concentric cylindrical element rotate together with the drive shaft such that the array of at least three eccentric abrasive burrs move in an orbital path offset from the axis of rotation while the distal metallic concentric cylindrical element simultaneously rotates at a position generally axially aligned with the axis of rotation.
14. The device of claim 13 , wherein each eccentric abrasive burr in the array of at least three eccentric abrasive burrs has an abrasive outer surface, wherein a middle abrasive burr in the array of at least three eccentric abrasive burrs has a maximum outer diameter that is greater than a maximum outer diameter of a proximal-most abrasive burr in the array of at least three eccentric abrasive burrs and that is greater than a maximum outer diameter of a distal-most abrasive burr in the array of at least three eccentric abrasive burrs, and wherein the center of mass of each of the at least three eccentric abrasive burrs is offset from the longitudinal axis such that said orbital path of the array of at least three eccentric abrasive burrs is larger than a maximum diameter of a rotational path of the distal metallic concentric cylindrical element.
15. The device of claim 14 , wherein the distal metallic concentric cylindrical element is distally spaced apart from the distal-most abrasive burr in the array of at least three eccentric abrasive burrs by a distal separation distance.
16. The device of claim 15 , wherein each abrasive burrs in the array of at least three eccentric abrasive burrs is spaced apart from an adjacent abrasive burr by an element spacing distance, and the distal separation distance is greater than the element spacing distance.
17. The device of claim 13 , wherein the distal metallic concentric cylindrical element defines an inner diameter and the distal metallic concentric cylindrical element is fixed along the inner diameter to the helically wound metallic filars of the drive shaft.
18. The device of claim 13 , wherein the array of at least three eccentric abrasive burrs comprises five spherical eccentric abrasive burrs positioned along the drive shaft, each of the five spherical eccentric abrasive burrs having an abrasive outer surface.
19. The device of claim 13 , wherein the array of at least three eccentric abrasive burrs having the same shape comprise spherical eccentric abrasive burrs.
20. The device of claim 13 , wherein the array of at least three eccentric abrasive burrs having the same shape comprise ellipsoid eccentric abrasive burrs.