JP2000229124A - Flowing thrombus extraction catheter and its use - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a catheter that can be run easily through a curved canal existing in a fragile blood vessel of the brain by providing an external assembly containing a guide catheter and an internal assembly having a means to produce more than one saline water jet and deliver the jets to a thrombotic site in a base. SOLUTION: This flowing thrombus extraction catheter has a guide catheter 32 as a first tube where a fixed stopping member 150 that partially closes a hollow portion is fitted in a terminal end side open end, and an external assembly 12 where a guide wire 46 is inserted into the hollow portion. An internal assembly 14 furnished with a subsidiary tube 34 as a second tube having a terminal side end with more than one orifice and an internal assembly 14 furnished with a jet cap 44 that directs jets of saline water flowing out the orifices to the terminal side end of the guide catheter 32 is provided. The jet cap 44 of this internal assembly 14 is held against the terminal side end of the guide catheter 32 by the engagement of the fixed stopping member 150 of the external assembly 12 with a moving stopping member 40.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a flow-type thrombectomy catheter for extracting a thrombus from a human blood vessel or other body cavity, and a method of using the same.

[0002]

2. Description of the Related Art Methods and instruments for facilitating the removal of human tissues and various kinds of deposits have been developed. Some such instruments employ a jet of saline as a working tool to help break down deposits on human tissue,
It is provided with a suction means for extracting attached matter. US Patent No. 5,13, granted to Neracher
No. 5,482, discloses a flowable device for extracting organic deposits from human blood vessels. The supplied saline is delivered to the distal end of the catheter through a high pressure conduit. The saline solution is discharged from the conduit as a jet generally directed forward and toward the directly decomposed body tissue.
The conduit is contained in a hose positioned around the conduit and is movable axially with respect to the hose. A vacuum is applied to the hose to remove debris resulting from the breakdown of human tissue.

Another drainage catheter disclosed in US Pat. No. 5,320,599 to Griep has a drainage passage and a pressure passage.

[0004]

The above-mentioned U.S. Pat.
The flowable device described in 35,482 is not intended to be passed through tortuous tracts present in the vulnerable blood vessels of the brain, and the device may be used for such purposes. Too much emotional shock to the patient.

The drainage passage and pressure passage described in US Pat. No. 5,320,599 are formed in a single catheter tube in which two tubes are secured together.
This catheter did not have the necessary flexibility to accommodate the tortuous vascular tract present in the blood vessels of the brain.

It is a general object of the present invention to provide a flowable thrombectomy catheter for removing a thrombus from a human body vessel or other body cavity and a method of using the same.

[0007]

SUMMARY OF THE INVENTION A flowable thrombectomy catheter of the present invention is a surgical instrument for removing a thrombus-like substance from a blood vessel or other body cavity. As shown in one or more embodiments, a flowable thrombectomy catheter for extracting human tissue from a blood vessel or other body cavity includes a hollow portion having a distal open end and a hollow portion at the distal open end. An outer assembly comprising a first tube, i.e., a guide catheter, which partially occludes and has a stationary stop located therein, said hollow portion having a diameter sufficient to pass a guide wire; A high-pressure second tube having a high-pressure hollow portion and a distal end with one or more orifices, ie, a dependent tube, and a moveable fixed to the high-pressure dependent tube adjacent the distal end. A stop member and a jet cap positioned at a distal end of the dependent tube to direct a jet of one or more saline solutions exiting the orifice to a distal end of the guide catheter; An inner assembly axially movable within an outer assembly such that a detent member engages a stationary stop member to hold the jet cap in a desired relationship to the distal end of the guide catheter. Become.

In another embodiment, a flow thrombectomy device for removing a thrombus or other body tissue from an occluded body vessel or cavity comprises a proximal end and a distal open end incorporating a locking stop. And a standard coronary guidewire or interneuronal radiation guidewire (interven
an outer assembly with a discharge tube having a discharge cavity of sufficient diameter to allow passage of a conventional neuroradiological guidewire, a high pressure cavity, a proximal end, and a distal end; The end has one or more orifices through which a saline solution can flow out of the high pressure cavity and be directed to the distal open end of the discharge tube; A movable stop member fixed to the high-pressure dependent tube at a position closer to the distal end than the distal end, and a distal open end of the discharge tube positioned at the distal end of the high-pressure dependent tube and cooperating with the high-pressure dependent tube. And an internal assembly comprising a jet cap for directing one or more jets of saline in the portion.

Preferably, the flow thrombectomy catheter comprises:
It has a guide wire coil mounted at its distal end to advance both the inner and outer assemblies within the vasculature. Preferably, the flow thrombectomy catheter has a jet cap that directs the jet of saline to the distal end of the guide catheter and functions as a drain tube. Preferably, the flow-through thrombectomy catheter comprises a high-pressure dependent tube having at least one orifice and a jet formed and arranged to direct one or more saline jets to impinge on or near the guide catheter. And a cap. Preferably, the flowable thrombectomy catheter is flexible and capable of passing a standard guidewire through a tortuous vascular line.

[0010] The present invention also provides a method for removing a thrombus from an occluded blood vessel. The method includes providing a guide wire and an outer assembly comprising a guide catheter having a distal end and a fixed stop positioned and positioned adjacent the distal end. Advancing the vascular site containing the thrombus, guiding the guide catheter to the vascular site containing the thrombus by following the guide wire, positioning the distal end to the vascular site, and guiding the guide wire Removing the catheter from the catheter; providing an inner assembly comprising a spout cap and a slave tube carrying a movable stop spaced from the spout cap; and moving the inner assembly forward within the guide catheter of the outer assembly. Engaging a stop member with the stationary stop member, supplying high pressure saline to the second catheter and jetting the saline jet. Was allowed to escape, including the distal end of the guiding catheter, or by impinging a thrombus in the vicinity thereof, to eliminate the thrombus, a step of transferring to a further guiding catheter along with the brine jets.

In this method, preferably, the jet cap carries a distally projecting coil to allow both the inner and outer assemblies to be distally coupled to a vascular site containing additional thrombus in the vasculature. Another distal clot is removed to facilitate further advancement.

Further, the present invention is a catheter combination comprising a proximal end, a distal open end, and a hollow portion extending between the proximal end and the distal open end. A tube, i.e., a guide catheter that is part of an outer assembly, having a proximal end, a distal end, and a hollow portion extending between the proximal and distal ends. , First
A second tube that is separable from the first tube and that can be inserted into the hollow portion of the first tube,
A slave tube that is part of the inner assembly, and a portion of the inner assembly that is connected to the second tube at a distal end of the second tube and that delivers fluid flowing out of the hollow portion of the second tube; Wherein the jet cap is capable of passing through the hollow portion of the first tube, and when the jet cap is appropriately positioned and oriented with respect to the distal open end of the first tube. A jet cap characterized by the ability to provide a low pressure local area cooperating with a generally proximally directed liquid flow through the distal open end of the first tube into the hollow portion of the first tube. And means for determining the proper positional relationship between the jet cap relative to the distal open end of the first tube and the distal end of the second tube.

The indexing means preferably includes a fixed stop member projecting inward from the first tube and a movable stop member projecting outward from the second tube. As the second tube is advanced within the first tube, their stops engage each other to provide orientation, spacing and relationship between the jet cap and the distal open end of the first tube. Control. More preferably, the stop members are each tapered to provide further lateral positioning within the first tube relative to the second tube. Most preferably, the tubes are centered and concentric. Preferably, one or both stop members interact by engagement to retain the flow path for liquid flow without completely closing the cavity between the first and second tubes.

One important aspect and feature of the present invention is a jet cap that is variously designed to be oriented to direct a saline jet in a proximal direction.

Another important aspect and feature of the present invention is a fixed stop at the distal end of the guide catheter and a movable stop on the dependent tube, which cooperate together to form the jet cap. At a set position beyond the distal end of the guide catheter.

Still other important aspects and features of the present invention are:
It is a hole for accommodating a movable stop member having a discharge hollow portion and a dependent tube that is unevenly distributed from an axis in the longitudinal direction of the movable stop member.

Yet another important aspect and feature of the invention is that
Complementary angled surfaces on the fixed and movable stop members that function to center the inner assembly within the outer assembly when engaged.

Another important aspect and feature of the present invention is a fixed stop formed integrally with the guide catheter wall at the distal end of the guide catheter.

Yet another important aspect and feature of the invention is that
A guidewire coil provided at the distal end of the jet cap to advance the inner and outer assemblies together within the vasculature.

While the features of the embodiments and important aspects of the present invention have been described, it is a primary object of the present invention to provide a flow-through thrombectomy catheter for extracting a thrombus from a human vessel and a method of using the same.

One object of the present invention is to provide a flowable thrombectomy catheter of a size, flexibility and construction that allows easy passage through tortuous conduits present in vulnerable blood vessels in the brain. is there.

It is another object of the present invention to provide a flow thrombectomy having means for generating one or more saline jets and delivering those jets toward a proximal thrombus site and further toward a drain passage. It is to provide a catheter.

Yet another object of the present invention is a flowable thrombus having means for generating one or more jets of saline and indexing means for positioning the jet generating means at a predetermined location at the distal end of the catheter. An object of the present invention is to provide an extraction catheter.

It is yet another object of the present invention to provide a model of the type having an internal assembly insertable into the external assembly, and further comprising stop means for limiting the internal assembly to such a degree that it can be inserted into the external assembly. To provide a flow-type thrombectomy catheter.

Another object of the present invention is to have an inner assembly and an outer assembly, further centering the inner assembly within the outer assembly, and internalizing relative to portions of the outer assembly in a predetermined manner. It is an object of the present invention to provide a flowable thrombectomy catheter of the type comprising means for orienting parts of the assembly.

It is yet another object of the present invention to provide an improved method for removing a thrombus from an occluded human vessel.

[0027] Other objects of the present invention, as well as many of the advantages associated with the present invention, will be better understood with reference to the following detailed description when taken in conjunction with the accompanying drawings. Note that the same reference numerals indicate the same parts throughout the drawings.

[0028]

FIG. 1 is a side view of a flow thrombectomy catheter 10 useful for thrombectomy, and FIG.
1 is a half-exploded side view of a flow-type thrombectomy catheter 10. FIG. Flowable thrombectomy catheter 10 includes two main assemblies: an outer assembly 12 and an inner assembly 14. Inner assembly 14 is aligned concentrically within outer assembly 12 and extends beyond the length of outer assembly 12. As shown in FIGS. 1 and 2, the external assembly 12 of the flowable thrombectomy catheter 10 includes a manifold, also known as a Y-adapter, as a component or part of the component that is visible from the outside. 16, a hemostatic nut 18 secured at a base end 20 of the manifold 16, a Luer connection member 22, located at a base end 23 of an angled manifold branch 24 extending from the manifold 16, Luer attachment member 2 fixed to distal end 28 of manifold 16
6. The strain relief member 30 fixed to the distal end 28 of the manifold 16 by the luer attachment member 26, and the manifold 16 by the strain relief member 30 and the luer attachment member 26.
A first tube secured to and having a distal end 33;
That is, the guide catheter 32 is included. The internal assembly 14 shown in FIG. 2 is aligned so as to be concentric with the second high-pressure tube, that is, the dependent tube 34 and the dependent tube base end 38, as components visible from the outside. And a filter housing / high pressure connection member 36 secured on its perimeter, aligned concentrically with the dependent tube 34 at a location adjacent and adjacent to the distal end 42 of the dependent tube, and secured on its perimeter. A shaped movable stop member 40, a jet cap 44 aligned concentrically with the slave tube 34 at the slave tube distal end 42 and secured on its periphery, and one end of the jet cap 44. A concentrically aligned and fixed guidewire coil 46 is included. The high pressure slave tube 34 is tapered out in stages so as to provide each degree of flexibility over its length. In the example shown for illustrative purposes, the slave tube 34
Has an outer diameter of 0.0
A slave tube portion 34a that is 18 inches or less, and a plurality of step-wise reduced slave tube portions 34b-34n each having a smaller outer diameter can be included.
In this case, the last dependent tube section 34n is reduced to 0.008 inches at the dependent tube distal end 42.

The gradual reduction in outer diameter over the length of the stub tube portion 34 provides greater gradual flexibility from the stub tube base end 38 to the stub tube distal end 42. Can be obtained. The increased flexibility over the length of the dependent tube 34 makes it easier to flexibly insert into a bent vessel tract. The subordinate tube 34 is gradually reduced in diameter, but it is also possible to reduce the outer diameter to a constant value so as to increase the flexibility over the length thereof, which is interpreted so as to limit the scope of the present invention. should not be done.

FIG. 3 is a partially exploded cross-sectional side view of the manifold 16 and adjacent components. In FIG. 3, all reference numerals correspond to the components described above. The manifold 16 includes a tapered center passage 48 disposed along a longitudinal axis of the manifold 16 and a branch 2 that intersects and connects with the center passage 48.
4 includes a branch passage 50 extending along the axis. The manifold proximal end 20 includes a circular outer cavity portion 54 and a circular, smaller radius inner cavity portion 56 connected with a threaded surface 58 on the proximal portion of the cavity portion.
To accommodate a multi-radius cavity 52 including: The hemostatic nut 18 is
A body 62 having a gripping surface 64 extending therearound, a threaded surface 66 extending from the body 62, an annular surface 63 at the end of the threaded surface 66, and centered on the longitudinal axis of the hemostatic nut 18. Provided with a passage 68. Passage 6
The radius of 8 is larger at the base end,
It decreases in diameter toward the distal end. The large radius of the tip aids in insertion of the inner assembly 14, guidewire, and the like. The seal 60 is aligned with an annular surface 61 provided on the distal side of the circular inner cavity portion 56, presses and supports the annular surface 63 of the hemostatic nut 18, and allows the manifold 16 to communicate with the passage 68 in the hemostatic nut 18. The central passage 48 is sealed. The multi-radius cavity 52 and its internal shape conforms to the shape of the corresponding hemostatic nut 18 and seal 60. A luer connection member 22 extends from the base end 23 of the angled manifold branch. The filter 72 is aligned with the opening of the branch passage 50. The filter 72 and a luer mounting member (not shown) prevent the particles from flowing out.
It is used for metered outflow and, alternatively, for suction to evacuate fluids or particles.

The luer attachment member 26 includes a strain relief member 30 and a manifold distal end 28 of a guide catheter 32.
Used for fixing to The strain relief member 30 is a tube 3
1. Central lumen 74 inside tube 31 containing guide catheter 32, annular flange 7 around tube 31
6, and a tapered tube base side open end 78. The outer diameter of the tube 31 is constant from the annular flange 76 to the tube distal end 80, and the outer diameter is reduced from the annular flange 76 to the tapered tube base open end 78. Note that a tapered tube surface portion 82 is formed that mates with and fits properly with the tapered portion of the tapered central passage surface 88 of the central passage 48. The tapered tube base open end 78 allows for easy alignment of the guidewire and other assemblies, such as the internal assembly 14, with the hollow portion 87 provided within the guide catheter 32. Luer mounting member 2
6 includes a threaded portion 84 that is threadedly engaged with a corresponding threaded portion 86 at the distal end 28 of the manifold 16. The luer attachment member 26 presses and supports the annular flange 76 of the strain relief 30 and presses the tapered tube surface 82 of the strain relief 30 against the tapered center passage surface 88 of the central passage 48 to provide an appropriate seal. Form.

FIG. 4 is a longitudinal sectional view of the filter housing / high-pressure connecting member 36 provided at the dependent tube base end 38 of the dependent tube 34. In FIG. It corresponds to the member. The filter housing / high pressure connection member 36 extends through a cylindrical body 90 having a threaded surface portion 92, a tubular cavity 94, a fine filter 96 and a coarse filter 98 provided in the tubular cavity 94, the body 90, Tubular cavity 9
4 and a plug-like cap 102 having a central lumen 104 extending into a tubular cavity 94 of the body 90. Dependent tube 34 is suitably secured within central lumen 104 of cap 102.
The central passage 100 includes the fine filter 96 and the coarse filter 9.
8 and communicate with the hollow portion 106 of the dependent tube 34.

FIG. 5 is a side view of the movable stop member 40, the jet cap 44, and the guide wire coil 46 disposed on or about the periphery of the slave tube 34 at or near the slave tube distal end 42. In FIG. 5, all reference numerals correspond to the components described above. Movable stop member 4
For the relative size between both the zero and the jet cap 44, and the relative size to the hollow portion 87 of the guide catheter 32 and the size of the fixed stop member 150 provided in the guide catheter 32, and the details of the movable stop member 40, This will be described in detail below with reference to the related FIGS. 6, 12 and 13.

FIG. 6 is an isometric view of the movable stop member 40. In FIG. 6, all reference numerals correspond to the components described above. The integrated movable stop 40 comprises a tubular body 108 having a central lumen 110 and a plurality of guide bars 11 extending radially from the tubular body 108.
2a to 112n. Information bars 112a to 112n
Are formed from the front edge of the main body 108 to the arcuate surface portions 116a to 116
0n leading edge 114a-1 extending to 6n
14n. Angled leading edge 114a-1
14n contacts a fixed stop 150 within guide catheter 32, as described in detail below. In the preferred example shown for purposes of illustration, the arcuate surfaces 116a-116n define an arc centered on the longitudinal axis of the tubular body 108, but alternatively,
Arcs with other centers may be defined, or may be flat or of other shapes and should not be construed as limiting the scope of the invention.

FIG. 7 shows the movable stop member 40, the jet cap 44, and the guide wire coil 46 disposed at or near the distal end 42 of the slave tube 34 near the slave tube 34 in FIG. FIG. 8 is a view in longitudinal section along the line, and FIG. 8 is a view of the jet cap 44 as viewed in the direction of the line 8-8 in FIG. 7, wherein all reference numerals in FIGS. Corresponds to the described components. The central lumen 110 of the movable stop member 40 includes the last subordinate tube section 3
4n and mounted properly, the movable stop member 40 is mounted on the perimeter near the distal end 42 of the dependent tube. The base end of the movable stop member 40 is juxtaposed with and abuts the shoulder-shaped movable portion 117 between the portion 34g immediately before the last dependent tube portion and the last dependent tube portion 34n. The jet cap 44 is positioned and secured around the last slave tube section 34n at the slave tube distal end 42. As shown in FIGS. 7 and 8, the jet cap 44 is tubular and has a circular outer edge wall 118 and a circular outer edge wall 1.
18 includes a circular wall end 120 extending inward from one end. As shown in FIG. 8, a long hole 122 is formed at the center of the circular wall end 120, and the hole 122 is
Each of the side portions has an arcuate end and opposing side portions, each of the side portions having an arcuate middle section and a straight portion extending oppositely from the arcuate middle section to the opposing arcuate end. The arcuate intermediate sections of the opposing sides of the elongate aperture 122 are positioned at the center of the elongate aperture 122, have a common radius, and are disposed oppositely disposed arcuate portions 124 and 126. Is defined by The last dependent tube section 34n is aligned with the center of the elongated bore 122, extends through the center thereof, and
The elongate bore 122, surrounded by 24 and 126, divides into two jet orifices 128 and 130. The jet orifice 128 is defined by one side of the outer surface of the last subordinate tube portion 34n and a portion of the elongated bore 122, and the jet orifice 130 is elongated by the opposite side of the outer surface of the last subordinate tube portion 34n. Hole 12
Two parts. A welding portion 132 is formed at the distal end of the circular outer peripheral wall portion 118, and the welding portion 132 is formed.
Joins together the circular outer wall 118, the distal end of the distal end 42 of the dependent tube 34, the guidewire coil 46, and the tapered core 134. A plurality of orifices, including orifices 136 and 138 in the distal end 42 of the dependent tube 34, extend from the hollow 106 to the central cavity 14.
0, and also two jet orifices 128 and 1
For communication of fluid to 30, it is located in the central cavity 140 of the jet cap 44. A weld 142 is provided at the distal end of the guidewire coil 46 such that the end of the tapered core 134 is secured to the guidewire coil 46 to allow for smooth insertion into a blood vessel or other body cavity. Become.

In FIG. 9, a slight improvement has been made to the jet cap 44 so that two separate jet orifices 144 and 146 replace the elongated hole 122 shown in FIG. The lumen 148 provided in the end 120 and within the circular wall end 120 is adapted to accommodate the last subordinate tube section 34.
n.

FIG. 10 is a longitudinal cross-sectional view of the guide catheter distal end 33 of the guide catheter 32 taken along line 10-10 of FIG.
This corresponds to the component described above. Specifically shown is a fixed stop 150 having a plurality of radii that frictionally engages the hollow 87 at the distal end 33 of the guide catheter. One outer radius defines a cylindrical body 152 that frictionally engages the hollow portion 87 and another larger outer radius defines a cap 15 at the end of the fixed stop 150.
3 is defined. The central lumen 154 is coaxially aligned within the cylindrical body 152 and the cap 153. Annular shoulder 15 between cap 153 and cylindrical body 152
6 is aligned to abut the distal end 33 of the guide catheter. An angled annular surface 158 that is complementary to the angled leading edges 114a-114n of the movable stop member 40 shown in FIG. 6 is provided at the proximal end of the cylindrical body 152. Guide catheter distal end 3
3 with an annular crimp sleeve 160 that fits around
It is possible to reliably fix the fixing stop member 150 in the hollow portion 87.

FIG. 11 shows that the jet cap 44 moves through the central bore 154 of the fixed stop member 150 and
Is a longitudinal cross-sectional view of the distal end of the guide catheter disposed within the hollow portion 87 of the guide catheter 32;
In FIG. 11, all reference numerals correspond to the components described above.

FIG. 12 shows that the movable stop member 40 is disposed in the hollow portion 87 of the guide catheter 32 and the fixed stop member 15
FIG. 13 is a longitudinal cross-sectional view of the distal end of the guide catheter interengaging with 0, wherein all reference numerals in FIG. 12 correspond to previously described components. The mutual engagement of the fixed stop member 150 with the movable stop member 40 allows the jet cap 44
Are positioned at a desired and limited distance from the fixed stop 150 at the distal end 33 of the guide catheter.

The tubular guide catheter 32 can be constructed of a soft polymer material and has the unique function of following a bendable guide wire through the vasculature of the patient being treated. Tubular guiding catheter 3
2 must be able to withstand crushing or bursting under the pressure differential used, as it may be placed under reduced or vacuum pressure in certain applications. Again, in the example shown for illustrative purposes, the guiding catheter 32
Has an outside diameter of about 4 French or less, or an outside diameter of about 0.040 inches and an inside diameter of about 0.028 inches, and can be tapered in diameter. As is known in the art, the guide catheter 32 can be advanced and manipulated through the vasculature to guide the distal end 33 of the guide catheter 33 to the site of the desired surgical procedure, such as a thrombus that occludes a blood vessel. It can be selectively positioned, for example, adjacent to.

The fixed stop member 150 can be formed from various materials. Preferably fixed stop 150
Is formed from the same material as that of the guide catheter 32.

The movable stop member 40 is attached to the slave tube 34 at a position spaced from the slave tube distal end 42 and at a position distal to the slave tube portion 34g. The movable stop member 40 has a cross-sectional size that does not allow the fixed stop member 150 to pass freely. The movable stop member 40 has a substantially X-shaped cross section when viewed in the axial direction, as shown in FIG. 13, thereby allowing fluid to pass in the base direction. However, as will be explained subsequently, at least the movable stop member 40 is
0 is prevented, the movable stop member 4
For 0, a number of alternative shapes could be employed.
Preferably, the distal end of movable stop member 40 includes a tapered surface, such as angled leading edges 114a-114n. The jet cap 44 is fixed to the fixed stop member 150.
Has a cross-section that allows it to pass through the central lumen 154. The angled leading edges 114a-114n juxtaposed with the angled annular surface 158 of the fixed stop 150,
It helps to position the movable stop member 40 in the desired longitudinal direction with respect to the fixed stop member 150. Guide catheter 3
Guide bars 112a to 112n in the second hollow portion 87
The close longitudinal alignment of, for example, each of the first
A laterally spaced relationship is created, such as a concentric relationship between one tube, or guide catheter 32, and a second tube, or dependent tube 34. Preferably, the cross-sectional size of the movable stop member 40 is roughly between about 0.010 inches and about 0.030 inches, but an important consideration in the cross-sectional dimensions of the movable stop member 40 is The stop member 40 includes a first tube,
That is, it must pass through the hollow portion 87 of the guide catheter 32 but must not pass through the fixed stop member 150.

The jet cap 44 is attached to the distal end 42 of the dependent tube 34 and includes a guide wire coil 46 extending distally from the jet cap 44. In a preferred embodiment, the jet cap 44, the guide wire coil 46 and the movable stop 40 are radially symmetric about the longitudinal axis of the slave tube 34.
In such an embodiment, the jet cap 44
Preferably, it has a diameter of about 0.010 inches to about 0.030 inches. Dependent tube 34 preferably has an outer diameter of about 0.008 inches to about 0.018 inches,
Further, a continuous high pressure hollow portion 106 extends from the dependent tube base end 38 to the dependent tube distal end 42 and continues into the jet cap 44. Dependent tube 34
As the dependent tube distal end 42 advances through the hollow portion 87 of the guide catheter 32, the guidewire coil 46 and the jet cap 44, and any portion of the dependent tube 34 distal to the movable stop 40, are secured. It can pass freely through the position of the stop member 150. However, the passage of the movable stop member 40 causes the fixed stop member 1
50 is obstructed by a partial obstruction of the hollow portion 87 of the guiding catheter 32. Accordingly, the angled leading edges 114a-114n on the distal side of the movable stop member 40 are angled annular surface portions 158 of the fixed stop member 150.
Engagement ensures that the desired longitudinal relationship is created between the jet cap 44 and the distal end 33 of the guide catheter 32 at the cap 153 of the guide catheter 32. Most importantly, the jet cap 44 is oriented, spaced, and positioned distally in the desired relationship to the guide catheter distal end 33 of the guide catheter 32.

Preferably, the jet cap 44 further facilitates advancement of the compliant tube 34, and furthermore, when advanced beyond the guide catheter 32, the locking stop 150, or the distal end 33 of the guide catheter. The distal end is rounded or tapered to avoid snagging or breakage at the end.

Fluid communication between the hollow portion 87 and the central bore 154 of the fixed stop member 150 is possible in a longitudinal direction, distally around the geometry of the movable stop member 40. As shown partially in FIGS. 5 and 6 and fully in FIG. 13, longitudinal passages 162a-162n are formed. For example, passageway 162a may include guide bars 112a and 112b and distal stop 40 including angled leading edges 114a and 114b.
And a part of the peripheral portion of the movable stop body 108 extending from the base side region. Longitudinal passage 162b-
162n are similarly formed. When the movable stop 40 interacts with the fixed stop 150 to allow passage of small pieces of suspended tissue and liquid in the proximal direction through the guide catheter 32, one of the hollows 87 Note in particular that the parts remain open.

FIG. 13 is a sectional view of the distal end portion 33 of the guide catheter taken along the line 13-13 in FIG.
, All symbols correspond to the components described above. FIG. 13 shows a plurality of passages 1 around the movable stop member 40.
62a-162n are particularly indicated, whereby:
Proximal passage of small pieces of suspended tissue and liquid through the hollow portion 87 of the guide catheter 32 is enabled. Although the guide bars 112a-112n have planar sides, other shapes with rounded intersections and non-planar intersection walls can be used, and other modifications to the longitudinal passage can be made. And should not be construed as limiting the scope of the invention.

FIG. 14 shows a mode of operation of the flow-type thrombectomy catheter 10 with particular attention to the guide catheter distal end 33 and the jet cap 44 positioned at the blood vessel 164 or artery at the site of the thrombus deposit and lesion 166. Is best shown.

The guidewire is first advanced percutaneously through the vasculature to the site of the thrombus deposit and lesion 166. In the case of peripheral coronary arteries or cerebral blood vessels,
The guidewire has a diameter between 0.010 inches and 0.016 inches. The present invention is also applicable to larger vessels that require larger diameter guidewires.
Once the guidewire is advanced along the blood vessel 164 and reaches the thrombus deposits and lesion 166, the guide catheter 32, which functions as a flexible drainage tube, ie, the first tube, is passed over the wire through a bent bend. To reach the thrombus deposits and lesion 166. With guide catheter distal end 33 of guide catheter 32 positioned near the thrombus deposit and lesion 166, the guide wire can then be removed from guide catheter 32 and the patient's body. So the second
The tubing, ie, the jet cap 44 at the end of the dependent tube 34, is advanced within the hollow 87 of the guide catheter 32 until the movable stop 40 contacts the fixed stop 150 of the guide catheter 32.

Guide bars 112a-1 of movable stop member 40
Arcuate surface portions 116a-116n at the ends of 12n
Guides the movable stop member 40 along the hollow portion 87, positions the jet cap 44 at the center of the guide catheter 32 during the initial movement, and further engages the movable stop member 40 with the fixed stop member 150. Prior to mating, the jet stop cap 44 is positioned within the central bore 154 of the fixed stop member 150. Engagement of the angled leading edges 114a-114n with the fixed stop 150 provides a predetermined spacing from the proximal end of the jet cap 44 to the fixed stop 150,
That is, the distance is set. The central lumen 154 and the hollow portion 87 of the guide catheter 32 serve as a drainage tube at the distal end 33 of the guide catheter. Subsequently, the flow thrombectomy catheter 10 is activated by supplying a high pressure liquid, preferably saline, to the proximal end of the guiding catheter 32 via the manifold 16.

A saline solution or other liquid from the manifold 16 is supplied and flushed through the hollow portion 106 of the tubing 34 and out of the orifices 136 and 138 to the central cavity 140 of the jet cap 44. Leads to.
The high-pressure saline exits the jet orifices 128 and 130 as a high-speed saline inverse jet 170 directed to a central lumen 154 opening in the fixed stop 150 at the guide catheter distal end 33. The high velocity saline jet 170 removes the human tissue from the thrombus deposits and lesions 166 and entrains the human tissue into the saline water jet 170, thereby breaking down the human tissue into small pieces. The stagnation pressure is generated in the discharge hollow portion 87 by the jet of the saline 170 colliding with the opening at the distal end of the guide catheter,
Human tissue debris particles are ejected from the thrombus deposits and lesion 166 toward the proximal end of the guide catheter 32.

A positive displacement piston pump (not shown) can be used to supply a liquid, preferably saline, under pressure to the proximal end of the slave tube 34. 500ps
Pressures in the range of i to 15000 psi provide energy to produce high velocity jets useful as the saline solution exits the jet orifices 128 and 130 provided at the circular wall end 120 of the jet cap 44. The flow rate of the saline solution can be controlled by adjusting the pumping rate of the positive displacement pump. The proximal end of the guide catheter 32 is
The thrombus debris that is connected via a luer connection member 22 at the manifold branch 24 to a suction device, such as a roller pump, is discharged into a collection bag for disposal. The rate of discharge can be controlled by adjusting the delivery rate of the roller pump. The amount of saline solution delivered can be balanced with the amount of thrombus debris removed by adjusting the piston pump and roller pump simultaneously.
The amount of saline delivered can be less than, equal to, or greater than the amount of thrombus debris removed. The amount of thrombus removal can be set to slightly exceed the saline delivery to reduce the possibility of peripheral embolism of the thrombus tissue.

FIG. 15 shows a first alternative embodiment.
Includes a movable stop member 40, a jet cap 180 replacing the jet cap 44, and a slave tube distal end 42.
FIG. 16 is a longitudinal cross-sectional view of a guide wire coil 46a arranged and fixed on the periphery of the dependent tube 34 at or near the sub-tube 34, and FIG.
FIG. 17 is a view of the jet cap 180 as seen in the direction of line 16, and all reference numerals in FIGS. 15 and 16 correspond to the components described above. The jet cap 180 includes some of the components as described above. The jet cap 180
Located on the periphery of the last subordinate tube section 34na,
And fixed, the slave tube portion 34na is angled downwardly from the longitudinal axis of the slave tube 34 at the slave tube distal end 42a. The jet cap 180 is tubular and includes a circular outer edge wall 118a and a circular wall end 120a extending inward from one end of the circular outer edge wall 118a. In the circular wall end 120a,
Two holes 182 and 184 are provided to support a U-shaped slave tube section 34x extending from the last slave tube section 34na. U-shaped dependent tube section 34
x aligns with holes 182 and 184 in circular wall end 120a and extends through holes 182 and 184 and further through jet cap center cavity 140a. The free end of the U-shaped dependent tube portion 34x is fixed in the hole 184, is flush with the circular wall end 120a, and is open.
An orifice is defined that is directed to direct the high velocity jet, preferably saline, proximally in the manner described above. The welded portion 13 is provided at the distal end of the circular outer edge wall portion 118a.
2a, the weld 132a is a circular outer edge wall 118
a, curved portion of U-shaped portion 34x of dependent tube 34, guide wire coil 46a, and tapered core 134a
Are joined together. The welding portion 142a is provided at the distal end of the guide wire coil 46a, and is provided with a tapered core 13a.
The end of 4a is secured to a guide wire coil 46a to allow for smooth insertion into a blood vessel or other body cavity.

FIG. 16 is a view of the proximal end of the first alternative jet cap embodiment as viewed in the direction of line 16-16 in FIG. 15, wherein all reference numerals in FIG. Correspond to the constituent members described in (1).

FIG. 17 shows a second alternative embodiment.
Includes a movable stop member 40, a jet cap 200 replacing the jet cap 44, and a slave tube distal end 42.
FIG. 18 is a longitudinal sectional view of a guide wire coil 46b disposed and fixed on or around the dependent tube 34 at or near the sub tube 34, and FIG.
FIG. 19 is a view of the jet cap 200 as viewed in the direction of line −18;
17 and 18, all reference numerals correspond to the components described above. The jet cap 200 includes some of the components described above. Jet cap 200
Is located and secured around the periphery of the last subordinate tube portion 34nb,
The slave tube 3 at the slave tube distal end 42b.
4 are angled downward from the longitudinal axis. The jet cap 200 is tubular and has a circular outer edge wall 118.
b, and a circular wall end 120b extending inward from one end of the circular outer wall 118b. A hole 202 and a preferably centrally located jet orifice 206 are provided in the circular wall end 120b. Preferably, one jet orifice is provided, but it should be understood that more jet orifices could be utilized and not to limit the scope of the invention. The last subordinate tube section 34nb aligns with and extends through aperture 202 in circular wall end 120b and
0, which has an open end terminating in the jet cap center cavity 140b, that is, the orifice, the hollow 106
Through the central cavity 140b and further into the jet orifice 206 to direct a high velocity jet, preferably saline, in the proximal direction in the manner described above. At the distal end of the circular outer wall 118b is a weld 132b, which joins the circular outer wall 118b, the guide wire coil 46b, and the tapered core 134b together. The welding portion 142b is provided with a guide wire coil 46b.
At its distal end to secure the end of the tapered core 134b to the guidewire coil 46b to allow for smooth insertion into a blood vessel or other body cavity.

FIG. 18 is a view of the proximal end of a second alternative jet cap embodiment viewed in the direction of line 18-18 in FIG. 17, where all reference numerals are used. Correspond to the constituent members described in (1).

FIG. 19 shows a third alternative embodiment.
Are the movable stop member 210, the jet cap 180 of FIG.
And the jet cap 212, which replaces the jet cap 44, and the non-angled slave tube distal end 42c, similar to the shape of the guidewire coil 46a, or at or near the slave tube 34 FIG. 20 is a longitudinal cross-sectional view of a guidewire coil 46c disposed and secured over the perimeter, and FIG. 20 is a view of the guide catheter distal end 33 as viewed in the direction of line 20-20 in FIG. In FIG. 19 and FIG. 20, all reference numerals correspond to the components described above. In this third alternative embodiment, the jet cap 212 is located around the periphery of the last subordinate tube portion 34nc, and
Fixed and the slave tube portion 34nc is
And it protrudes straight outward from the movable stop member 210. Dependent tube 34 and last dependent tube portion 34n
c and the longitudinal axis is the slave tube distal end 42c.
At the center of the movable stop member 210. By eccentrically providing the last slave tube section 34nc, the last slave tube section angled downward from the longitudinal axis of the slave tube 34 is not required,
Alignment of the jet cap 212 with the central lumen 154 of the fixed stop 150 is possible without having the last angled subordinate tube section. Movable stop member 210
Is a solid material having a circular cross-section, one end of which is formed in a frusto-conical shape having an angled annular surface portion 214 and spaced from a longitudinal central axis of the movable stop member 210. The movable stop member 210 has a longitudinal hollow portion 218 which is separated from the longitudinal central axis of the movable stop member 210. As shown in FIG. 19, the movable stop member 210 is
As the 50 angled annular surface 158 is positioned to mate with the angled annular surface 214, the jet cap 212 moves from the fixed stop 150 at the guide catheter distal end 33. By being positioned at a desired and limited distance, the high-speed jet, preferably saline, flowing out of the open end of the slave tube, i. The thrombus tissue debris is removed, disassembled, and further transported to the hollow portion 218 in the direction.

FIG. 20 is a view of the distal end 33 of the guide catheter as viewed in the direction of line 20-20 in FIG.
, All symbols correspond to the components described above.

FIG. 21 shows a fourth alternative embodiment.
Shows a longitudinal cross-sectional view of the guide catheter distal end 33a, and alternative forms of fixed and movable stop members, in which all numerals in FIG. 21 correspond to previously described components. A fixed stop member 230 is provided at the guide catheter distal end 33a of the guide catheter 32. The fixed stop member 230 is permanently connected, welded, or formed to the tube wall of the guide catheter 32 and projects into the hollow 87 of the guide catheter 32. The fixed stop member 230 including a plurality of arc-shaped stop members 230a to 230n partially closes the hollow portion 87 by protruding inward into the hollow portion 87. However, the fixing stop member 230 does not completely close the hollow portion 87. In addition, the locking stop 230 is capable of freely passing a standard guidewire through the hollow 87 in an area adjacent to the guide catheter distal end 33a of the guide catheter 32. Preferably, in the example shown for illustrative purposes, the location and dimensions of the fixed stop 230 are at least 0.010 inches,
More preferably, a coronary or nervous system guide wire having a diameter of 0.016 inches is free to pass through the fixation stop 230. Most preferably, the unobstructed diameter of the locking stop 230 is about 0.010
Inches to about 0.030 inches. Guide catheter 32 has an outer diameter of about 0.040 inches, and about 0.040 inches.
It has an inside diameter of 28 inches, or less than about 4 French. As is known in the art, guide catheter 32 is adapted to selectively position guide catheter distal end 33a adjacent to the site of a desired surgical procedure, for example, a thrombus that occludes a blood vessel. It is possible to advance and manipulate through the system.

The fixed stop member 230 is connected to the guide catheter 3
A plurality of arc-shaped stop members 23 aligned in parallel with the central axis 2
0a to 230n, and each stop member 230a to
230n are base-side tapered surface portions 234a to 234
n and the distal tapered surface portions 236a to 236n
Having. The fixed stop member 230 can be formed from various materials. Preferably, fixed stop 230 is formed from the same material as guide catheter 32. Most preferably, the locking stop 230 comprises
It is manufactured by permanently deforming the wall portion at a desired position to make it thicker. Alternatively, the locking stop 230 may be separately fabricated and secured within the guide catheter 32.

The slave tube 34, the second tube, is as described above and has a slave tube distal end 42d and a base end (not shown). The movable stop 238 is mounted on the last slave tube section 34nd at a location remote from the jet cap 240, and the guide wire coil 46d is also mounted on the last section 34nd of the last slave tube. The movable stop member 238 has a cross-sectional size such that the fixed stop member 230 cannot pass freely. In one embodiment, the movable stop 238 has a rounded cross section when viewed in the axial direction. However, a number of alternative shapes for the movable stop 238 could be employed, at least if the movable stop is prevented from passing through the fixed stop 230. Preferably, the distal tapered surface 2 of the movable stop member 238
42 is such that the distal end of the movable stop member 238 has a cross-section that allows it to pass through the proximal end of the fixed stop member 230, as schematically illustrated by the proximal tapered surface portions 234a-234n. Can be tapered. The distal tapered surface 242 is, first, a guide catheter 3
2 to reduce the tendency of snagging or sticking within
Second, the movable stop member 238 is positioned in the desired short direction with respect to the fixed stop member 230 so as to facilitate passage and advancement of the dependent tube 34, and the short direction relationship, for example, the guide catheter 32 and It serves the dual function of creating a concentric relationship with the slave tube 34. Preferably, the cross-sectional size of the movable stop member 238 is approximately between about 0.010 inches and about 0.030 inches,
An important consideration in the cross-sectional dimensions of the movable stop 238 is that the movable stop 238
, But must not pass through the fixed stop member 230.

As described above, the jet cap 240 is attached to the slave tube distal end 42 d of the slave tube 34. Guide wire coil 46d is jet cap 2
Extends distally from 40. The jet cap 240, the guidewire coil 46, and the movable stop 238 are radially symmetric about the longitudinal axis of the slave tube 34. The jet cap 240 is preferably about 0.010
It has a diameter from inches to about 0.030 inches. Dependent tube 34 is preferably between about 0.008 inches and about 0.4 inches.
It has an outer diameter of 018 inches and further comprises a continuous high pressure hollow 106 extending from the proximal end to the slave tube distal end 42d and continuing into the jet cap 240. The end of the dependent tube 34 is inserted into the hollow portion 8 of the guiding catheter 32.
7, the guide wire coil 46d adjacent to the jet cap 240 and the movable stop member 2
Any portion of the slave tube 34 distal from 38
It passes freely through the position of the fixed stop member 230. However, the passage of the movable stop member 238 does not
0 is obstructed by a partial occlusion of the hollow portion 87 of the guiding catheter 32. Accordingly, when the distal tapered surface portion 242 of the movable stop member 238 engages the base tapered surface portions 234a-234n of the fixed stop member 230, the desired longitudinal relationship is with the jet cap 240. It is reliably generated between the guide catheter distal end 33a. Most importantly, the jet cap 240 is oriented, spaced, and distally positioned in the desired relationship to the guide catheter distal end 33a of the guide catheter 32.

FIG. 22 shows the distal end 33a of the guide catheter as viewed in the direction of the line 22-22 in FIG. 21, in which all reference numerals correspond to the previously described components. Particularly shown are a plurality of arcuate stop members 230a-230n in contact with the distal tapered surface 242 of the movable stop member 238. Fluid containing thrombus debris may travel along the inner wall of guide catheter 32 adjacent between arcuate stop members 230a-230n and further along arcuate stop members 238 along arcuate stop members 230a-23.
0n, and flows into the hollow portion 87 of the guide catheter 32 which is a passage to the manifold 16.

FIG. 23 shows a fifth alternative embodiment.
Is a partial cross-sectional side view of the guide catheter distal end 33, with the dependent tube 34 secured along the longitudinal axis of the guide catheter 32. In FIG. 23, all reference numerals correspond to the components described above. In this fifth alternative embodiment using an integrated catheter, the dependent tube 34 is suitable for the lumen 244 of the cylindrical mounting member 246 secured to the end of the guide catheter 32 by a crimp ring 248. And fixed. Jet cap 250 and guide wire coil 46
e is fixed to the last slave tube section 34nd at a distance from the guide catheter distal end 33. In this fifth alternative embodiment, the movable or fixed stop is incorporated since the entire catheter system incorporating the longitudinally secured slave tube 34 is inserted into the body without the use of a guidewire. Not. Cylindrical mounting member 246 is provided for guiding catheter 32.
And has a hollow portion having the same contour as the movable stop member 40.

Since many modifications may be made to the present invention without departing from the spirit thereof, the scope of the invention is not limited to the illustrated and described embodiments. Absent. Rather, the scope of the invention is determined by the appended claims and what is equivalent thereto. The tip can be radiopaque. The guidewire can be a braided polymer or other suitable material.

[Brief description of the drawings]

FIG. 1 is a side view of a flow-type thrombectomy catheter useful for extracting a thrombus according to the present invention.

FIG. 2 is a semi-exploded side view of a flowable thrombectomy catheter showing two main assemblies, an outer assembly and an inner assembly.

FIG. 3 is a partially exploded cross-sectional side view of a manifold constituting a part of the outer assembly and adjacent components.

FIG. 4 is a partial longitudinal cross-sectional view of a filter housing / high pressure connection member mounted on a proximal end of a dependent tube.

FIG. 5 is a side view of a movable stop, a jet cap, and a guidewire coil disposed on the perimeter of the dependent tube at the distal end of the dependent tube.

FIG. 6 is an isometric view of a movable stop member.

FIG. 7 is a longitudinal sectional view taken along the line 7-7 in FIG. 5;

8 is a view of the base end of the jet cap on the slave tube as viewed in the direction of line 8-8 in FIG. 7 showing a cross section of the slave tube.

FIG. 9 is a view similar to FIG. 8, but with a slightly modified jet cap;

FIG. 10 is a longitudinal cross-sectional view of the distal end of the guide catheter taken along line 10-10 of FIG. 2;

FIG. 11 is a longitudinal cross-sectional view of the guide catheter distal end as the movable stop, spout cap and guide wire coil on the dependent tube are advanced through the guide catheter distal end.

FIG. 12 is a longitudinal cross-sectional view of the distal end of the guide catheter with the movable stop, spout cap, and guidewire coil on the dependent tube in a final advanced position.

FIG. 13 is a cross-sectional view taken along line 13-13 of FIG.

FIG. 14 is a schematic view showing the mode of operation of the flow-type thrombectomy catheter, and is a longitudinal cross-sectional view depicting the distal end of the flow-type thrombectomy catheter in a blood vessel at a site of a thrombus deposit and a lesion. It is.

FIG. 15 is a view similar to FIG. 7, but in a longitudinal cross-section of an alternative jet cap embodiment.

FIG. 16 is a cross-sectional view of the slave tube.
FIG. 16 is a view of the proximal end of the alternative jet cap embodiment shown in FIG. 15 as viewed in the direction of six lines.

FIG. 17 is a view similar to FIG. 15, but in a longitudinal cross-section of another alternative jet cap embodiment.

FIG. 18-1 of FIG. 17 showing a cross section of the slave tube.
FIG. 18 is a view of the proximal end of the alternative jet cap embodiment shown in FIG. 17 viewed in the direction of line 8;

FIG. 19 is a view similar to FIG. 12, but in a longitudinal section of another jet cap embodiment;

FIG. 20 is a cross-sectional view of the slave tube.
FIG. 4 is a view of the distal end portion of the guide catheter viewed in the direction of line 0.

FIG. 21 is a view similar to FIG. 12, but showing an alternative embodiment of the movable stop member and the fixed stop member.

FIG. 22-2-2 of FIG. 21 showing a cross section of the slave tube.
FIG. 4 is a view of the distal end of the guide catheter as seen in the direction of two lines.

FIG. 23 is a fifth alternative embodiment, a partial cross-sectional side view of the distal end of a guide catheter with a dependent tube secured along the longitudinal axis of the guide catheter.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 10 Flowable thrombectomy catheter 12 External assembly 14 Internal assembly 16 Manifold 18 Hemostatic nut 20 Manifold base end 22 Luer connection member 23 Base end (branch) 24 Branch 26 Luer attachment member 28 Manifold end end Part 30 strain relief member 31 tube 32 first tube or guide catheter 33, 33a guide catheter distal end 34 second tube or slave tube 34a-34n slave tube portion 34n, 34na-34ne last slave tube portion 34x U Shape dependent tube portion 36 Filter housing / high pressure connection member 38 Dependent tube base end 40, 210, 238 Movable stop member 42, 42a-42e Dependent tube end end 44, 180, 200, 212, 240, 250 Top 46, 46a-46e Guide wire coil 48, 100 Central passage 50 Branch passage 52 Multi-radius cavity 54 Circular outer cavity 56 Circular inner cavity 58, 66, 92 Screw surface 60 Seal 61 Terminal annular surface 62, 90, 108 Body 63 Annular surface 64 Grip surface 68 Passage 72 Filter 74 Central lumen 76 Annular flange 78 Tapered tube base open end 80 Terminal tube end 82 Tapered tube surface 84, 86 Screw Part 87 hollow part of guide catheter 88 tapered central passage surface part 94 tubular cavity 96 fine filter 98 coarse filter 102 cap 104, 110, 154 central lumen 106 hollow part of dependent tube 112a to 112n guide bar 114a to 114n Attached leading edge 1 6a to 116n Arc-shaped surface portion 117 Shoulder-shaped movable portion 118, 118a, 118b Outer edge wall 120, 120a, 120b Circular wall end 122 Long hole 124, 126 Arc-shaped portion 128, 130, 144, 146, 206 Jet orifice 132, 132a, 132b, 142, 142a, 14
2b Welds 134, 134a, 134b Tapered core 136, 138 Orifices 140, 140a, 140b Central cavity 148, 244 Lumen 150, 230 Fixed stop 152 Cylindrical body 153 Cap 156 Shoulder 158, 214 Angled Annular surface part 160 Crimp sleeve 162a-162n Passage 164 Blood vessel 166 Thrombus deposits and lesions 170 Jet of saline 182, 184, 202, 216 Hole part 218 Hollow part 230a-230n Arc-shaped stop member 234a-234n Base tapered surface Parts 236a to 236n, 242 Tapered surface part 246 Cylindrical mounting member 248 Crimp ring

 ──────────────────────────────────────────────────の Continued on the front page (72) Inventor Cindy M. Setum 29410 Avenue North 17410 (72) 55447 Plymouth, Minnesota, United States of America Inventor William Jay. Drassler Dynasty Drive, 55345 Minnetonka, Minnesota, USA 4100 (72) Inventor Hubu. Le 55409 Minneapolis, Minnesota, United States, Apartment 3, Bryant Avenue South 4340 (72) Inventor Robert G. Dutcher 55369 Maple Grove, Minnesota, USA No. 88 Place North 14178 F Term (Reference) 4C060 GG19 MM24 MM25 4C077 CC02 DD07 DD10 DD12 DD19 DD21 EE02 EE04 JJ04 KK25 KK30

Claims (8)

[Claims] 1. A catheter for extracting tissue from a body cavity comprising (a) an outer assembly and (b) an inner assembly, wherein (a) the outer assembly comprises: (1) a distal opening end A first tube having a hollow portion having a diameter sufficient to allow a guide wire to pass therethrough, and having a fixed stop member located at the interior, partially closing the hollow portion at the distal open end; Wherein the hollow has a diameter sufficient to pass a guidewire; and (b) the internal assembly comprises: (1) a high pressure hollow having a distal end with an orifice. (2) a movable stop member fixed to the second tube adjacent to the distal end, and (3) a saline solution positioned at the distal end and flowing out of the orifice. At the end of the first tube And a jet cap for directing the open end,
The second tube is configured such that the movable stop member engages the fixed stop member to hold the jet cap in a desired relationship to the distal open end of the first tube. A catheter for removing tissue from a body cavity, wherein the catheter is movable in the axial direction in the first tube. 2. A catheter for removing a thrombus or other human tissue from a closed human blood vessel or body cavity, comprising: (a) an outer assembly and (b) an inner assembly, wherein (a) the outer assembly. (1) having a proximal end and a distal open end containing a fixed stop member, and comprising a standard coronary artery guidewire or an interventional neuroradiology guidewire;
a discharge tube having a discharge cavity of sufficient diameter to allow passage of an iological guidewire; (b) said internal assembly comprises: (1) a high pressure cavity, a proximal end, and a distal end. Wherein the distal end has one or more orifices;
A high-pressure tube through which saline can flow out of the high-pressure hollow portion and be directed to the distal open end of the discharge tube; and (2) the distal side relative to the base-side end. A movable stop member fixed to the high-pressure tube at a position close to the end; and (3) the distal-side opening of the discharge tube positioned at the distal-side end of the high-pressure tube and cooperating with the high-pressure tube. A jet cap for directing one or more saline jets at an end thereof, wherein the catheter removes a thrombus or other human tissue from an occluded human vessel or body cavity. 3. The catheter of claim 2, wherein said jet cap has a distal end, and said distal end of said jet cap has a mounted guide wire coil within the vasculature. The catheter wherein the outer assembly and the inner assembly are advanced together. 4. The catheter of claim 2, wherein said jet cap produces an annular jet of saline solution directed at said distal open end of said discharge tube. 5. The catheter according to claim 2, wherein said drainage tube is flexible and passes a standard guidewire through a tortuous vascular line. 6. Providing a guide wire and a first catheter having a distal end and a fixed stop positioned therein and positioned adjacent to the distal end; (B) advancing the guidewire to a vascular site containing a thrombus; and (c) advancing the first catheter to a vascular site containing a thrombus following the guidewire and the distal end. (D) removing the guidewire from the first catheter; and (e) a second cap carrying a jet cap and a movable stop member spaced from the jet cap. Providing a catheter; (f) advancing a second catheter within the first catheter to engage the movable stop with the fixed stop; Supplying a pressurized saline solution to a second catheter to cause a jet of saline solution to flow out of the jet cap and introducing a thrombus into the jet of saline solution at the distal end of the first catheter. And removing the thrombus from the occluded blood vessel with a saline jet and further into the first catheter. 7. The method of claim 6, wherein the jet cap carries a distally projecting coil to the first catheter and the second catheter to a vascular site containing a further thrombus in the vasculature. Extracting a thrombus from an occluded blood vessel, wherein the method further facilitates further advancement of both the catheter and the catheter to the distal side, and extracts another thrombus located on the distal side. 8. A first tube having a distal open end and a hollow portion extending to the distal open end, (b) a distal end, and extending to the distal end. A second tube having an extending hollow portion, separable from the first tube, and insertable into the hollow portion in the first tube; and (c) the second tube. A jet cap connected to the second tube at the distal end of the tube to deliver fluid flowing out of the hollow portion of the second tube, the jet cap passing through the hollow portion of the first tube. A spout cap through the distal open end of the first tube when the jet cap is properly positioned and oriented with respect to the distal open end of the first tube. In the hollow portion of the first tube so as to be directed substantially to the base side. A jet cap characterized by the function of providing a low pressure local area that cooperates with the flow of the liquid; and (d) the jet cap and the second tube relative to the distal open end of the first tube. Means for determining an appropriate positional relationship with the distal end.