Inverting thrombectomy apparatuses having enhanced tracking
AssigneeStryker Corporation
InventorsMichael P. Wallace, Robert Garabedian, Roy Leguidleguid, E. Skott Greenhalgh
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Abstract
Mechanical thrombectomy apparatuses, and particularly knitted rolling tube mechanical thrombectomy apparatuses configured to have improved tracking for delivery through tortious vessels are described herein. Also described herein are methods of removing clots using a mechanical thrombectomy apparatuses in which the clot is larger than the tractor portion of the mechanical thrombectomy apparatus.
Claims20
A method of removing a clot from a vessel having an inner diameter (ID), the method comprising:
- advancing an inverting tube apparatus through the vessel until a distal end of the inverting tube apparatus is proximate to a clot, wherein the inverting tube apparatus comprises an inversion support catheter, a puller within a lumen of the support catheter, and a knitted tube having a first end coupled to a distal end region of the puller, and a second end that is free to move relative to the inversion support catheter, wherein the knitted tube comprises a filament knitted to form a plurality of interlocking loop stitches, wherein each loop stitch has a stitch length;
- expanding the knitted tube to a first configuration along an outer surface of the inversion support catheter to an outer diameter that is between 10% and 80% of an inner diameter of the vessel for a first region of the knitted tube that is adjacent to the first end, wherein the knitted tube has a second configuration within the inversion support catheter having an inner diameter that is greater than 30% of an inner diameter of the inversion support catheter, and wherein a second region of the knitted tube adjacent to the second end has an expanded outer diameter that is less than the expanded outer diameter of the first configuration;
- pulling the puller proximally within the inversion support catheter to roll the knitted tube over the distal end of the inversion support catheter so that the knitted tube inverts over a distal end of the inversion support catheter, driving the loop stitches outward from the knitted tube by between 0.5 mm and 10 mm;
- capturing the clot with the knitted tube;
- and
- pulling the clot proximally into the inversion support catheter.
A method of delivering an inverting mechanical thrombectomy apparatus for removing a clot from a vessel, the method comprising:
- advancing a guidewire distally through a tortious vessel toward a deployment site;
- and
- advancing a pre-loaded mechanical thrombectomy apparatus distally over the guidewire, wherein the pre-loaded mechanical thrombectomy apparatus comprises an intermediate catheter having a lumen, an inversion support catheter within the lumen of the intermediate catheter, a puller catheter within a lumen of the inversion support catheter, a flexible tube attached to a distal end region of the puller catheter and extending proximally between the intermediate catheter and the inversion support catheter,
- wherein advancing the pre-loaded mechanical thrombectomy apparatus comprises moving the intermediate catheter and the inversion support catheter so that a distal end of the inversion support catheter remains within the intermediate catheter while a distal end of the puller catheter and at least a portion of the flexible tube are advanced ahead of a distal end of the intermediate catheter.
A method of delivering an inverting mechanical thrombectomy apparatus for removing a clot from a vessel, the method comprising:
- advancing a guidewire distally through a tortious vessel toward a deployment site;
- and
- advancing a pre-loaded mechanical thrombectomy apparatus distally over the guidewire, wherein the pre-loaded mechanical thrombectomy apparatus comprises an intermediate catheter having a lumen, an inversion support catheter within a lumen of the intermediate catheter, a puller catheter within a lumen of the inversion support catheter, a flexible tube attached to a distal end region of the puller catheter and extending proximally between the intermediate catheter and the inversion support catheter,
- wherein advancing the pre-loaded mechanical thrombectomy apparatus comprises moving the inversion support catheter with the puller catheter distally ahead of the intermediate catheter over the guidewire.
Dependencies are inferred from the claim text.