Exchange method for emboli containment

A method of performing treatment in a blood vessel while isolating emboli to a portion of the blood vessel, the method comprising the steps of:

• (a) delivering a guidewire having a proximal end and a distal end into the vasculature of a patient until the distal end is near to a treatment site in the blood vessel, the distal end of the guidewire having an occlusive device thereon, the occlusive device being actuatable between an expanded state in which the occlusive device engages at least a portion of the walls of the blood vessel, and a nonexpanded state in which the occlusive device does not engage the walls of the blood vessel;
• (b) delivering a therapy catheter comprising an elongate catheter shaft having a proximal end and a distal end into the vasculature until the distal end of the therapy catheter is near to the treatment site;
• (c) actuating the occlusive device at a location distal to the treatment site from its nonexpanded state to its expanded state;
• (d) performing treatment on the treatment site with the therapy catheter, said treatment resulting in emboli in the vessel proximal to the actuated occlusive device;
• (e) removing the therapy catheter from the vasculature and from the guidewire;
• (f) delivering an emboli removal device having a proximal end and a distal end into the vasculature until the distal end of the emboli removal device is near to the treatment site and proximal to the occlusive device;
• (g) removing emboli from the treatment site with the emboli removal device;
• and
• (h) de-actuating the occlusive device;
• wherein the occlusive device is maintained in its expanded state continuously from step (c) through step (g) to isolate emboli to the treatment site proximal to the occlusive device.

A method for exchanging catheters while isolating emboli to a working area in a blood vessel, comprising:

• delivering a guidewire having a proximal end and a distal end into the blood vessel until the distal end of the guidewire is near to a desired working area, the distal end having an occlusive device thereon;
• delivering a first catheter having a proximal end and a distal end over the guidewire until the distal end of the first catheter is near to the desired working area;
• actuating the occlusive device at a location distal to the desired working area such that the device at least partially obstructs blood flow through the vessel;
• performing treatment in the working area with the first catheter while continuously maintaining actuation of the occlusive device, said treatment resulting in emboli within the working area isolated proximal to the occlusive device;
• removing the first catheter from the guidewire while continuously maintaining actuation of the occlusive device;
• delivering an aspiration catheter having a proximal and a distal end over the guidewire while continuously maintaining actuation of the occlusive device such that the distal end of the aspiration catheter is located within the working area;
• and
• applying negative pressure to the aspiration catheter to remove emboli isolated within the working area.

A method for exchanging catheters, comprising:

• delivering a guidewire having a proximal end and a distal end into the blood vessel until the distal end of the guidewire is near to a desired working area, the distal end having an occlusive device thereon;
• delivering a first catheter having a proximal end and a distal end over the guidewire until the distal end of the first catheter is near to the desired working area;
• expanding the occlusive device at a location distal to the desired working area such that the device at least partially obstructs blood flow through the vessel;
• performing treatment in the working area with the first catheter while continuously maintaining the occlusive device in its expanded state, said treatment resulting in emboli within the working area;
• removing the first catheter from the guidewire while continuously maintaining the occlusive device in its expanded state;
• delivering an emboli removal device over the guidewire while continuously maintaining the occlusive device in its expanded state;
• and
• removing said emboli from the working area.

A method for exchanging catheters in a blood vessel, comprising:

• delivering a guidewire having a proximal end and a distal end into the blood vessel until the distal end of the guidewire is near to a desired working area, the distal end having an occlusive device thereon;
• actuating the occlusive device at a location distal to the desired working area such that the occlusive device inhibits emboli from moving past the occlusive device;
• delivering a first catheter having a proximal end and a distal end over the guidewire until the distal end of the first catheter is near to the desired working area;
• performing a first treatment in the working area with the first catheter while the occlusive device is actuated to inhibit emboli from moving past the occlusive device;
• removing the first catheter from the guidewire while the occlusive device is actuated;
• delivering a second catheter :over the guidewire while the occlusive device is actuated;
• and
• performing a second treatment in the working area with the second catheter while the occlusive device is actuated to inhibit emboli from moving past the occlusive device.