Thrombectomy and stenting system
A design capable of both mechanical thrombectomy and stenting for treating occlusions in the cerebral vasculature provides for a three-catheter setup. The first outer catheter has the largest diameter and can serve as a guide catheter while also being a sheath for the other catheters. The second deployment catheter can be configured for the aspiration of occlusions and can include a stepped or recessed section proximal of the distal tip that can act as a housing for a braided expandable stent. The outer diameter of this stepped section can be lined with an inflation device on top of which the braided stent sits. Internal to the second deployment catheter is a microcatheter which can deliver mechanical thrombectomy devices to the target site to retrieve an occlusion in the vessel, after which the stent can be expanded and implanted in the vessel.
1. A method of using a thrombectomy and stenting system comprising: a sheath member, a deployment catheter, a stenting device comprising an inflation device and a stent, a microcatheter, and a thrombectomy device, the method comprising:
positioning the system approximate a lesion;
extending the thrombectomy device and a distal portion of the microcatheter towards an occlusive clot in a vasculature region while maintaining the deployment catheter, the stenting device, and the sheath member approximate the lesion;
deploying the thrombectomy device from the microcatheter;
capturing the occlusive clot with the thrombectomy device by expanding a plurality of struts of the thrombectomy device within and to either side of the occlusive clot to embed in the occlusive clot;
extending the sheath member, the deployment catheter, and the stenting device to cross the lesion such that the thrombectomy device is retracted within the deployment catheter before the stent is deployed approximate the lesion;
retracting the sheath member from the lesion;
inflating the inflation device of the stenting device across the lesion; and
releasing the stent of the stenting device to cross the lesion.
2. The method of claim 1 further comprising retracting the occlusive clot into the deployment catheter.
3. The method of claim 1 further comprising positioning the deployment catheter within a lumen of the sheath member.
4. The method of claim 1 further comprising positioning the microcatheter within the deployment catheter.
5. The method of claim 1 further comprising positioning the thrombectomy device within the microcatheter.
6. The method of claim 1 , wherein the stenting device comprises the stent disposed on an outer surface of the deployment catheter.
7. The method of claim 1 , wherein inflating the stenting device comprises increasing a diameter of a first portion of the vasculature region comprising the lesion to at least 75% of a diameter of a second portion of the vasculature region adjacent to the first portion.
8. The method of claim 1 further comprising releasing the stent of the stenting device in proximity to the lesion by deflating the inflation device.
9. The method of claim 1 further comprising:
crossing the occlusive clot with the microcatheter and the thrombectomy device; and
retracting the microcatheter while maintaining the thrombectomy device across the occlusive clot.
10. The method of claim 1 , wherein the deployment catheter is oriented within a lumen of the sheath member, the deployment catheter comprising:
a deployment catheter lumen;
a deployment catheter outer diameter;
a deployment catheter inner diameter;
a deployment catheter outer surface; and
a depressed region on the deployment catheter outer surface, and proximate to a distal end of the deployment catheter, the depressed region comprising a depressed region outer diameter configured to be less than the deployment catheter outer diameter, and a depressed region inner diameter configured to be less than the deployment catheter inner diameter and the depressed region outer diameter.
11. The method of claim 10 , wherein the stenting device comprises the stent circumscribing the depressed region of the deployment catheter, and
wherein the stenting device is located at the distal end of the deployment catheter and circumscribes the deployment catheter outer surface.
12. The method of claim 10 , wherein the distal end of the deployment catheter comprises a flexible portion proximal of and distal of the stenting device.
13. The method of claim 1 , wherein the struts of the thrombectomy device are configured to deploy from a lumen of the microcatheter and retract within a lumen of the deployment catheter.
14. The method of claim 1 , wherein the inflation device is coupled to an outer surface of the deployment catheter, wherein a portion of the stenting device circumscribes the inflation device, and wherein the inflation device has an expanded condition configured to expand the stenting device.
15. The method of claim 1 , wherein a lumen of the sheath member, a lumen of the deployment catheter and a lumen of the microcatheter are substantially concentric.
16. The method of claim 1 , wherein the thrombectomy device comprises an expandable clot retriever collapsible to fit within a lumen of the microcatheter and self-expandable upon exiting the microcatheter lumen, the expandable clot retriever comprising a capture portion expandable to grip portions of the occlusive clot.
17. The method of claim 1 , wherein the thrombectomy device and the microcatheter are withdrawn from the deployment catheter before the sheath member is advanced across the lesion and the sheath member is retracted such that a distal end of the sheath member is located proximal of the lesion to expose the stent.