Endovascular tissue removal device
An endovascular tissue removal system including an expandable mechanism introduceable to the ventricular side of a valve to support the leaflets of the valve in a closed position and a tissue removal device advanceable to the leaflets and configured to resect the leaflets as they are supported by the expandable mechanism.
1. An endovascular tissue removal system comprising:
an expandable mechanism introduceable to the ventricular side of a valve to support the leaflets of the valve in a closed position; and
a tissue removal device advanceable to the leaflets and configured to resect the leaflets as they are supported by the expandable mechanism.
2. The system of claim 1 in which the tissue removal device includes a lumen connected to a source of ablation energy and further including an absorptive surface on the expandable mechanism for absorbing the ablation energy or a reflection surface for reflecting the energy.
3. The system of claim 1 in which the expandable mechanism is a balloon.
4. The system of claim 1 in which the tissue removal device includes:
a lumen including a rotatable terminal hub advanceable in vasculature,
at least one fiber extending from the hub for ablating tissue, and
a second expandable mechanism connected to the fiber for biasing it into position for precisely ablating tissue as the hub rotates.
5. The system of claim 4 in which there are a plurality of fibers extending from the hub and connected to the second expandable mechanism so that the plurality of fibers can be spread apart for tissue ablation and also collapsed together for vascular insertion and removal.
6. The system of claim 4 in which the second expandable mechanism is a circumferentially expanding balloon.
7. The system of claim 6 in which there are two balloons, one inside and one outside of the distal end of the fiber.
8. The system of claim 6 in which the lumen includes an inflation conduit therein connected to the balloon.
9. The system of claim 4 in which the fiber is an optical fiber connected to a source of laser energy.
10. The system of claim 4 in which the fiber is a waveguide connected to a source of laser energy.
11. The system of claim 4 further including a tissue trap device surrounding the expandable mechanism.
12. The system of claim 4 in which the fiber includes an angled distal portion.
13. The system of claim 4 further including a mirror for redirecting the ablation energy.
14. The system of claim 1 in which the tissue removal device includes:
a lumen including a distal steerable tip portion extending from a joint portion,
registration means for holding the joint portion fixed in place in the vasculature, and
a source of ablation energy in communication with the lumen whereby tissue can be resected by ablation energy as the tip portion is steered within the vasculature.
15. The system of claim 14 in which the registration means includes a second inflatable balloon about the joint portion.
16. The system of claim 14 in which the source of ablation energy is a laser.
17. The system of claim 16 in which the distal steerable tip portion includes a deflectable tip catheter.
18. The system of claim 17 in which there is an optical fiber inside the deflectable tip catheter and connected to the laser.
19. The system of claim 14 further including an expandable barrier for trapping any debris resected.
20. The system of claim 1 in which the tissue removal device includes:
a fiber advanceable within vasculature to ablate tissue,
an outer expandable balloon, and
an inner expandable balloon spaced from the outer expandable balloon forming a space within which the fiber travels to resect tissue.
21. The system of claim 20 in which the outer expandable balloon is a portion of a tissue trap device.
22. The system of claim 20 in which the distal end of the fiber is angled.
23. An endovascular tissue removal system comprising:
an expandable mechanism introduceable to the ventricular side of a valve to support the leaflets of the valve in the closed position; and
a tissue removal device advanceable to the leaflets and configured to resect the leaflets as they are supported by the expandable mechanism, the tissue removal device including:
a lumen including a rotatable terminal hub advanceable and vasculature,
at least one fiber extending from the hub for ablating tissue, and
a second expandable mechanism connected to the fiber for biasing it into position for precisely ablating tissue as the hub rotates.
24. An endovascular tissue removal system comprising:
an expandable mechanism introduceable to the ventricular side of a valve to support the leaflets of the valve in the closed position; and
a tissue removal device advanceable to the leaflets and configured to resect the leaflets as they are supported by the expandable mechanism the tissue removal device including:
a lumen including a distal steerable tip portion extending from a joint portion,
registration means for holding the joint portion fixed in place in the vasculature, and
a source of ablation energy in communication with the lumen whereby tissue can be resected by ablation energy as the tip portion is steered within the vasculature.
25. An endovascular tissue removal system comprising:
an expandable mechanism introduceable to the ventricular side of a valve to support the leaflets of the valve in the closed position; and
a tissue removal device advanceable to the leaflets and configured to resect the leaflets as they are supported by the expandable mechanism, the tissue removal device including:
a fiber advanceable within vasculature to ablate tissue,
an outer expandable balloon, and
an inner expandable balloon spaced from the outer expandable balloon forming a space within which the fiber travels to resect tissue.
26. A method of endovascularly removing a heart valve, the method comprising:
introducing an expandable mechanism to the ventricular side of the valve;
expanding the mechanism to support the leaflets of the valve in a closed position; and
resecting the leaflets of the valve as they are supported by the expandable mechanism.
27. The method of claim 26 in which resecting includes directing ablative energy at the leaflets.
28. The method of claim 27 in which resecting includes:
introducing a lumen within the vasculature of a patient to a situs proximate a heart valve to be resected,
introducing ablative energy into the lumen, and
rotating the lumen to resect the heart valve.
29. The method of claim 27 in which resecting includes:
endovascularly introducing a lumen with a distal steerable tip portion to a position proximate a valve to be resected,
registering the lumen in place in the vasculature,
directing ablation energy through the lumen, and
steering the distal steerable tip portion to resect the valve.