Intravascular treatment of vascular occlusion and associated devices, systems, and methods

A method of treating deep vein thrombosis in a peripheral vasculature of a patient, the method comprising:

• percutaneously accessing a venous vessel of a patient with an introducer sheath through an access site into the venous vessel of the patient;
• deploying a self-expanding funnel on a distal end of the introducer sheath proximal of a vascular thrombus, wherein deploying the self-expanding funnel comprises advancing an obturator having a capture sheath feature on a distal end thereof to unsheathe the self-expanding funnel from a constrained configuration within the capture sheath feature to a deployed configuration free of the capture sheath feature;
• removing the obturator from the introducer sheath by retracting the obturator through the deployed self-expanding funnel and through a lumen of the introducer sheath
• inserting a catheter constraining a thrombus extraction device through the lumen of the introducer sheath so that a distal tip of the catheter is distally past a portion of the vascular thrombus in the venous vessel, wherein the thrombus extraction device comprises a proximal self-expanding coring portion defining a coring angle and a distal expandable tubular portion formed of a mesh structure, wherein a proximal end of the mesh structure is coupled to a distal end of the coring portion;
• deploying the thrombus extraction device from the catheter from a constrained configuration to an expanded configuration until the coring portion of the thrombus extraction device is beyond a distal end of the catheter, wherein the coring angle is in a range between about 20 degrees and about 50 degrees when the thrombus extraction device is in an expanded state;
• retracting the thrombus extraction device proximally so that the coring portion cores and separates the portion of the vascular thrombus from a venous vessel wall while the mesh structure captures the vascular thrombus portion, wherein the coring portion maintains sufficient radial force on the venous vessel wall to core and separate the vascular thrombus portion in the expanded state;
• and
• withdrawing the thrombus extraction device from the patient.

A method of treating deep vein thrombosis in a peripheral vasculature of a patient, the method comprising:

• percutaneously accessing a venous vessel of a patient with an introducer sheath through an access site into the venous vessel of the patient;
• inserting a catheter constraining a thrombus extraction device through a lumen of the introducer sheath so that a distal tip of the catheter is distally past a portion of a vascular thrombus in the venous vessel, wherein the thrombus extraction device comprises a proximal self-expanding coring portion defining a coring angle and a distal expandable tubular portion formed of a mesh structure, wherein a proximal end of the mesh structure is coupled to a distal end of the coring portion;
• deploying the thrombus extraction device from the catheter from a constrained configuration to an expanded configuration until the coring portion of the thrombus extraction device is beyond a distal end of the catheter, wherein the coring angle is in a range between about 20 degrees and about 50 degrees when the thrombus extraction device is in an expanded state, wherein deploying the thrombus extraction device further comprises advancing an intermediate shaft distally until the coring portion of the thrombus extraction device is beyond the distal end of the catheter, wherein the intermediate shaft slidably extends through the catheter and a distal end thereof is coupled to a proximal end of the coring portion, locking the intermediate shaft with respect to the catheter, retracting an inner shaft with respect to the catheter and the intermediate shaft until a stop feature fixed on the inner shaft engages a corresponding feature on the coring portion for further expansion of the thrombus extraction device to the expanded state, and dynamically coupling the inner shaft with respect to the intermediate shaft
• retracting the thrombus extraction device proximally so that the coring portion cores and separates the portion of the vascular thrombus from a venous vessel wall while the mesh structure captures the vascular thrombus portion, wherein the coring portion maintains sufficient radial force on the venous vessel wall to core and separate the vascular thrombus portion in the expanded state;
• and
• withdrawing the thrombus extraction device from the patient.

A thrombus extraction device for removal of a vascular thrombus from a blood vessel of a patient, the thrombus extraction device comprising:

• a catheter having a proximal end and a distal end, an outer shaft defining a first lumen, an intermediate shaft defining a second lumen, and an inner shaft, where the intermediate shaft is coaxial the first lumen and the inner shaft is coaxial the second lumen;
• a proximal self-expanding coring element having a proximal end and a distal end and configured to core and separate a portion of the vascular thrombus from the blood vessel, wherein the proximal end of the coring element is coupled to the distal end of the intermediate shaft;
• and
• a distal expandable cylindrical portion formed of a filament mesh structure having a proximal end and a distal end and configured to capture the vascular thrombus portion, wherein the mesh structure filaments are interwoven with the coring element so that the proximal end of the mesh structure is attached to the distal end of the coring element, and wherein the distal end of the mesh structure is coupled to the distal end of the inner shaft.