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DE375381T1 - Atherektomiesystem. - Google Patents

Atherektomiesystem.

Info

Publication number
DE375381T1
DE375381T1 DE198989313315T DE89313315T DE375381T1 DE 375381 T1 DE375381 T1 DE 375381T1 DE 198989313315 T DE198989313315 T DE 198989313315T DE 89313315 T DE89313315 T DE 89313315T DE 375381 T1 DE375381 T1 DE 375381T1
Authority
DE
Germany
Prior art keywords
arterectomy
flexible
tongue
obstruction
catheter
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
DE198989313315T
Other languages
English (en)
Inventor
Samuel Billerica Mass. Shiber
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of DE375381T1 publication Critical patent/DE375381T1/de
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • A61B18/082—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • A61B18/245—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter for removing obstructions in blood vessels or calculi
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16C—SHAFTS; FLEXIBLE SHAFTS; ELEMENTS OR CRANKSHAFT MECHANISMS; ROTARY BODIES OTHER THAN GEARING ELEMENTS; BEARINGS
    • F16C1/00—Flexible shafts; Mechanical means for transmitting movement in a flexible sheathing
    • F16C1/02—Flexible shafts; Mechanical means for transmitting movement in a flexible sheathing for conveying rotary movements
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16D—COUPLINGS FOR TRANSMITTING ROTATION; CLUTCHES; BRAKES
    • F16D7/00—Slip couplings, e.g. slipping on overload, for absorbing shock
    • F16D7/02—Slip couplings, e.g. slipping on overload, for absorbing shock of the friction type
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A61B2017/22052—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation eccentric
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/005—Auxiliary appliance with suction drainage system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • A61M1/75—Intermittent or pulsating suction
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16C—SHAFTS; FLEXIBLE SHAFTS; ELEMENTS OR CRANKSHAFT MECHANISMS; ROTARY BODIES OTHER THAN GEARING ELEMENTS; BEARINGS
    • F16C2316/00—Apparatus in health or amusement
    • F16C2316/10—Apparatus in health or amusement in medical appliances, e.g. in diagnosis, dentistry, instruments, prostheses, medical imaging appliances

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • General Engineering & Computer Science (AREA)
  • Mechanical Engineering (AREA)
  • Physics & Mathematics (AREA)
  • Otolaryngology (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Optics & Photonics (AREA)
  • Electromagnetism (AREA)
  • Plasma & Fusion (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Surgical Instruments (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Claims (23)

Ansprüche
1. Arterektomie-System zum Ausschneiden, Aufnehmen und Entfernen einer Obstruktion innerhalb eines Blutgefäßes eines Patienten, gekennzeichnet durch einen in das Blutgefäß einführbaren flexiblen Führungsdraht (17), einen flexiblen rotierenden Katheter (15), der drehbar und über den Führungsdraht verschieblich angeordnet ist und rotierende Ausschneidemittel (22) an seinem distalen Ende aufweist, um einen kreisförmigen Schnitt in eine vor ihm liegende Obstruktion zu machen, und mit Kupplungsmitteln (30) an seinem proximalen Ende, einen zwischen dem flexiblen rotierenden Katheter (15) und dem flexiblen Führungsdraht (17) definierten ununterbrochenen Durchgang zur Aufnahme des ausgeschnittenen Obstruktionsmaterials, wobei die Relativbewegung zwischen dem flexiblen rotierenden Katheter und dem flexiblen Führungsdraht bei der Bewegung des aufgenommenen Obstruktionsmaterials in den ununterbrochenen Durchgang behilflich ist, und durch eine Hülse (26), in der der flexible Katheter verschieblich angeordnet ist, welche Hülse eine sich von ihrem distalen Ende weg erstreckende verlängerte Zunge (35) aufweist, die in dem Blutgefäß eine exzentrisch ausgerichtete Leitbahn zum Entlangbewegen der Ausschneidemittel definiert.
2. Arterektomie-System nach Anspruch 1, dadurch gekennzeichnet, daß die Zunge (35) einen Kreisquerschnitt aufweist, die den flexiblen Katheter definitiv einschließt.
3. Arterektomie-System nach Anspruch 1, dadurch gekennzeichnet, daß die Zunge (35) einen U-förmigen Querschnitt aufweist.
4. Arterektomie-System nach Anspruch 1, dadurch gekennzeichnet, daß die Zunge einen wahlweise veränderbaren Querschnitt aufweist, um ihr Einführen in das Blutgefäß zu erleichtern.
5. Arterektomie-System nach irgendeinem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß der Durchmesser der Zunge wahlweise veränderbar und angepaßt ist zum Entfalten in Reaktion auf die Füllung einer Kammeranordnung (42), die außerhalb einer Unterseite der Zunge (35) angebracht ist.
6. Arterektomie-System nach irgendeinem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß der Querschnitt der Zunge durch Verstärkungsmittel (47) stabilisiert ist.
7. Arterektomie-System nach irgendeinem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß die Zunge wahlweise einstellbare Ausrichtmittel aufweist, um sie in dem Blutgefäß außermittig auszurichten.
8. Arterektomie-System nach Anspruch 7, dadurch gekennzeichnet, daß die Ausrichtmittel eine an der Unterseite der Zunge angebrachte aufblasbare Kammer (42) umfassen.
9. Arterektomie-System nach irgendeinem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß die Zunge einen Abschirmdeckel (61) an ihrem distalen Ende aufweist.
10. Arterektomie-System nach Anspruch 9, dadurch gekennzeichnet, daß der Abschirmdeckel (61) mittels mechanischer Mittel wahlweise einstellbar ist.
11. Arterektomie-System nach Anspruch 9, dadurch gekennzeichnet, daß der Abschirmdeckel (61) mittels aufblasbarer Kammern (63) wahlweise einstellbar ist.
12. Arterektomie-System nach irgendeinem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß
Saugmittel am proximalen Ende des ununterbrochenen Durchgangs in Betrieb sind, um das ausgeschnittene Obstruktionsmaterial in dem ununterbrochenen Durchgang proximal zu ziehen.
20
13. Arterektomie-System nach irgendeinem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß das Ausschneidemittel eine rotierende rohrförmige Klinge ist.
14. Arterektomie-System nach irgendeinem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß der flexible Katheter ein flexibler rotierender Katheter ist.
15. Arterektomie-System nach Anspruch 14, dadurch gekennzeichnet, daß der flexible rotierende Katheter an
seinem proximalen Abschnitt einen verminderten Durchmesser aufweist, um Reibungsverluste zwischen dem flexiblen rotierenden Katheter und der Hülse zu verringern.
5
16. Arterektomie-System nach irgendeinem der Ansprüche 1 bis 12, dadurch gekennzeichnet, daß das Ausschneidemittel ein Strahlen aussendendes Gerät ist.
17. Arterektomie-System nach irgendeinem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß der flexiblen Führungsdraht sich radial erstreckende distale Sperrglieder (67, 68) aufweist, um der distalen Bewegung von Obstruktionsmaterial entgegen zu wirken.
18. Arterektomie-System nach Anspruch 1 7, dadurch gekennzeichnet, daß die distale Sperre (67, 68) fähig ist, sich elastisch zusammenzuziehen.
19. Arterektomie-System nach Anspruch 18, dadurch gekennzeichnet, daß die distale Sperre (67, 68) wahlweise ausdehnbar ist.
20. Arterektomie-System nach irgendeinem der vorhergehenden Ansprüche, dadurch gekennzeichnet, daß mit der Hülse Mittel zum Einführen von Fluiden in das Blutgefäß verbunden sind.
21 . Verfahren zum Entfernen einer Obstruktion aus einem Blutgefäß mit einem Arterektomie-System, umfassend die folgenden Schritte:
Einführen eines flexiblen Führungsdrahtes in ein Blutgefäß und iri eine Obstruktion,
Vorschieben eines mit Ausschneidemitteln an seinem distalen Ende ausgerüsteten flexiblen Katheters und einer eine sich von ihrem distalen Ende wegerstreckende Zunge aufweisenden Hülse über den flexiblen Führungsdraht,
Plazieren der Zunge längs der Obstruktion,
Vorschieben der Ausschneidemittel zur Obstruktion, Vorschieben des flexiblen Katheters und Ausschneiden längs einer exzentrisch ausgerichteten, von der Zunge während des Ausschneidens und Aufnehmens des Obstruktionsmaterials in den flexiblen Katheter definierten Bahn,
Entfernen des flexiblen Katheters und des aufgenommenen Obstruktionsmaterials aus dem Blutgefäß.
22. Verfahren zum Entfernen einer Obstruktion aus einem Blutgefäß mit einem Arterektomie-System, umfassend die folgenden Schritte:
Einführen eines flexiblen Führungsdrahtes in ein Blutgefäß und in eine Obstruktion,
Vorschieben eines Ausschneidemittels und Ausschneiden eines Anfangs-Hohlraums in die Obstruktion,
Zurückziehen der Ausschneidemittel aus dem Anfangs-Hohlraum,
Einführen einer Zunge in den Anfangs-Hohlraum.
Vorschieben des flexiblen Katheters und Ausschneiden längs einer exzentrisch ausgerichteten, von der Zunge während des Ausschneidens und Aufnehmens des Obstruktionsmaterials in den flexiblen Katheter definierten Bahn, um den Anfangs-Hohlraum zu vergrößern.
23. Verfahren nach Anspruch 21 oder Anspruch 22, dadurch gekennzeichnet, daß Unterdruck benutzt wird, um der ausgeschnittenen Obstruktion in den ununterbrochenen Durchgang zu verhelfen.
DE198989313315T 1988-12-19 1989-12-19 Atherektomiesystem. Pending DE375381T1 (de)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US07/286,509 US4894051A (en) 1984-05-14 1988-12-19 Atherectomy system with a biasing sleeve and method of using the same

Publications (1)

Publication Number Publication Date
DE375381T1 true DE375381T1 (de) 1991-04-11

Family

ID=23098936

Family Applications (2)

Application Number Title Priority Date Filing Date
DE68925803T Expired - Fee Related DE68925803T2 (de) 1988-12-19 1989-12-19 Atherektomiesystem
DE198989313315T Pending DE375381T1 (de) 1988-12-19 1989-12-19 Atherektomiesystem.

Family Applications Before (1)

Application Number Title Priority Date Filing Date
DE68925803T Expired - Fee Related DE68925803T2 (de) 1988-12-19 1989-12-19 Atherektomiesystem

Country Status (5)

Country Link
US (1) US4894051A (de)
EP (1) EP0375381B1 (de)
JP (1) JPH0347276A (de)
CA (1) CA2005817A1 (de)
DE (2) DE68925803T2 (de)

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EP0375381A1 (de) 1990-06-27
DE68925803T2 (de) 1996-08-29
JPH0347276A (ja) 1991-02-28
CA2005817A1 (en) 1990-06-19
EP0375381B1 (de) 1996-02-28
DE68925803D1 (de) 1996-04-04
US4894051A (en) 1990-01-16

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