WO2008020905A2 - Methods and devices for cutting tissue at a vascular location - Google Patents
Methods and devices for cutting tissue at a vascular location Download PDFInfo
- Publication number
- WO2008020905A2 WO2008020905A2 PCT/US2007/012008 US2007012008W WO2008020905A2 WO 2008020905 A2 WO2008020905 A2 WO 2008020905A2 US 2007012008 W US2007012008 W US 2007012008W WO 2008020905 A2 WO2008020905 A2 WO 2008020905A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- cutting element
- tissue
- tissue cutting
- sizer
- vascular location
- Prior art date
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
- A61B17/32—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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- 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
-
- 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
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/00296—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means mounted on an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00305—Constructional details of the flexible means
- A61B2017/00309—Cut-outs or slits
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/0034—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means adapted to be inserted through a working channel of an endoscope
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
-
- 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
- A61B2017/22039—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 eccentric
-
- 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
- A61B2017/22072—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 instrument channel, e.g. for replacing one instrument by the other
- A61B2017/22074—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 instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
- A61B2017/22077—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 instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel with a part piercing the tissue
-
- 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
- A61B2017/22094—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 for crossing total occlusions, i.e. piercing
- A61B2017/22095—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 for crossing total occlusions, i.e. piercing accessing a blood vessel true lumen from the sub-intimal space
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
-
- 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
- A61B2017/320052—Guides for cutting instruments
-
- 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
- A61B2017/320766—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven eccentric
-
- 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
- A61B2017/320791—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 with cutter extending outside the cutting window
Definitions
- the present invention is directed to devices and methods for cutting tissue.
- the present invention is directed to devices and methods for re-entering the true lumen from a subintimal space such as a dissection plane or so-called "false lumen.”
- Guidewires and other interventional devices are used to treat vessels and organs using endovascular approaches.
- a guidewire is typically guided through blood vessels to the treatment site and the device is then advanced over the guidewire.
- angioplasty and stenting are generally accomplished by first introducing a guidewire to the desired site and then advancing the angioplasty or stent catheter over the guidewire.
- the guidewire or device When attempting to advance a guidewire or other interventional device through a highly stenosed region or chronic total occlusion (CTO), the guidewire or device may inadvertently enter into the wall of the vessel to create a sub-intimal space. Once in a sub-intimal space, it can be difficult to re-enter the vessel true lumen.
- CTO chronic total occlusion
- the device has a cutter, an opening, and an energy emitter coupled to the cutter.
- the device is advanced into the subintimal space and energy is then emitted from the energy emitter to locate the true lumen.
- the energy emitter and cutting element are moved together which exposes the cutting element to cut an access path into the true lumen.
- the device may have a bendable tip which is bent while cutting tissue to create the access path or may be bent to direct the device or a guidewire through the access path.
- the device has a rotatable cutting element which may be moved from a stored position to a cutting position which exposes over 180 degrees, and even 220 or even 270 degrees of the cutting element relative to the axis of rotation.
- the cutter may be gradually exposed as necessary.
- the body of device may be wider along a portion of the device to urge tissue toward the cutting element.
- the opening is relatively large and may be open at the distal end and may expose at least part of the cutter at all positions distal to the opening. The open end of the device permits the tissue to naturally move toward the cutter due to the generally open nature of the distal end.
- a system for accessing a subintimal space includes a catheter through which the tissue cutting device is advanced.
- the catheter may be coupled to a fluid source to inject contrast or the like and may also be coupled to a pressure monitor for monitoring pressure to determine when the access path has been created as described in greater detail below.
- a method of entering a true lumen from a false lumen during an endovascular procedure is provided.
- a guidewire is positioned in the subintimal space.
- a reentry device is then advanced over the guidewire to the target location in the subintimal space.
- the access path is then created using the reentry device to cut the access path.
- the same guidewire is then directed through the access path.
- the reentry device may have two different openings with the first being used during advancement of the reentry device and a second opening through which the guidewire extends when being directed through the access path.
- the first opening may be configured to direct the guidewire substantially longitudinal while the second opening directs the guidewire at an angle relative to the longitudinal axis.
- the present invention is also directed to a device for cutting tissue which automatically adjusts the position of the tissue cutting element in response to changes in vessel size.
- the device has a sizer coupled to the body which moves in response changes in vessel size.
- the sizer is coupled to the tissue cutting element so that the tissue cutting element changes position relative to the body when the vessel size changes.
- the tissue cutting element changes position relative to the body when the vessel size changes.
- the vessel size decreases, the tissue cutting element is moved to expose more of the cutting element.
- the cutting element is moved to expose less of the cutting element.
- vessel size as used herein is used to generally describe a lateral dimension of the vessel.
- Fig. 1 shows a view of the system of the present invention.
- Fig. 2 shows a guidewire positioned proximate to a total occlusion.
- Fig. 3 shows a subintimal space created adjacent a true lumen by the . guidewire.
- Fig. 4 shows a reentry device of the present invention advanced over the guidewire to the subintimal space.
- Fig. 5 shows a guidewire positioned in the true lumen.
- Fig. 6 shows the reentry device with the cutting element in a stored position.
- Fig. 7 shows the reentry device with the cutting element in a cutting position.
- Fig. 8 is a side view of the reentry device of Fig. 7.
- Fig. 9 shows another reentry device with the cutting element in a stored position.
- Fig. 10 shows the reentry device of Fig. 9 with the cutting element in a cutting position and the distal portion bent.
- Fig. 1 1 shows the reentry device of Figs. 9 and 10 with the cutting element advanced to another cutting position which exposes even more of the cutting element and also bends the distal tip further.
- Fig. 12 shows another reentry device which has a bendable distal portion.
- Fig. 13 shows the reentry device of Fig. 12 with the distal portion bent.
- Fig. 14 shows still another reentry device with a cutting element which may be tilted.
- Fig. 15 shows the reentry device of Fig. 14 with the cutting element tilted to expose more of the cutting element and to move the cutting element through the opening in the body of the device.
- Fig. 16 shows the reentry device of Fig. 6 having a junction leading to two separate guidewire outlets with the guidewire positioned in the first outlet during advancement of the device over the guidewire.
- Fig.17 shows the reentry device of Fig. 16 with the guidewire extending through the second outlet for directing the guidewire into the true lumen.
- Fig. 18 shows a catheter having a lumen for receiving a guidewire and another lumen which receives the reentry device.
- Fig. 19 shows another catheter having a single lumen through which the guidewire and reentry device pass.
- Fig. 20 shows an external view of another device for cutting tissue having a sizer.
- Fig. 21 shows another external view of the device of Fig. 20.
- Fig. 22 is a cross-sectional view of the device of Figs. 20 and 21.
- Fig. 23 is a cross-sectional view of the device of Figs. 20 and 21 with the sizer moved inward.
- a system 2 and device 4 for reentering a true lumen from a subintimal space, dissection plane or so-called false lumen is shown.
- the device 4 includes a cutting element 6 coupled to a torque transmitting element 8, such as a wire 10, which rotates the cutting element 6.
- the device 4 has an opening 12 at a distal end 14 with the cutting element 6 movable between a stored position (Fig. 6) and a cutting position (Figs. 7 and 8) which exposes the cutting element 6.
- the cutting element 6 may be any suitable cutting element 6 such as the cutting element 6 described in patents incorporated by reference above.
- the cutting element 6 has a circular cutting edge which has a diameter of about 1 mm although any suitable size may be used depending upon the particular application.
- the cutting element 6 may also be any other type of cutter such as a laser, ultrasound, RF or other type of cutter without departing from various aspects of the present invention.
- the device 4 has a flexible body 16 to navigate through blood vessels or other body lumens to a target location.
- the body 16 may be made of any suitable material as is known in the art such as Pebax.
- the torque transmitting element 8 extends through a lumen 18 in the body 16.
- the body 16 may have more lumens for various reasons such as introduction of fluids, such as contrast, or for delivery of another device 4 such as a guidewire or interventional device.
- the torque transmitting element 8 is coupled to a driver 20 which rotates the torque transmitting element 8 at a variable or fixed speed.
- the device 4 may also have an energy emitting element 22, such as an ultrasound element 25, which emits (and may receive) energy to determine the location of the true lumen as explained below.
- the energy emitting element 22 is coupled to the cutting element 6 so that the energy emitting element 22 and cutting element 6 are rotated together.
- the cutting element 6 is in the stored position when locating the true lumen so that the cutting element 6 is not exposed and will not cut or damage tissue.
- the energy emitting element 22 is positioned adjacent a window 24 which may be a side opening 26 or may simply be a portion of the sidewall which transmits a sufficient amount of the energy therethrough. Any suitable energy emitting element 22 may be used such as the ultrasound emitting element available from Boston Scientific and is marketed under the name AtlantisTM.
- the cutting element 6 may be mounted to a collar which is then mounted to an ultrasound element holder 28 or the cutting element 6 may be integrally formed with the ultrasound element holder 28.
- the device 4 has an atraumatic tip 34 which is relatively flexible to prevent damaging tissue.
- the tip 34 may be a separate piece laminated or glued to the body 16.
- the tip 34 is preferably made out of a relatively soft, flexible material, such as tecothane, and may be used for blunt dissection as necessary.
- a reinforcing element 36 is encapsulated in the tip 34 to help the tip 34 maintain its general shape.
- the tip 34 may also have one or more guidewire lumens 38 or any of the guidewire features described herein.
- the opening 12 in the distal portion may be designed to expose over 180 degrees of the cutting element 6 and may even expose 220 degrees or even 270 degrees of the cutting element 6 as defined by the axis of rotation. This provides advantages over WO 02/45598 which does not expose much of the cutting element 6 and requires invagination of the tissue within the opening to cut tissue.
- the cutting element 6 may be gradually exposed. For example, the cutting element 6 may be gradually exposed from 180-220 degrees or even 200-270 degrees. As explained below, this feature provides the user with the ability to change the amount of cutter 6 that is exposed depending upon the tissue thickness between the subintimal location and true lumen.
- opening 12 and amount of exposure of the cutting element 6 are defined by the outer bounds of the opening 12 and the axis of rotation. Referring to Figs. 7 and 8, the cutting element 6 is exposed relative to the outer bounds of the opening 12 due to the relatively open distal end- Referring to Figs. 9-11, another device 4A for reentering a true lumen from a subintimal location is shown wherein the same or similar reference numbers refer to the same or similar structure.
- the device 4A also has an opening 12A at the distal end to expose the cutting element 6 A.
- Fig. 9 shows the cutting element 6A in a stored position
- Fig. 10 shows the cutting element 6A in a first cutting position
- Fig. 1 1 shows the cutting element 6A in a second cutting position which further exposes the element 6A.
- the device 4A also has the window 24 through which the energy emitting element 22, such as the ultrasound element, may emit energy when the cutting element 6A is in the stored position.
- a distal portion 40 of the body can bend or articulate to further expose the cutting element 6 A and to move the cutting element 6A toward true lumen.
- the body has slots 42 formed therein to increase the flexibility of the distal portion 40.
- the cutting element 6A has a surface 44 which engages a lip 46 on the body. As the cutting element 6A is advanced, the interaction between the surface 44 and lip 46 causes the distal portion 40 to deflect. Bending the distal portion 40 can be helpful in moving the cutting element 6A toward the tissue and may also expose more of the cutting element 6A. As also explained below, the tip 40 may also be bent to direct the device 4A itself or a guidewire into the true lumen.
- the cutting element 6A may also be gradually exposed as the cutting element 6A moves distally and may be gradually exposed in the same manner described above.
- FIG. 12 and 13 another reentry device 4B is shown which has a distal portion or tip 60 which bends or articulates.
- the tip 60 may be articulated and actuated in any suitable manner.
- the tip 60 may be bent upon longitudinal movement of the cutting element 6 (as shown above) or a separate actuator, such as a pull wire 62, may be used.
- the tip 60 is bent or articulated to move the cutting element 6 toward the true lumen and to expose more of the cutting element 6.
- the device 4B may also be bent to direct the device 4B itself or another device or guidewire through the guidewire lumen 38 to the access path into the true lumen as described further below.
- the device 4C includes a cutting element 6C, an energy emitting element 22C and a torque transmitter 8C for rotating the elements.
- the device 4C has an opening 64 along one side.
- the cutting element 6C is contained within the opening 64 in the stored position of Fig. 14 and extends out of the opening 64 in the cutting position of Fig. 15.
- the cutting element 6C is moved out of the window 24 using an actuator 68, such as a wire 70, which tilts a bearing 72 supporting the shaft of the rotatable cutting element 6C.
- an actuator 68 such as a wire 70, which tilts a bearing 72 supporting the shaft of the rotatable cutting element 6C.
- any other suitable structure may be used to move the cutting element 6C outside the opening 64 such as those described in U.S.
- Patent No. 6,447,525 which is hereby incorporated by reference.
- the cutting element 6C may be moved out of the opening 64 by bending the distal portion or tip as described herein.
- Use of the devices 4, 4A-C is now described with reference to the device 4 although it is understood that any of the devices 4, 4A-C may be used.
- the device 4 may be used to perform any suitable procedure to cut from one location to another in the body such as a procedure to reenter a true lumen.
- the device 4 is initially advanced to a position within a subint ⁇ mal space SS.
- the subintimal space SS may be inadvertently created during an endovascular procedure with a guidewire GW or other device creating the subintimal space SS as shown in Figs. 2 and 3.
- the device 4 may be introduced over the same guidewire GW or device which created the subintimal space SS as shown in Figs. 4 and 5.
- the device 4 may also be advanced over the guidewire GW to a position proximate to the subintimal space SS after which the device 4 is then advanced by itself into the subintimal space SS.
- the energy emitting element 22 is used to determine the location of the true lumen.
- the ultrasound element 28 is rotated while emitting ultrasound energy and the energy emitted through the window 24 and reflected back through the window 24 is processed as is known in the art.
- the entire device 4 is rotated within the subintimal space SS to orient the window 24 until the true lumen is located.
- the angular orientation of the device 4 is then maintained so that the opening 12 and window 24 are directed toward the true lumen.
- the cutting element 6 is then moved to the cutting position to expose the cutting element 6.
- the cutting element 6 may be rotated with the driver 20 during this time so that cutting is initiated as the cutting element 6 is exposed.
- the entire device 4 itself may be moved through the subintimal space to cut tissue. This provides advantages over the method of WO 02/45598 which requires invagination of tissue through a window to attempt a cut at one location. If the tissue does not invaginate sufficiently into the window, such as when the tissue is too thick, the device of WO 02/45598 will not be able to cut completely through the tissue to create the access path to the true lumen. The user must then move the device and again attempt to invaginate enough tissue to cut an access path.
- the present invention provides the ability to move the entire device 4 through the subintimal space to create the access path rather than attempting a cut at a single discrete location as in WO 02/45598.
- the device 4 may also be used by moving only the cutting element 6 rather than the entire device 4 without departing from the invention.
- the cutting element 6 may also be exposed to varying degrees, as described above, until enough of the cutting element 6 is exposed to cut through to the true lumen. For example, the user may choose to expose half of the cutting element 6 and attempt to create an access path to the true lumen. If an access path is not created, the user may then choose to expose more of the cutting element 6 and again attempt to create an access path. This procedure can be repeated until the access path is formed to the true lumen.
- the device 4A, 4B may be also have a distal tip or portion 40, 60 which bends to move the cutting element 6 toward the tissue and/or expose more of the cutting element 6 during cutting.
- the device 4 After successfully creating the access path into the true lumen, the device 4 itself or part thereof may be directed toward or through the access path. Referring to Fig. 9- 13, for example, the distal portion or tip 40, 60 may be bent to help direct the device 4A, 4B itself or the guidewire GW through the access path.
- FIG. 16 and 17 another device 4D, similar to device 4, is shown which has a guidewire lumen 74 having a junction 76 so the guidewire can be directed through either a first lumen 77 having a first outlet 78 or a second lumen 19 having a second outlet 80.
- the first outlet 78 directs the guidewire substantially longitudinally for advancing the device 4D over the guidewire to the target area in a conventional manner.
- the second outlet 80 directs the guidewire at an angle relative to the longitudinal axis, such as 30-75 degrees, to direct the guidewire through the access path into the true lumen.
- the junction 76 may include a feature which directs the guidewire into the second outlet 80.
- the junction 76 may include a flap or stop 82 which closes and prevents or inhibits the guidewire from passing through the first outlet 78 after the guidewire has been withdrawn proximal to the junction 76.
- the guidewire passes through the second outlet 80 due to the stop 82.
- the device 4 and/or guidewire GW are then manipulated to direct the guidewire GW through the access path.
- the junction 76 may also simply be a relatively open junction 76 with the user manipulating and rotating the guidewire GW to direct the guidewire GW through the desired outlet 78, 80. The device is rotated about 180 degrees after creating the access path to direct the GW through outlet 80 and into the true lumen.
- the system 2 may also include a sheath or catheter 90 which is advanced proximal to the treatment site.
- the sheath 90 may help provide better control of the guidewire GW and devices 4 of the present invention during manipulation in the subintimal space.
- the sheath 90 may also used to deliver contrast solution to the treatment site from a source of contrast 97 (see Fig. 1 ) or may be coupled to a pressure sensor 94.
- the pressure sensor 94 may be part of the contrast delivery system 97 or may be a separate component. Deliver of contrast and/or pressure monitoring may be used to determine when the access path has been created.
- the sheath 90 may include only one lumen 92 with fluid delivery and pressure sensing being accomplished in the annular space between the device and sheath as shown in Fig. 19.
- the sheath 90 may also have first and second lumens 96, 98 for separate delivery of the device 4 and guidewire GW.
- the devices 4 of the present invention may be advanced over the same guidewire or device that created the subintimal space or may be advanced over another guidewire or even through the sheath 90 by itself.
- another interventional device may be introduced into the true lumen for the intended therapy or procedure.
- a stent catheter, angioplasty catheter, or atherectomy device may be used to treat the occlusion.
- the present invention has been described for reentering a true lumen from a subintimal space but, of course, may be used for other purposes to gain access from one space to another anywhere within the body.
- the device 100 includes an elongate body 116 and a cutting element 106 coupled to a drive element 108 which is rotated to drive the cutting element 106.
- the drive element 108 extends through a lumen 118 in the body 1 16 and is driven by a driver (not shown) at the proximal end.
- the cutting element 106 may be any suitable cutting element 106 including those described in the applications incorporated herein.
- the cutting element 106 has an essentially circular cutting surface 107 along the leading edge of the cutting element 106.
- the body 116 has an opening 112 therein and the tissue cutter 106 is movable from the stored position of Figs. 20 and 22 to the cutting position of Fig. 23. When moved to the cutting position of Fig. 23, part of the tissue cutting element 116 becomes exposed relative to opening 112.
- the opening 112 may be a side opening as shown in Figs. 20-23 or may be a distal opening as shown in other devices described herein such as the devices of Figs. 1-19.
- the tissue cutting element 106 moves relative to the body 1 16 so that a cutting height 1 17 of the tissue cutting element 106 changes as the position of the cutting element changes relative to the body 116.
- the cutting height 117 is defined by a maximum distance from the cutting surface 107 to an outer surface 109 of the body 116.
- the device 100 has a sizer 119 coupled to the body 1 16 which automatically adjusts the cutting height 117 based on vessel size.
- the sizer 1 19 is naturally biased to an outer position of Fig. 22 by a spring 122 which defines a maximum width of the device along the sizer 119.
- the sizer 119 is moved inward from the position of Fig. 22 when contact with the vessel wall overcomes the force biasing the sizer 1 19 outward.
- the sizer 1 19 is essentially moved inward by the vessel wall when the vessel size is smaller than the width of the device 100.
- the sizer 119 moves between the positions of Figs. 22 and 23 as the diameter of the vessel varies within a given range.
- the tissue cutting element 106 When the vessel diameter is larger than the diameter of the device 100, the tissue cutting element 106 will remain in the stored position of Fig. 22. Stated another way, the sizer 1 19 is coupled to the tissue cutting element 106 so that an outward force is applied to the tissue cutting element 106 when the sizer 119 moves inward. The outward force on the tissue cutting element 106 being directed away from the body 1 16.
- the sizer 119 is coupled to the tissue cutting element 106 so that the amount of exposure of the cutting element, such as the cutter height 1 17, changes when the vessel diameter changes.
- the exposure of the tissue cutting element 106 is increased when the vessel diameter decreases so that a deeper cut is made in smaller vessels. A deeper cut may be desired when removing tissue in smaller vessels to increase the flow of blood through the vessel.
- the user may still move the tissue cutting element 106 to the cutting position of Fig. 23 by pulling on the drive element 108 so that a contact surface 123 on the sizer 1 19 engages a ramp 126 on an inner wall 128 of the body 116 to move the cutting element 106 to the position of Fig. 23.
- the tissue cutting device 100 may be used to cut tissue for any purpose. Furthermore, the device 100 has been described in connection with cutting tissue in blood vessels but may be used for any other purpose in the vasculature. The tissue may be cut and left within the body or may be removed in any suitable manner.
- the device 100 may include a tissue collection chamber 130 coupled to the body 116 distal to the cutting element 106. The tissue cutting element 106 cuts tissue and directs the tissue into the collection chamber 130. The tissue cut by the tissue cutting element 106 is parted off from the surrounding tissue by moving the cutting element 106 back to the stored position.
Abstract
A tissue cutting device includes a sizing element which detects the diameter of the vessel in which the cutting device is positioned. The sizing element is coupled to the cutting element so that the amount of the cutting element that is exposed varies in response to movement of the sizing element.
Description
METHODS AND DEVICES FOR CUTTING TISSUE AT A VASCULAR
LOCATION
CROSS-REFERENCES TO RELATED APPLICATIONS The present application is a continuation in part of Serial No. 10/421,980, filed April 22, 2003 which is hereby incorporated by reference.
BACKGROUND OF THE INVENTION
The present invention is directed to devices and methods for cutting tissue. In a specific application, the present invention is directed to devices and methods for re-entering the true lumen from a subintimal space such as a dissection plane or so-called "false lumen."
Guidewires and other interventional devices are used to treat vessels and organs using endovascular approaches. A guidewire is typically guided through blood vessels to the treatment site and the device is then advanced over the guidewire. For example, angioplasty and stenting are generally accomplished by first introducing a guidewire to the desired site and then advancing the angioplasty or stent catheter over the guidewire.
When attempting to advance a guidewire or other interventional device through a highly stenosed region or chronic total occlusion (CTO), the guidewire or device may inadvertently enter into the wall of the vessel to create a sub-intimal space. Once in a sub-intimal space, it can be difficult to re-enter the vessel true lumen. Devices for reentering a vessel true lumen from a subintimal location are described in WO 02/45598 which is hereby incorporated by reference.
BRIEF SUMMARY OF THE INVENTION
Various aspects of the invention are directed to methods and devices for re- entering a lumen during an endovascular procedure. In one embodiment, the device has a cutter, an opening, and an energy emitter coupled to the cutter. The device is advanced into the subintimal space and energy is then emitted from the energy emitter to locate the true lumen. In one aspect, the energy emitter and cutting element are moved together which exposes the cutting element to cut an access path into the true lumen. In another aspect of the present invention, the device may have a bendable tip which is bent while cutting tissue to
create the access path or may be bent to direct the device or a guidewire through the access path.
In another aspect of the present invention, the device has a rotatable cutting element which may be moved from a stored position to a cutting position which exposes over 180 degrees, and even 220 or even 270 degrees of the cutting element relative to the axis of rotation. In another aspect of the invention, the cutter may be gradually exposed as necessary. In still another aspect of the present invention, the body of device may be wider along a portion of the device to urge tissue toward the cutting element. The opening is relatively large and may be open at the distal end and may expose at least part of the cutter at all positions distal to the opening. The open end of the device permits the tissue to naturally move toward the cutter due to the generally open nature of the distal end.
In still another aspect of the present invention, a system for accessing a subintimal space includes a catheter through which the tissue cutting device is advanced. The catheter may be coupled to a fluid source to inject contrast or the like and may also be coupled to a pressure monitor for monitoring pressure to determine when the access path has been created as described in greater detail below.
In a still further aspect of the invention, a method of entering a true lumen from a false lumen during an endovascular procedure is provided. A guidewire is positioned in the subintimal space. A reentry device is then advanced over the guidewire to the target location in the subintimal space. The access path is then created using the reentry device to cut the access path. The same guidewire is then directed through the access path. The reentry device may have two different openings with the first being used during advancement of the reentry device and a second opening through which the guidewire extends when being directed through the access path. The first opening may be configured to direct the guidewire substantially longitudinal while the second opening directs the guidewire at an angle relative to the longitudinal axis.
The present invention is also directed to a device for cutting tissue which automatically adjusts the position of the tissue cutting element in response to changes in vessel size. The device has a sizer coupled to the body which moves in response changes in vessel size. The sizer is coupled to the tissue cutting element so that the tissue cutting element changes position relative to the body when the vessel size changes. When the vessel size decreases, the tissue cutting element is moved to expose more of the cutting element. When the vessel size increases, the cutting element is moved to expose less of the cutting
element. The term vessel size as used herein is used to generally describe a lateral dimension of the vessel.
These and other aspects of the invention will become apparent from the following description, drawings and claims.
BRIEF DESCRIPTION OF THE DRAWINGS
Fig. 1 shows a view of the system of the present invention.
Fig. 2 shows a guidewire positioned proximate to a total occlusion.
Fig. 3 shows a subintimal space created adjacent a true lumen by the . guidewire.
Fig. 4 shows a reentry device of the present invention advanced over the guidewire to the subintimal space.
Fig. 5 shows a guidewire positioned in the true lumen.
Fig. 6 shows the reentry device with the cutting element in a stored position.
Fig. 7 shows the reentry device with the cutting element in a cutting position.
Fig. 8 is a side view of the reentry device of Fig. 7.
Fig. 9 shows another reentry device with the cutting element in a stored position.
Fig. 10 shows the reentry device of Fig. 9 with the cutting element in a cutting position and the distal portion bent.
Fig. 1 1 shows the reentry device of Figs. 9 and 10 with the cutting element advanced to another cutting position which exposes even more of the cutting element and also bends the distal tip further.
Fig. 12 shows another reentry device which has a bendable distal portion.
Fig. 13 shows the reentry device of Fig. 12 with the distal portion bent.
Fig. 14 shows still another reentry device with a cutting element which may be tilted.
Fig. 15 shows the reentry device of Fig. 14 with the cutting element tilted to expose more of the cutting element and to move the cutting element through the opening in the body of the device.
Fig. 16 shows the reentry device of Fig. 6 having a junction leading to two separate guidewire outlets with the guidewire positioned in the first outlet during advancement of the device over the guidewire.
Fig.17 shows the reentry device of Fig. 16 with the guidewire extending through the second outlet for directing the guidewire into the true lumen.
Fig. 18 shows a catheter having a lumen for receiving a guidewire and another lumen which receives the reentry device.
Fig. 19 shows another catheter having a single lumen through which the guidewire and reentry device pass.
Fig. 20 shows an external view of another device for cutting tissue having a sizer.
Fig. 21 shows another external view of the device of Fig. 20.
Fig. 22 is a cross-sectional view of the device of Figs. 20 and 21.
Fig. 23 is a cross-sectional view of the device of Figs. 20 and 21 with the sizer moved inward.
DETAILED DESCRIPTION OF THE INVENTION Referring to Figs. 1 -8, a system 2 and device 4 for reentering a true lumen from a subintimal space, dissection plane or so-called false lumen is shown. The device 4 includes a cutting element 6 coupled to a torque transmitting element 8, such as a wire 10, which rotates the cutting element 6. The device 4 has an opening 12 at a distal end 14 with the cutting element 6 movable between a stored position (Fig. 6) and a cutting position (Figs. 7 and 8) which exposes the cutting element 6. The cutting element 6 may be any suitable cutting element 6 such as the cutting element 6 described in patents incorporated by reference above. The cutting element 6 has a circular cutting edge which has a diameter of about 1 mm although any suitable size may be used depending upon the particular application. The cutting element 6 may also be any other type of cutter such as a laser, ultrasound, RF or other type of cutter without departing from various aspects of the present invention.
The device 4 has a flexible body 16 to navigate through blood vessels or other body lumens to a target location. The body 16 may be made of any suitable material as is known in the art such as Pebax. The torque transmitting element 8 extends through a lumen 18 in the body 16. The body 16 may have more lumens for various reasons such as introduction of fluids, such as contrast, or for delivery of another device 4 such as a guidewire or interventional device. The torque transmitting element 8 is coupled to a driver 20 which rotates the torque transmitting element 8 at a variable or fixed speed.
The device 4 may also have an energy emitting element 22, such as an ultrasound element 25, which emits (and may receive) energy to determine the location of the
true lumen as explained below. The energy emitting element 22 is coupled to the cutting element 6 so that the energy emitting element 22 and cutting element 6 are rotated together. The cutting element 6 is in the stored position when locating the true lumen so that the cutting element 6 is not exposed and will not cut or damage tissue. The energy emitting element 22 is positioned adjacent a window 24 which may be a side opening 26 or may simply be a portion of the sidewall which transmits a sufficient amount of the energy therethrough. Any suitable energy emitting element 22 may be used such as the ultrasound emitting element available from Boston Scientific and is marketed under the name Atlantis™. The cutting element 6 may be mounted to a collar which is then mounted to an ultrasound element holder 28 or the cutting element 6 may be integrally formed with the ultrasound element holder 28.
The device 4 has an atraumatic tip 34 which is relatively flexible to prevent damaging tissue. The tip 34 may be a separate piece laminated or glued to the body 16. The tip 34 is preferably made out of a relatively soft, flexible material, such as tecothane, and may be used for blunt dissection as necessary. A reinforcing element 36 is encapsulated in the tip 34 to help the tip 34 maintain its general shape. The tip 34 may also have one or more guidewire lumens 38 or any of the guidewire features described herein.
The opening 12 in the distal portion may be designed to expose over 180 degrees of the cutting element 6 and may even expose 220 degrees or even 270 degrees of the cutting element 6 as defined by the axis of rotation. This provides advantages over WO 02/45598 which does not expose much of the cutting element 6 and requires invagination of the tissue within the opening to cut tissue. In another aspect of the invention, the cutting element 6 may be gradually exposed. For example, the cutting element 6 may be gradually exposed from 180-220 degrees or even 200-270 degrees. As explained below, this feature provides the user with the ability to change the amount of cutter 6 that is exposed depending upon the tissue thickness between the subintimal location and true lumen. The term opening 12 and amount of exposure of the cutting element 6 are defined by the outer bounds of the opening 12 and the axis of rotation. Referring to Figs. 7 and 8, the cutting element 6 is exposed relative to the outer bounds of the opening 12 due to the relatively open distal end- Referring to Figs. 9-11, another device 4A for reentering a true lumen from a subintimal location is shown wherein the same or similar reference numbers refer to the same or similar structure. The device 4A also has an opening 12A at the distal end to expose the cutting element 6 A. Fig. 9 shows the cutting element 6A in a stored position, Fig. 10 shows the cutting element 6A in a first cutting position and Fig. 1 1 shows the cutting element 6A in
a second cutting position which further exposes the element 6A. The device 4A also has the window 24 through which the energy emitting element 22, such as the ultrasound element, may emit energy when the cutting element 6A is in the stored position.
A distal portion 40 of the body can bend or articulate to further expose the cutting element 6 A and to move the cutting element 6A toward true lumen. The body has slots 42 formed therein to increase the flexibility of the distal portion 40. The cutting element 6A has a surface 44 which engages a lip 46 on the body. As the cutting element 6A is advanced, the interaction between the surface 44 and lip 46 causes the distal portion 40 to deflect. Bending the distal portion 40 can be helpful in moving the cutting element 6A toward the tissue and may also expose more of the cutting element 6A. As also explained below, the tip 40 may also be bent to direct the device 4A itself or a guidewire into the true lumen. The cutting element 6A may also be gradually exposed as the cutting element 6A moves distally and may be gradually exposed in the same manner described above.
Referring to Figs. 12 and 13, another reentry device 4B is shown which has a distal portion or tip 60 which bends or articulates. The tip 60 may be articulated and actuated in any suitable manner. For example, the tip 60 may be bent upon longitudinal movement of the cutting element 6 (as shown above) or a separate actuator, such as a pull wire 62, may be used. As can be appreciated from Fig. 13, the tip 60 is bent or articulated to move the cutting element 6 toward the true lumen and to expose more of the cutting element 6. The device 4B may also be bent to direct the device 4B itself or another device or guidewire through the guidewire lumen 38 to the access path into the true lumen as described further below.
Referring to Figs. 14 and 15, still another device 4C for cutting tissue is shown wherein the same or similar numbers refer to the same or similar structure. The device 4C includes a cutting element 6C, an energy emitting element 22C and a torque transmitter 8C for rotating the elements. The device 4C has an opening 64 along one side. The cutting element 6C is contained within the opening 64 in the stored position of Fig. 14 and extends out of the opening 64 in the cutting position of Fig. 15. The cutting element 6C is moved out of the window 24 using an actuator 68, such as a wire 70, which tilts a bearing 72 supporting the shaft of the rotatable cutting element 6C. Of course, any other suitable structure may be used to move the cutting element 6C outside the opening 64 such as those described in U.S. Patent No. 6,447,525 which is hereby incorporated by reference. Furthermore, the cutting element 6C may be moved out of the opening 64 by bending the distal portion or tip as described herein.
Use of the devices 4, 4A-C is now described with reference to the device 4 although it is understood that any of the devices 4, 4A-C may be used. As mentioned above, the device 4 may be used to perform any suitable procedure to cut from one location to another in the body such as a procedure to reenter a true lumen. The device 4 is initially advanced to a position within a subintϊmal space SS. As described above, the subintimal space SS may be inadvertently created during an endovascular procedure with a guidewire GW or other device creating the subintimal space SS as shown in Figs. 2 and 3. The device 4 may be introduced over the same guidewire GW or device which created the subintimal space SS as shown in Figs. 4 and 5. Of course, the device 4 may also be advanced over the guidewire GW to a position proximate to the subintimal space SS after which the device 4 is then advanced by itself into the subintimal space SS.
After the device 4 is positioned at the appropriate location in the subintimal space SS, the energy emitting element 22 is used to determine the location of the true lumen. When using the ultrasound element 28, for example, the ultrasound element 28 is rotated while emitting ultrasound energy and the energy emitted through the window 24 and reflected back through the window 24 is processed as is known in the art. The entire device 4 is rotated within the subintimal space SS to orient the window 24 until the true lumen is located. The angular orientation of the device 4 is then maintained so that the opening 12 and window 24 are directed toward the true lumen.
The cutting element 6 is then moved to the cutting position to expose the cutting element 6. The cutting element 6 may be rotated with the driver 20 during this time so that cutting is initiated as the cutting element 6 is exposed. In another aspect of the invention, the entire device 4 itself may be moved through the subintimal space to cut tissue. This provides advantages over the method of WO 02/45598 which requires invagination of tissue through a window to attempt a cut at one location. If the tissue does not invaginate sufficiently into the window, such as when the tissue is too thick, the device of WO 02/45598 will not be able to cut completely through the tissue to create the access path to the true lumen. The user must then move the device and again attempt to invaginate enough tissue to cut an access path. The present invention provides the ability to move the entire device 4 through the subintimal space to create the access path rather than attempting a cut at a single discrete location as in WO 02/45598. Of course, the device 4 may also be used by moving only the cutting element 6 rather than the entire device 4 without departing from the invention.
The cutting element 6 may also be exposed to varying degrees, as described above, until enough of the cutting element 6 is exposed to cut through to the true lumen. For example, the user may choose to expose half of the cutting element 6 and attempt to create an access path to the true lumen. If an access path is not created, the user may then choose to expose more of the cutting element 6 and again attempt to create an access path. This procedure can be repeated until the access path is formed to the true lumen. The device 4A, 4B may be also have a distal tip or portion 40, 60 which bends to move the cutting element 6 toward the tissue and/or expose more of the cutting element 6 during cutting.
After successfully creating the access path into the true lumen, the device 4 itself or part thereof may be directed toward or through the access path. Referring to Fig. 9- 13, for example, the distal portion or tip 40, 60 may be bent to help direct the device 4A, 4B itself or the guidewire GW through the access path.
Referring to Figs. 16 and 17, another device 4D, similar to device 4, is shown which has a guidewire lumen 74 having a junction 76 so the guidewire can be directed through either a first lumen 77 having a first outlet 78 or a second lumen 19 having a second outlet 80. The first outlet 78 directs the guidewire substantially longitudinally for advancing the device 4D over the guidewire to the target area in a conventional manner. The second outlet 80 directs the guidewire at an angle relative to the longitudinal axis, such as 30-75 degrees, to direct the guidewire through the access path into the true lumen.
The junction 76 may include a feature which directs the guidewire into the second outlet 80. Referring to Fig. 17, for example, the junction 76 may include a flap or stop 82 which closes and prevents or inhibits the guidewire from passing through the first outlet 78 after the guidewire has been withdrawn proximal to the junction 76. When the guidewire is advanced again as shown in Fig. 17, the guidewire passes through the second outlet 80 due to the stop 82. The device 4 and/or guidewire GW are then manipulated to direct the guidewire GW through the access path. Although the stop 82 may be provided, the junction 76 may also simply be a relatively open junction 76 with the user manipulating and rotating the guidewire GW to direct the guidewire GW through the desired outlet 78, 80. The device is rotated about 180 degrees after creating the access path to direct the GW through outlet 80 and into the true lumen.
Referring to Figs. 18 and 19, the system 2 may also include a sheath or catheter 90 which is advanced proximal to the treatment site. The sheath 90 may help provide better control of the guidewire GW and devices 4 of the present invention during manipulation in the subintimal space. The sheath 90 may also used to deliver contrast
solution to the treatment site from a source of contrast 97 (see Fig. 1 ) or may be coupled to a pressure sensor 94. The pressure sensor 94 may be part of the contrast delivery system 97 or may be a separate component. Deliver of contrast and/or pressure monitoring may be used to determine when the access path has been created.
The sheath 90 may include only one lumen 92 with fluid delivery and pressure sensing being accomplished in the annular space between the device and sheath as shown in Fig. 19. The sheath 90 may also have first and second lumens 96, 98 for separate delivery of the device 4 and guidewire GW. As mentioned above, the devices 4 of the present invention may be advanced over the same guidewire or device that created the subintimal space or may be advanced over another guidewire or even through the sheath 90 by itself.
After accessing the true lumen, another interventional device may be introduced into the true lumen for the intended therapy or procedure. For example, a stent catheter, angioplasty catheter, or atherectomy device may be used to treat the occlusion. The present invention has been described for reentering a true lumen from a subintimal space but, of course, may be used for other purposes to gain access from one space to another anywhere within the body.
Referring to Figs. 20-23, another device 100 for cutting tissue is shown wherein the same or similar reference numbers refer to the same or similar structure. The device 100 includes an elongate body 116 and a cutting element 106 coupled to a drive element 108 which is rotated to drive the cutting element 106. The drive element 108 extends through a lumen 118 in the body 1 16 and is driven by a driver (not shown) at the proximal end. The cutting element 106 may be any suitable cutting element 106 including those described in the applications incorporated herein. The cutting element 106 has an essentially circular cutting surface 107 along the leading edge of the cutting element 106.
The body 116 has an opening 112 therein and the tissue cutter 106 is movable from the stored position of Figs. 20 and 22 to the cutting position of Fig. 23. When moved to the cutting position of Fig. 23, part of the tissue cutting element 116 becomes exposed relative to opening 112. The opening 112 may be a side opening as shown in Figs. 20-23 or may be a distal opening as shown in other devices described herein such as the devices of Figs. 1-19. The tissue cutting element 106 moves relative to the body 1 16 so that a cutting height 1 17 of the tissue cutting element 106 changes as the position of the cutting element changes relative to the body 116. The cutting height 117 is defined by a maximum distance from the cutting surface 107 to an outer surface 109 of the body 116.
The device 100 has a sizer 119 coupled to the body 1 16 which automatically adjusts the cutting height 117 based on vessel size. The sizer 1 19 is naturally biased to an outer position of Fig. 22 by a spring 122 which defines a maximum width of the device along the sizer 119. The sizer 119 is moved inward from the position of Fig. 22 when contact with the vessel wall overcomes the force biasing the sizer 1 19 outward. In simplistic terms, the sizer 1 19 is essentially moved inward by the vessel wall when the vessel size is smaller than the width of the device 100. Thus, the sizer 119 moves between the positions of Figs. 22 and 23 as the diameter of the vessel varies within a given range. When the vessel diameter is larger than the diameter of the device 100, the tissue cutting element 106 will remain in the stored position of Fig. 22. Stated another way, the sizer 1 19 is coupled to the tissue cutting element 106 so that an outward force is applied to the tissue cutting element 106 when the sizer 119 moves inward. The outward force on the tissue cutting element 106 being directed away from the body 1 16.
The sizer 119 is coupled to the tissue cutting element 106 so that the amount of exposure of the cutting element, such as the cutter height 1 17, changes when the vessel diameter changes. In the embodiment of Fig. 16, the exposure of the tissue cutting element 106 is increased when the vessel diameter decreases so that a deeper cut is made in smaller vessels. A deeper cut may be desired when removing tissue in smaller vessels to increase the flow of blood through the vessel. The user may still move the tissue cutting element 106 to the cutting position of Fig. 23 by pulling on the drive element 108 so that a contact surface 123 on the sizer 1 19 engages a ramp 126 on an inner wall 128 of the body 116 to move the cutting element 106 to the position of Fig. 23.
The tissue cutting device 100 may be used to cut tissue for any purpose. Furthermore, the device 100 has been described in connection with cutting tissue in blood vessels but may be used for any other purpose in the vasculature. The tissue may be cut and left within the body or may be removed in any suitable manner. For example, the device 100 may include a tissue collection chamber 130 coupled to the body 116 distal to the cutting element 106. The tissue cutting element 106 cuts tissue and directs the tissue into the collection chamber 130. The tissue cut by the tissue cutting element 106 is parted off from the surrounding tissue by moving the cutting element 106 back to the stored position.
The present invention has been described in connection with the preferred embodiments, however, it is understood that numerous alternatives and modifications can be made within the scope of the present invention as defined by the claims.
Claims
1 . A device for cutting tissue at a vascular location, comprising: an elongate body having an outer surface; a tissue cutting element having a cutting surface, the tissue cutting element being coupled to the elongate body and movable relative to the body to a plurality of operating positions, wherein an amount of exposure of the tissue cutting element changes in the plurality of operating positions; and a sizer coupled to the body and movable relative to the body, the sizer being biased outward from the body to an outer position and being movable inward from the outer position, the sizer being operatively coupled to the tissue cutting element so that the tissue cutting element is in one of the plurality of different operating positions in response to a position of the sizer.
2. The device of claim 1, wherein: the sizer automatically moves in response to a change in the size of the vascular location in which the tissue cutting device is positioned.
3. The device of claim 1, wherein: the tissue cutting element is movable relative to the body so that a cutting height of the tissue cutting element changes in each of the plurality of operating positions, the cutting height being a maximum distance from the cutting surface to the outer surface of the body.
4. The device of claim 3, wherein: the cutting height of the tissue cutting element increases when the sizer moves inward in response to a decrease in size of the vascular location.
5. The device of claim 3, wherein: the cutting height of the tissue cutting element decreases when the sizer moves outward in response to an increase in size of the vascular location.
H
6. The device of claim 1 , wherein: the body has an opening; and the tissue cutting element moves relative to the opening in response to the position of the sizer, the tissue cutting element being movable relative to the opening to change an amount of the tissue cutting element exposed through the opening.
7. The device of claim 1 , further comprising: a tissue collection element coupled to the body, the tissue collection element being positioned distal to the tissue cutting element.
8. The device of claim 7, wherein: the body has an opening therein; the tissue cutting element rotates during cutting, the tissue cutting element configured to direct tissue into the opening and distally into the tissue collection element when the tissue cutting element and the opening are moved together.
9. The device of claim 1, wherein: the sizer is biased outward to an outermost position, the outermost position defining a maximum width of the device along the sizer, the sizer being moved inwardly by contact with the vascular location when the size of the vascular location is smaller than the maximum width.
10. A method of cutting tissue at a vascular location, comprising the steps of: providing a tissue cutting device having an elongate body with an outer surface, a tissue cutting element, and a sizer, the tissue cutting element being coupled to the elongate body and being movable relative to the body to a plurality of different operating positions relative to the body, the sizer also being movable relative to the body in response to a size of a vascular location in which the tissue cutting device is positioned, the sizer being operatively coupled to the tissue cutting element so that the tissue cutting element is in one of the plurality of different operating positions in response to a position of the sizer; advancing the tissue cutting device through a blood vessel; positioning the tissue cutting device at a vascular location, the sizer moving relative to the body in response to the size of the vascular location and the tissue cutting element moving relative to the body in response to movement of the sizer; and cutting tissue with the tissue cutting element.
1 1. The method of claim 10, wherein: the positioning step is carried out with the sizer automatically moving in response to a change in the size of the vascular location in which the tissue cutting device is positioned.
12. The method of claim 10, wherein: the providing step is carried out with the tissue cutting element being movable relative to the body so that a cutting height of the tissue cutting element changes in each of the plurality of operating positions, the cutting height being a maximum distance from the cutting surface to the outer surface of the body.
13. The method of claim 12, wherein: the providing step is carried out with the cutting height of the tissue cutting element increasing when the sizer moves inward in response to a decrease in size of the vascular location.
14. The method of claim 12, wherein: the providing step is carried out with the cutting height of the tissue cutting element decreasing when the sizer moves outward in response to an increase in size of the vascular location.
15. The method of claim 10, wherein: the providing step is carried out with the body having an opening, the tissue cutting element being movable relative to the opening so that an amount of the tissue cutting element exposed through the opening is dependent upon a position of the sizer.
16. The method of claim 10, wherein: the providing step is carried out with the elongate body having an opening; the cutting step being carried out with the tissue cutting element directing the tissue through the opening.
17. The method of claim 10, wherein: the cutting step is carried out by moving the tissue cutting element and the opening together, the tissue cutting element being rotated during cutting.
18. The method of claim 17, wherein: the providing step is carried out with the tissue cutting device having a tissue collection element, the tissue collection element being positioned distal to the tissue cutting element; the cutting step is carried out with the tissue cutting element being moved distally, the tissue cutting element directing the tissue distally into the tissue collection element as the tissue cutting element moves distally.
19. The method of claim 10, wherein: the providing step is carried out with the sizer being biased outward to an outermost position, the outermost position defining a maximum width of the device defined along the sizer; the cutting step being carried out with the sizer being moved inward by contact with the vascular location when the size of the vascular location is smaller than the maximum width of the device.
20. A device for cutting tissue at a vascular location, comprising: an elongate body having an outer surface; a tissue cutting element coupled to the elongate body, the tissue cutting element being movable relative to the body between a stored position and an operating position, the tissue cutting element having a cutting surface which cuts tissue; and a sizer coupled to the body and movable relative to the body, the sizer being naturally biased outward from the body to an outer position and being movable inward from the outer position, the sizer being coupled to the tissue cutting element so that an outward force is applied to the tissue cutting element when the sizer moves inward from the outer position, the outward force applied to the tissue cutting element being directed away from the body.
21. The device of claim 20, wherein: the tissue cutting element is movable to a plurality of operating positions, wherein an amount of exposure of the tissue cutting element changes in the plurality of operating positions.
22. The device of claim 20, wherein: the sizer automatically moves in response to a change in the size of the vascular location in which the tissue cutting device is positioned.
23. The device of claim 20, wherein: the tissue cutting element is movable relative to the body so that a cutting height of the tissue cutting element changes in each of the plurality of operating positions, the cutting height being a maximum distance from the cutting surface to the outer surface of the body.
24. The device of claim 23, wherein: the cutting height of the tissue cutting element increases when the sizer moves inward in response to a decrease in size of the vascular location.
25. The device of claim 23, wherein: the cutting height of the tissue cutting element decreases when the sizer moves outward in response to an increase in size of the vascular location.
26. The device of claim 20, wherein: the body has an opening; and the tissue cutting element being movable relative to the opening in response to the position of the sizer, the tissue cutting element being movable relative to the opening to change an amount of the tissue cutting element exposed through the opening.
27. The device of claim 20, further comprising: a tissue collection element coupled to the body, the tissue collection element being positioned distal to the tissue cutting element; the tissue cutting element being rotatable relative to the body and being rotated during cutting, the tissue cutting element configured to direct tissue distally into the tissue collection element when the tissue cutting element is moved distally.
28. The device of claim 20, wherein: the sizer is naturally biased outward to an outermost position, the outer most position defining a maximum lateral dimension of the device along the sizer, the sizer being deflected inwardly by contact with the vascular location when the lateral size of the vascular location is smaller than the maximum lateral dimension.
29. A method of cutting tissue at a vascular location, comprising the steps of: providing a tissue cutting device including an elongate body having an outer surface, a tissue cutting element having a cutting surface, and a sizer, the tissue cutting element being coupled to the elongate body and being movable relative to the body between a stored position and an operating position; the sizer also being coupled to the body and being movable relative to the body, the sizer moving relative to the body in response to a size of vascular location in which the tissue cutting device is positioned, the sizer being coupled to the tissue cutting element so that an outward force is applied to the tissue cutting element when the sizer is moved inward, the outward force on the tissue cutting element being directed away from the body; advancing the tissue cutting device through a blood vessel; positioning the tissue cutting device at a vascular location, the sizer moving relative to the body in response to the lateral size of the vascular location, the outward force on the tissue cutting element being applied to the tissue cutting element when the sizer moves inward relative to the body; and cutting tissue with the tissue cutting element.
30. The method of claim 29, wherein: the positioning step is carried out with the sizer automatically moving in response to a change in the lateral size of the vascular location in which the tissue cutting device is positioned.
31 . The method of claim 29, wherein: the providing step is carried out with the tissue cutting element being movable to a plurality of operating positions, the tissue cutting element being exposed to varying degrees in the plurality of operating positions.
32. The method of claim 31, wherein: the providing step is carried out with the tissue cutting element being movable relative to the body so that a cutting height of the tissue cutting element changes in each of the plurality of operating positions, the cutting height being a maximum distance from the cutting surface to the outer surface of the body.
33. The method of claim 31, wherein: the providing step is carried out with the cutting height of the tissue cutting element increasing when the sizer moves inward in response to a decrease in size of the vascular location.
34. The method of claim 29, wherein: the providing step is carried out with the cutting height of the tissue cutting element decreasing when the sizer moves outward in response to an increase in size of the vascular location.
35. The method of claim 29, wherein: the providing step is carried out with the body having an opening, the tissue cutting element being movable relative to the opening so that an amount of the tissue cutting element exposed through the opening is dependent upon a position of the sizer.
36. The method of claim 29, wherein: the providing step is carried out with the tissue cutting element moves laterally relative to the body when moving to the operating position.
37. The method of claim 29, wherein: the cutting step is carried out by moving the tissue cutting element and the opening together.
38. The method of claim 37, wherein: the providing step is carried out with the tissue cutting device having a tissue collection element, the tissue collection element being positioned distal to the tissue cutting element; and the cutting step is carried out with the tissue cutting element being moved distally, the tissue cutting element directing the tissue distally into the tissue collection element as the tissue cutting element moves distally.
39. The method of claim 29, wherein: the providing step is carried out with the sizer being biased outward to an outermost position, the outermost position defining a maximum width of the device along the sizer; the cutting step being carried out with the sizer being moved inward by contact with the vascular location when the size of the vascular location is smaller than the maximum width.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP07809112.1A EP2019634B1 (en) | 2006-05-18 | 2007-05-18 | Devices for cutting tissue at a vascular location |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/437,849 | 2006-05-18 | ||
US11/437,849 US8246640B2 (en) | 2003-04-22 | 2006-05-18 | Methods and devices for cutting tissue at a vascular location |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2008020905A2 true WO2008020905A2 (en) | 2008-02-21 |
WO2008020905A3 WO2008020905A3 (en) | 2008-11-06 |
Family
ID=39082496
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2007/012008 WO2008020905A2 (en) | 2006-05-18 | 2007-05-18 | Methods and devices for cutting tissue at a vascular location |
Country Status (3)
Country | Link |
---|---|
US (3) | US8246640B2 (en) |
EP (1) | EP2019634B1 (en) |
WO (1) | WO2008020905A2 (en) |
Families Citing this family (82)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6299622B1 (en) | 1999-08-19 | 2001-10-09 | Fox Hollow Technologies, Inc. | Atherectomy catheter with aligned imager |
US8328829B2 (en) | 1999-08-19 | 2012-12-11 | Covidien Lp | High capacity debulking catheter with razor edge cutting window |
US7713279B2 (en) | 2000-12-20 | 2010-05-11 | Fox Hollow Technologies, Inc. | Method and devices for cutting tissue |
US7887556B2 (en) | 2000-12-20 | 2011-02-15 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
US7708749B2 (en) | 2000-12-20 | 2010-05-04 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
ATE499054T1 (en) | 2000-12-20 | 2011-03-15 | Fox Hollow Technologies Inc | REDUCTION CATHETER |
US8246640B2 (en) | 2003-04-22 | 2012-08-21 | Tyco Healthcare Group Lp | Methods and devices for cutting tissue at a vascular location |
US20070276419A1 (en) | 2006-05-26 | 2007-11-29 | Fox Hollow Technologies, Inc. | Methods and devices for rotating an active element and an energy emitter on a catheter |
US8784440B2 (en) | 2008-02-25 | 2014-07-22 | Covidien Lp | Methods and devices for cutting tissue |
US8548571B2 (en) | 2009-12-08 | 2013-10-01 | Avinger, Inc. | Devices and methods for predicting and preventing restenosis |
US20100125253A1 (en) * | 2008-11-17 | 2010-05-20 | Avinger | Dual-tip Catheter System for Boring through Blocked Vascular Passages |
US8062316B2 (en) | 2008-04-23 | 2011-11-22 | Avinger, Inc. | Catheter system and method for boring through blocked vascular passages |
US9125562B2 (en) | 2009-07-01 | 2015-09-08 | Avinger, Inc. | Catheter-based off-axis optical coherence tomography imaging system |
KR101645754B1 (en) | 2008-10-13 | 2016-08-04 | 코비디엔 엘피 | Devices and methods for manipulating a catheter shaft |
WO2010129075A1 (en) | 2009-04-28 | 2010-11-11 | Avinger, Inc. | Guidewire support catheter |
CN102625673B (en) | 2009-04-29 | 2014-12-24 | 泰科保健集团有限合伙公司 | Methods and devices for cutting and abrading tissue |
AU2010248909B2 (en) | 2009-05-14 | 2013-03-21 | Covidien Lp | Easily cleaned atherectomy catheters and methods of use |
CA2763324C (en) | 2009-05-28 | 2018-10-23 | Avinger, Inc. | Optical coherence tomography for biological imaging |
EP2448502B1 (en) * | 2009-07-01 | 2022-04-06 | Avinger, Inc. | Atherectomy catheter with laterally-displaceable tip |
US20110087258A1 (en) * | 2009-10-14 | 2011-04-14 | Sluss Robert K | Cannulated arthroscopic knife |
AU2010326063B2 (en) | 2009-12-02 | 2013-07-04 | Covidien Lp | Methods and devices for cutting tissue |
JP5511107B2 (en) | 2009-12-11 | 2014-06-04 | コヴィディエン リミテッド パートナーシップ | Substance removal device and method with improved substance capture efficiency |
US9119662B2 (en) | 2010-06-14 | 2015-09-01 | Covidien Lp | Material removal device and method of use |
JP2013531542A (en) | 2010-07-01 | 2013-08-08 | アビンガー・インコーポレイテッド | An atherectomy catheter having a longitudinally movable drive shaft |
WO2014039099A1 (en) | 2012-09-06 | 2014-03-13 | Avinger, Inc. | Balloon atherectomy catheters with imaging |
WO2014039096A1 (en) | 2012-09-06 | 2014-03-13 | Avinger, Inc. | Re-entry stylet for catheter |
US11382653B2 (en) | 2010-07-01 | 2022-07-12 | Avinger, Inc. | Atherectomy catheter |
PT105255A (en) * | 2010-08-18 | 2012-02-20 | Jose Dinis Carmo | SURGICAL CUTTING INSTRUMENT FOR PRECISION CUTTING |
US8932315B2 (en) | 2010-10-18 | 2015-01-13 | W. L. Gore & Associates, Inc. | Systems and methods for percutaneous occlusion crossing |
CA2815186C (en) | 2010-10-28 | 2015-12-29 | Covidien Lp | Material removal device and method of use |
AU2011326420B2 (en) | 2010-11-11 | 2014-11-27 | Covidien Lp | Flexible debulking catheters with imaging and methods of use and manufacture |
US9949754B2 (en) | 2011-03-28 | 2018-04-24 | Avinger, Inc. | Occlusion-crossing devices |
WO2012145133A2 (en) | 2011-03-28 | 2012-10-26 | Avinger, Inc. | Occlusion-crossing devices, imaging, and atherectomy devices |
US8992717B2 (en) | 2011-09-01 | 2015-03-31 | Covidien Lp | Catheter with helical drive shaft and methods of manufacture |
WO2013059363A1 (en) * | 2011-10-17 | 2013-04-25 | Avinger, Inc. | Atherectomy catheters and non-contact actuation mechanism for catheters |
EP2775945B1 (en) * | 2011-11-11 | 2019-05-08 | Avinger, Inc. | Occlusion-crossing devices, atherectomy devices, and imaging |
US9345406B2 (en) | 2011-11-11 | 2016-05-24 | Avinger, Inc. | Occlusion-crossing devices, atherectomy devices, and imaging |
EP2849660B1 (en) | 2012-05-14 | 2021-08-25 | Avinger, Inc. | Atherectomy catheter drive assemblies |
EP2849661B1 (en) | 2012-05-14 | 2020-12-09 | Avinger, Inc. | Atherectomy catheters with imaging |
EP2849636B1 (en) | 2012-05-14 | 2020-04-22 | Avinger, Inc. | Optical coherence tomography with graded index fiber for biological imaging |
US9456842B2 (en) * | 2012-07-13 | 2016-10-04 | Boston Scientific Scimed, Inc. | Wire-guided recanalization system |
US9498247B2 (en) | 2014-02-06 | 2016-11-22 | Avinger, Inc. | Atherectomy catheters and occlusion crossing devices |
US11284916B2 (en) | 2012-09-06 | 2022-03-29 | Avinger, Inc. | Atherectomy catheters and occlusion crossing devices |
US9579157B2 (en) | 2012-09-13 | 2017-02-28 | Covidien Lp | Cleaning device for medical instrument and method of use |
US9943329B2 (en) | 2012-11-08 | 2018-04-17 | Covidien Lp | Tissue-removing catheter with rotatable cutter |
US9636139B2 (en) * | 2012-12-12 | 2017-05-02 | Covidien Lp | Tissue-removing catheter with ball and socket deployment mechanism |
US9272121B2 (en) * | 2013-03-13 | 2016-03-01 | Invatec S.P.A. | Side lumen reentry catheters and related methods |
WO2014143064A1 (en) | 2013-03-15 | 2014-09-18 | Avinger, Inc. | Chronic total occlusion crossing devices with imaging |
US10932670B2 (en) | 2013-03-15 | 2021-03-02 | Avinger, Inc. | Optical pressure sensor assembly |
US11096717B2 (en) | 2013-03-15 | 2021-08-24 | Avinger, Inc. | Tissue collection device for catheter |
EP3019096B1 (en) | 2013-07-08 | 2023-07-05 | Avinger, Inc. | System for identification of elastic lamina to guide interventional therapy |
US9308356B2 (en) | 2013-07-29 | 2016-04-12 | Invatec S.P.A. | Occlusion bypassing apparatuses and methods for bypassing an occlusion in a blood vessel |
US9301777B2 (en) | 2013-07-29 | 2016-04-05 | Invatec S.P.A. | Occlusion bypassing apparatuses and methods for bypassing an occlusion in a blood vessel |
US9364642B2 (en) | 2013-08-14 | 2016-06-14 | Invatec S.P.A. | Balloon catheter systems and methods for bypassing an occlusion in a blood vessel |
US9320874B2 (en) | 2013-08-15 | 2016-04-26 | Invatec S.P.A. | Catheter systems with a blocking mechanism and methods for bypassing an occlusion in a blood vessel |
US9526519B2 (en) * | 2014-02-03 | 2016-12-27 | Covidien Lp | Tissue-removing catheter with improved angular tissue-removing positioning within body lumen |
US9456843B2 (en) * | 2014-02-03 | 2016-10-04 | Covidien Lp | Tissue-removing catheter including angular displacement sensor |
CN106102608B (en) | 2014-02-06 | 2020-03-24 | 阿维格公司 | Atherectomy catheters and occlusion crossing devices |
US9446222B2 (en) | 2014-03-05 | 2016-09-20 | Invatec S.P.A. | Catheter assemblies and methods for stabilizing a catheter assembly within a subintimal space |
WO2015200702A1 (en) | 2014-06-27 | 2015-12-30 | Covidien Lp | Cleaning device for catheter and catheter including the same |
EP3166512B1 (en) | 2014-07-08 | 2020-08-19 | Avinger, Inc. | High speed chronic total occlusion crossing devices |
US10456557B2 (en) | 2014-08-14 | 2019-10-29 | Invatec S.P.A. | Occlusion bypassing apparatus with varying flexibility and methods for bypassing an occlusion in a blood vessel |
MA40946A (en) | 2014-11-14 | 2017-09-19 | Access Closure Inc | APPARATUS AND METHODS FOR MAKING A VASCULAR PUNCTURE WATERTIGHT |
US10314667B2 (en) | 2015-03-25 | 2019-06-11 | Covidien Lp | Cleaning device for cleaning medical instrument |
US10568520B2 (en) | 2015-07-13 | 2020-02-25 | Avinger, Inc. | Micro-molded anamorphic reflector lens for image guided therapeutic/diagnostic catheters |
US10292721B2 (en) | 2015-07-20 | 2019-05-21 | Covidien Lp | Tissue-removing catheter including movable distal tip |
US10172632B2 (en) | 2015-09-22 | 2019-01-08 | Medtronic Vascular, Inc. | Occlusion bypassing apparatus with a re-entry needle and a stabilization tube |
US10314664B2 (en) | 2015-10-07 | 2019-06-11 | Covidien Lp | Tissue-removing catheter and tissue-removing element with depth stop |
US10327791B2 (en) | 2015-10-07 | 2019-06-25 | Medtronic Vascular, Inc. | Occlusion bypassing apparatus with a re-entry needle and a distal stabilization balloon |
USD865166S1 (en) * | 2015-11-13 | 2019-10-29 | Access Closure, Inc. | Sheath adapter |
EP3407777B1 (en) | 2016-01-25 | 2020-12-30 | Avinger, Inc. | Oct imaging catheter with lag correction |
CN113855176A (en) * | 2016-02-15 | 2021-12-31 | 泰尔茂株式会社 | Medical instrument |
CN108697435B (en) * | 2016-02-15 | 2021-07-30 | 泰尔茂株式会社 | Medical instrument and treatment method |
CN108882948A (en) | 2016-04-01 | 2018-11-23 | 阿维格公司 | Rotary-cut art conduit with zigzag cutter |
WO2017210466A1 (en) | 2016-06-03 | 2017-12-07 | Avinger, Inc. | Catheter device with detachable distal end |
CN109414273B (en) * | 2016-06-30 | 2023-02-17 | 阿维格公司 | Atherectomy catheter with shapeable distal tip |
CN110446469B (en) * | 2017-03-24 | 2023-04-18 | 泰尔茂株式会社 | Medical device |
US10588656B2 (en) | 2017-11-10 | 2020-03-17 | Penumbra, Inc. | Thrombectomy catheter |
EP3946540A4 (en) * | 2019-04-05 | 2023-04-12 | Traverse Vascular, Inc. | Reentry catheters for traversing chronic total occlusions |
EP4044942A4 (en) | 2019-10-18 | 2023-11-15 | Avinger, Inc. | Occlusion-crossing devices |
WO2023278495A2 (en) | 2021-06-28 | 2023-01-05 | Inquis Medical, Inc. | Apparatuses and methods for controlling removal of obstructive material |
CN116019529B (en) * | 2023-03-30 | 2023-07-21 | 杭州启明医疗器械股份有限公司 | Interventional cutting device |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6027514A (en) | 1997-12-17 | 2000-02-22 | Fox Hollow Technologies, Inc. | Apparatus and method for removing occluding material from body lumens |
WO2001015609A1 (en) | 1999-08-31 | 2001-03-08 | Fox Hollow Technologies | Atherectomy catheter with a rotating and telescoping cutter |
WO2002045598A2 (en) | 2000-12-05 | 2002-06-13 | Lumend, Inc. | Catheter system for vascular re-entry from a sub-intimal space |
US20040167554A1 (en) | 2000-12-20 | 2004-08-26 | Fox Hollow Technologies, Inc. | Methods and devices for reentering a true lumen from a subintimal space |
Family Cites Families (590)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US1481078A (en) * | 1922-11-24 | 1924-01-15 | Albertson & Company | Flexible shafting |
US2178790A (en) * | 1938-05-07 | 1939-11-07 | Abner E Henry | Cutting implement |
US2701559A (en) * | 1951-08-02 | 1955-02-08 | William A Cooper | Apparatus for exfoliating and collecting diagnostic material from inner walls of hollow viscera |
US2850007A (en) * | 1956-05-31 | 1958-09-02 | American Cyanamid Co | Biopsy device |
US3064651A (en) * | 1959-05-26 | 1962-11-20 | Henderson Edward | Hypodermic needle |
US3082805A (en) * | 1960-12-21 | 1963-03-26 | John H Royce | Tissue macerator |
US3320957A (en) * | 1964-05-21 | 1967-05-23 | Sokolik Edward | Surgical instrument |
GB1235321A (en) * | 1968-01-30 | 1971-06-09 | Nat Res Dev | Improvements in or relating to drills for clearing obstructions |
US3732858A (en) * | 1968-09-16 | 1973-05-15 | Surgical Design Corp | Apparatus for removing blood clots, cataracts and other objects from the eye |
ES152231Y (en) * | 1969-10-02 | 1970-07-01 | Ballestero Sierra | A PERFECTED TROCAR. |
US3683891A (en) * | 1970-06-26 | 1972-08-15 | Marshall Eskridge | Tissue auger |
US3749085A (en) * | 1970-06-26 | 1973-07-31 | J Willson | Vascular tissue removing device |
US3945375A (en) * | 1972-04-04 | 1976-03-23 | Surgical Design Corporation | Rotatable surgical instrument |
SU442795A1 (en) | 1972-04-27 | 1974-09-15 | Л.С. Юхин | Intravascular Surgery Device |
US3815604A (en) * | 1972-06-19 | 1974-06-11 | Malley C O | Apparatus for intraocular surgery |
US3800783A (en) * | 1972-06-22 | 1974-04-02 | K Jamshidi | Muscle biopsy device |
US3831585A (en) * | 1972-07-19 | 1974-08-27 | T Brondy | Retrograde renal biopsy device |
US3837345A (en) * | 1973-08-31 | 1974-09-24 | A Matar | Venous valve snipper |
US3937222A (en) * | 1973-11-09 | 1976-02-10 | Surgical Design Corporation | Surgical instrument employing cutter means |
US3845375A (en) * | 1973-11-09 | 1974-10-29 | Mclaughlin Ward & Co | Electronic rotational sensor |
US3976077A (en) * | 1975-02-03 | 1976-08-24 | Kerfoot Jr Franklin W | Eye surgery device |
US4007732A (en) * | 1975-09-02 | 1977-02-15 | Robert Carl Kvavle | Method for location and removal of soft tissue in human biopsy operations |
US4038985A (en) * | 1975-10-07 | 1977-08-02 | Medico Developments, Inc. | Device for repairing arteries |
US3995619A (en) * | 1975-10-14 | 1976-12-07 | Glatzer Stephen G | Combination subcutaneous suture remover, biopsy sampler and syringe |
US4020847A (en) * | 1975-11-05 | 1977-05-03 | Clark Iii William T | Rotating cutter catheter |
US4030503A (en) * | 1975-11-05 | 1977-06-21 | Clark Iii William T | Embolectomy catheter |
US4034744A (en) * | 1975-11-13 | 1977-07-12 | Smith Kline Instruments, Inc. | Ultrasonic scanning system with video recorder |
US4177797A (en) * | 1977-03-04 | 1979-12-11 | Shelby M. Baylis | Rotary biopsy device and method of using same |
US4112708A (en) * | 1976-06-21 | 1978-09-12 | Nippon Cable Systems Inc. | Flexible drive cable |
SU665908A1 (en) | 1977-11-09 | 1979-06-05 | Silin Semen A | Device for intravascular surgery |
US4210146A (en) * | 1978-06-01 | 1980-07-01 | Anton Banko | Surgical instrument with flexible blade |
US4306562A (en) * | 1978-12-01 | 1981-12-22 | Cook, Inc. | Tear apart cannula |
JPS5581633A (en) * | 1978-12-15 | 1980-06-19 | Olympus Optical Co | Endoscope |
US4273128A (en) * | 1980-01-14 | 1981-06-16 | Lary Banning G | Coronary cutting and dilating instrument |
US4306570A (en) | 1980-08-20 | 1981-12-22 | Matthews Larry S | Counter rotating biopsy needle |
US4368730A (en) * | 1981-02-12 | 1983-01-18 | Nigel Sharrock | Intravenous catheter |
GB2093353B (en) | 1981-02-25 | 1984-09-19 | Dyonics Inc | A surgical instrument for arthroscopic arthroplasty |
US4436091A (en) * | 1981-03-20 | 1984-03-13 | Surgical Design Corporation | Surgical cutting instrument with release mechanism |
JPS5887494U (en) * | 1981-12-05 | 1983-06-14 | 株式会社モリタ製作所 | Speed control device for small medical motors |
CH660015A5 (en) | 1982-02-01 | 1987-03-13 | Sandoz Ag | PREPARATIONS CONTAINING POLYMER AND SURFACTANTS, THEIR PRODUCTION AND USE. |
US4445509A (en) * | 1982-02-04 | 1984-05-01 | Auth David C | Method and apparatus for removal of enclosed abnormal deposits |
US4692141A (en) * | 1982-03-08 | 1987-09-08 | Mahurkar Sakharam D | Double lumen catheter |
US4512344A (en) * | 1982-05-12 | 1985-04-23 | Barber Forest C | Arthroscopic surgery dissecting apparatus |
US4424045A (en) * | 1982-05-24 | 1984-01-03 | Pennwalt Corporation | Rigid high speed flexible shaft casing assembly for tight radii installations |
DE3235612A1 (en) | 1982-09-25 | 1984-03-29 | Bayer Ag, 5090 Leverkusen | MICROEMULSIONS |
US4490139A (en) * | 1983-01-28 | 1984-12-25 | Eli Lilly And Company | Implant needle and method |
US4936987A (en) * | 1983-03-07 | 1990-06-26 | Calgon Corporation | Synergistic scale and corrosion inhibiting admixtures containing carboxylic acid/sulfonic acid polymers |
US4603694A (en) * | 1983-03-08 | 1986-08-05 | Richards Medical Company | Arthroscopic shaver |
US4730616A (en) * | 1983-08-12 | 1988-03-15 | Advanced Cardiovascular Systems, Inc. | Multiple probe angioplasty apparatus and method |
US5669936A (en) | 1983-12-09 | 1997-09-23 | Endovascular Technologies, Inc. | Endovascular grafting system and method for use therewith |
US5104399A (en) | 1986-12-10 | 1992-04-14 | Endovascular Technologies, Inc. | Artificial graft and implantation method |
DE3347671A1 (en) * | 1983-12-31 | 1985-07-11 | Richard Wolf Gmbh, 7134 Knittlingen | TISSUE SAMPLING INSTRUMENT |
US4589412A (en) * | 1984-01-03 | 1986-05-20 | Intravascular Surgical Instruments, Inc. | Method and apparatus for surgically removing remote deposits |
US4631052A (en) * | 1984-01-03 | 1986-12-23 | Intravascular Surgical Instruments, Inc. | Method and apparatus for surgically removing remote deposits |
US4732154A (en) * | 1984-05-14 | 1988-03-22 | Surgical Systems & Instruments, Inc. | Rotary catheter system |
US5024651A (en) | 1984-05-14 | 1991-06-18 | Surgical Systems & Instruments, Inc. | Atherectomy system with a sleeve |
US4819634A (en) * | 1984-05-14 | 1989-04-11 | Surgical Systems & Instruments | Rotary-catheter for atherectomy system |
US5002553A (en) | 1984-05-14 | 1991-03-26 | Surgical Systems & Instruments, Inc. | Atherectomy system with a clutch |
US4894051A (en) * | 1984-05-14 | 1990-01-16 | Surgical Systems & Instruments, Inc. | Atherectomy system with a biasing sleeve and method of using the same |
US4842579B1 (en) * | 1984-05-14 | 1995-10-31 | Surgical Systems & Instr Inc | Atherectomy device |
US4754755A (en) * | 1984-05-14 | 1988-07-05 | Husted Royce Hill | Catheter with a rotary blade |
US4886490A (en) * | 1984-05-14 | 1989-12-12 | Surgical Systems & Instruments, Inc. | Atherectomy catheter system and method of using the same |
US4957482A (en) | 1988-12-19 | 1990-09-18 | Surgical Systems & Instruments, Inc. | Atherectomy device with a positive pump means |
US4979939A (en) | 1984-05-14 | 1990-12-25 | Surgical Systems & Instruments, Inc. | Atherectomy system with a guide wire |
US5135531A (en) | 1984-05-14 | 1992-08-04 | Surgical Systems & Instruments, Inc. | Guided atherectomy system |
US5007896A (en) | 1988-12-19 | 1991-04-16 | Surgical Systems & Instruments, Inc. | Rotary-catheter for atherectomy |
US4883458A (en) * | 1987-02-24 | 1989-11-28 | Surgical Systems & Instruments, Inc. | Atherectomy system and method of using the same |
US4979951A (en) | 1984-05-30 | 1990-12-25 | Simpson John B | Atherectomy device and method |
US4926858A (en) * | 1984-05-30 | 1990-05-22 | Devices For Vascular Intervention, Inc. | Atherectomy device for severe occlusions |
US4781186A (en) * | 1984-05-30 | 1988-11-01 | Devices For Vascular Intervention, Inc. | Atherectomy device having a flexible housing |
US4646719A (en) * | 1984-06-11 | 1987-03-03 | Aries Medical Incorporated | Intra-aortic balloon catheter having flexible torque transmitting tube |
USRE33258E (en) | 1984-07-23 | 1990-07-10 | Surgical Dynamics Inc. | Irrigating, cutting and aspirating system for percutaneous surgery |
US4646736A (en) * | 1984-09-10 | 1987-03-03 | E. R. Squibb & Sons, Inc. | Transluminal thrombectomy apparatus |
US4649919A (en) * | 1985-01-23 | 1987-03-17 | Precision Surgical Instruments, Inc. | Surgical instrument |
US4705038A (en) * | 1985-01-23 | 1987-11-10 | Dyonics, Inc. | Surgical system for powered instruments |
US4653496A (en) * | 1985-02-01 | 1987-03-31 | Bundy Mark A | Transluminal lysing system |
US4745919A (en) * | 1985-02-01 | 1988-05-24 | Bundy Mark A | Transluminal lysing system |
US4686982A (en) * | 1985-06-19 | 1987-08-18 | John Nash | Spiral wire bearing for rotating wire drive catheter |
US4747406A (en) * | 1985-02-13 | 1988-05-31 | Intravascular Surgical Instruments, Inc. | Shaft driven, flexible intravascular recanalization catheter |
US4706671A (en) * | 1985-05-02 | 1987-11-17 | Weinrib Harry P | Catheter with coiled tip |
US4664112A (en) * | 1985-08-12 | 1987-05-12 | Intravascular Surgical Instruments, Inc. | Catheter based surgical methods and apparatus therefor |
US4679558A (en) * | 1985-08-12 | 1987-07-14 | Intravascular Surgical Instruments, Inc. | Catheter based surgical methods and apparatus therefor |
US4790812A (en) * | 1985-11-15 | 1988-12-13 | Hawkins Jr Irvin F | Apparatus and method for removing a target object from a body passsageway |
US4696298A (en) * | 1985-11-19 | 1987-09-29 | Storz Instrument Company | Vitrectomy cutting mechanism |
US4646738A (en) * | 1985-12-05 | 1987-03-03 | Concept, Inc. | Rotary surgical tool |
CA1293663C (en) | 1986-01-06 | 1991-12-31 | David Christopher Auth | Transluminal microdissection device |
AU607692B2 (en) | 1986-01-06 | 1991-03-14 | Boston Scientific Corporation Northwest Technology Center, Inc. | Transluminal microdissection device |
US4794931A (en) * | 1986-02-28 | 1989-01-03 | Cardiovascular Imaging Systems, Inc. | Catheter apparatus, system and method for intravascular two-dimensional ultrasonography |
US5000185A (en) | 1986-02-28 | 1991-03-19 | Cardiovascular Imaging Systems, Inc. | Method for intravascular two-dimensional ultrasonography and recanalization |
US4669469A (en) * | 1986-02-28 | 1987-06-02 | Devices For Vascular Intervention | Single lumen atherectomy catheter device |
US4771774A (en) * | 1986-02-28 | 1988-09-20 | Devices For Vascular Intervention, Inc. | Motor drive unit |
US4728319A (en) * | 1986-03-20 | 1988-03-01 | Helmut Masch | Intravascular catheter |
US4696667A (en) * | 1986-03-20 | 1987-09-29 | Helmut Masch | Intravascular catheter and method |
US5350395A (en) | 1986-04-15 | 1994-09-27 | Yock Paul G | Angioplasty apparatus facilitating rapid exchanges |
US4757819A (en) * | 1986-05-21 | 1988-07-19 | Olympus Optical Co., Ltd. | Ultrasonic endoscope |
US4729763A (en) * | 1986-06-06 | 1988-03-08 | Henrie Rodney A | Catheter for removing occlusive material |
US4765332A (en) * | 1986-07-14 | 1988-08-23 | Medinnovations, Inc. | Pullback atherectomy catheter system |
US4747821A (en) * | 1986-10-22 | 1988-05-31 | Intravascular Surgical Instruments, Inc. | Catheter with high speed moving working head |
US4749376A (en) | 1986-10-24 | 1988-06-07 | Intravascular Surgical Instruments, Inc. | Reciprocating working head catheter |
SE455834B (en) * | 1986-10-31 | 1988-08-15 | Medinvent Sa | DEVICE FOR TRANSLUMINAL IMPLANTATION OF A PRINCIPLE RODFORMALLY RADIALLY EXPANDABLE PROSTHESIS |
US4733662A (en) * | 1987-01-20 | 1988-03-29 | Minnesota Mining And Manufacturing Company | Tissue gripping and cutting assembly for surgical instrument |
US4733622A (en) * | 1987-02-24 | 1988-03-29 | Ssmc Inc. | Thread end holder for sewing machine with thread winding bobbin |
US4923462A (en) * | 1987-03-17 | 1990-05-08 | Cordis Corporation | Catheter system having a small diameter rotatable drive member |
US4846192A (en) | 1987-04-17 | 1989-07-11 | Eastman Kodak Company | Rearwardly acting surgical catheter |
US4784636A (en) * | 1987-04-30 | 1988-11-15 | Schneider-Shiley (U.S.A.) Inc. | Balloon atheroectomy catheter |
US4817613A (en) * | 1987-07-13 | 1989-04-04 | Devices For Vascular Intervention, Inc. | Guiding catheter |
US4954338A (en) | 1987-08-05 | 1990-09-04 | Rohm And Haas Company | Microbicidal microemulsion |
US4867157A (en) * | 1987-08-13 | 1989-09-19 | Baxter Travenol Laboratories, Inc. | Surgical cutting instrument |
US4819635A (en) * | 1987-09-18 | 1989-04-11 | Henry Shapiro | Tubular microsurgery cutting apparatus |
DE3732236C1 (en) | 1987-09-24 | 1988-12-15 | Rainer Dr Baumgart | Recanalization catheter |
US5165421A (en) | 1987-09-30 | 1992-11-24 | Lake Region Manufacturing Co., Inc. | Hollow lumen cable apparatus |
US5154705A (en) | 1987-09-30 | 1992-10-13 | Lake Region Manufacturing Co., Inc. | Hollow lumen cable apparatus |
US4844064A (en) * | 1987-09-30 | 1989-07-04 | Baxter Travenol Laboratories, Inc. | Surgical cutting instrument with end and side openings |
US4857046A (en) * | 1987-10-21 | 1989-08-15 | Cordis Corporation | Drive catheter having helical pump drive shaft |
US5047040A (en) | 1987-11-05 | 1991-09-10 | Devices For Vascular Intervention, Inc. | Atherectomy device and method |
US4870953A (en) * | 1987-11-13 | 1989-10-03 | Donmicheal T Anthony | Intravascular ultrasonic catheter/probe and method for treating intravascular blockage |
US4887613A (en) * | 1987-11-23 | 1989-12-19 | Interventional Technologies Inc. | Cutter for atherectomy device |
NZ222930A (en) | 1987-12-15 | 1990-08-28 | Moffat Appliances Ltd | Gas infra-red burner in heat exchanger |
US4850957A (en) * | 1988-01-11 | 1989-07-25 | American Biomed, Inc. | Atherectomy catheter |
US5053044A (en) | 1988-01-11 | 1991-10-01 | Devices For Vascular Intervention, Inc. | Catheter and method for making intravascular incisions |
DE3801318A1 (en) | 1988-01-19 | 1989-07-27 | Stocksmeier Uwe | MEDICAL CATHETER WITH CUTTER |
US4886061A (en) * | 1988-02-09 | 1989-12-12 | Medinnovations, Inc. | Expandable pullback atherectomy catheter system |
US4899757A (en) * | 1988-02-22 | 1990-02-13 | Intertherapy, Inc. | Ultrasound imaging probe with zero dead space |
DE58906466D1 (en) | 1988-03-04 | 1994-02-03 | Angiomed Ag | Method and device for removing deposits in vessels and organs of living beings. |
US4838268A (en) * | 1988-03-07 | 1989-06-13 | Scimed Life Systems, Inc. | Non-over-the wire balloon catheter |
US5183432A (en) | 1988-03-19 | 1993-02-02 | Nihonmatai Co., Ltd. | Floating body of sophisticated shape produced from a single sheet of film with a single sealing |
US5368035A (en) | 1988-03-21 | 1994-11-29 | Boston Scientific Corporation | Ultrasound imaging guidewire |
US5372138A (en) | 1988-03-21 | 1994-12-13 | Boston Scientific Corporation | Acousting imaging catheters and the like |
US4935017A (en) | 1988-04-29 | 1990-06-19 | C. R. Bard, Inc. | Variable shaped catheter system and method for catheterization |
US4950238A (en) | 1988-07-07 | 1990-08-21 | Clarence E. Sikes | Hydro-rotary vascular catheter |
US4919133A (en) * | 1988-08-18 | 1990-04-24 | Chiang Tien Hon | Catheter apparatus employing shape memory alloy structures |
US5071425A (en) | 1988-09-12 | 1991-12-10 | Devices For Vascular Intervention, Inc. | Atherectomy catheter and method of forming the same |
GB8822149D0 (en) | 1988-09-21 | 1988-10-26 | Ciba Geigy Ag | Treatment of aqueous systems |
DE8813144U1 (en) | 1988-10-19 | 1988-12-15 | Guenther, Rolf W., Prof. Dr., 5100 Aachen, De | |
GB8829182D0 (en) | 1988-12-14 | 1989-01-25 | Univ Birmingham | Surgical instrument |
DE8900059U1 (en) | 1989-01-04 | 1989-05-24 | Schneider (Europe) Ag, Zuerich, Ch | |
AU4945490A (en) | 1989-01-06 | 1990-08-01 | Angioplasty Systems Inc. | Electrosurgical catheter for resolving atherosclerotic plaque |
US4966604A (en) | 1989-01-23 | 1990-10-30 | Interventional Technologies Inc. | Expandable atherectomy cutter with flexibly bowed blades |
US4986807A (en) | 1989-01-23 | 1991-01-22 | Interventional Technologies, Inc. | Atherectomy cutter with radially projecting blade |
US4889061A (en) | 1989-02-01 | 1989-12-26 | Mcpherson Systems, Inc. | Refractory bin for pit burning |
US5077506A (en) | 1989-02-03 | 1991-12-31 | Dyonics, Inc. | Microprocessor controlled arthroscopic surgical system |
US5431673A (en) | 1989-02-17 | 1995-07-11 | American Biomed, Inc. | Distal atherectomy catheter |
US4994067A (en) | 1989-02-17 | 1991-02-19 | American Biomed, Inc. | Distal atherectomy catheter |
US5087265A (en) | 1989-02-17 | 1992-02-11 | American Biomed, Inc. | Distal atherectomy catheter |
US4928693A (en) * | 1989-03-13 | 1990-05-29 | Schneider (Usa), Inc. | Pressure monitor catheter |
US5078723A (en) | 1989-05-08 | 1992-01-07 | Medtronic, Inc. | Atherectomy device |
ATE134492T1 (en) | 1989-06-01 | 1996-03-15 | Schneider Europ Ag | CATHETER ARRANGEMENT WITH A GUIDE WIRE AND METHOD FOR PRODUCING SUCH A GUIDE WIRE |
US5029588A (en) | 1989-06-15 | 1991-07-09 | Cardiovascular Imaging Systems, Inc. | Laser catheter with imaging capability |
US5226910A (en) | 1989-07-05 | 1993-07-13 | Kabushiki Kaisha Topcon | Surgical cutter |
US5269793A (en) | 1989-07-20 | 1993-12-14 | Devices For Vascular Intervention, Inc. | Guide wire systems for intravascular catheters |
US5100426A (en) | 1989-07-26 | 1992-03-31 | Fts Engineering, Inc. | Catheter for performing an atherectomy procedure |
US5115814A (en) | 1989-08-18 | 1992-05-26 | Intertherapy, Inc. | Intravascular ultrasonic imaging probe and methods of using same |
US5211651A (en) | 1989-08-18 | 1993-05-18 | Evi Corporation | Catheter atherotome |
US5282484A (en) | 1989-08-18 | 1994-02-01 | Endovascular Instruments, Inc. | Method for performing a partial atherectomy |
US5226909A (en) | 1989-09-12 | 1993-07-13 | Devices For Vascular Intervention, Inc. | Atherectomy device having helical blade and blade guide |
US4997435A (en) | 1989-09-25 | 1991-03-05 | Methodist Hospital Of Indiana Inc. | Percutaneous catheter with encapsulating receptacle |
US5092839A (en) | 1989-09-29 | 1992-03-03 | Kipperman Robert M | Coronary thrombectomy |
US5116352A (en) | 1989-10-06 | 1992-05-26 | Angiomed Ag | Apparatus for removing deposits from vessels |
US5049124A (en) | 1989-10-14 | 1991-09-17 | Dow Corning Wright Corporation | Catheter drive apparatus having fluid delivery bearing |
US5024234A (en) | 1989-10-17 | 1991-06-18 | Cardiovascular Imaging Systems, Inc. | Ultrasonic imaging catheter with guidewire channel |
US5009659A (en) | 1989-10-30 | 1991-04-23 | Schneider (Usa) Inc. | Fiber tip atherectomy catheter |
ZA908425B (en) | 1989-11-03 | 1991-07-31 | Rohm & Haas | Synergistic microbicidal combinations |
US5505210A (en) | 1989-11-06 | 1996-04-09 | Mectra Labs, Inc. | Lavage with tissue cutting cannula |
US5026384A (en) | 1989-11-07 | 1991-06-25 | Interventional Technologies, Inc. | Atherectomy systems and methods |
US5019088A (en) | 1989-11-07 | 1991-05-28 | Interventional Technologies Inc. | Ovoid atherectomy cutter |
US5085662A (en) | 1989-11-13 | 1992-02-04 | Scimed Life Systems, Inc. | Atherectomy catheter and related components |
US5030201A (en) | 1989-11-24 | 1991-07-09 | Aubrey Palestrant | Expandable atherectomy catheter device |
US5178625A (en) | 1989-12-07 | 1993-01-12 | Evi Corporation | Catheter atherotome |
US5011490A (en) | 1989-12-07 | 1991-04-30 | Medical Innovative Technologies R&D Limited Partnership | Endoluminal tissue excision catheter system and method |
US5003918A (en) | 1989-12-28 | 1991-04-02 | Interventional Technologies, Inc. | Apparatus for manufacturing atherectomy torque tubes |
US5120323A (en) | 1990-01-12 | 1992-06-09 | Schneider (Usa) Inc. | Telescoping guide catheter system |
US5916210A (en) | 1990-01-26 | 1999-06-29 | Intraluminal Therapeutics, Inc. | Catheter for laser treatment of atherosclerotic plaque and other tissue abnormalities |
US5074841A (en) | 1990-01-30 | 1991-12-24 | Microcision, Inc. | Atherectomy device with helical cutter |
US5152744A (en) | 1990-02-07 | 1992-10-06 | Smith & Nephew Dyonics | Surgical instrument |
US5084010A (en) | 1990-02-20 | 1992-01-28 | Devices For Vascular Intervention, Inc. | System and method for catheter construction |
US5092873A (en) | 1990-02-28 | 1992-03-03 | Devices For Vascular Intervention, Inc. | Balloon configuration for atherectomy catheter |
US5222966A (en) | 1990-02-28 | 1993-06-29 | Devices For Vascular Intervention, Inc. | Balloon connection and inflation lumen for atherectomy catheter |
US5366463A (en) | 1990-05-02 | 1994-11-22 | Ryan William J | Atherectomy catheter for the removal of atherosclerosis from within blood vessels |
US5267955A (en) | 1990-05-10 | 1993-12-07 | Lake Region Manufacturing Company, Inc. | Atherectomy device |
US5154724A (en) | 1990-05-14 | 1992-10-13 | Andrews Winston A | Atherectomy catheter |
US5395311A (en) | 1990-05-14 | 1995-03-07 | Andrews; Winston A. | Atherectomy catheter |
US5095911A (en) | 1990-05-18 | 1992-03-17 | Cardiovascular Imaging Systems, Inc. | Guidewire with imaging capability |
US5558093A (en) | 1990-05-18 | 1996-09-24 | Cardiovascular Imaging Systems, Inc. | Guidewire with imaging capability |
US5100424A (en) | 1990-05-21 | 1992-03-31 | Cardiovascular Imaging Systems, Inc. | Intravascular catheter having combined imaging abrasion head |
US5674232A (en) | 1990-06-05 | 1997-10-07 | Halliburton; Alexander George | Catheter and method of use thereof |
US5181920A (en) | 1990-06-08 | 1993-01-26 | Devices For Vascular Intervention, Inc. | Atherectomy device with angioplasty balloon and method |
US5527298A (en) | 1990-06-11 | 1996-06-18 | Schneider (Usa) Inc. | Tracking guidewire |
US5360443A (en) | 1990-06-11 | 1994-11-01 | Barone Hector D | Aortic graft for repairing an abdominal aortic aneurysm |
JPH06114070A (en) | 1990-06-22 | 1994-04-26 | Vance Prod Inc | Tissue abscission device for surgery |
US5064435A (en) | 1990-06-28 | 1991-11-12 | Schneider (Usa) Inc. | Self-expanding prosthesis having stable axial length |
US5520189A (en) | 1990-07-13 | 1996-05-28 | Coraje, Inc. | Intravascular ultrasound imaging guidewire |
CA2048120A1 (en) | 1990-08-06 | 1992-02-07 | William J. Drasler | Thrombectomy method and device |
US5078722A (en) | 1990-08-14 | 1992-01-07 | Cordis Corporation | Method and apparatus for removing deposits from a vessel |
US5100423A (en) | 1990-08-21 | 1992-03-31 | Medical Engineering & Development Institute, Inc. | Ablation catheter |
US5127902A (en) | 1990-09-05 | 1992-07-07 | Medical Innovative Technologies R&D Limited Partnership | Apparatus and method for precisely controlling the excision of obstructive tissue in a human blood vessel |
US5250065A (en) | 1990-09-11 | 1993-10-05 | Mectra Labs, Inc. | Disposable lavage tip assembly |
US5114399A (en) | 1990-10-01 | 1992-05-19 | Intramed Laboratories | Surgical device |
US5190528A (en) | 1990-10-19 | 1993-03-02 | Boston University | Percutaneous transseptal left atrial cannulation system |
US5242460A (en) | 1990-10-25 | 1993-09-07 | Devices For Vascular Intervention, Inc. | Atherectomy catheter having axially-disposed cutting edge |
US5527292A (en) | 1990-10-29 | 1996-06-18 | Scimed Life Systems, Inc. | Intravascular device for coronary heart treatment |
US5496267A (en) | 1990-11-08 | 1996-03-05 | Possis Medical, Inc. | Asymmetric water jet atherectomy |
DE4036570A1 (en) | 1990-11-16 | 1992-05-21 | Osypka Peter | CATHETER FOR REDUCING OR REMOVING CONSTRUCTIONS IN VESSELS |
JP2550778B2 (en) | 1990-11-30 | 1996-11-06 | 富士写真光機株式会社 | Ultrasonic inspection equipment |
US5108500A (en) | 1990-12-10 | 1992-04-28 | Rohm And Haas Company | Stabilization of water insoluble 3-isothiazolones |
US5054492A (en) | 1990-12-17 | 1991-10-08 | Cardiovascular Imaging Systems, Inc. | Ultrasonic imaging catheter having rotational image correlation |
US5112345A (en) | 1990-12-17 | 1992-05-12 | Interventional Technologies | Atherectomy cutter with arcuate blades |
US5110822A (en) | 1991-01-03 | 1992-05-05 | Rohm And Haas Company | Synergistic combinations of 4,5-dichloro-2-n-octyl-3-isothiazolone or 2-methyl-3-isothiazolone with ferric dimethyl dithiocarbamate fungicide |
CA2075973A1 (en) | 1991-02-19 | 1992-08-20 | Robert E. Fischell | Apparatus and method for atherectomy |
US5445155A (en) | 1991-03-13 | 1995-08-29 | Scimed Life Systems Incorporated | Intravascular imaging apparatus and methods for use and manufacture |
US5295958A (en) | 1991-04-04 | 1994-03-22 | Shturman Cardiology Systems, Inc. | Method and apparatus for in vivo heart valve decalcification |
CA2065634C (en) | 1991-04-11 | 1997-06-03 | Alec A. Piplani | Endovascular graft having bifurcation and apparatus and method for deploying the same |
US6134003A (en) | 1991-04-29 | 2000-10-17 | Massachusetts Institute Of Technology | Method and apparatus for performing optical measurements using a fiber optic imaging guidewire, catheter or endoscope |
WO1992019930A1 (en) | 1991-04-29 | 1992-11-12 | Massachusetts Institute Of Technology | Method and apparatus for optical imaging and measurement |
US6501551B1 (en) | 1991-04-29 | 2002-12-31 | Massachusetts Institute Of Technology | Fiber optic imaging endoscope interferometer with at least one faraday rotator |
IT1249059B (en) | 1991-05-22 | 1995-02-11 | Rosa Antonio | ULTRASONIC DISSECTOR-DISCONNECTOR OF ATEROSCLEROTIC PLATES |
US5395335A (en) | 1991-05-24 | 1995-03-07 | Jang; G. David | Universal mode vascular catheter system |
US5284486A (en) | 1991-06-11 | 1994-02-08 | Microvena Corporation | Self-centering mechanical medical device |
US5569275A (en) | 1991-06-11 | 1996-10-29 | Microvena Corporation | Mechanical thrombus maceration device |
US5263928A (en) | 1991-06-14 | 1993-11-23 | Baxter International Inc. | Catheter and endoscope assembly and method of use |
US5273526A (en) | 1991-06-21 | 1993-12-28 | Lake Region Manufacturing Company, Inc. | Vascular occulusion removal devices and method |
US5217474A (en) | 1991-07-15 | 1993-06-08 | Zacca Nadim M | Expandable tip atherectomy method and apparatus |
US5261877A (en) | 1991-07-22 | 1993-11-16 | Dow Corning Wright | Method of performing a thrombectomy procedure |
US5242461A (en) | 1991-07-22 | 1993-09-07 | Dow Corning Wright | Variable diameter rotating recanalization catheter and surgical method |
US5336167A (en) | 1991-07-22 | 1994-08-09 | Theratek International, Inc. | Controller for intravascular catheter system |
JPH0542162A (en) | 1991-08-15 | 1993-02-23 | Nissho Corp | Embolus excision catheter |
JP3084830B2 (en) | 1991-08-29 | 2000-09-04 | 株式会社ニッショー | Embolectomy catheter |
US5377682A (en) | 1991-09-05 | 1995-01-03 | Matsushita Electric Industrial Co., Ltd. | Ultrasonic probe for transmission and reception of ultrasonic wave and ultrasonic diagnostic apparatus including ultrasonic probe |
US5285795A (en) | 1991-09-12 | 1994-02-15 | Surgical Dynamics, Inc. | Percutaneous discectomy system having a bendable discectomy probe and a steerable cannula |
US5263959A (en) | 1991-10-21 | 1993-11-23 | Cathco, Inc. | Dottering auger catheter system and method |
US5423846A (en) | 1991-10-21 | 1995-06-13 | Cathco, Inc. | Dottering auger catheter system |
AU669338B2 (en) | 1991-10-25 | 1996-06-06 | Cook Incorporated | Expandable transluminal graft prosthesis for repair of aneurysm and method for implanting |
US5704361A (en) | 1991-11-08 | 1998-01-06 | Mayo Foundation For Medical Education And Research | Volumetric image ultrasound transducer underfluid catheter system |
US5316023A (en) | 1992-01-08 | 1994-05-31 | Expandable Grafts Partnership | Method for bilateral intra-aortic bypass |
ES2116355T3 (en) | 1992-01-13 | 1998-07-16 | Schneider Usa Inc | CUTTING DEVICE FOR ATERECTOMY CATHETER. |
US5224949A (en) | 1992-01-13 | 1993-07-06 | Interventional Technologies, Inc. | Camming device |
DE9290166U1 (en) | 1992-01-13 | 1994-10-13 | Schneider Usa Inc | Surgical cutting tool |
US5192291A (en) | 1992-01-13 | 1993-03-09 | Interventional Technologies, Inc. | Rotationally expandable atherectomy cutter assembly |
US5224945A (en) | 1992-01-13 | 1993-07-06 | Interventional Technologies, Inc. | Compressible/expandable atherectomy cutter |
US5250059A (en) | 1992-01-22 | 1993-10-05 | Devices For Vascular Intervention, Inc. | Atherectomy catheter having flexible nose cone |
US5318032A (en) | 1992-02-05 | 1994-06-07 | Devices For Vascular Intervention | Guiding catheter having soft tip |
WO1993016642A1 (en) | 1992-02-21 | 1993-09-02 | Boston Scientific Corporation | Ultrasound imaging guidewire |
US5295493A (en) | 1992-03-19 | 1994-03-22 | Interventional Technologies, Inc. | Anatomical guide wire |
US5350390A (en) | 1992-03-25 | 1994-09-27 | Arieh Sher | Device for removal of intraluminal occlusions |
US5176693A (en) | 1992-05-11 | 1993-01-05 | Interventional Technologies, Inc. | Balloon expandable atherectomy cutter |
US5269759A (en) | 1992-07-28 | 1993-12-14 | Cordis Corporation | Magnetic guidewire coupling for vascular dilatation apparatus |
US5364376A (en) * | 1992-08-04 | 1994-11-15 | Danforth Biomedical Incorporated | Convertible catheter |
US5306294A (en) | 1992-08-05 | 1994-04-26 | Ultrasonic Sensing And Monitoring Systems, Inc. | Stent construction of rolled configuration |
US5707376A (en) | 1992-08-06 | 1998-01-13 | William Cook Europe A/S | Stent introducer and method of use |
US5224488A (en) | 1992-08-31 | 1993-07-06 | Neuffer Francis H | Biopsy needle with extendable cutting means |
US5383460A (en) | 1992-10-05 | 1995-01-24 | Cardiovascular Imaging Systems, Inc. | Method and apparatus for ultrasound imaging and atherectomy |
US5360432A (en) | 1992-10-16 | 1994-11-01 | Shturman Cardiology Systems, Inc. | Abrasive drive shaft device for directional rotational atherectomy |
US5356418A (en) | 1992-10-28 | 1994-10-18 | Shturman Cardiology Systems, Inc. | Apparatus and method for rotational atherectomy |
US5312427A (en) | 1992-10-16 | 1994-05-17 | Shturman Cardiology Systems, Inc. | Device and method for directional rotational atherectomy |
JP3186256B2 (en) | 1992-10-21 | 2001-07-11 | セイコーエプソン株式会社 | Method for manufacturing flexible circuit board for TAB |
US5531690A (en) | 1992-10-30 | 1996-07-02 | Cordis Corporation | Rapid exchange catheter |
US5336178A (en) | 1992-11-02 | 1994-08-09 | Localmed, Inc. | Intravascular catheter with infusion array |
US5571122A (en) | 1992-11-09 | 1996-11-05 | Endovascular Instruments, Inc. | Unitary removal of plaque |
US5643297A (en) | 1992-11-09 | 1997-07-01 | Endovascular Instruments, Inc. | Intra-artery obstruction clearing apparatus and methods |
US5501694A (en) | 1992-11-13 | 1996-03-26 | Scimed Life Systems, Inc. | Expandable intravascular occlusion material removal devices and methods of use |
US5540707A (en) | 1992-11-13 | 1996-07-30 | Scimed Life Systems, Inc. | Expandable intravascular occlusion material removal devices and methods of use |
US5792157A (en) | 1992-11-13 | 1998-08-11 | Scimed Life Systems, Inc. | Expandable intravascular occlusion material removal devices and methods of use |
US5372602A (en) | 1992-11-30 | 1994-12-13 | Device For Vascular Intervention, Inc. | Method of removing plaque using catheter cutter with torque control |
AU677808B2 (en) | 1992-12-01 | 1997-05-08 | Intella Interventional Systems, Inc. | Vibratory element for crossing stenoses |
US5584842A (en) | 1992-12-02 | 1996-12-17 | Intramed Laboratories, Inc. | Valvulotome and method of using |
US5318576A (en) | 1992-12-16 | 1994-06-07 | Plassche Jr Walter M | Endovascular surgery systems |
US5373849A (en) | 1993-01-19 | 1994-12-20 | Cardiovascular Imaging Systems, Inc. | Forward viewing imaging catheter |
US5669926A (en) | 1993-01-25 | 1997-09-23 | Aust & Taylor Medical Corporation | Surgical instrument |
US5620447A (en) | 1993-01-29 | 1997-04-15 | Smith & Nephew Dyonics Inc. | Surgical instrument |
CA2114330A1 (en) | 1993-01-29 | 1994-07-30 | Smith & Nephew Endoscopy, Inc. | Rotatable curved instrument |
DE9303531U1 (en) | 1993-03-11 | 1994-07-14 | Redha Falah | Medical instrument |
US5378234A (en) | 1993-03-15 | 1995-01-03 | Pilot Cardiovascular Systems, Inc. | Coil polymer composite |
CH685738A5 (en) | 1993-03-25 | 1995-09-29 | Ferromec Sa | Medical instrument for removing deposits formed on the inner walls of the arteries or veins. |
US5372601A (en) | 1993-03-30 | 1994-12-13 | Lary; Banning G. | Longitudinal reciprocating incisor |
US5322508A (en) | 1993-04-08 | 1994-06-21 | Cordis Corporation | Guidewire fluid delivery system and method of use |
US5318528A (en) | 1993-04-13 | 1994-06-07 | Advanced Surgical Inc. | Steerable surgical devices |
US5429136A (en) | 1993-04-21 | 1995-07-04 | Devices For Vascular Intervention, Inc. | Imaging atherectomy apparatus |
US5716410A (en) | 1993-04-30 | 1998-02-10 | Scimed Life Systems, Inc. | Temporary stent and method of use |
US5456667A (en) | 1993-05-20 | 1995-10-10 | Advanced Cardiovascular Systems, Inc. | Temporary stenting catheter with one-piece expandable segment |
WO1994027501A1 (en) | 1993-05-24 | 1994-12-08 | Boston Scientific Corporation | Medical acoustic imaging catheter and guidewire |
US5531685A (en) | 1993-06-11 | 1996-07-02 | Catheter Research, Inc. | Steerable variable stiffness device |
AU678263B2 (en) | 1993-07-03 | 1997-05-22 | Medical Miracles Company Limited | Angioplasty catheter with guidewire |
US5514115A (en) | 1993-07-07 | 1996-05-07 | Device For Vascular Intervention, Inc. | Flexible housing for intracorporeal use |
US5527325A (en) | 1993-07-09 | 1996-06-18 | Device For Vascular Intervention, Inc. | Atherectomy catheter and method |
US5419774A (en) | 1993-07-13 | 1995-05-30 | Scimed Life Systems, Inc. | Thrombus extraction device |
US5458585A (en) | 1993-07-28 | 1995-10-17 | Cardiovascular Imaging Systems, Inc. | Tracking tip for a work element in a catheter system |
US5395313A (en) | 1993-08-13 | 1995-03-07 | Naves; Neil H. | Reciprocating arthroscopic shaver |
US5441510A (en) | 1993-09-01 | 1995-08-15 | Technology Development Center | Bi-axial cutter apparatus for catheter |
US5573008A (en) | 1993-10-29 | 1996-11-12 | Boston Scientific Corporation | Multiple biopsy sampling coring device |
US5444078A (en) | 1993-10-01 | 1995-08-22 | Rohm And Haas Company | Fully water-dilutable microemulsions |
US5456689A (en) | 1993-10-13 | 1995-10-10 | Arnold J. Kresch | Method and device for tissue resection |
DE4335931B4 (en) | 1993-10-21 | 2006-10-12 | Cerasiv Gmbh Innovatives Keramik-Engineering | acetabulum |
WO1995013033A1 (en) | 1993-11-08 | 1995-05-18 | Lazarus Harrison M | Intraluminal vascular graft and method |
US5507760A (en) | 1993-11-09 | 1996-04-16 | Devices For Vascular Intervention, Inc. | Cutter device |
US5443497A (en) | 1993-11-22 | 1995-08-22 | The Johns Hopkins University | Percutaneous prosthetic by-pass graft and method of use |
US5427107A (en) | 1993-12-07 | 1995-06-27 | Devices For Vascular Intervention, Inc. | Optical encoder for catheter device |
AU1399995A (en) | 1993-12-09 | 1995-06-27 | Devices For Vascular Intervention, Inc. | Composite drive shaft |
US5503155A (en) | 1994-01-26 | 1996-04-02 | Cardiovascular Imaging Systems, Inc. | Drive cable having internal lead wires |
US5591127A (en) | 1994-01-28 | 1997-01-07 | Barwick, Jr.; Billie J. | Phacoemulsification method and apparatus |
US5507769A (en) | 1994-10-18 | 1996-04-16 | Stentco, Inc. | Method and apparatus for forming an endoluminal bifurcated graft |
US5413107A (en) | 1994-02-16 | 1995-05-09 | Tetrad Corporation | Ultrasonic probe having articulated structure and rotatable transducer head |
US5485840A (en) | 1994-03-15 | 1996-01-23 | Bauman; Robert P. | Method of precise guidance for directional atherectomy using ultrasound |
US5624457A (en) | 1994-04-07 | 1997-04-29 | Devices For Vascular Intervention | Directional atherectomy device with flexible housing |
US5507795A (en) | 1994-04-29 | 1996-04-16 | Devices For Vascular Intervention, Inc. | Catheter with perfusion system |
US5569279A (en) | 1994-04-29 | 1996-10-29 | Rainin; Edgar A. | Surgical abrading device |
US5466382A (en) | 1994-05-03 | 1995-11-14 | Rohm And Haas Company | Synergistic microbicidal combinations containing 4,5-dichloro-2-n-octyl-3-isothiazolone and certain commercial biocides |
USRE38335E1 (en) | 1994-05-24 | 2003-11-25 | Endius Incorporated | Surgical instrument |
US5628761A (en) | 1994-07-08 | 1997-05-13 | Rizik; David G. | Guide wire passage creation device |
US5531700A (en) | 1994-07-29 | 1996-07-02 | Cardiovascular Imaging Systems, Inc. | Convertible tip catheters and sheaths |
US5575817A (en) | 1994-08-19 | 1996-11-19 | Martin; Eric C. | Aorto femoral bifurcation graft and method of implantation |
US5609605A (en) | 1994-08-25 | 1997-03-11 | Ethicon, Inc. | Combination arterial stent |
WO1996010366A1 (en) | 1994-10-03 | 1996-04-11 | Heart Technology, Inc. | Transluminal thrombectomy apparatus |
US5571130A (en) | 1994-10-04 | 1996-11-05 | Advanced Cardiovascular Systems, Inc. | Atherectomy and prostectomy system |
US5491524A (en) | 1994-10-05 | 1996-02-13 | Carl Zeiss, Inc. | Optical coherence tomography corneal mapping apparatus |
US5549601A (en) | 1994-10-11 | 1996-08-27 | Devices For Vascular Intervention, Inc. | Delivery of intracorporeal probes |
US5507761A (en) | 1994-10-11 | 1996-04-16 | Duer; Edward Y. | Embolic cutting catheter |
US5512044A (en) | 1994-10-11 | 1996-04-30 | Duer; Edward Y. | Embolic cutting catheter |
US6032673A (en) | 1994-10-13 | 2000-03-07 | Femrx, Inc. | Methods and devices for tissue removal |
AU3783295A (en) | 1994-11-16 | 1996-05-23 | Advanced Cardiovascular Systems Inc. | Shape memory locking mechanism for intravascular stent |
US5626562A (en) | 1994-11-28 | 1997-05-06 | Devices For Vascular Intervention | Drug delivery catheter |
DE4444166C2 (en) | 1994-12-12 | 1998-09-24 | Urotech Med Tech Gmbh | Flexible knife device for surgical purposes |
US5643296A (en) | 1994-12-16 | 1997-07-01 | Devices For Vasclar Intervention | Intravascular catheter with guiding structure |
US5584843A (en) | 1994-12-20 | 1996-12-17 | Boston Scientific Corporation | Shaped wire multi-burr rotational ablation device |
US5836957A (en) | 1994-12-22 | 1998-11-17 | Devices For Vascular Intervention, Inc. | Large volume atherectomy device |
US5632754A (en) | 1994-12-23 | 1997-05-27 | Devices For Vascular Intervention | Universal catheter with interchangeable work element |
US6027450A (en) | 1994-12-30 | 2000-02-22 | Devices For Vascular Intervention | Treating a totally or near totally occluded lumen |
CA2157697C (en) | 1995-01-10 | 2007-03-13 | Banning Gray Lary | Vascular incisor/dilator |
US5700687A (en) | 1995-01-30 | 1997-12-23 | Bedminster Bioconversion Corporation | Odor control system |
US5683449A (en) | 1995-02-24 | 1997-11-04 | Marcade; Jean Paul | Modular bifurcated intraluminal grafts and methods for delivering and assembling same |
US5985397A (en) | 1995-03-20 | 1999-11-16 | Witt; Alvin E. | Coated synthetic resin board tiles |
DE19549466C2 (en) | 1995-03-25 | 1999-10-14 | Rieter Ingolstadt Spinnerei | Support disc |
WO1996029941A1 (en) | 1995-03-28 | 1996-10-03 | Straub Federnfabrik Ag | Catheter for detaching abnormal deposits in human blood vessels |
WO1996029942A1 (en) | 1995-03-28 | 1996-10-03 | Straub Federnfabrik Ag | Catheter for detaching abnormal deposits in human blood vessels |
US5728123A (en) | 1995-04-26 | 1998-03-17 | Lemelson; Jerome H. | Balloon actuated catheter |
US5554163A (en) | 1995-04-27 | 1996-09-10 | Shturman Cardiology Systems, Inc. | Atherectomy device |
US5556408A (en) | 1995-04-27 | 1996-09-17 | Interventional Technologies Inc. | Expandable and compressible atherectomy cutter |
US5827229A (en) | 1995-05-24 | 1998-10-27 | Boston Scientific Corporation Northwest Technology Center, Inc. | Percutaneous aspiration thrombectomy catheter system |
US5938645A (en) | 1995-05-24 | 1999-08-17 | Boston Scientific Corporation Northwest Technology Center Inc. | Percutaneous aspiration catheter system |
US5618293A (en) | 1995-06-06 | 1997-04-08 | Smith & Nephews Dyonics, Inc. | Surgical instrument |
US5596990A (en) | 1995-06-06 | 1997-01-28 | Yock; Paul | Rotational correlation of intravascular ultrasound image with guide catheter position |
JPH11507251A (en) | 1995-06-07 | 1999-06-29 | カーディマ・インコーポレイテッド | Guide catheter for coronary sinus |
US5779673A (en) | 1995-06-26 | 1998-07-14 | Focal, Inc. | Devices and methods for application of intraluminal photopolymerized gels |
US5883458A (en) | 1995-07-31 | 1999-03-16 | Murata Manufacturing Co., Ltd. | Terminal for a piezoelectric device |
US5669275A (en) | 1995-08-18 | 1997-09-23 | Mills; Edward Otis | Conductor insulation remover |
US5681336A (en) | 1995-09-07 | 1997-10-28 | Boston Scientific Corporation | Therapeutic device for treating vien graft lesions |
US6027460A (en) | 1995-09-14 | 2000-02-22 | Shturman Cardiology Systems, Inc. | Rotatable intravascular apparatus |
US5707383A (en) | 1995-10-05 | 1998-01-13 | Xomed Surgical Products, Inc. | Method of removing soft tissue in the middle ear |
IL151563A0 (en) | 1995-10-13 | 2003-04-10 | Transvascular Inc | A longitudinal compression apparatus for compressing tissue |
US6283983B1 (en) | 1995-10-13 | 2001-09-04 | Transvascular, Inc. | Percutaneous in-situ coronary bypass method and apparatus |
US5830222A (en) | 1995-10-13 | 1998-11-03 | Transvascular, Inc. | Device, system and method for intersititial transvascular intervention |
US6283951B1 (en) | 1996-10-11 | 2001-09-04 | Transvascular, Inc. | Systems and methods for delivering drugs to selected locations within the body |
US6302875B1 (en) | 1996-10-11 | 2001-10-16 | Transvascular, Inc. | Catheters and related devices for forming passageways between blood vessels or other anatomical structures |
US6375615B1 (en) | 1995-10-13 | 2002-04-23 | Transvascular, Inc. | Tissue penetrating catheters having integral imaging transducers and their methods of use |
US5766192A (en) | 1995-10-20 | 1998-06-16 | Zacca; Nadim M. | Atherectomy, angioplasty and stent method and apparatus |
US5843022A (en) | 1995-10-25 | 1998-12-01 | Scimied Life Systems, Inc. | Intravascular device utilizing fluid to extract occlusive material |
US5989281A (en) | 1995-11-07 | 1999-11-23 | Embol-X, Inc. | Cannula with associated filter and methods of use during cardiac surgery |
US5868685A (en) | 1995-11-14 | 1999-02-09 | Devices For Vascular Intervention | Articulated guidewire |
US5697944A (en) | 1995-11-15 | 1997-12-16 | Interventional Technologies Inc. | Universal dilator with expandable incisor |
US5827304A (en) | 1995-11-16 | 1998-10-27 | Applied Medical Resources Corporation | Intraluminal extraction catheter |
US6042605A (en) | 1995-12-14 | 2000-03-28 | Gore Enterprose Holdings, Inc. | Kink resistant stent-graft |
US5688234A (en) | 1996-01-26 | 1997-11-18 | Cardiometrics Inc. | Apparatus and method for the treatment of thrombotic occlusions in vessels |
US5695506A (en) | 1996-02-06 | 1997-12-09 | Devices For Vascular Intervention | Catheter device with a flexible housing |
US5733296A (en) | 1996-02-06 | 1998-03-31 | Devices For Vascular Intervention | Composite atherectomy cutter |
JPH09215753A (en) | 1996-02-08 | 1997-08-19 | Schneider Usa Inc | Self-expanding stent made of titanium alloy |
US5800389A (en) | 1996-02-09 | 1998-09-01 | Emx, Inc. | Biopsy device |
US5709698A (en) | 1996-02-26 | 1998-01-20 | Linvatec Corporation | Irrigating/aspirating shaver blade assembly |
US6036707A (en) | 1996-03-07 | 2000-03-14 | Devices For Vascular Intervention | Catheter device having a selectively flexible housing |
US5830224A (en) | 1996-03-15 | 1998-11-03 | Beth Israel Deaconess Medical Center | Catheter apparatus and methodology for generating a fistula on-demand between closely associated blood vessels at a pre-chosen anatomic site in-vivo |
US5807329A (en) | 1996-05-07 | 1998-09-15 | Gelman; Martin L. | Displaceable catheter device |
DE19618945C2 (en) | 1996-05-10 | 2003-02-27 | Phonak Ag Staefa | Fixable positioning system for a firm, play-free connection to the human skull |
US6152909A (en) | 1996-05-20 | 2000-11-28 | Percusurge, Inc. | Aspiration system and method |
US20010049517A1 (en) | 1997-03-06 | 2001-12-06 | Gholam-Reza Zadno-Azizi | Method for containing and removing occlusions in the carotid arteries |
US5709701A (en) | 1996-05-30 | 1998-01-20 | Parodi; Juan C. | Apparatus for implanting a prothesis within a body passageway |
US5779643A (en) | 1996-11-26 | 1998-07-14 | Hewlett-Packard Company | Imaging guidewire with back and forth sweeping ultrasonic source |
WO1997046164A1 (en) | 1996-06-07 | 1997-12-11 | Scieran Technologies, Inc. | An apparatus and method for performing ophthalmic procedures |
US5843161A (en) | 1996-06-26 | 1998-12-01 | Cordis Corporation | Endoprosthesis assembly for percutaneous deployment and method of deploying same |
US5819738A (en) | 1996-07-03 | 1998-10-13 | Symbiosis Corporation | Jaw assembly having progressively larger teeth and endoscopic biopsy forceps instrument incorporating same |
US5820592A (en) | 1996-07-16 | 1998-10-13 | Hammerslag; Gary R. | Angiographic and/or guide catheter |
US5662671A (en) | 1996-07-17 | 1997-09-02 | Embol-X, Inc. | Atherectomy device having trapping and excising means for removal of plaque from the aorta and other arteries |
US5735816A (en) | 1996-07-23 | 1998-04-07 | Medtronic, Inc. | Spiral sheath retainer for autoperfusion dilatation catheter balloon |
US5972019A (en) | 1996-07-25 | 1999-10-26 | Target Therapeutics, Inc. | Mechanical clot treatment device |
US5827201A (en) | 1996-07-26 | 1998-10-27 | Target Therapeutics, Inc. | Micro-braided guidewire |
US5779721A (en) | 1996-07-26 | 1998-07-14 | Kensey Nash Corporation | System and method of use for revascularizing stenotic bypass grafts and other blood vessels |
US6080170A (en) | 1996-07-26 | 2000-06-27 | Kensey Nash Corporation | System and method of use for revascularizing stenotic bypass grafts and other occluded blood vessels |
US6830577B2 (en) | 1996-07-26 | 2004-12-14 | Kensey Nash Corporation | System and method of use for treating occluded vessels and diseased tissue |
US5676697A (en) | 1996-07-29 | 1997-10-14 | Cardiovascular Dynamics, Inc. | Two-piece, bifurcated intraluminal graft for repair of aneurysm |
US7603166B2 (en) | 1996-09-20 | 2009-10-13 | Board Of Regents University Of Texas System | Method and apparatus for detection of vulnerable atherosclerotic plaque |
US6682536B2 (en) | 2000-03-22 | 2004-01-27 | Advanced Stent Technologies, Inc. | Guidewire introducer sheath |
US5713913A (en) | 1996-11-12 | 1998-02-03 | Interventional Technologies Inc. | Device and method for transecting a coronary artery |
US6217595B1 (en) | 1996-11-18 | 2001-04-17 | Shturman Cardiology Systems, Inc. | Rotational atherectomy device |
US5931848A (en) | 1996-12-02 | 1999-08-03 | Angiotrax, Inc. | Methods for transluminally performing surgery |
EP1011460A4 (en) | 1996-12-02 | 2001-09-19 | Angiotrax Inc | Apparatus and methods for percutaneously performing surgery |
JP4200459B2 (en) | 1997-01-06 | 2008-12-24 | 二郎 北村 | Seismic isolation device or seismic isolation structure |
US5893857A (en) | 1997-01-21 | 1999-04-13 | Shturman Cardiology Systems, Inc. | Handle for atherectomy device |
US6129734A (en) | 1997-01-21 | 2000-10-10 | Shturman Cardiology Systems, Inc. | Rotational atherectomy device with radially expandable prime mover coupling |
DE19703779C2 (en) | 1997-02-01 | 2003-06-05 | Karlsruhe Forschzent | Method and device for producing a disperse mixture |
US5720735A (en) | 1997-02-12 | 1998-02-24 | Dorros; Gerald | Bifurcated endovascular catheter |
US5882329A (en) | 1997-02-12 | 1999-03-16 | Prolifix Medical, Inc. | Apparatus and method for removing stenotic material from stents |
EP1007139A4 (en) | 1997-02-12 | 2000-06-14 | Prolifix Medical Inc | Apparatus for removal of material from stents |
US5968064A (en) | 1997-02-28 | 1999-10-19 | Lumend, Inc. | Catheter system for treating a vascular occlusion |
US6217549B1 (en) | 1997-02-28 | 2001-04-17 | Lumend, Inc. | Methods and apparatus for treating vascular occlusions |
US5741270A (en) | 1997-02-28 | 1998-04-21 | Lumend, Inc. | Manual actuator for a catheter system for treating a vascular occlusion |
US6010449A (en) | 1997-02-28 | 2000-01-04 | Lumend, Inc. | Intravascular catheter system for treating a vascular occlusion |
US6120516A (en) | 1997-02-28 | 2000-09-19 | Lumend, Inc. | Method for treating vascular occlusion |
US6849068B1 (en) | 1997-03-06 | 2005-02-01 | Medtronic Ave, Inc. | Aspiration catheter |
US5843103A (en) | 1997-03-06 | 1998-12-01 | Scimed Life Systems, Inc. | Shaped wire rotational atherectomy device |
US5824055A (en) | 1997-03-25 | 1998-10-20 | Endotex Interventional Systems, Inc. | Stent graft delivery system and methods of use |
JP3430436B2 (en) | 1997-03-28 | 2003-07-28 | 株式会社大井製作所 | Door lock device for automobile |
US5772674A (en) | 1997-03-31 | 1998-06-30 | Nakhjavan; Fred K. | Catheter for removal of clots in blood vessels |
US5810867A (en) | 1997-04-28 | 1998-09-22 | Medtronic, Inc. | Dilatation catheter with varied stiffness |
US5911734A (en) | 1997-05-08 | 1999-06-15 | Embol-X, Inc. | Percutaneous catheter and guidewire having filter and medical device deployment capabilities |
US5922003A (en) | 1997-05-09 | 1999-07-13 | Xomed Surgical Products, Inc. | Angled rotary tissue cutting instrument and method of fabricating the same |
US5954745A (en) | 1997-05-16 | 1999-09-21 | Gertler; Jonathan | Catheter-filter set having a compliant seal |
US6048349A (en) | 1997-07-09 | 2000-04-11 | Intraluminal Therapeutics, Inc. | Systems and methods for guiding a medical instrument through a body |
US6013072A (en) | 1997-07-09 | 2000-01-11 | Intraluminal Therapeutics, Inc. | Systems and methods for steering a catheter through body tissue |
US6159442A (en) | 1997-08-05 | 2000-12-12 | Mfic Corporation | Use of multiple stream high pressure mixer/reactor |
GB9717580D0 (en) | 1997-08-19 | 1997-10-22 | Curry Paul | Device for opening blocked tubes |
US6050949A (en) | 1997-09-22 | 2000-04-18 | Scimed Life Systems, Inc. | Catheher system having connectable distal and proximal portions |
US6361545B1 (en) | 1997-09-26 | 2002-03-26 | Cardeon Corporation | Perfusion filter catheter |
US5951480A (en) | 1997-09-29 | 1999-09-14 | Boston Scientific Corporation | Ultrasound imaging guidewire with static central core and tip |
US6066149A (en) | 1997-09-30 | 2000-05-23 | Target Therapeutics, Inc. | Mechanical clot treatment device with distal filter |
US6193676B1 (en) | 1997-10-03 | 2001-02-27 | Intraluminal Therapeutics, Inc. | Guide wire assembly |
US5951482A (en) | 1997-10-03 | 1999-09-14 | Intraluminal Therapeutics, Inc. | Assemblies and methods for advancing a guide wire through body tissue |
US6156046A (en) | 1997-11-07 | 2000-12-05 | Prolifix Medical, Inc. | Methods and systems for treating obstructions in a body lumen |
US5947985A (en) | 1997-11-12 | 1999-09-07 | Imran; Mir A. | Apparatus and method for cleaning diseased vein grafts |
US6183432B1 (en) | 1997-11-13 | 2001-02-06 | Lumend, Inc. | Guidewire and catheter with rotating and reciprocating symmetrical or asymmetrical distal tip |
US5938671A (en) | 1997-11-14 | 1999-08-17 | Reflow, Inc. | Recanalization apparatus and devices for use therein and method |
US5935108A (en) | 1997-11-14 | 1999-08-10 | Reflow, Inc. | Recanalization apparatus and devices for use therein and method |
US6330884B1 (en) | 1997-11-14 | 2001-12-18 | Transvascular, Inc. | Deformable scaffolding multicellular stent |
DE29722136U1 (en) | 1997-12-15 | 1999-04-15 | Ischinger Thomas Prof Dr | Vascular thrombectomy catheter to remove endoluminal thrombus |
US6217527B1 (en) | 1998-09-30 | 2001-04-17 | Lumend, Inc. | Methods and apparatus for crossing vascular occlusions |
US6231546B1 (en) | 1998-01-13 | 2001-05-15 | Lumend, Inc. | Methods and apparatus for crossing total occlusions in blood vessels |
US6081738A (en) | 1998-01-15 | 2000-06-27 | Lumend, Inc. | Method and apparatus for the guided bypass of coronary occlusions |
US5865748A (en) | 1998-01-16 | 1999-02-02 | Guidant Corporation | Guided directional coronary atherectomy distal linear encoder |
AU1927399A (en) | 1998-01-16 | 1999-08-02 | Lumend, Inc. | Catheter apparatus for treating arterial occlusions |
JP2002502626A (en) | 1998-02-10 | 2002-01-29 | アーテミス・メディカル・インコーポレイテッド | Supplementary device and method of using the same |
JP4157183B2 (en) | 1998-02-17 | 2008-09-24 | オリンパス株式会社 | Endoscopic treatment tool |
US6159195A (en) | 1998-02-19 | 2000-12-12 | Percusurge, Inc. | Exchange catheter and method of use |
US20060074442A1 (en) | 2000-04-06 | 2006-04-06 | Revascular Therapeutics, Inc. | Guidewire for crossing occlusions or stenoses |
US6398798B2 (en) | 1998-02-28 | 2002-06-04 | Lumend, Inc. | Catheter system for treating a vascular occlusion |
US6454727B1 (en) | 1998-03-03 | 2002-09-24 | Senorx, Inc. | Tissue acquisition system and method of use |
US6475187B1 (en) * | 1998-03-04 | 2002-11-05 | Scimed Life Systems, Inc. | Convertible catheter incorporating distal force transfer mechanism |
US6019778A (en) | 1998-03-13 | 2000-02-01 | Cordis Corporation | Delivery apparatus for a self-expanding stent |
US6561998B1 (en) | 1998-04-07 | 2003-05-13 | Transvascular, Inc. | Transluminal devices, systems and methods for enlarging interstitial penetration tracts |
US6001112A (en) | 1998-04-10 | 1999-12-14 | Endicor Medical, Inc. | Rotational atherectomy device |
US6482217B1 (en) | 1998-04-10 | 2002-11-19 | Endicor Medical, Inc. | Neuro thrombectomy catheter |
US6666874B2 (en) | 1998-04-10 | 2003-12-23 | Endicor Medical, Inc. | Rotational atherectomy system with serrated cutting tip |
US6383195B1 (en) | 1998-04-13 | 2002-05-07 | Endoline, Inc. | Laparoscopic specimen removal apparatus |
US6036646A (en) | 1998-07-10 | 2000-03-14 | Guided Therapy Systems, Inc. | Method and apparatus for three dimensional ultrasound imaging |
US6106515A (en) | 1998-08-13 | 2000-08-22 | Intraluminal Therapeutics, Inc. | Expandable laser catheter |
US6241744B1 (en) | 1998-08-14 | 2001-06-05 | Fox Hollow Technologies, Inc. | Apparatus for deploying a guidewire across a complex lesion |
US6095990A (en) | 1998-08-31 | 2000-08-01 | Parodi; Juan Carlos | Guiding device and method for inserting and advancing catheters and guidewires into a vessel of a patient in endovascular treatments |
US6440147B1 (en) | 1998-09-03 | 2002-08-27 | Rubicor Medical, Inc. | Excisional biopsy devices and methods |
US6022362A (en) | 1998-09-03 | 2000-02-08 | Rubicor Medical, Inc. | Excisional biopsy devices and methods |
US6620180B1 (en) | 1998-09-09 | 2003-09-16 | Medtronic Xomed, Inc. | Powered laryngeal cutting blade |
AU6279299A (en) | 1998-10-02 | 2000-04-26 | Stereotaxis, Inc. | Magnetically navigable and/or controllable device for removing material from body lumens and cavities |
US6428551B1 (en) | 1999-03-30 | 2002-08-06 | Stereotaxis, Inc. | Magnetically navigable and/or controllable device for removing material from body lumens and cavities |
US6264611B1 (en) | 1998-11-25 | 2001-07-24 | Ball Semiconductor, Inc. | Monitor for interventional procedures |
US6228076B1 (en) | 1999-01-09 | 2001-05-08 | Intraluminal Therapeutics, Inc. | System and method for controlling tissue ablation |
US6165199A (en) | 1999-01-12 | 2000-12-26 | Coaxia, Inc. | Medical device for removing thromboembolic material from cerebral arteries and methods of use |
US6191862B1 (en) | 1999-01-20 | 2001-02-20 | Lightlab Imaging, Llc | Methods and apparatus for high speed longitudinal scanning in imaging systems |
US6592526B1 (en) | 1999-01-25 | 2003-07-15 | Jay Alan Lenker | Resolution ultrasound devices for imaging and treatment of body lumens |
US7524289B2 (en) | 1999-01-25 | 2009-04-28 | Lenker Jay A | Resolution optical and ultrasound devices for imaging and treatment of body lumens |
US6110121A (en) | 1999-01-25 | 2000-08-29 | Lenker; Jay Alan | Method and apparatus for obtaining improved resolution from intraluminal ultrasound |
US6475226B1 (en) | 1999-02-03 | 2002-11-05 | Scimed Life Systems, Inc. | Percutaneous bypass apparatus and method |
US6113615A (en) * | 1999-02-03 | 2000-09-05 | Scimed Life Systems, Inc. | Atherectomy burr including a bias wire |
WO2000045691A2 (en) | 1999-02-04 | 2000-08-10 | Da Silva Branco Antonio Carlos | Kit for endovascular venous surgery |
US6196963B1 (en) | 1999-03-02 | 2001-03-06 | Medtronic Ave, Inc. | Brachytherapy device assembly and method of use |
DE19911777A1 (en) | 1999-03-17 | 2000-09-21 | Merck Patent Gmbh | Process for the preparation of cosmetic formulations |
US6245012B1 (en) | 1999-03-19 | 2001-06-12 | Nmt Medical, Inc. | Free standing filter |
US6911026B1 (en) | 1999-07-12 | 2005-06-28 | Stereotaxis, Inc. | Magnetically guided atherectomy |
US6066153A (en) | 1999-03-31 | 2000-05-23 | Lev; Avigdor | Device and method for resecting body tissues |
US6277138B1 (en) | 1999-08-17 | 2001-08-21 | Scion Cardio-Vascular, Inc. | Filter for embolic material mounted on expandable frame |
US6319275B1 (en) | 1999-04-07 | 2001-11-20 | Medtronic Ave, Inc. | Endolumenal prosthesis delivery assembly and method of use |
DE19917148C2 (en) | 1999-04-16 | 2002-01-10 | Inst Mikrotechnik Mainz Gmbh | Process and micromixer for producing a dispersion |
US7526481B1 (en) | 1999-04-19 | 2009-04-28 | Oracle International Corporation | Web servers with queryable dynamic caches |
US6238405B1 (en) | 1999-04-30 | 2001-05-29 | Edwards Lifesciences Corp. | Percutaneous material removal device and method |
US6790215B2 (en) | 1999-04-30 | 2004-09-14 | Edwards Lifesciences Corporation | Method of use for percutaneous material removal device and tip |
DE19925184A1 (en) | 1999-05-26 | 2000-11-30 | Schering Ag | Continuous process for the production of morphologically uniform micro and nanoparticles by means of a micromixer as well as particles produced by this process |
US6126649A (en) | 1999-06-10 | 2000-10-03 | Transvascular, Inc. | Steerable catheter with external guidewire as catheter tip deflector |
US6605061B2 (en) | 1999-07-14 | 2003-08-12 | Tricardia, L.L.C. | Catheter for drug injection in cardiovascular system |
US6179859B1 (en) | 1999-07-16 | 2001-01-30 | Baff Llc | Emboli filtration system and methods of use |
US6142987A (en) | 1999-08-03 | 2000-11-07 | Scimed Life Systems, Inc. | Guided filter with support wire and methods of use |
US6445939B1 (en) | 1999-08-09 | 2002-09-03 | Lightlab Imaging, Llc | Ultra-small optical probes, imaging optics, and methods for using same |
US6231549B1 (en) | 1999-08-17 | 2001-05-15 | Sherwood Services, Ag | Shim device for enteral feeding system |
US7713279B2 (en) | 2000-12-20 | 2010-05-11 | Fox Hollow Technologies, Inc. | Method and devices for cutting tissue |
US6299622B1 (en) | 1999-08-19 | 2001-10-09 | Fox Hollow Technologies, Inc. | Atherectomy catheter with aligned imager |
US8328829B2 (en) | 1999-08-19 | 2012-12-11 | Covidien Lp | High capacity debulking catheter with razor edge cutting window |
US6638233B2 (en) | 1999-08-19 | 2003-10-28 | Fox Hollow Technologies, Inc. | Apparatus and methods for material capture and removal |
US7708749B2 (en) | 2000-12-20 | 2010-05-04 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
US6447525B2 (en) | 1999-08-19 | 2002-09-10 | Fox Hollow Technologies, Inc. | Apparatus and methods for removing material from a body lumen |
US7887556B2 (en) | 2000-12-20 | 2011-02-15 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
US20030125757A1 (en) | 2000-12-20 | 2003-07-03 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
US20030120295A1 (en) | 2000-12-20 | 2003-06-26 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
US6187025B1 (en) | 1999-09-09 | 2001-02-13 | Noble-Met, Ltd. | Vascular filter |
WO2001019444A1 (en) | 1999-09-17 | 2001-03-22 | Bacchus Vascular Inc. | Mechanical pump for removal of fragmented matter and methods of manufacture and use |
US6533749B1 (en) | 1999-09-24 | 2003-03-18 | Medtronic Xomed, Inc. | Angled rotary tissue cutting instrument with flexible inner member |
AU1313301A (en) | 1999-10-26 | 2001-05-08 | Mark Wilson Ian Webster | A guidewire positioning device |
US6263236B1 (en) | 1999-11-29 | 2001-07-17 | Illumenex Corporation | Non-occlusive expandable catheter |
WO2001043809A1 (en) | 1999-12-16 | 2001-06-21 | Advanced Cardiovascular Systems, Inc. | Catheter assembly and method for positioning the same at a bifurcated vessel |
DE19961257C2 (en) | 1999-12-18 | 2002-12-19 | Inst Mikrotechnik Mainz Gmbh | micromixer |
US6394976B1 (en) | 2000-01-31 | 2002-05-28 | Intraluminal Therapeutics, Inc. | Catheter for controlling the advancement of a guide wire |
US6629953B1 (en) | 2000-02-18 | 2003-10-07 | Fox Hollow Technologies, Inc. | Methods and devices for removing material from a vascular site |
GB2357762B (en) | 2000-03-13 | 2002-01-30 | Lundbeck & Co As H | Crystalline base of citalopram |
US20010031981A1 (en) | 2000-03-31 | 2001-10-18 | Evans Michael A. | Method and device for locating guidewire and treating chronic total occlusions |
CA2403925C (en) | 2000-04-05 | 2008-09-16 | Stx Medical, Inc. | Intralumenal material removal systems and methods |
US6565588B1 (en) | 2000-04-05 | 2003-05-20 | Pathway Medical Technologies, Inc. | Intralumenal material removal using an expandable cutting device |
US7344546B2 (en) | 2000-04-05 | 2008-03-18 | Pathway Medical Technologies | Intralumenal material removal using a cutting device for differential cutting |
US6627784B2 (en) | 2000-05-17 | 2003-09-30 | Hydro Dynamics, Inc. | Highly efficient method of mixing dissimilar fluids using mechanically induced cavitation |
US6422736B1 (en) | 2000-06-21 | 2002-07-23 | Eastman Kodak Company | Scalable impeller apparatus for preparing silver halide grains |
US6532380B1 (en) | 2000-06-30 | 2003-03-11 | Cedars Sinai Medical Center | Image guidance for coronary stent deployment |
US6425870B1 (en) | 2000-07-11 | 2002-07-30 | Vermon | Method and apparatus for a motorized multi-plane transducer tip |
US6497711B1 (en) | 2000-08-16 | 2002-12-24 | Scimed Life Systems, Inc. | Therectomy device having a light weight drive shaft and an imaging device |
DE10041823C2 (en) | 2000-08-25 | 2002-12-19 | Inst Mikrotechnik Mainz Gmbh | Method and static micromixer for mixing at least two fluids |
US6656195B2 (en) | 2000-09-22 | 2003-12-02 | Medtronic Xomed, Inc. | Flexible inner tubular members and rotary tissue cutting instruments having flexible inner tubular members |
US20020058904A1 (en) | 2000-11-08 | 2002-05-16 | Robert Boock | Thrombus removal device |
US20070049958A1 (en) | 2005-08-30 | 2007-03-01 | Arthrex, Inc. | Spiral cut curved blade |
US7699790B2 (en) | 2000-12-20 | 2010-04-20 | Ev3, Inc. | Debulking catheters and methods |
EP1767159A1 (en) | 2000-12-20 | 2007-03-28 | Fox Hollow Technologies Inc. | Catheter for removing atheromatous or thrombotic occlusive material |
ATE499054T1 (en) | 2000-12-20 | 2011-03-15 | Fox Hollow Technologies Inc | REDUCTION CATHETER |
US7169165B2 (en) | 2001-01-16 | 2007-01-30 | Boston Scientific Scimed, Inc. | Rapid exchange sheath for deployment of medical devices and methods of use |
US6569177B1 (en) | 2001-01-19 | 2003-05-27 | Scimed Life Systems, Inc. | Ablation atherectomy burr |
US6428552B1 (en) | 2001-01-22 | 2002-08-06 | Lumend, Inc. | Method and apparatus for crossing intravascular occlusions |
WO2002083229A2 (en) | 2001-04-16 | 2002-10-24 | Medtronic Percusurge, Inc. | Aspiration catheters and method of use |
US20030023263A1 (en) | 2001-07-24 | 2003-01-30 | Incept Llc | Apparatus and methods for aspirating emboli |
US6623437B2 (en) | 2001-08-28 | 2003-09-23 | Rex Medical, L.P. | Tissue biopsy apparatus |
US6610059B1 (en) | 2002-02-25 | 2003-08-26 | Hs West Investments Llc | Endoscopic instruments and methods for improved bubble aspiration at a surgical site |
US20030199747A1 (en) | 2002-04-19 | 2003-10-23 | Michlitsch Kenneth J. | Methods and apparatus for the identification and stabilization of vulnerable plaque |
US6932502B2 (en) | 2002-05-01 | 2005-08-23 | Hewlett-Packard Development Company, L.P. | Mixing apparatus |
US7153315B2 (en) | 2002-06-11 | 2006-12-26 | Boston Scientific Scimed, Inc. | Catheter balloon with ultrasonic microscalpel blades |
EP1534152A1 (en) | 2002-07-13 | 2005-06-01 | Stryker Corporation | System and method for performing irrigated nose and throat surgery |
US20040210245A1 (en) | 2002-07-26 | 2004-10-21 | John Erickson | Bendable needle with removable stylet |
US20040049225A1 (en) | 2002-09-11 | 2004-03-11 | Denison Andy E. | Aspiration catheter |
US7734332B2 (en) | 2002-10-18 | 2010-06-08 | Ariomedica Ltd. | Atherectomy system with imaging guidewire |
JP2006514369A (en) | 2003-02-21 | 2006-04-27 | センサーマチック・エレクトロニックス・コーポレーション | Integrated electronic merchandise monitoring (EAS) and point of sale (POS) system and method |
US20040193034A1 (en) | 2003-03-28 | 2004-09-30 | Lawrence Wasicek | Combined long rail/short rail IVUS catheter |
US8246640B2 (en) | 2003-04-22 | 2012-08-21 | Tyco Healthcare Group Lp | Methods and devices for cutting tissue at a vascular location |
US20050004594A1 (en) | 2003-07-02 | 2005-01-06 | Jeffrey Nool | Devices and methods for aspirating from filters |
US6919690B2 (en) | 2003-07-22 | 2005-07-19 | Veeco Instruments, Inc. | Modular uniform gas distribution system in an ion source |
JP4026829B2 (en) | 2003-07-24 | 2007-12-26 | ローム アンド ハース カンパニー | Microbicidal composition |
JP2005068125A (en) | 2003-08-21 | 2005-03-17 | Rohm & Haas Co | Method for preparing biocide-blended material |
US20050090849A1 (en) | 2003-10-22 | 2005-04-28 | Adams Kenneth M. | Angled tissue cutting instruments and method of fabricating angled tissue cutting instrument having flexible inner tubular members of tube and single wrap construction |
US7338495B2 (en) | 2003-10-22 | 2008-03-04 | Medtronic Xomed, Inc. | Angled tissue cutting instruments having flexible inner tubular members of tube and sleeve construction |
US7488322B2 (en) | 2004-02-11 | 2009-02-10 | Medtronic, Inc. | High speed surgical cutting instrument |
US7959634B2 (en) | 2004-03-29 | 2011-06-14 | Soteira Inc. | Orthopedic surgery access devices |
DE102004015639B4 (en) | 2004-03-31 | 2007-05-03 | Siemens Ag | Apparatus for performing cutting-balloon intervention with IVUS monitoring |
US7479148B2 (en) | 2004-11-08 | 2009-01-20 | Crescendo Technologies, Llc | Ultrasonic shear with asymmetrical motion |
JP2008543511A (en) | 2005-06-24 | 2008-12-04 | ヴォルケイノウ・コーポレーション | Vascular image preparation method |
KR100668852B1 (en) | 2005-06-30 | 2007-01-16 | 주식회사 하이닉스반도체 | Duty Cycle Correction Device |
DE102005045373A1 (en) | 2005-09-22 | 2007-04-05 | Siemens Ag | catheter device |
US20080051812A1 (en) | 2006-08-01 | 2008-02-28 | Baxano, Inc. | Multi-Wire Tissue Cutter |
US20070167824A1 (en) | 2005-11-30 | 2007-07-19 | Warren Lee | Method of manufacture of catheter tips, including mechanically scanning ultrasound probe catheter tip, and apparatus made by the method |
DE102005059271B4 (en) | 2005-12-12 | 2019-02-21 | Siemens Healthcare Gmbh | catheter device |
DE102005059262B4 (en) | 2005-12-12 | 2008-02-07 | Siemens Ag | catheter device |
US7951161B2 (en) | 2006-05-09 | 2011-05-31 | Medrad, Inc. | Atherectomy system having a variably exposed cutter |
US20070276419A1 (en) | 2006-05-26 | 2007-11-29 | Fox Hollow Technologies, Inc. | Methods and devices for rotating an active element and an energy emitter on a catheter |
US20090018566A1 (en) | 2006-06-30 | 2009-01-15 | Artheromed, Inc. | Atherectomy devices, systems, and methods |
US20080004645A1 (en) | 2006-06-30 | 2008-01-03 | Atheromed, Inc. | Atherectomy devices and methods |
US20080045986A1 (en) | 2006-06-30 | 2008-02-21 | Atheromed, Inc. | Atherectomy devices and methods |
US8007506B2 (en) | 2006-06-30 | 2011-08-30 | Atheromed, Inc. | Atherectomy devices and methods |
US8361094B2 (en) | 2006-06-30 | 2013-01-29 | Atheromed, Inc. | Atherectomy devices and methods |
US8628549B2 (en) | 2006-06-30 | 2014-01-14 | Atheromed, Inc. | Atherectomy devices, systems, and methods |
JP4776032B2 (en) | 2006-07-26 | 2011-09-21 | 古河スカイ株式会社 | Heat exchanger |
WO2008042987A2 (en) | 2006-10-04 | 2008-04-10 | Pathway Medical Technologies, Inc. | Interventional catheters |
US8211025B2 (en) | 2006-10-20 | 2012-07-03 | General Electric Company | Four-way steerable catheter system and method of use |
US20080161840A1 (en) | 2006-12-29 | 2008-07-03 | Vascure Ltd. | Atherectomy methods and apparatus |
CA2675619C (en) | 2007-01-19 | 2016-08-16 | Sunnybrook Health Sciences Centre | Scanning mechanisms for imaging probe |
US20080208227A1 (en) | 2007-02-23 | 2008-08-28 | Terumo Cardiovascular Systems Corporation | Self-contained dissector/harvester device |
US8574253B2 (en) | 2007-04-06 | 2013-11-05 | Hologic, Inc. | Method, system and device for tissue removal |
US20080312673A1 (en) | 2007-06-05 | 2008-12-18 | Viswanathan Raju R | Method and apparatus for CTO crossing |
US8475478B2 (en) | 2007-07-05 | 2013-07-02 | Cardiovascular Systems, Inc. | Cleaning apparatus and method for high-speed rotational atherectomy devices |
US8070762B2 (en) | 2007-10-22 | 2011-12-06 | Atheromed Inc. | Atherectomy devices and methods |
US8236016B2 (en) | 2007-10-22 | 2012-08-07 | Atheromed, Inc. | Atherectomy devices and methods |
US20090138031A1 (en) | 2007-11-24 | 2009-05-28 | Tsukernik Vladimir B | Thrombectomy catheter with a helical cutter |
US8784440B2 (en) | 2008-02-25 | 2014-07-22 | Covidien Lp | Methods and devices for cutting tissue |
EP2262423B1 (en) | 2008-03-06 | 2018-01-10 | Covidien LP | Image enhancement and application functionality for medical and other uses |
US8062316B2 (en) | 2008-04-23 | 2011-11-22 | Avinger, Inc. | Catheter system and method for boring through blocked vascular passages |
US20090275966A1 (en) | 2008-05-05 | 2009-11-05 | Miroslav Mitusina | Flexible inner members having flexible regions comprising a plurality of intertwined helical cuts |
US9186170B2 (en) | 2008-06-05 | 2015-11-17 | Cardiovascular Systems, Inc. | Bidirectional expandable head for rotational atherectomy device |
US20100030216A1 (en) | 2008-07-30 | 2010-02-04 | Arcenio Gregory B | Discectomy tool having counter-rotating nucleus disruptors |
JP5042162B2 (en) | 2008-08-12 | 2012-10-03 | 株式会社日立ハイテクノロジーズ | Semiconductor processing method |
KR101645754B1 (en) | 2008-10-13 | 2016-08-04 | 코비디엔 엘피 | Devices and methods for manipulating a catheter shaft |
DE102009014489B4 (en) | 2009-03-23 | 2011-03-10 | Siemens Aktiengesellschaft | Catheter and medical device |
CN102625673B (en) | 2009-04-29 | 2014-12-24 | 泰科保健集团有限合伙公司 | Methods and devices for cutting and abrading tissue |
AU2010248909B2 (en) | 2009-05-14 | 2013-03-21 | Covidien Lp | Easily cleaned atherectomy catheters and methods of use |
EP2448502B1 (en) | 2009-07-01 | 2022-04-06 | Avinger, Inc. | Atherectomy catheter with laterally-displaceable tip |
US8142464B2 (en) | 2009-07-21 | 2012-03-27 | Miroslav Mitusina | Flexible inner member having a flexible region composed of longitudinally and rotationally offset partial circumferential cuts |
WO2011040250A1 (en) | 2009-09-29 | 2011-04-07 | コニカミノルタホールディングス株式会社 | Actuator, drive device, and camera module |
AU2010326063B2 (en) | 2009-12-02 | 2013-07-04 | Covidien Lp | Methods and devices for cutting tissue |
JP5511107B2 (en) | 2009-12-11 | 2014-06-04 | コヴィディエン リミテッド パートナーシップ | Substance removal device and method with improved substance capture efficiency |
JP6269460B2 (en) | 2014-12-10 | 2018-01-31 | 京セラドキュメントソリューションズ株式会社 | Image forming apparatus |
-
2006
- 2006-05-18 US US11/437,849 patent/US8246640B2/en active Active
-
2007
- 2007-05-18 EP EP07809112.1A patent/EP2019634B1/en not_active Not-in-force
- 2007-05-18 WO PCT/US2007/012008 patent/WO2008020905A2/en active Application Filing
-
2012
- 2012-07-17 US US13/551,123 patent/US8961546B2/en not_active Expired - Fee Related
-
2015
- 2015-02-23 US US14/628,648 patent/US9999438B2/en active Active
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6027514A (en) | 1997-12-17 | 2000-02-22 | Fox Hollow Technologies, Inc. | Apparatus and method for removing occluding material from body lumens |
WO2001015609A1 (en) | 1999-08-31 | 2001-03-08 | Fox Hollow Technologies | Atherectomy catheter with a rotating and telescoping cutter |
WO2002045598A2 (en) | 2000-12-05 | 2002-06-13 | Lumend, Inc. | Catheter system for vascular re-entry from a sub-intimal space |
US20040167554A1 (en) | 2000-12-20 | 2004-08-26 | Fox Hollow Technologies, Inc. | Methods and devices for reentering a true lumen from a subintimal space |
Non-Patent Citations (1)
Title |
---|
See also references of EP2019634A4 |
Also Published As
Publication number | Publication date |
---|---|
US20120283761A1 (en) | 2012-11-08 |
EP2019634B1 (en) | 2015-11-11 |
US8246640B2 (en) | 2012-08-21 |
US20150238222A1 (en) | 2015-08-27 |
US8961546B2 (en) | 2015-02-24 |
WO2008020905A3 (en) | 2008-11-06 |
US9999438B2 (en) | 2018-06-19 |
EP2019634A4 (en) | 2013-05-22 |
EP2019634A2 (en) | 2009-02-04 |
US20070010840A1 (en) | 2007-01-11 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US11666355B2 (en) | Catheter including cutting element and energy emitting element | |
US8246640B2 (en) | Methods and devices for cutting tissue at a vascular location | |
EP2641551B1 (en) | Devices for reentering a true lumen from a subintimal space | |
US10022145B2 (en) | Methods and devices for cutting tissue | |
US7771444B2 (en) | Methods and devices for removing material from a body lumen | |
US7887556B2 (en) | Debulking catheters and methods | |
US20030125757A1 (en) | Debulking catheters and methods | |
US20030120295A1 (en) | Debulking catheters and methods | |
EP1767159A1 (en) | Catheter for removing atheromatous or thrombotic occlusive material |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 07809112 Country of ref document: EP Kind code of ref document: A2 |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2007809112 Country of ref document: EP |
|
NENP | Non-entry into the national phase |
Ref country code: DE |