# US 11,896,251 B2 · Inverting thrombectomy apparatuses and methods of use

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- Number: US 11,896,251 B2
- Document ID: US11896251B2
- Status: Granted
- Kind: B2
- Application number: 17/387,959
- Filed: 2021-07-28
- Published: 2021-11-18
- Granted: 2024-02-13
- Earliest claimed: 2018-05-14
- Assignees: Stryker Corporation
- Applicants: Stryker Corporation
- Inventors: Michael P. Wallace; E. Skott Greenhalgh
- Web page: https://patentgrep.com/patent/US11896251B2

## CPC

- A61B 17/22031: {Gripping instruments, e.g. forceps, for removing or smashing calculi (A61B17/221 takes precedence)}
- A61B 17/221: Gripping devices in the form of loops or baskets {for gripping calculi or similar types of obstructions (surgical snare instruments A61B17/32056)}
- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 2017/00292: {mounted on or guided by flexible, e.g. catheter-like, means}
- A61B 2017/00349: {Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue (A61B17/06066 takes precedence)}
- A61B 2017/00778: {Operations on blood vessels (A61B2017/22097, A61B2017/320741 take precedence)}
- A61B 2017/22038: {with a guide wire}
- A61B 2017/22079: {with suction of debris}
- A61B 2017/2215: {having an open distal end}
- A61B 2017/3435: {using everted sleeves}
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Inverting tube thrombectomy apparatus for removing clot that are configured to prevent compression of the apparatus that may separate the distal end of the apparatus from the clot and may make it difficult to advance the apparatus to engage with the clot, particularly in a tortious vessel. The apparatuses and methods of using them described herein may be adapted to prevent tension in the flexible tube that is rolling and inverting over the distal end of the inversion support catheter when capturing a clot. Also described herein are inverting tube thrombectomy apparatus that are configured to reload either automatically or manually within the vessel to capture additional clot material.

## Claims

### Claim 1

An apparatus for removing a clot, the apparatus comprising:
an intermediate catheter comprising an outer surface and an inner surface defining a lumen;
an inversion support catheter comprising an outer surface and an inner surface defining a lumen, the inversion support catheter being disposed within the lumen of the intermediate catheter;
a puller disposed within the lumen of the inversion support catheter;
a flexible tube having a first end coupled at a distal end region of the puller, and a second end held between the outer surface of a distal end region of the inversion support catheter and the inner surface of the intermediate catheter, wherein the flexible tube comprises a slack region formed by a portion of the flexible tube being bunched up on itself on the outer surface of the distal end region of the inversion support catheter, wherein the intermediate catheter is configured to be advanced distally to form the slack region.

### Claim 2 (depends on 1)

The apparatus of claim 1, wherein the first end of the flexible tube is coupled proximal to the distal end region of the puller by greater than 0.5 mm.

### Claim 3 (depends on 1)

The apparatus of claim 1, wherein the puller is a puller catheter.

### Claim 4 (depends on 1)

The apparatus of claim 1, wherein the puller is a wire.

### Claim 5 (depends on 1)

The apparatus of claim 1, wherein the flexible tube comprises a woven or knitted material.

### Claim 6 (depends on 1)

The apparatus of claim 1, wherein the flexible tube comprises a braided material.

### Claim 7 (depends on 1)

The apparatus of claim 1, wherein an outer diameter of the puller is within about 10% of an inner diameter of the inversion support catheter.

### Claim 8 (depends on 1)

The apparatus of claim 1, further comprising a guidewire extending through the flexible tube.

### Claim 9 (depends on 1)

The apparatus of claim 1, wherein the second end of the flexible tube includes a cuff.

### Claim 10 (depends on 9)

The apparatus of claim 9, wherein the cuff is less flexible than a region of the flexible tube adjacent to the cuff.

### Claim 11 (depends on 9)

The apparatus of claim 9, wherein the intermediate catheter is configured to be retracted or removed over the flexible tube and then be advanced distally against the cuff to distally drive the flexible tube and form the slack region.

### Claim 12 (depends on 1)

The apparatus of claim 1, wherein the flexible tube comprises a woven flexible tube and the slack region comprises compressed weaves.

### Claim 13 (depends on 1)

The apparatus of claim 1, wherein an outside region of the flexible tube is configured to be compressed to form the slack region.

### Claim 14 (depends on 13)

The apparatus of claim 13, wherein the outside region of the flexible tube adjacent to the first end coupled at the distal end region of the puller is configured to be compressed to form the slack region.

### Claim 15 (depends on 1)

The apparatus of claim 1, wherein the intermediate catheter is configured to be advanced distally to axially compress an outside region of the flexible tube to form the slack region.