CN113423451B - Thrombolysis catheter and use method thereof - Google Patents

Abstract

A thrombectomy catheter comprising a catheter or delivery sheath has a dual-lumen body extending throughout, said catheter comprising a proximal section, a distal section, and a linear section sandwiched between the two sections. The distal section is configured as an annular ring and a port or opening is formed in the dual chamber of the catheter. The port is located proximate to the distal section, and a guide wire is positioned longitudinally through one of the dual lumens of the catheter. A suction device is connected to one of the dual chambers and is configured to create a vacuum in the conduit and the annular ring to remove biological material.

Description

Thrombectomy Catheter and How to Use it

Cross References to Related Applications

To the fullest extent permitted by law, this U.S. Continuing Patent Application-in-Part claims priority to U.S. Patent Application No. 15/964,593, filed April 27, 2018, and entitled "Embolic Retrieval Catheter and Method of Use" and In its entirety, this U.S. patent application claims priority to U.S. Provisional Application No. 62/598,436, filed December 13, 2017, and entitled "X-Type Traction Thrombectomy Catheter and Method of Use," both in their entirety Incorporated herein by reference.

technical field

This disclosure relates to medical catheter devices, and more particularly to medical catheter devices having deployable tools for removing thrombus(s).

Background technique

Catheters are manufactured from medical-grade materials and serve a wide range of functions, such as medical devices or instruments that are inserted into the body to treat disease or perform surgical procedures. In addition, most catheters are long strips with manipulative tools at their distal ends, and are used to perform surgical operations in limited or inaccessible places such as human or animal bodies. For example, catheters can be used for suturing, cutting with a knife or scissors, or through small arthroscopic, endoscopic incisions, skin or body openings as capture and retrieval devices.

In addition, angioplasty, atherectomy, and the deployment of stents and stent bypasses, procedures in the treatment of vascular disease, often result in the stripping of material or plaque from the vessel wall, which may lead to clot formation or dissociation of the clot into the bloodstream, And it can be so large that it plugs smaller downstream blood vessels and potentially blocks blood flow to body tissues. If a blockage occurs in a vital organ such as the heart, lungs, or brain, the result can be a serious threat to the patient's health or life.

A previous proposal included a catheter apparatus having a hose equipped with an axial bore, wherein a remote actuator tool was provided at the proximal end to actuate an annular ring elastically deformable by sliding to pass over the deployment opening at the distal end limits. Thereby deploying the elastically deformable annular ring and the partition portion adjoining it and maintaining its deployed configuration. A disadvantage of this solution is that the elastically deformable annular ring may overextend or stretch linearly causing tearing of tissue or blood vessels in the deployment area. Another disadvantage of this approach is that the slidably elastically deformable annular ring may nick or puncture biopsy tissue, thrombi, or puncture the vessel wall when extended and/or retracted into the deployment opening. Furthermore, the elastically deformable annular ring is generally not capable of preventing material from being released from the filter (blocking portion) during collapse and retraction.

In another previous approach, the catheter device was equipped with a self-expanding vascular device, such as a malleable support cuff in the joint area to support a capsule or mesh filter to filter or remove material from the vasculature and capture Thrombosis. The disadvantage of this approach is that the mesh filter may degrade and flow through the vessel, potentially damaging downstream cells and tissues that the blocked vessel would normally supply. Therefore, it may be difficult or impossible to use in small diameter vessels.

Accordingly, a thrombectomy catheter and method of use thereof are capable of deploying, scooping, collecting, and Removing material, plaques, emboli, and emboli, there is clearly an unmet need. In addition, to prevent material from dislodging from the filter (blocking part) during catheter collapse and recovery, prevent degradables from flowing through the blood vessel and possibly cause damage to downstream cells and tissues normally supplied by the blocked blood vessel, and realize catheter Operations in small diameter vessels.

Contents of the invention

Briefly described, in an exemplary embodiment, by providing a catheter or delivery sheath with dual chambers (channels) extending throughout the body, this instrument overcomes the above-mentioned deficiencies and meets the need for a thrombectomy catheter and method of use. The catheter has a proximal section, a distal section, and a linear section sandwiched between the two sections, and a guide wire, the distal section is configured as an annular ring (pigtail (pigtail)) or an annular ring, the catheter's A port or opening is formed in the dual chamber, the port is located proximate to the distal section, a guide wire is disposed longitudinally through one of the dual chambers of the catheter, the guide wire is configured with a is a mesh filter (basket/net) that runs longitudinally through the other of the catheter's dual chambers and exits the port and forms a retrievable mesh filter along the annular ring, and is thus used for Deploy, scoop up, collect, and remove material, plaque, thrombus, and embolism from within the vessel interior without tearing tissue or the vessel, scratching or puncturing biopsy tissue, clots, or puncturing the vessel wall, while Prevent material from dislodging from the filter (blocking part) during catheter collapse and retraction, prevent non-degradable flow through the blood vessel and may cause damage to downstream cells and tissues normally supplied by the blocked blood vessel, and achieve catheter in Operations in small diameter vessels.

According to its main aspects and broadly stated, the embolectomy catheter and method of use include a catheter or a delivery sheath with a double-chamber extending throughout the body, the catheter has a proximal section, a distal section, and a linear tube sandwiched between the two sections. segment, and a guide wire, the distal segment is configured as an annular ring, a port or opening is formed in the dual chamber of the catheter, the port is located close to the distal segment, and the guide wire is configured as a longitudinal passing through one of the catheter dual chambers, the first end of the guide wire is fixed with a mesh filter belt, and the mesh filter belt is arranged to longitudinally penetrate the other lumen of the catheter dual chambers chamber and exits through the port and forms a retrievable mesh filter belt along the annular ring.

In an exemplary embodiment a teleoperated surgical device includes a flexible positioning tool having an elongated catheter containing a dual lumen bore extending from a first catheter end to a second catheter end, the dual lumen The chamber bore has a first chamber and a second chamber, and a pigtail fitted at the end of the second conduit, the first chamber extends throughout the stretch conduit and the pigtail, the A second chamber extends throughout the stretch catheter, a guide wire extends throughout the extension catheter and the first chamber of the pigtail and is extendable from the pigtail, the guide wire Arranged to angulate a pigtail, the retrieval tool is configured to have a proximal end portion and a distal end portion connected to the proximal end portion, the distal end portion having a deformable annular ring and attached to the deformable annular ring, a whole body A barrier membrane extensible in the second chamber of the stretch catheter.

In a further exemplary embodiment of the method of removing biological material from a blood vessel of a patient, comprising the step of providing a teleoperated surgical device having a flexible positioning tool having a A stretchable catheter with a dual chamber bore having a first chamber and a second chamber, and a pigtail fitted at the end of the second catheter, the first chamber in the The stretching catheter and the pigtail are extended throughout, the second chamber is extending throughout the stretching catheter, and the guide wire is in the first chamber of the stretching catheter and the pigtail and a retracting tool configured to have a proximal end portion and a distal end portion connected to the proximal end portion. The distal end portion includes a deformable annular ring and a barrier membrane attached to the deformable annular ring that is extendable throughout the second chamber of the stretchable catheter to mobilize and operate surgical equipment in the patient's blood vessel, positioning the pigtail to access the biological material, deploying the deformable annular ring and the barrier membrane from the second chamber, rotating the deformable annular ring and the barrier membrane adjacent to the biological material, at the Biological material is collected in the barrier membrane, and the deformable annular ring, the barrier membrane and the biological material are withdrawn through the second chamber.

Based on this, a feature of the thrombectomy catheter and method of use is that it can turn the pigtail tube multiple times or set it as the far section of the annular ring to approach the non-demanding material, so that it can dig out the embolism in the mesh blood filter belt. clots, plaques, embolisms, thrombi (thrombi), fatty deposits, or other unwanted material or debris, and are removed from human blood vessels.

Another feature of the thrombus removal catheter and method of use is that it can provide a mesh filter belt or a basket-shaped permeator (porous), that is, when a clot, plaque, embolism, thrombus (plural thrombus), fatty deposits, or other non- Blood cells pass freely while desired material or debris is trapped therein.

Still another thrombectomy catheter and method of use are characterized in that a dual-chamber catheter can be provided, one chamber of which forms a channel for a guide wire and the other chamber of which forms a channel for a mesh filter belt.

Yet another feature of the thrombectomy catheter and method of use is its ability to provide distal manipulation of surgical equipment or guide wires.

Yet another feature of the thrombectomy catheter and method of use is its ability to provide a flexible dual lumen catheter.

Yet another feature of the embolectomy catheter and method of use is its ability to provide a flexible dual lumen catheter with a flexible pigtail with a channel for the guide wire and a deployment or exit port formed near or at the caudal end.

Yet another feature of the thrombectomy catheter and method of use is its ability to provide penetration around the distal segment, configured as an annular ring to form a basket or net, for scooping up emboli, plaque, thrombus, or other debris in the mesh filter band. Retractable mesh filter belt for stripping substances.

Yet another feature of the thrombectomy catheter and method of use is the ability to provide a catheter with a deployable mesh basket, mesh, mesh filter band to encircle an annular ring, pigtail at the distal end of said catheter.

Yet another feature of the thrombectomy catheter and method of use is the ability to provide a vascular device that overcomes the deficiencies of previously known vascular filters and thrombectomy/thrombectomy devices and uses a reduced number of components.

Yet another feature of the embolectomy catheter and method of use is the ability to provide a vascular device that can be shrunk into a small delivery framework, thereby allowing the device to be used in small vessels.

Yet another feature of the embolectomy catheter and method of use is its ability to provide vascular access without the need for a dedicated delivery catheter.

Yet another feature of the embolectomy catheter and method of use is its ability to provide a vascular device to provide a vascular device to reduce clots, plaques, embolisms, thrombi (blood clots), fatty deposits, or other undesired material or debris from becoming dislodged from the equipment when said equipment is recovered or removed.

Yet another feature of the thrombectomy catheter and method of use is its ability to provide a vascular device for the percutaneous removal of clots, plaques, Embolism, thrombi (blood clots), fatty deposits, other unwanted material or debris.

Yet another feature of the embolectomy catheter and method of use is its ability to provide a vascular device to multiple rotations of a pigtail, an annular ring, or a distal section configured as an annular ring to access the unwanted material, from human blood vessels. Captures emboli, plaque, embolism, thrombi (blood clots), fatty deposits, other unwanted material or debris.

Yet another feature of the thrombectomy catheter and method of use is its ability to remove the mesh, basket, deployable mesh basket, or mesh filter strip multiple times from the dual chamber catheter without losing the pigtail, The annulus, or the distal portion of the annulus, is positioned adjacent to the working area.

Yet another feature of the thrombectomy catheter and method of use is its ability to provide a vascular device with suction or cavitation by which the unwanted material is approached in the distal end of the lumen and pulled through the lumen Channel, suctioning of unwanted material (aspiration thrombectomy) to collect and remove clots, plaques, embolisms, thrombi (thrombi multiples), fatty deposits, or other unwanted material or debris from human blood vessels .

These and other features of the described thrombectomy catheters and methods of use will become more apparent to those skilled in the art from the detailed description of the following examples and claims when read in light with the figures.

Description of drawings

This thrombus catheter and method of use are easier to understand after reading the detailed description of the embodiment and referring to the accompanying pictures. The reference numerals indicate similar structures and can be regarded as similar elements in the general text, wherein:

Figure 1A is a top perspective view of an exemplary embodiment of a thrombus access catheter;

1B is a cross-sectional perspective view of an exemplary embodiment of a dual lumen stretch catheter of the thrombus access catheter of FIG. 1A;

1C is a cross-sectional perspective view of an exemplary embodiment of a single-chamber pigtail of the embolectomy catheter of FIG. 1A;

2 is a top perspective view of the exemplary embodiment of the thrombus catheter of FIG. 1A; showing a guide wire extending the pigtail through the first lumen;

3 is a top perspective view of an exemplary embodiment of a vascular medical tool;

4A is a top perspective view of the exemplary embodiment of the embolectomy catheter of FIG. 1; showing a guide wire threaded through the first lumen, and a retractable tool threaded through the second lumen;

4B is a cross-sectional perspective view of the stretched catheter of the thrombus catheter of FIG. 1; showing a guide wire and retractable tool extending throughout;

5A is a top perspective view of the exemplary embolectomy catheter of FIG. 1 with a retractable tool deployed between it and a pigtail;

5B is a front perspective view of the thrombus access catheter with the vascular medical tool of FIG. 5A, showing the net capturing recovered unwanted material or debris;

6 is a top perspective view of the embolectomy catheter with the retractable tool passed through the heart and deployed in the vascular wall of the lung in FIG. 5A , showing the netting of unwanted material or debris recovered;

7 is a flowchart of a method of deploying, using, and retrieving the embolectomy catheter of FIGS. 1-6 to remove unwanted material or debris from the vessel wall;

8 is a top perspective view of an exemplary embodiment of a thrombus access catheter with a suction device;

9 is a top perspective view of the exemplary thrombus catheter of FIG. 8 with unwanted material being drawn into the distal end of the chamber; and

10 is a flowchart of a method of deploying, using, and retrieving the embolectomy catheter of FIGS. 1-6 and 8-9 to withdraw unwanted material or debris from a vessel wall by suction;

Note that the pictures shown are for illustration purposes only and they are neither intended nor intended to limit the actual details of any or all of the constructions shown, except to the extent they may be considered an essential part of the claimed invention.

Detailed ways

In describing the exemplary embodiments of the present disclosure, namely, as set forth in FIGS. clarify. The present disclosure, however, is not limited by the specific terms selected, and it is understood that each specific element includes all technical equivalents that operate in a similar manner to perform a similar function. Embodiments of the claims may, however, be embodied in various forms and should not be limited to the embodiments set forth herein. The examples set forth herein are non-limiting examples and are only some of the other possible examples.

Reference is now made to FIGS. 1A , 1B , 1C by way of example, and not limitation, which illustrate an exemplary embodiment of a flexible surgical positioning tool 10 . The surgical positioning tool 10 may comprise a base portion, such as a handle 36, having a first 37 and a second 38 rotational petals, attached to a longitudinal linear portion, hose, housing, catheter, or sheath, as the catheter 20 is stretched from the handle. 36 for linear extension. Preferably, the stretch catheter 20 may comprise two or biaxial bores or spaces therethrough or formed therein and extend from a first catheter end 21 to a second catheter end 22 . Additionally, two or biaxial bores therethrough may contain a first chamber 31 and a second chamber 32 separated by a divider 33 .

Additionally, the second catheter end 22 of the surgical positioning tool 10 may be configured as an annular ring, a split ring, or a closed ring, such as a pigtail 50 formed or mounted on the second catheter end 22 . It is contemplated herein that the pigtail 50 may be formed in a variety of sizes or configurations and includes a first pigtail portion 51 and a second pigtail portion 52, the first pigtail portion 51 being attached to the second catheter end 22 of the stretch catheter 20 , while the second pigtail portion 52 forms a closed loop that wraps back around to a position near the second conduit end 22 . It is contemplated here that the stretch conduit 20 and the pigtail 50 may preferably be provided or constructed of plastic, polymeric materials, including polytetrafluoroethylene, polyurethane, polyethylene, Teflon, etc., that is, such materials provide a variety of Form, shape, ease of manufacture, and flexibility; however, other suitable materials may also be used, ie, materials having sufficient strength, flexibility, and/or durability to meet this goal. The material of the stretch catheter 20, the second chamber 32, the pigtail 50, the second chamber or the medical tool outlet opening 25 can be reinforced by fibers, rings, or longitudinal ribs, for example, so that the retrievable tool 60 can withstand being wrapped The force exerted on the second chamber 32 and when deformed by the stretching catheter 20 .

The first chamber 31 can extend through the handle 36, the stretch catheter 20, and the pigtail 50, starting from an entry hole, such as the first chamber or guidewire entry opening 24, and extending from the pigtail 50 at the proximal end of the pigtail. 53 exits from an exit or deployment aperture that is open to the environment, such as the first chamber or guidewire exit opening 26 .

The second chamber 32 can extend throughout the handle 36, the stretch catheter 20, from an inlet opening, such as the first tool opening 23, and from the second catheter proximal end 22 of the stretch catheter 20, to an exit or deployment hole, e.g. Second tool opening 25 second catheter proximal end 22 .

Referring now to FIG. 2 , by way of example and not limitation, an exemplary embodiment of deployment and retrieval of guide wire 40 in first lumen 31 of stretch catheter 20 and pigtail lumen 31B of pigtail 50 is illustrated. The guide wire 40 may include a first guide wire end 41 and a second guide wire end 42 . In use, a pathway or vascular guidance device, such as a guide wire 40, may be extended through the first lumen 31 of the draw catheter 20 and the pigtail lumen 31B of the pigtail 50, starting from an inlet hole, such as the first lumen chamber inlet opening 24, and exits the environment from the pigtail 50 proximal end 53 through an exit or deployment port, such as from the first chamber outlet opening 26 to a position beyond or beyond, or, extendable from the pigtail 50 to assist or The second catheter tip 22 and pigtail 50 are guided through the vessel V, diverted, bifurcated, or otherwise moved in the vessel. First guidewire end 41 extends through a deployment port, such as guidewire opening 26 and is remotely controlled from second guidewire end 42 . Additionally, guidewire 40 is passed through pigtail 50, which may be angled or vertical (as shown in FIG. -270 degrees, 9 o'clock counterclockwise to 12 o'clock), depending on the flexibility and rigidity of the first guide wire end 41 passed through. Additionally, the first rotation R1 of the stretch catheter 20 causes or causes a similar rotation, such as the rotation R2 of the pigtail 50 . The two pigtail angles A and rotation R2 allow for various positioning of the first guidewire tip 41 to assist or guide or position the guidewire 40, pigtail 50, and second catheter tip 22 to pass through the vessel V, divert, diverge. forks or make other precise movements in blood vessels. Moreover, movement of the guidewire 40 or movement of the guidewire 40, such as pushing/pulling the P1 of the second guidewire end 42, causes the first guidewire end 41 to move in and out of the guidewire opening 26 to assist or guide or Guidewire 40, pigtail 50, and second catheter tip 22 are positioned through the vessel, diverted, bifurcated, or otherwise moved within vessel V.

As an option, the first chamber 31 and the pigtail chamber 31B can be used for the inlet of additional laparoscopic or endoscopic equipment, and/or fluid inlet or retraction, illumination, video, and medical tools such as Class 40A. import. Such endoscopes may also be provided with surgical implements such as lasers, scalpels, irrigation and aspiration implements, visualization implements, and class 40A implements. The specific configuration and dimensions of the first chamber 31 and pigtail chamber 31B will vary depending on the intended use of the surgical positioning tool 10 and whether additional surgical tools 40A are provided. Generally speaking, the axial bore of the first chamber 31 may have an inner diameter of 6-12F (French, the unit is equal to 1/3 mm), but other diameters may be considered herein to adapt to the working channel of the endoscope.

Referring now to FIG. 3 , which illustrates, by way of example and not limitation, an exemplary embodiment of a retractable tool 60 for use with surgical positioning tool 10 . The retrievable tool 60 may include a proximal or tensile portion or operative member, such as a proximal portion 64 having a first portion end 65 and a second portion end 66 . The first portion end 65 may be provided with an annular ring, a closed ring, or a basket, pigtail (eg, a deformable ring 67 disposed thereon and proximate to the second portion end 66). It is contemplated herein that the deformable ring 67 can be configured from a variety of sizes and shapes to match the size and shape of the pigtail 50 .

In addition, the deformable ring 67 may be configured to consist of one or two parts, such as a first deforming portion 61 and a second deforming portion 62 and optionally includes a or more pivot joints 68 . The deformable ring 67 is preferably made of a flexible, elastic, or shape memory material or alloy, biocompatible material that can be bent, bent, or collapsed so as to be configured to enter and exit the first tool opening 23 through the second lumen The axial bore of the chamber 32, after passing through the second tool opening 26, expands to deploy the mesh and collapses to re-enter the second tool opening 26 to remove biological material from the blood vessel or other vascular passage or conduit (tube) V .

It can be additionally considered here that the deformable ring 67 may comprise one or more joints or hinges, such as a joint point 68 located near the deformable ring 67, or between the first deformable portion 61 and the second deformable portion 62, so as to realize The deformation ring 67 , the first deformation portion 61 , and the second deformation portion 62 are collapsed or folded linearly and pass through the first tool opening 23 , the axial bore of the second chamber 32 , and the second tool opening 25 . It is also conceivable here that the deformable ring 67 can form an opening, such as an annular inlet 69 .

When extended, the deformable ring 67 may have a diameter of from about 1 centimeter or less to about 3 centimeters, although other dimensions are contemplated herein. Additionally, a barrier membrane or other shifting or filtering membrane, such as a mesh filter belt 63 preferably runs loosely over, across, or is attached to the deformable ring 67 to form a circular opening across the annular inlet 69 end capture net. The mesh filter belt 63 can be used to filter or capture clots, plaques, embolisms, thrombi (plural thrombi), fatty deposits, or other unwanted material or debris from the human blood vessel V.

The particular arrangement and size of the axial bore of the second chamber 32 will vary according to the purpose of the surgical positioning tool 10, the circumference of the retractable tool 60, such as the insertion/retraction portion 64 and dimensioned to receive the The constrained deformable ring 67 of the part 61 and the second deformable part 62 , that is, the mesh filter belt is rolled up near the first deformable part 61 , the second deformable part 62 and the insertion/retraction part 64 . Typically, the axial bore of the second chamber 32 may have an axial bore or inner diameter of 6-12F (French, in units equal to 1/3 mm) to accommodate the restrained retractable tool 60, however, it may Consider using other diameters.

As an option, the second chamber 32 can be used for additional laparoscopes or endoscopes, and/or fluid inlet or retrieval, lighting, video, and inlet for medical tools such as Class 40A. Such endoscopes may also be provided with surgical instruments such as lasers, scalpels, irrigation and aspiration tools, visualization tools, and class 40A tools.

Referring again to FIG. 1A , the outer diameter of the catheter 20 may vary depending on the application, the size of the first chamber 31 and the second chamber 32 , the deformable ring of the retrievable tool 60 having the first deforming portion 61 and the second deforming portion 62 67, whether it is used as an additional laparoscope or endoscope, and/or fluid inlet or retraction, lighting, video, and inlet for medical tools such as Class 40A, and whether additional chambers are included in the surgical positioning tool 10. Variety.

Referring now to FIGS. 4A and 4B , by way of example and not limitation, an exemplary embodiment of a retractable tool 60 for deployment and retrieval in the second chamber 32 of the surgical positioning tool 10 is illustrated. Alternatively the second guidewire end 42 can be pulled and the guidewire 40 withdrawn through the pigtail 50, which can revert to the pigtail or annular ring configuration shown in Figures 1 and 4A.

In use, the deformable loop 67 of the first portion end 65 may tend to collapse and the mesh filter belt 63 may be rolled or wrapped around the deformable loop 67 and/or the first portion end 65 of the retrievable tool 60 . The collapsed deformable ring 67 and rolled mesh filter belt 63 may be inserted into the first tool opening 23 of the second chamber 32 . The collapsed deformation ring 67 and rolled mesh filter belt 63 can be placed, stretched, and passed through the second chamber 32 of the stretch catheter 20 and exit, or deployed throughout, or stretchable therefrom. When the deformable ring 67 and the rolled mesh filter belt 63 leave the second chamber 32, the deformable ring 67 expands to have the mesh filter belt 63 spread out, which is positioned at the proximal end of the pigtail tube 50 and is stretched and collected. Deformable tube 67 in post-deployment state. When the first deformable portion 61 and the second deformable portion 62 of the deformable ring 67 reversely extend to the non-compressed position as shown in FIG. 67, the extended deformable ring 67 tends to conform or can be positioned close to or within the pigtail 50, as shown in FIG.

Referring now to FIGS. 5A and 5B , by way of example and not limitation, an exemplary embodiment of the retractable tool 60 shown deployed from the second chamber 32 of the surgical positioning tool 103 is illustrated in use, with the second portion end 66 in use. Push/pull P1 can deploy or extend the deformable ring 67 in the pigtail 50, or across the confines of the second tool opening 25 at the distal end of the second catheter tip 22, to deploy the deformable ring 67 and the device mounted thereon. Mesh filter belt 63 and maintain its deployed setting. The rotation R3 of the second part end 66 causes or causes a similar rotation, such as the rotation R4 of the deformable ring 67 with the annular inlet 69 and the mesh filter belt 63, thereby causing the retrievable tool 60 to have the annular inlet 69 and the mesh filter. The deformable ring 67 of the band 63 scoops or collects or captures emboli, plaque, embolism, thrombus(s), fatty deposits, or other unwanted material or debris M from the blood vessel V. In addition, rotation R1 on stretching catheter 20 causes rotation R2 on pigtail 50, resulting in an annular inlet due to abutment or contact of pigtail and deformable ring 67 (deformable annular ring 67 abutting pigtail 50) 69 and the rotation R4 on the deformable ring 67 of the mesh filter belt 63, thereby causing the deformable ring 67 with the annular inlet 69 and the mesh filter belt 63 of the retractable tool 60 to scoop up or collect or capture Thrombus, plaque, embolus, thrombus (thrombus multiples), fatty deposits, or other unwanted material or debris M is taken. Unwanted material or debris M can be removed from the blood vessel V through the second tool opening 25 by the retractable tool 60 containing the unwanted material or debris M and the deformable ring 67 having the annular inlet 69 and the mesh filter belt 63 In addition, the deformable ring 67 is collapsed and the retractable tool 60 is pulled down from the second chamber 32 of the surgical positioning tool 10 and out of the first tool opening 23, as shown in FIGS. 4A and 4B. The deformable ring 67 is recovered by pushing/pulling P1 of the second part end 66 to collapse the deformable ring 67, and the mesh filter belt 63 can be rolled or wrapped around the deformable ring 67 and/or the first part end 65, Instead, the retractable tool 60 with undesired material or debris M can be drawn into the second tool opening 25 and out of the first tool opening 23 .

It is contemplated here that the deformable ring 67 and the pigtail 50 may be similar or matched in size and shape, such as circumference and/or diameter, to achieve abutment or contact (deformable contact) between the pigtail 50 and the deformable ring 67. Ring 67 abuts pigtail 50).

Referring now to FIG. 6 , by way of example, and not limitation, an exemplary embodiment of a surgical apparatus comprising a retractable tool 60 and a surgical positioning tool 10 in combination is illustrated. In use, surgical positioning tool 10 , shown with pigtail 50 , is inserted into a patient and deployed serpentinely into vessels V, heart H, lungs L, and pulmonary vessels V. It is contemplated herein that the surgical positioning tool 10 may be deployed in any fluid-carrying vessel in which debris needs to be removed.

In use, a push/pull P1 of the guide wire 40 can be stretched in the pigtail 50, causing the pigtail 50 to be vertical or stretched (shown in FIG. 2 ) or bent in the vessel V, such as the pigtail angle A, Depends on the flexibility or rigidity of the first guide wire end 41 passing therethrough. Additionally, the first rotation R1 of the stretch catheter 20 causes a similar rotation R2 of the pigtail 50 in the vessel V. FIG. Both the pigtail angle A and the rotation R2 enable extensive positioning of the first guidewire tip 41 to assist or guide or position the guidewire 40, the pigtail 50, and the second catheter tip 22 through or within the vessel V , the heart H, the lungs L, to meander, turn, bifurcate or otherwise move in the blood vessel to precisely move and deploy the pigtail 50 in the blood vessel V. The goal of the surgical positioning tool 10 is to preferably position the pigtail 50 at a specific location within the patient's blood vessel.

The push/pull P1 of the second part end 66 causes the exit or deployment of the deformable ring 67 with the annular inlet 69 and the mesh filter belt 63, from the second tool opening 25 to access the junction between the second conduit ends 22, and Expand to deploy the deformable ring 67 with the mesh filter band through the second tool opening 25 to a location close to the pigtail 50 in the vessel V.

In addition, the rotation R3 of the second part end 66 results in the rotation R4 of the deformable ring 67 with the annular inlet 69 and the mesh filter 63 in the vessel V, resulting in the retractable tool 60 having the annular inlet 69 and the mesh filter 63. The deformable ring 67 scoops or collects or captures emboli, plaque, embolism, thrombus(s), fatty deposits, or other unwanted material or debris M from the blood vessel V.

In addition, the rotation R1 of the stretch catheter 20 causes the rotation R2 of the pigtail 50 in the vessel V, resulting in the abutment or contact between the pigtail 50 and the deformable ring 67, with the annular inlet 69 and the mesh filter belt 63. The rotation R4 of the deformable ring 67, thus causing the deformable tube 67 of the retrievable tool 60 with the annular inlet 69 and the mesh filter belt 63 to scoop up or collect or catch the embolus, plaque, embolism in the blood vessel V , thrombus(s), fatty deposits, or other unwanted material or debris M.

Pushing/pulling P1 of the second part end 66 causes the collapsed deformable ring 67 with the annular inlet 69 and the mesh filter belt 63 to retract or enter the second tool opening 25 and pass through the second chamber 32 to the first tool Opening 23 to remove unwanted material or debris M trapped in mesh filter belt 63 from blood vessel V. It is contemplated here that such capture and retrieval of unwanted material or debris M may be accomplished multiple times through multiple round trips, i.e. deploying, retracting, and retrieving the retractable tool in the second chamber 32 of the surgical positioning tool 10 60.

It is considered herein that in the second chamber 32 , angioplasty, atherectomy, and deployment of stents and stent bypasses, procedures for treating vascular diseases, can be deployed through the second chamber 32 . Such tools often dislodge material, or plaque, from the vessel wall, potentially allowing clot formation or clot freeing into the bloodstream, where it can become so large that it occludes smaller downstream vessels and potentially blocks blood flow to body tissues. If a blockage occurs in a vital organ such as the heart, lungs, or brain, the result can be a serious threat to the patient's health or life. The retractable tool 60 may be used here to penetrate the second chamber 32 to capture and remove unwanted material or debris M from the blood vessel V. As shown in FIG.

It is further considered here that the pigtail 50 around the deformable ring 67 can protect the blood vessel V when the deformable ring 67 is extended in the blood vessel V, prevent it from contacting the blood vessel V, and prevent tissue or blood vessel tearing in the deployment area.

Here it is further considered that the pigtail tube 50 around the deformable ring 67 can protect the blood vessel V when the deformable ring 67 is extended or retracted in the blood vessel V, preventing scratching or puncturing biopsy tissue, clots, or blood vessels that puncture the blood vessel V wall.

It is further considered that the second chamber 32 can be used to transport other medical tools, such as sutures to guide biopsy tissue or other medical tools to meet the medical application requirements of the surgical positioning tool 10 .

It is further contemplated that the second chamber 32 may be resized or configured to accommodate medical tools 60 of different diameters or sizes.

Referring now to FIG. 7 , a flowchart 700 is illustrated for using surgical positioning tool 10 and retractable tool 60 to remove clots or free emboli, biological material, such as unwanted material or debris M from a blood vessel V . In block or step 710, a surgical positioning tool 10 is provided having two or biaxially bored stretched portions 20 extending therethrough, such as first chamber 31 and second chamber 32, and a pigtail at one end. Tube 50 and integrated retractable tool 60 with deformable ring 67 and mesh filter belt 63 as described above in FIGS. Insert the second chamber 32 of the first tool opening 23) and (through the first tool opening 23 (push/pull P1 of the second part end 66) to the second tool opening 25 of the second chamber 32).

In block or step 715, manipulation or movement of the guide wire 40 (push/pull P1 of the guide wire 40 or rotation R1 of the stretch portion 20) changes the position of the pigtail 50 for the path or vessel guidance device to move or advance Surgical positioning tool 10 passes through vessel V, turns, bifurcates or otherwise maneuvers within the vessel and deploys pigtail 50 to access material or debris M.

In block or step 720, after passing through the second tool opening 25 to a position close to the pigtail 50 (deploying the deformable ring 67 and the mesh filter belt 63 from the second chamber 32), the The deformable ring 67 of the belt 63 deploys the retractable tool 60 . When deployed, the first deformable portion 61 and the second deformable portion 62 of the deformable ring 67 expand inversely to a non-compressible position.

In block or step 730, the material or debris M is approached by rotating the second portion end 66 of the retractable tool 60 to rotate the deformable ring 67 and mesh filter belt 63, rotating R3 resulting in an annular inlet 69 and mesh filter belt Rotation R4 of the deformable ring 67 of 63, thereby causing the deformable ring 67 of the retractable tool 60 with annular inlet 69 and mesh filter belt 63 to scoop up or collect or capture embolism, plaque, embolism from the blood vessel V , thrombus(s), fatty deposits, or other unwanted material or debris M.

In block or step 730, the deformable ring 67 and the mesh filter belt 63 are approached by stretching the conduit 20 to rotate the deformable ring 67 and the mesh filter belt 63 to approach the material or debris M, a rotation R1, causing a rotation R2 of the pigtail 50, whereby the pigtail 50 and the deformable ring 67, resulting in the rotation R4 of the deformable ring 67 with the annular inlet 69 and the mesh filter belt 63, which in turn causes the deformable ring 67 of the retractable tool 60 to have the annular inlet 69 and the mesh filter belt 63. Ring 67 scoops or collects or captures clots, plaques, embolisms, thrombus(s), fatty deposits, or other unwanted material or debris M from blood vessel V.

In block or step 735, by digging or collecting or capturing clots, plaques, embolisms, thrombi (plural thrombi), fat deposits, or other unwanted material or debris M from the blood vessel V in the mesh filter In belt 63 material or debris M is collected in mesh filter belt 63 .

In block or step 740 , the deformable ring 67 , the mesh filter belt 63 , and the material or debris M are retrieved by collapsing the deformable ring 67 in the second tool opening 25 of the second chamber 32 . The collapsed deformable ring 67 can be retrieved by pushing/pulling P1 at the end 66 of the second part, and the mesh filter belt 63 can be wrapped around or wrapped around the deformable ring 67 and/or near the end 65 of the first part with non- A retractable tool 60 of desired material or debris M can be pushed or entered into the second tool opening 25 and out of the first tool opening 23 .

In block or step 745, steps 715-740 are repeated.

Referring now to FIG. 8 , by way of example, and not limitation, an exemplary embodiment of a flexible surgical positioning tool 10 is illustrated. Surgical positioning tool 10 may include an access receptacle or port, such as suction port 90 located proximate handle 36 or first catheter tip 21 . Suction port 90 may provide access, may be connected, communicate with first chamber 31 having the length of stretch catheter 20 , pigtail chamber 31B of pigtail 50 , to pigtail tip 53 . Additionally, the surgical positioning tool 10 may include a side arm or a conduit, such as a suction tube 80 , which may have a distal end, such as a first tube end 81 and a proximal, or second tube end 82 . The second tube end 82 may be fixed or removably fixed to the suction port 90 . Suction tube 80 may contain a three-way stopcock 84 including a stopcock bar 85 . The cock bar 85 can be rotated (rotatable) in an open position for access path and air suction, a diverted position for changing the direction of debris M to the threaded interface and cap 83, and a closed position for closing the second tube end 82 Location. Further, the surgical positioning tool 10 may include suction, vacuum or negative pressure devices, such as the suction device 70 . The aspiration device 70 may comprise a syringe comprising a housing or body of a syringe 72 into which the plunger 71 is drawn or moved, such as within the syringe 72 and within an adapter port 73 providing an outlet or inlet for the syringe 72 M. The suction device 70 or more specifically the adapter port 73 can be connected to, communicate with, or be removably connected to the first tube end 81 , preferably through the suction tube 80 , the suction port 90 , the stretch catheter 20 The chamber 31, the pigtail chamber 31B of the pigtail 50, and pass through the pigtail end 53 for suction, vacuum, or air suction S.

Referring now to FIG. 9 , by way of example, and not limitation, an exemplary embodiment of a pigtail 50 is illustrated showing a proximal thrombus, plaque, embolus, thrombus (thrombus multiples), fatty deposits, or other non-invasive Required material or scrap M. Additionally, suction or cavitation by the suction device 70 tends to cause debris M to be sucked or pulled or pulled (multi-pulling/cavitation) or collected or captured into the pigtail tip 53 . Furthermore, through the continuous suction or empty suction of the suction device 70 (suction through the plug), the debris M can be pulled or run through the pigtail chamber 31B of the pigtail 50, the chamber 31 of the stretching catheter 20, the suction Suction port 90, and suction tube 80, to suction device 70, from which debris M is removed from blood vessel V.

It can be considered here that in the suction or air suction (suction through plug) of the debris M, the pigtail tube 50 can be extended as shown in FIG. 2 instead of surrounding as shown in FIG. 5 .

Referring now to FIG. 10 , a flowchart 1000 is illustrated for using the surgical positioning tool 10 and the retractable tool 60 to remove a clot or free emboli, biological material, such as optional, from a blood vessel V by aspiration or cavitation. Material or debris M. At block or step 1010, a surgical positioning tool 10 is provided having an elongated portion 20 having two or biaxial bores throughout. 8-9 above, the first chamber 31 and the second chamber 32, and one end on the pigtail 50 and the suction port 90, the suction tube 80, and the suction device 70.

In block or step 1015, the first catheter tip 21 is manipulated or moved to change the position of the pigtail 50, to move or advance the surgical positioning tool 10 in the vessel V for a path or vessel guidance device, to divert, diverge or otherwise maneuver in the vessel V. Move and position the pigtail 50 to approach the material or debris M, block or step 1020 .

At block or step 1030 , the suction device 70 (suction or suction) is operated to collect, capture, debris M in the pigtail tip 53 . Further through the suction device 70, do continuous suction or air suction step 1040 (suction plugging), the debris M can pass through the pigtail chamber 31B of the pigtail 50, stretch the chamber 31 of the catheter 20, and the suction port 90, and the suction tube 80 is pushed or threaded to the suction device 70 step 1050 to remove debris M from the blood vessel V.

The foregoing description and drawings contain illustrative examples of this disclosure. Having this exemplary embodiment, those of ordinary skill in the art should note that the disclosures are examples only, and that various alternatives, adaptations, and modifications are possible in the present disclosure. The mere listing or enumeration of the steps of a method in a particular order is not to be considered a limitation on the order of the steps of the method. Numerous modifications and other embodiments in this disclosure will occur to those of ordinary skill in the art that retain the teaching benefit of the foregoing description and associated Figures. Although specific terms may be used herein, they are used in a generic and descriptive sense only and not for purposes of limitation. Also, having described this disclosure in detail, it should be understood that various changes, substitutions and modifications may be made therein without departing from the spirit and scope of this disclosure, as defined by the appended claims. Accordingly, this disclosure is not to be limited to the specific embodiments set forth herein, but only by the following claims.

Claims (17)

1. A teleoperated surgical device for penetration into a patient's blood vessel to reach a thrombus therein, the surgical device comprising:

a flexible positioning tool having a stretch conduit with a dual chamber bore extending from a first conduit end to a second conduit end, the dual chamber bore having a first chamber and a second chamber, a flexible pigtail extending from the second conduit end, the first chamber extending generally in the stretch conduit and the flexible pigtail, the flexible pigtail being configured to have a pigtail end looped back to a position proximate the second conduit end, the pigtail end having a guidewire outlet opening, the second chamber extending generally in the stretch conduit, passing from the first conduit end to the second conduit end to a tool outlet opening proximate the second conduit end;

a guidewire threaded in the first lumen of the tensioning catheter and the flexible pigtail, the guidewire extending through the flexible pigtail to erect the flexible pigtail, the second catheter tip and the flexible pigtail being threaded into a patient's blood vessel to thrombus;

A retrievable tool having a proximal end portion and a distal end portion connected to the proximal end portion, the distal end portion containing a deformable annular ring and a barrier membrane affixed to the deformable annular ring, the deformable annular ring being extendable entirely through the tool outlet opening to extend the deformable annular ring to deploy the barrier membrane, wherein rotation of the first catheter end of the tensioning catheter rotates the flexible pigtail which rotates the deformable annular ring and the barrier membrane to capture thrombus in the barrier membrane; and

a suction device connected to the first chamber and arranged to create a vacuum in the first chamber of the tensioning catheter and the flexible pigtail.

2. The teleoperated surgical device of claim 1, further comprising a guidewire inlet opening located proximate to the first conduit end and a guidewire outlet opening located proximate to the pigtail end of the flexible pigtail.

3. The teleoperated surgical device of claim 1, rotation of the tensioning catheter resulting in the rotation of the flexible pigtail.

4. The teleoperated surgical device of claim 1, further comprising a handle secured to the first catheter tip.

5. The teleoperated surgical device of claim 3, the flexible pigtail configured to be disposed at a location within a patient's blood vessel.

6. The teleoperated surgical device of claim 1, further comprising a first tool opening located proximate the first conduit end and a second tool opening located proximate the second conduit end.

7. The teleoperated surgical device of claim 1, the flexible pigtail further comprising a pigtail chamber in communication with the first chamber.

8. The teleoperated surgical device of claim 7, further comprising an aspiration port located proximate the first conduit end, the aspiration port in communication with the first chamber.

9. The teleoperated surgical device of claim 8, further comprising a suction tube having a first tube end and a second tube end, the second tube end in communication with the suction port.

10. The teleoperated surgical device of claim 9, wherein the aspiration device is in communication with the first tube end.

11. The teleoperated surgical device of claim 10, wherein the aspiration device further comprises a syringe having a syringe barrel, a plunger in the syringe barrel, and an adapter port forming an outlet of the syringe barrel.

12. The teleoperated surgical device of claim 9, wherein the suction tube comprises a tap valve having a tap rotatable between an open position, a steering position, and a closed position.

13. The teleoperated surgical device of claim 10, wherein rotation of the first catheter tip is configured to cause the rotation of a tail tube tip adjacent the thrombus.

14. The teleoperated surgical device of claim 13, wherein suction in the suction device creates suction in the suction tube, in the suction port, in the first chamber, and in the pigtail chamber to collect the thrombus therein.

15. The teleoperated surgical device of claim 14, wherein further aspiration in the aspiration device empties the thrombus from the pigtail chamber, the first chamber, the aspiration port, the aspiration tube into the aspiration device.

16. The teleoperated surgical device of claim 1, further comprising a tool inlet opening connected to the second chamber and located proximate the first conduit end.

17. The teleoperated surgical device of claim 1, wherein the retractable tool is configured to be retracted in the second chamber to remove the thrombus from the patient's blood vessel.