CROSS REFERENCE TO RELATED APPLICATION This is a continuation of copending application Ser. No. 10/621,599 filed on Jul. 17, 2003, which is a continuation of application Ser. No. 09/801,263 filed on Mar. 7, 2001, now U.S. Pat. No. 6,616,681, which in turn claims priority to U.S. Provisional Application Ser. No. 60/238,188, filed Oct. 5, 2000.
FIELD OF THE INVENTION The present invention relates generally to devices and methods for treating occluded or stenoic blood vessels. More particularly, the present invention relates to devices and methods for providing temporary placement of a filter in a blood vessel during a procedure to remove an occlusion or stenosis.
BACKGROUND OF THE INVENTION It is critical that the heart muscle be well oxygenated so that the blood pumping action of the heart is not impaired. Blood vessels which have become occluded (blocked) or stenotic (narrowed) may interrupt the oxygen supply to the heart muscle.
Occluded or stenotic blood vessels may be treated with a number of medical procedures including angioplasty and atherectomy. Angioplasty techniques such as percutaneous transluminal angioplasty (PTA) and percutaneous transluminal coronary angioplasty (PTCA) are relatively non-invasive methods of treating a stenotic lesion. These angioplasty techniques typically involve the use of a guidewire and a balloon catheter. In these procedures, a balloon catheter is advanced over a guidewire such that the balloon is positioned proximate a restriction in a diseased vessel. The balloon is then inflated and the restriction in the vessel is opened. During an atherectomy procedure, the stenotic lesion is mechanically cut or abraded away from the blood vessel wall using an atherectomy catheter.
During atherectomy procedures, stenotic debris that is separated from the stenosis may be free to flow within the lumen of the vessel. If this debris enters the circulatory system, it may facilitate the formation of an occlusion in the neural vasculature, or in the lungs, both of which are highly undesirable. An occlusion in the neural vasculature may cause a stroke, and an occlusion in the lungs may interfere with the oxygenation of the blood. During angioplasty procedures, stenotic debris may also break loose due to manipulation of the blood vessel.
SUMMARY OF THE INVENTION The present invention relates generally to devices and methods for treating occluded or stenoic blood vessels. More particularly, the present invention relates to devices and methods for providing temporary placement of a filter in a blood vessel during a procedure to remove an occlusion or stenosis. A filter delivery system in accordance with one exemplary embodiment of the present invention includes a catheter having an elongate shaft and a tubular member disposed within a shaft lumen defined by the elongate shaft. The elongate shaft also includes a proximal end, a distal end, and a wall defining the shaft lumen. The tubular member has a first end fixed to the wall of the elongate shaft, and a second end disposed within the shaft lumen. The tubular member defines a guidewire lumen that is in fluid communication with a distal guidewire port defined by the second end of the tubular member. The catheter also includes a proximal guidewire port extending through the wall of the elongate shaft.
A filter may be disposed within a distal portion of the shaft lumen. A distal end of a guidewire is preferably fixed to the filter. The guidewire preferably extends through the distal guidewire port, the guidewire lumen, and the proximal guidewire port. The elongate shaft of the catheter may be moved proximally relative to the guidewire so that the filter is disposed outside of the shaft lumen. The filter is preferably free to assume an expanded configuration when it is outside of the shaft lumen.
The catheter may be moved relative to the guidewire, for example, by grasping a proximal portion of the guidewire and applying a pulling force to a hub of the catheter. The pulling force may be applied to the hub until the filter is deployed in the expanded configuration. The pulling force may also be continued until the catheter is removed from the blood vessel. Once the catheter has been removed from the blood vessel, the guidewire may be utilized to guide additional catheters (e.g., balloon catheters, atherectomy catheters, etc.) as they are advanced through the blood vessel.
A wire gripper may be used to aid in grasping the guidewire. One exemplary embodiment of a wire gripper includes a handle and a plurality of jaws for grasping the guidewire. A knurl nut fitting is used to urge the jaws against the guidewire.
An additional exemplary embodiment of a filter delivery system in accordance with the present invention includes a catheter having an elongate shaft and a hub disposed about the elongate shaft proximate the proximal end thereof. A slider is disposed in sliding engagement with a cavity of the hub. The slider includes a wire lock having a plurality of jaws. The wire lock may be used to selectively fix a proximal portion of a guidewire to the slider. A distal end of the guidewire is preferably fixed to a filter which is disposed in a shaft lumen of the catheter.
During a procedure to deliver the filter to a target location in a blood vessel, the hub and the shaft of the catheter may be moved proximally relative to the slider and the guidewire. When the hub is moved proximally relative to slider, the filter is urged out of the shaft lumen of the catheter. Once the filter is out of the shaft lumen it is free to assume an expanded configuration. The sliding relationship between the slider and the hub gives the user of the filter deployment system a defined distance to move the slider relative to the hub when deploying the filter.
Yet another exemplary embodiment of a filter delivery system in accordance with the present invention includes a catheter having an elongate shaft including a proximal portion, a distal portion, and a longitudinally collapsible portion disposed between the proximal portion and the distal portion. A ring is fixed to the distal portion of the elongate shaft distally of the collapsible portion. A pull wire is disposed within a shaft lumen defined by the elongate shaft. The distal end of the pull wire is fixed to the ring and the proximal end of the pull wire is fixed to a slider. The slider is disposed in sliding engagement with a hub that is disposed about a proximal end of the elongate shaft. In a preferred embodiment, the slider and the pull wire may be used to selectively collapse the longitudinally collapsible portion of the elongate shaft. The collapsible portion of the elongate shaft is preferably collapsed by urging the slider proximally relative to the hub. In a preferred method, the guidewire is held stationary relative to the slider, while the slider is moved proximally.
A filter retrieval system in accordance with an exemplary embodiment of the present invention includes a retrieval catheter which may be utilized to retrieve a filter that was previously delivered to a target location in a blood vessel. The filter may be delivered to the target location, for example, using a filter delivery system in accordance with an exemplary embodiment of the present invention.
During a retrieval procedure, the retrieval catheter may be advanced along the guidewire until a distal end of the catheter is proximate the filter. In a preferred embodiment, the catheter includes an elongate shaft and a cone disposed at a distal end of the elongate shaft. The cone preferably has a generally tapered shape that may aid in advancing the catheter through the blood vessel. Also in a preferred embodiment, the cone comprises a flexible material, allowing the cone to deflect as the filter is drawn through an aperture defined by the cone. Embodiments of the cone are possible in which the cone is adapted to fold proximally. Embodiments of the cone are also possible in which the aperture of the cone is adapted to expand radially as the filter passes through the aperture. The distal end of the catheter may be advanced distally relative to the guidewire so that the filter is disposed within a shaft lumen of the catheter.
An additional exemplary embodiment of a filter retrieval system in accordance with the present invention includes a catheter having an elongate shaft and a hub disposed about the elongate shaft proximate the proximal end thereof. A slider is disposed in sliding engagement with a cavity of the hub. The slider includes a wire lock having a plurality of jaws. The wire lock may be used to selectively fix a proximal portion of a guidewire to the slider. A distal end of the guidewire is preferably fixed to a filter which is disposed within a blood vessel.
During a filter retrieval procedure, the hub and the elongate shaft of the catheter may be moved distally relative to the slider and the guidewire. During the movement of the elongate shaft, the longitudinal position of the filter is preferably fixed by the guidewire, since the proximal portion of the guidewire is fixed to the slider by the wire lock. As the catheter is advanced distally, it preferably engulfs the filter. The sliding relationship between the slider and the hub gives the user of the system a defined distance to move the slider relative to the hub when retrieving the filter.
Yet another exemplary embodiment of a filter retrieval system in accordance with the present invention includes a catheter having an elongate shaft including a proximal portion, a distal portion, and a longitudinally expandable portion disposed between the proximal portion and the distal portion. A ring is fixed to the distal portion of the elongate shaft distally of the expandable portion. A push rod is disposed within a shaft lumen defined by the elongate shaft. The distal end of the push rod is fixed to the ring and the proximal end of the push rod is fixed to a slider. The slider is disposed in sliding engagement with a hub that is disposed about a proximal end of the elongate shaft. In a preferred embodiment, the slider and the push rod may be used to selectively expand the longitudinally expandable portion of the elongate shaft. The expandable portion of the elongate shaft is preferably expanded by urging the slider distally relative to the hub. In a preferred method, the guidewire is held stationary relative to the slider, while the slider is moved distally. When this is the case, the filter is preferably engulfed by the distal portion of the catheter.
BRIEF DESCRIPTION OF THE DRAWINGSFIG. 1 is a partial cross-sectional view of a filter delivery system in accordance with an exemplary embodiment of the present invention;
FIG. 2 is a partial cross-sectional view of the filter delivery system ofFIG. 1;
FIG. 3 is a partial cross-sectional view of a filter retrieval system in accordance with an exemplary embodiment of the present invention;
FIG. 4 is a partial cross-sectional view of the filter retrieval system ofFIG. 3;
FIG. 5 is a partial cross-sectional view of a filter delivery system in accordance with an additional exemplary embodiment of the present invention;
FIG. 6 is a partial cross-sectional view of the filter delivery system ofFIG. 5;
FIG. 7 is a partial cross-sectional view of a filter retrieval system in accordance with an additional exemplary embodiment of the present invention;
FIG. 8 is a partial cross-sectional view of the filter retrieval system ofFIG. 7;
FIG. 9 is a partial cross-sectional view of a filter delivery system in accordance with an additional exemplary embodiment of the present invention;
FIG. 10 is a partial cross-sectional view of the filter delivery system ofFIG. 9;
FIG. 11 is a partial cross-sectional view of a filter retrieval system in accordance with an additional exemplary embodiment of the present invention;
FIG. 12 is a partial cross-sectional view of the filter retrieval system ofFIG. 11;
FIG. 13 is a partial cross-sectional view of a filter delivery system in accordance with an additional exemplary embodiment of the present invention;
FIG. 14 is a partial cross-sectional view of the filter delivery system ofFIG. 13;
FIG. 15 is a partial cross-sectional view of a filter retrieval system in accordance with an additional exemplary embodiment of the present invention;
FIG. 16 is a partial cross-sectional view of the filter retrieval system ofFIG. 15;
FIG. 17 is a partial cross-sectional view of a filter retrieval system in accordance with an exemplary embodiment of the present invention;
FIG. 18 is a partial cross-sectional view of the filter retrieval system illustrated inFIG. 17;
FIG. 19 is a partial cross-sectional view of a filter retrieval system in accordance with an exemplary embodiment of the present invention;
FIG. 20 is an additional partial cross-sectional view of filter retrieval system illustrated inFIG. 19;
FIG. 21 is a partial cross-sectional view of a filter retrieval system in accordance with an exemplary embodiment of the present invention;
FIG. 22 is an additional partial cross-sectional view of filter retrieval system illustrated inFIG. 21;
FIG. 23 is a partial cross-sectional view of a filter retrieval system in accordance with an exemplary embodiment of the present invention; and
FIG. 24 is an additional partial cross-sectional view of filter retrieval system illustrated inFIG. 23.
DETAILED DESCRIPTION OF THE INVENTION The following detailed description should be read with reference to the drawings, in which like elements in different drawings are numbered in like fashion. The drawings which are not necessarily to scale, depict selected embodiments and are not intended to limit the scope of the invention. In some cases, the drawings may be highly diagrammatic in nature. Examples of constructions, materials, dimensions, and manufacturing processes are provided for various elements. Those skilled in the art will recognize that many of the examples provided have suitable alternatives which may be utilized.
FIG. 1 is a partial cross-sectional view of afilter delivery system100 in accordance with an exemplary embodiment of the present invention.Filter delivery system100 includes acatheter102 having anelongate shaft120.Elongate shaft120 includes aproximal end122, adistal end124, and awall126 defining ashaft lumen128. In the embodiment ofFIG. 1, the distal portion ofcatheter102 is disposed within ablood vessel130. In a preferred embodiment,catheter102 extends out ofblood vessel130, andproximal end122 ofelongate shaft120 is disposed outside the patient's body. Ahub132 is disposed aboutelongate shaft120 proximateproximal end122.
Catheter102 also includes atubular member134 having afirst end136 fixed to wall126 ofelongate shaft120, and asecond end138 disposed withinshaft lumen128.Tubular member134 defines aguidewire lumen140 which is in fluid communication with adistal guidewire port142 defined bysecond end138 oftubular member134.Catheter102 also includes aproximal guidewire port144 extending throughwall126 ofelongate shaft120. Various embodiments ofproximal guidewire port144 are possible without deviating from the spirit and scope of the present invention. For example,proximal guidewire port144 may be defined bywall126 ofelongate shaft120. By way of a second example,proximal guidewire port144 may be defined byfirst end136 oftubular member134.
In the embodiment ofFIG. 1,distal guidewire port142 is disposed proximally ofdistal end124 ofelongate shaft120, andproximal guidewire port144 is disposed proximally ofdistal guidewire port142. InFIG. 1, it may be appreciated thatdistal guidewire port142 andproximal guidewire port144 are separated by a longitudinal distance. In a preferred embodiment, the longitudinal distance between proximalguidewire port144 anddistal guidewire port142 is less than about 55 centimeters and the length ofelongate shaft120 is between about 100 centimeters and about 300 centimeters. In a more preferred embodiment, the longitudinal distance between proximalguidewire port144 anddistal guidewire port142 is less than about 45 centimeters. In a particularly preferred embodiment, the longitudinal distance between proximalguidewire port144 anddistal guidewire port142 is less than about 35 centimeters.
InFIG. 1, it may be appreciated thatsystem100 includes afilter146 disposed within adistal portion148 ofshaft lumen128. In the embodiment ofFIG. 1,filter146 is in a contracted configuration.System100 ofFIG. 1 also includes aguidewire104 having adistal end108 that is fixed to filter146. In the embodiment ofFIG. 1,guidewire104 extends throughdistal guidewire port142,guidewire lumen140, andproximal guidewire port144.
FIG. 2 is a partial cross-sectional view of thefilter delivery system100 ofFIG. 1. In the embodiment ofFIG. 2,catheter102 has been moved proximally relative to guidewire104 so thatfilter146 is disposed outside ofshaft lumen128. As shown inFIG. 2,filter146 is free to assume an expanded configuration when it is outside ofshaft lumen128.Catheter102 may be moved relative toguidewire104, for example, by grasping aproximal portion106 ofguidewire104 and applying a pulling force tohub132 ofcatheter102. The pulling force may be applied tohub132 untilfilter146 is deployed in the expanded configuration. The pulling force may also be continued untilcatheter102 is removed fromblood vessel130. Oncecatheter102 has been removed fromblood vessel130, guidewire104 may be utilized to guide additional catheters (e.g., balloon catheters, atherectomy catheters, etc.) as they are advanced throughblood vessel130.
In the embodiment ofFIG. 2, awire gripper150 is disposed aboutproximal portion106 ofguidewire104.Wire gripper150 includes ahandle152 and a plurality ofjaws154 for graspingguidewire104. A knurl nut fitting156 is used to selectively urgejaws154 againstguidewire104.Wire gripper150 may be used to assist a surgeon in graspingproximal portion106 ofguidewire104.
FIG. 3 is a partial cross-sectional view of afilter retrieval system200 in accordance with an exemplary embodiment of the present invention.Filter retrieval system200 includes acatheter202 that may be utilized to retrieve afilter246 that was previously delivered to atarget location258 in ablood vessel230.Filter246 may be delivered to target location, for example, using the filter delivery system ofFIG. 1 andFIG. 2, and/or other filter delivery systems in accordance with the present invention. InFIG. 3 it may be appreciated that adistal end208 of aguidewire204 is fixed to filter146.
In the embodiment ofFIG. 3,guidewire204 extends through adistal guidewire port242, and aguidewire lumen240 defined by atubular member234 ofcatheter202. In the embodiment ofFIG. 3, afirst end236 oftubular member234 is fixed to awall226 ofelongate shaft220 ofcatheter202. Asecond end238 oftubular member234 is disposed within ashaft lumen228 defined bywall226 ofelongate shaft220.
Guidewire204 also extends through aproximal guidewire port244 extending throughwall226 ofelongate shaft220. Various embodiments ofproximal guidewire port244 are possible without deviating from the spirit and scope of the present invention. For example,proximal guidewire port244 may be defined bywall226 ofelongate shaft220. By way of a second example,proximal guidewire port244 may be defined byfirst end236 oftubular member234.
In the embodiment ofFIG. 3,catheter202 has been advanced alongguidewire204 until adistal end224 ofelongate shaft220 isproximate filter246. InFIG. 3, it may be appreciated that acone260 is disposed atdistal end224 ofelongate shaft220. The generally tapered shape ofcone260 may aid in advancingcatheter202 throughblood vessel230. In a preferred embodiment,cone260 comprises a flexible material, allowingcone260 to deflect asfilter246 is drawn through anaperture262 defined bycone260. Embodiments ofcone260 are possible in whichcone260 is adapted to fold proximally asfilter246 passes throughaperture262. Embodiments ofcone260 are also possible in whichcone260 is adapted to expand radially asfilter246 passes throughaperture262.
In a preferred embodiment,catheter202 extends out ofblood vessel230, so that aproximal end222 ofelongate shaft220 is disposed outside the patient's body. As shown inFIG. 3, ahub232 is disposed aboutelongate shaft220 proximateproximal end222.Hub232 may aid a surgeon in graspingelongate shaft220.
In the embodiment ofFIG. 3,distal guidewire port242 is disposed proximally ofdistal end224 ofelongate shaft220, andproximal guidewire port244 is disposed proximally ofdistal guidewire port242. InFIG. 3, it may be appreciated thatdistal guidewire port242 andproximal guidewire port244 are separated by a longitudinal distance. In a preferred embodiment, the longitudinal distance between proximalguidewire port244 anddistal guidewire port242 is less than about 55 centimeters. In a more preferred embodiment, the longitudinal distance between proximalguidewire port244 anddistal guidewire port242 is less than about 45 centimeters. In a particularly preferred embodiment, the longitudinal distance between proximalguidewire port244 anddistal guidewire port242 is less than about 35 centimeters. InFIG. 3, it may be appreciated thatfilter246 is disposed withinblood vessel230 in an expanded configuration.
FIG. 4 is a partial cross-sectional view of thefilter retrieval system200 ofFIG. 3. In the embodiment ofFIG. 4,catheter202 has been advanced distally relative to guidewire204 so thatfilter246 is disposed within adistal portion248 ofshaft lumen228. As shown inFIG. 4,filter246 has been urged into a contracted configuration.Catheter202 may be moved relative toguidewire204, for example, by grasping aproximal portion206 ofguidewire204 and applying a pushing force tohub232.
In the embodiment ofFIG. 4, awire gripper250 is disposed aboutproximal portion206 ofguidewire204.Wire gripper250 includes ahandle252 and a plurality ofjaws254 for graspingguidewire204. A knurl nut fitting256 is used to selectively urgejaws254 againstguidewire204.Wire gripper250 may be used to assist a surgeon in graspingproximal portion206 ofguidewire204.
FIG. 5 is a partial cross-sectional view of afilter delivery system300 in accordance with an additional exemplary embodiment of the present invention.Filter delivery system300 includes acatheter302 having anelongate shaft320. Ahub332 is disposed aboutelongate shaft320 proximateproximal end322 thereof. Aslider364 is disposed in sliding engagement with acavity368 ofhub332.Slider364 includes awire lock366 having a plurality ofjaws354.Wire lock366 may be used to selectively fix aproximal portion306 of aguidewire304 toslider364.
Guidewire304 extends distally away fromwire lock366. As shown inFIG. 5, a portion ofguidewire304 is disposed in aguidewire lumen340 defined by atubular member334. Afirst end336 oftubular member334 is fixed to awall326 ofelongate shaft320, and asecond end338 oftubular member334 is disposed within ashaft lumen328 defined bywall326.Guidewire lumen340 is in fluid communication with adistal guidewire port342 defined bysecond end338 oftubular member334.Catheter302 also includes aproximal guidewire port344 extending throughwall326 ofelongate shaft320.
InFIG. 5, it may be appreciated that adistal end308 ofguidewire304 is fixed to afilter346 that is disposed within adistal portion348 ofshaft lumen328. In the embodiment ofFIG. 5,filter346 is in a contracted configuration.System300 may be utilized to deployfilter346 into ablood vessel330 as shown inFIG. 6.
FIG. 6 is a partial cross-sectional view of thefilter retrieval system300 ofFIG. 5. In the embodiment ofFIG. 6,hub332 ofcatheter302 has been moved proximally relative toslider364. As described previously,proximal portion306 ofguidewire304 is fixed toslider364 bywire lock366, and filter346 is fixed todistal end308 ofguidewire304. Thus, whenhub332 is moved proximally relative toslider364,distal end324 ofelongate shaft320 is urged proximally so thatfilter346 is disposed outside ofshaft lumen328 ofelongate shaft320. Oncefilter346 is out ofshaft lumen328 it is free to assume an expanded configuration as shown inFIG. 6. The sliding relationship betweenslider364 andhub332 gives the user of system300 a defined distance to moveslider364 relative tohub332 when deployingfilter346.
FIG. 7 is a partial cross-sectional view of afilter retrieval system400 in accordance with an exemplary embodiment of the present invention.Filter retrieval system400 includes acatheter402 that may be utilized to retrieve afilter446 that was previously delivered to atarget location458 in ablood vessel430.
In the embodiment ofFIG. 7, adistal end408 of aguidewire404 is fixedfilter446.Guidewire404 extends proximally away fromfilter446 passing through adistal guidewire port442, and aguidewire lumen440 defined by atubular member434 ofcatheter402. In the embodiment ofFIG. 7, afirst end436 oftubular member434 is fixed to awall426 of anelongate shaft420 ofcatheter402. Asecond end438 oftubular member434 is disposed within ashaft lumen428 defined bywall426 ofelongate shaft420.
Guidewire404 also extends through aproximal guidewire port444 extending throughwall426 ofelongate shaft420. Various embodiments ofproximal guidewire port444 are possible without deviating from the spirit and scope of the present invention. For example,proximal guidewire port444 may be defined bywall426 ofelongate shaft420. By way of a second example,proximal guidewire port444 may be defined byfirst end436 oftubular member434.
In the embodiment ofFIG. 7,catheter402 has been advanced alongguidewire404 until adistal end424 ofelongate shaft420 isproximate filter446. InFIG. 7, it may be appreciated that acone460 is disposed atdistal end424 ofelongate shaft420. The generally tapered shape ofcone460 may aid in advancingcatheter402 throughblood vessel430. In a preferred embodiment,cone460 comprises a flexible material, allowingcone460 to deflect asfilter446 is drawn through anaperture462 defined bycone460. Embodiments ofcone460 are possible in whichcone460 is adapted to fold proximally asfilter446 passes throughaperture462. Embodiments ofcone460 are also possible in whichcone460 is adapted to expand radially asfilter446 passes throughaperture462.
In a preferred embodiment,catheter402 extends out ofblood vessel430, so that aproximal end422 ofelongate shaft420 is disposed outside the patient's body. As shown inFIG. 7, ahub432 is disposed aboutelongate shaft420 proximateproximal end422. Aslider464 is disposed in sliding engagement with acavity468 ofhub432.Slider464 includes awire lock466 having a plurality ofjaws454.Wire lock466 may be used to selectively fix aproximal portion406 ofguidewire404 toslider464.System400 may be utilized to retrievefilter446 fromblood vessel430 as shown inFIG. 8.
FIG. 8 is a partial cross-sectional view of thefilter retrieval system400 ofFIG. 7. In the embodiment ofFIG. 8,hub432 andelongate shaft420 ofcatheter402 have been moved distally relative toslider464. During the movement ofelongate shaft420, the longitudinal position offilter446 is fixed byguidewire404, sinceproximal portion406 ofguidewire404 is fixed toslider464 bywire lock466 anddistal end408 ofguidewire404 is fixed to filter446.
Aselongate shaft420 is advanced distally, it engulfsfilter446. In the embodiment ofFIG. 8filter446 is disposed within adistal portion448 ofshaft lumen428. As shown inFIG. 8,filter446 is urged into a contracted configuration when it is disposed withinshaft lumen428. The sliding relationship betweenslider464 andhub432 gives the user of system400 a defined distance to moveslider464 relative tohub432 when retrievingfilter446.
FIG. 9 is a partial cross-sectional view of afilter delivery system500 in accordance with yet another exemplary embodiment of the present invention.Filter delivery system500 includes acatheter502 having anelongate shaft520.Elongate shaft520 includes aproximal portion570, adistal portion574, and a longitudinallycollapsible portion572 disposed betweenproximal portion570 anddistal portion574.
Aring578 is fixed todistal portion574 ofelongate shaft520 distally ofcollapsible portion572. Apull wire580 is disposed within ashaft lumen528 defined byelongate shaft520. The distal end ofpull wire580 is fixed to ring578 and the proximal end ofpull wire580 is fixed to aslider564.Slider564 is disposed in sliding engagement with ahub532 which is disposed about aproximal end522 ofelongate shaft520. In a preferred embodiment,slider564 and pullwire580 may be used to selectively collapse longitudinallycollapsible portion572 ofelongate shaft520.
Catheter502 also includes atubular member534 having afirst end536 fixed to awall526 ofproximal portion570 ofelongate shaft520, and asecond end538 disposed withinshaft lumen528.Tubular member534 defines aguidewire lumen540 which is in fluid communication with adistal guidewire port542 defined bysecond end538 oftubular member534.Catheter502 also includes aproximal guidewire port544 extending throughwall526 ofproximal portion570 ofelongate shaft520. Various embodiments ofproximal guidewire port544 are possible without deviating from the spirit and scope of the present invention. For example,proximal guidewire port544 may be defined bywall526 ofproximal portion570 ofelongate shaft520. By way of a second example,proximal guidewire port544 may be defined byfirst end536 oftubular member534.
In the embodiment ofFIG. 9,distal guidewire port542 is disposed proximally of adistal end524 ofelongate shaft520, andproximal guidewire port544 is disposed proximally ofdistal guidewire port542. InFIG. 9, it may be appreciated thatdistal guidewire port542 andproximal guidewire port544 are separated by a longitudinal distance. In a preferred embodiment, the longitudinal distance between proximalguidewire port544 anddistal guidewire port542 is less than about 55 centimeters. In a more preferred embodiment, the longitudinal distance between proximalguidewire port544 anddistal guidewire port542 is less than about 45 centimeters. In a particularly preferred embodiment, the longitudinal distance between proximalguidewire port544 anddistal guidewire port542 is less than about 35 centimeters.
InFIG. 9, it may be appreciated thatsystem500 includes afilter546 disposed within adistal portion548 ofshaft lumen528. In the embodiment ofFIG. 9,filter546 is in a contracted configuration.System500 ofFIG. 9 also includes aguidewire504 having adistal end508 that is fixed to filter546. In the embodiment ofFIG. 9,guidewire504 extends throughdistal guidewire port542,guidewire lumen540, andproximal guidewire port544.
FIG. 10 is a partial cross-sectional view of thefilter delivery system500 ofFIG. 9. In the embodiment ofFIG. 10, longitudinallycollapsible portion572 ofelongate shaft520 has been collapsed by urgingslider564 proximally relative tohub532. In a preferred method in accordance with the present invention, guidewire504 is held stationary whileslider564 is moved proximally.
Awire gripper550 may be used to assist a surgeon grasping aproximal portion506 ofguidewire504 and holding it stationary. In the embodiment ofFIG. 10,wire gripper550 is disposed aboutproximal portion506 ofguidewire504.Wire gripper550 includes ahandle552 and a plurality ofjaws554 for graspingguidewire504. A knurl nut fitting556 is used to selectively urgejaws554 againstguidewire504.
In the embodiment ofFIG. 10,collapsible portion572 has been collapsed to such an extent thatdistal end524 ofelongate shaft520 is located proximally offilter546 andfilter546 is disposed outside ofshaft lumen528. InFIG. 10 it may be appreciated thatfilter546 is free to assume an expanded configuration when it is outside ofshaft lumen528.
FIG. 11 is a partial cross-sectional view of afilter retrieval system600 in accordance with an exemplary embodiment of the present invention.Filter retrieval system600 includes acatheter602 that may be utilized to retrieve afilter646 that was previously delivered to atarget location658 in ablood vessel630.Filter646 may be delivered to a target location, for example, using the filter delivery system ofFIG. 9 andFIG. 10, and/or other filter delivery systems in accordance with the present invention.
Catheter602 offilter retrieval system600 includes anelongate shaft620 including aproximal portion670, adistal portion674, and a longitudinallyexpandable portion676 disposed betweenproximal portion670 anddistal portion674. Aring678 is fixed todistal portion674 ofelongate shaft620 distally ofexpandable portion676. Apush rod682 is disposed within ashaft lumen628 defined byelongate shaft620. The distal end ofpush rod682 is fixed to ring678 and the proximal end ofpush rod682 is fixed to aslider664.Slider664 is disposed in sliding engagement with ahub632 which is disposed about aproximal end622 ofelongate shaft620. In a preferred embodiment,slider664 and pushrod682 may be used to selectively expand longitudinallyexpandable portion676 ofelongate shaft620.
In the embodiment ofFIG. 11, aguidewire604 extends through adistal guidewire port642, and aguidewire lumen640 defined by atubular member634 ofcatheter602. In the embodiment ofFIG. 11, afirst end636 oftubular member634 is fixed to awall626 ofelongate shaft620 ofcatheter602. A second end638 oftubular member634 is disposed withinshaft lumen628 ofelongate shaft620.Guidewire604 also extends through aproximal guidewire port644 extending throughwall626 ofelongate shaft620. Various embodiments ofproximal guidewire port644 are possible without deviating from the spirit and scope of the present invention. For example,proximal guidewire port644 may be defined bywall626 ofelongate shaft620. By way of a second example,proximal guidewire port644 may be defined byfirst end636 oftubular member634.
In the embodiment ofFIG. 11,catheter602 has been advanced alongguidewire604 until adistal end624 ofelongate shaft620 isproximate filter646. InFIG. 11, it may be appreciated that acone660 is disposed atdistal end624 ofelongate shaft620. The generally tapered shape ofcone660 may aid in advancingcatheter602 throughblood vessel630. In a preferred embodiment,cone660 comprises a flexible material, allowingcone660 to deflect asfilter646 is drawn through anaperture662 defined bycone660. Embodiments ofcone660 are possible in whichcone660 is adapted to fold proximally asfilter646 passes throughaperture662. Embodiments ofcone660 are also possible in whichcone660 is adapted to expand radially asfilter646 passes throughaperture662.
In the embodiment ofFIG. 11,distal guidewire port642 is disposed proximally ofdistal end624 ofelongate shaft620, andproximal guidewire port644 is disposed proximally ofdistal guidewire port642. InFIG. 11, it may be appreciated thatdistal guidewire port642 andproximal guidewire port644 are separated by a longitudinal distance. In a preferred embodiment, the longitudinal distance between proximalguidewire port644 anddistal guidewire port642 is less than about 55 centimeters. In a more preferred embodiment, the longitudinal distance between proximalguidewire port644 anddistal guidewire port642 is less than about 45 centimeters. In a particularly preferred embodiment, the longitudinal distance between proximalguidewire port644 anddistal guidewire port642 is less than about 35 centimeters. InFIG. 11, it may be appreciated thatfilter646 is disposed withinblood vessel630 in an expanded configuration.
FIG. 12 is a partial cross-sectional view of thefilter retrieval system600 ofFIG. 11. In the embodiment ofFIG. 12,expandable portion676 ofelongate shaft620 has been expanded so thatfilter646 is disposed within adistal portion648 ofshaft lumen628.Expandable portion676 ofelongate shaft620 may be expanded, for example, by urgingslider664 distally relative tohub632. As shown inFIG. 12,filter646 has been urged into a contracted configuration.
In a preferred method in accordance with the present invention, guidewire604 is held in place while selectivelyexpandable portion676 is expanded, for example, by grasping aproximal portion606 ofguidewire604. In the embodiment ofFIG. 12, awire gripper650 is disposed aboutproximal portion606 ofguidewire604.Wire gripper650 includes ahandle652 and a plurality ofjaws654 for graspingguidewire604. A knurl nut fitting656 is used to selectively urgejaws654 againstguidewire604.Wire gripper650 may be used to assist a surgeon in graspingproximal portion606 ofguidewire604.
FIG. 13 is a partial cross-sectional view of afilter delivery system700 in accordance with an additional exemplary embodiment of the present invention.Filter delivery system700 includes acatheter702 having anelongate shaft720 having aproximal end722. Ahub732 is disposed aboutelongate shaft720 proximateproximal end722. Aslider764 is disposed in sliding engagement with acavity768 ofhub732.Hub732 includes awire lock766 having a plurality ofjaws754.Wire lock766 may be used to selectively fix aproximal portion706 of aguidewire704 tohub732.
Elongate shaft720 includes aproximal portion770, adistal portion774, and a longitudinallycollapsible portion772 disposed betweenproximal portion770 anddistal portion774. Aring778 is fixed todistal portion774 ofelongate shaft720 distally ofcollapsible portion772. Apull wire780 is disposed within ashaft lumen728 defined byelongate shaft720. The distal end ofpull wire780 is fixed to ring778 and the proximal end ofpull wire780 is fixed toslider764. In a preferred embodiment,slider764 and pullwire780 may be used to selectively collapse longitudinallycollapsible portion772 ofelongate shaft720.
Guidewire704 extends distally away fromhub732 andwire lock766. As shown inFIG. 13, a portion ofguidewire704 is disposed in aguidewire lumen740 defined by atubular member734. Afirst end736 oftubular member734 is fixed to awall726 ofproximal portion770 ofelongate shaft720, and asecond end738 oftubular member734 is disposed withinshaft lumen728 ofelongate shaft720.Guidewire lumen740 is in fluid communication with adistal guidewire port742 defined bysecond end738 oftubular member734.Catheter702 also includes aproximal guidewire port744 extending throughwall726 ofproximal portion770 ofelongate shaft720.
InFIG. 13, it may be appreciated thatsystem700 includes afilter746 disposed within adistal portion748 ofshaft lumen728. In the embodiment ofFIG. 13,filter746 is in a contracted configuration.System700 may be utilized to deployfilter746 into ablood vessel730 as shown inFIG. 14.
FIG. 14 is a partial cross-sectional view of thefilter delivery system700 ofFIG. 13. In the embodiment ofFIG. 14, longitudinallycollapsible portion772 ofelongate shaft720 has been collapsed by urgingslider764 proximally relative tohub732. In a preferred method in accordance with the present invention, guidewire704 is held stationary whileslider764 is moved proximally.
As described previously,proximal portion706 ofguidewire704 may be selectively fixed tohub732 bywire lock766, and filter746 is fixed to adistal end708 ofguidewire704. Thus, whencollapsible portion772 ofelongate shaft720 is collapsed, the longitudinal position offilter746 is maintained byguidewire704. In a preferred method,collapsible portion772 is collapsed to the point that filter746 is disposed outside ofshaft lumen728 as shown inFIG. 14.
FIG. 15 is a partial cross-sectional view of afilter retrieval system800 in accordance with an exemplary embodiment of the present invention.Filter retrieval system800 includes acatheter802 that may be utilized to retrieve afilter846 that was previously delivered to atarget location858 in ablood vessel830.
In the embodiment ofFIG. 15, adistal end808 of aguidewire804 is fixed to filter846.Guidewire804 extends through adistal guidewire port842, and aguidewire lumen840 defined by atubular member834 ofcatheter802. In the embodiment ofFIG. 15, afirst end836 oftubular member834 is fixed to a wall826 of anelongate shaft820 ofcatheter802. Asecond end838 oftubular member834 is disposed within ashaft lumen828 defined by wall826 ofelongate shaft820.
Guidewire804 also extends through aproximal guidewire port844 extending through wall826 ofelongate shaft820. Various embodiments ofproximal guidewire port844 are possible without deviating from the spirit and scope of the present invention. For example,proximal guidewire port844 may be defined by wall826 ofelongate shaft820. By way of a second example,proximal guidewire port844 may be defined byfirst end836 oftubular member834.
Elongate shaft820 ofcatheter802 includes aproximal portion870, adistal portion874, and a longitudinallyexpandable portion876 disposed betweenproximal portion870 anddistal portion874. Aring878 is fixed todistal portion874 ofelongate shaft820 distally ofexpandable portion876. Apush rod882 is disposed withinshaft lumen828 defined byelongate shaft820. The distal end ofpush rod882 is fixed to ring878 and the proximal end ofpush rod882 is fixed to aslider864.Slider864 is disposed in sliding engagement with ahub832 which is disposed about aproximal end822 ofelongate shaft820. In a preferred embodiment,slider864 and pushrod882 may be used to selectively expand longitudinallyexpandable portion876 ofelongate shaft820.
Agrabber884 is also disposed aboutelongate shaft820.Grabber884 may be used to assist a surgeon in graspingelongate shaft820 ofcatheter802.Grabber884 includes awire lock866 having a plurality ofjaws854.Wire lock866 may be used to selectively fix aproximal portion806 of aguidewire804 tograbber884.
In the embodiment ofFIG. 15,catheter802 has been advanced alongguidewire804 until adistal end824 ofelongate shaft820 isproximate filter846. InFIG. 15, it may be appreciated that acone860 is disposed atdistal end824 ofelongate shaft820. The generally tapered shape ofcone860 may aid in advancingcatheter802 through ablood vessel830.Cone860 defines anaperture862. Embodiments ofcone860 are possible in whichcone860 is adapted to fold proximally asfilter846 passes throughaperture862. Embodiments ofcone860 are also possible in whichaperture862 ofcone860 is adapted to expand radially asfilter846 passes therethrough.
FIG. 16 is a partial cross-sectional view of thefilter retrieval system800 ofFIG. 15. In the embodiment ofFIG. 16, selectivelyexpandable portion876 ofelongate shaft820 has been expanded so thatfilter846 is disposed within adistal portion848 ofshaft lumen828. As shown inFIG. 16,filter846 has been urged into a contracted configuration. In a preferred method in accordance with the present invention, aproximal portion806 ofguidewire804 is fixed to grabber884 usingwire lock866 prior to expanding longitudinallyexpandable portion876.Expandable portion876 may be expanded, for example, by urgingslider864 distally relative tohub832.
FIG. 17 is a partial cross-sectional view of afilter retrieval system900 in accordance with an exemplary embodiment of the present invention.Filter retrieval system900 includes acatheter902 that may be utilized to retrieve afilter946 that was previously delivered to atarget location958 in ablood vessel930.Filter946 may be delivered to target location, for example, using the filter delivery system ofFIG. 1 andFIG. 2, and/or other filter delivery systems in accordance with the present invention. InFIG. 17 it may be appreciated that adistal end908 of aguidewire904 is fixed to filter946.
In the embodiment ofFIG. 17, guidewire904 extends through aproximal guidewire port944 and ashaft lumen928 defined by anelongate shaft920 ofcatheter902. In the embodiment ofFIG. 17,catheter902 has been advanced alongguidewire904 until adistal end924 ofelongate shaft920 isproximate filter946. InFIG. 17, it may be appreciated that acone960 is disposed atdistal end924 ofelongate shaft920. In a preferred embodiment,cone960 is fixed to elongateshaft920 by ahinge943. In a particularly preferred embodiment, hinge943 comprises a flexible material, allowinghinge943 to deflect asfilter946 is drawn through anaperture962 defined bycone960. Embodiments ofcone960 are possible in which hinge943 andcone960 are adapted to fold proximally asfilter946 passes throughaperture962.
In a preferred embodiment,catheter902 extends out ofblood vessel930, so that aproximal end922 ofelongate shaft920 is disposed outside the patient's body. As shown inFIG. 17, ahub932 is disposed aboutelongate shaft920 proximateproximal end922.Hub932 may aid a surgeon in graspingelongate shaft920.
FIG. 18 is a partial cross-sectional view of thefilter retrieval system900 ofFIG. 17. In the embodiment ofFIG. 18,catheter902 has been advanced distally relative to guidewire904 so thatfilter946 is disposed within adistal portion948 ofshaft lumen928. As shown inFIG. 18,filter946 has been urged into a contracted configuration.Catheter902 may be moved relative toguidewire904, for example, by grasping aproximal portion906 ofguidewire904 and applying a pushing force tohub932.
In the embodiment ofFIG. 18, awire gripper950 is disposed aboutproximal portion906 ofguidewire904.Wire gripper950 includes ahandle952 and a plurality ofjaws954 for graspingguidewire904. A knurl nut fitting956 is used to selectively urgejaws954 againstguidewire904.Wire gripper950 may be used to assist a surgeon in graspingproximal portion906 ofguidewire904.
FIG. 19 is a partial cross-sectional view of afilter retrieval system1000 in accordance with an exemplary embodiment of the present invention.Filter retrieval system1000 includes afilter retrieval catheter1002. In the embodiment ofFIG. 19, a portion offilter retrieval catheter1002 is disposed within ablood vessel1030.Filter retrieval catheter1002 includes anelongate shaft1020 defining ashaft lumen1028 having adistal portion1048. Atip member1086 is partially disposed withindistal portion1048 ofshaft lumen1028. A tapereddistal portion1084 oftip member1086 extends distally beyondelongate shaft1020. The generally conical shape of tapereddistal portion1084 may facilitate the tracking offilter retrieval catheter1002 as it is advanced throughblood vessel1030.
Tip member1086 defines atip lumen1088. In the embodiment ofFIG. 19, a portion of aguidewire1004 is disposed withintip lumen1088.Guidewire1004 extends throughtip lumen1088, a portion ofshaft lumen1028, and aproximal guidewire port1042 defined by awall1026 ofelongate shaft1020. In the embodiment ofFIG. 19,catheter1002 has been advanced alongguidewire1004 until adistal end1024 ofelongate shaft1020 is proximate afilter1046 disposed withinblood vessel1030.Catheter1002 may preferably be utilized to removefilter1046 fromblood vessel1030 using methods in accordance with the present invention.
In a preferred embodiment,tip member1086 is configured such thatguidewire1004 is substantially centered withinelongate shaft1020. Centeringelongate shaft1020 aboutguidewire1004 may facilitate the tracking offilter retrieval catheter1002 as it is advanced along a guidewire disposed within a blood vessel. Centeringelongate shaft1020 aboutguidewire1004 may also reduced the magnitude of force which is required to urgeelongate shaft1020 overfilter1046 or other similar collapsible devices attached to guidewires.
Distal portion1048 ofshaft lumen1028 has aninner diameter1090.Tip member1086 has an outer radial extent comprising anouter diameter1092. In a preferred embodiment,outer diameter1092 oftip member1086 is similar toinner diameter1090 ofelongate shaft1020. In a particularly preferred embodiment,outer diameter1092 oftip member1086 is slightly smaller thaninner diameter1090 ofelongate shaft1020.
In a preferred embodiment,tip lumen1088 oftip member1086 has alumen diameter1096 and guidewire1004 has a guidewire diameter1094. In a particularly preferred embodiment,lumen diameter1096 is similar to guidewire diameter1094. In a more particularly preferred embodiment,lumen diameter1096 is slightly larger than guidewire diameter1094.
The position oftip member1086 shown inFIG. 19 may be referred to as an extended position.Tip member1086 offilter retrieval catheter1002 preferably also has a retracted position.Distal portion1048 ofshaft lumen1028 andtip member1086 are preferably configured such that a filter may be partially or completely disposed withindistal portion1048 ofshaft lumen1028 whentip member1086 is in the retracted position.
Whentip member1086 is in the extended position, tapereddistal portion1084 oftip member1086 preferably extends distally fromdistal portion1048 ofshaft lumen1028.Filter retrieval catheter1002 preferably includes adistal stop mechanism1023 that is preferably biased to retaintip member1086 in the extended position. In the embodiment ofFIG. 19,distal stop mechanism1023 includes astop member1025 that is preferably fixed to elongateshaft1020 and a trailingsurface1027 oftip member1086. As shown inFIG. 19, trailingsurface1027 preferably seats againststop member1025 whentip member1086 is in the extended position.
FIG. 20 is an additional partial cross-sectional view offilter retrieval system1000 ofFIG. 19. In the embodiment ofFIG. 20,tip member1086 is disposed in the retracted position andfilter1046 is partially disposed withindistal portion1048 ofshaft lumen1028.Tip member1086 andfilter1046 may be urged intodistal portion1048 ofshaft lumen1028, for example, by graspingguidewire1004 and applying a distally directed pushing force to elongateshaft1020. Awire gripper1050 may assist a physician in graspingguidewire1004. In the embodiment ofFIG. 20,wire gripper1050 is disposed about aproximal portion1006 ofguidewire1004.Wire gripper1050 includes ahandle1052 and a plurality ofjaws1054 for graspingguidewire1004. A knurl nut fitting1056 is used to selectively urgejaws1054 againstguidewire1004.Wire gripper1050 may be used to assist a surgeon in graspingproximal portion1006 ofguidewire1004.
Filter retrieval catheter1002 preferably includes aproximal stop mechanism1029. In the embodiment ofFIG. 20,proximal stop mechanism1029 includesstop member1025 that is preferably fixed to elongateshaft1020 and aflange1033 oftip member1086. As shown inFIG. 20,flange1033 preferably seats againststop member1025 whentip member1086 is in the retracted position. InFIG. 20, it may be appreciated thatstop member1025 may deflect whentip member1086 is moved from the extended position to the retracted position. In a particularly preferred embodiment,proximal stop mechanism1029 is adapted to provide a hard stop that may be sensed by a physician usingfilter retrieval catheter1002 in a surgical procedure. This hard stop provides tactile feedback indicating thattip member1086 has been successfully placed in the retracted position.
InFIG. 20, it may be appreciated thatfilter1046 has been urged into a contracted configuration. As described above,filter retrieval catheter1002 preferably includes aproximal stop mechanism1029 that is adapted to stop relative movement betweentip member1086 andelongate shaft1020 whentip member1086 is in the retracted position. In a particularly preferred embodiment, the relative movement required to movetip member1086 from the extended position to the retracted position is similar to the relative movement required to urgefilter1046 intodistal portion1048 ofshaft lumen1028 and into a contracted configuration. Also in a particularly preferred embodiment,proximal stop mechanism1029 is adapted to provide a hard stop that provides tactile feedback indicating thattip member1086 has been successfully placed in the retracted position andfilter1046 has been successfully urged into a contracted configuration. When a physician feels this hard stop, he or she will know thatfilter1046 has been urged into a retracted position, and the likelihood that a physician will attempt to withdrawfilter1046 fromblood vessel1030 while it is in an expanded condition is reduced.
FIG. 21 is a partial cross-sectional view of afilter retrieval system1100 in accordance with an exemplary embodiment of the present invention.Filter retrieval system1100 includes afilter retrieval catheter1102. In the embodiment ofFIG. 21, a portion offilter retrieval catheter1102 is disposed within ablood vessel1130.Filter retrieval catheter1102 includes anelongate shaft1120 defining ashaft lumen1128 having adistal portion1148. Atip member1186 is partially disposed withindistal portion1148 ofshaft lumen1128. A tapereddistal portion1184 oftip member1186 extends distally beyondelongate shaft1120. The generally conical shape of tapereddistal portion1184 may facilitate the tracking offilter retrieval catheter1102 as it is advanced throughblood vessel1130.
Tip member1186 defines atip lumen1188. In the embodiment ofFIG. 21, a portion of aguidewire1104 is disposed withintip lumen1188.Guidewire1104 extends throughtip lumen1188, a portion ofshaft lumen1128, and aproximal guidewire port1142 defined by awall1126 ofelongate shaft1120. In the embodiment ofFIG. 21,catheter1102 has been advanced alongguidewire1104 until adistal end1124 ofelongate shaft1120 is proximate afilter1146 disposed withinblood vessel1130.Catheter1102 may preferably be utilized to removefilter1146 fromblood vessel1130 using methods in accordance with the present invention.
In a preferred embodiment,tip member1186 is configured such thatguidewire1104 is substantially centered withinelongate shaft1120. Centeringelongate shaft1120 aboutguidewire1104 may facilitate the tracking offilter retrieval catheter1102 as it is advanced along a guidewire disposed within a blood vessel. Centeringelongate shaft1120 aboutguidewire1104 may also reduced the magnitude of force which is required to urgeelongate shaft1120 overfilter1146 or other similar collapsible devices attached to guidewires.
Distal portion1148 ofshaft lumen1128 has aninner diameter1190.Tip member1186 has an outer radial extent comprising anouter diameter1192. In a preferred embodiment,outer diameter1192 oftip member1186 is similar toinner diameter1190 ofelongate shaft1120. In a particularly preferred embodiment,outer diameter1192 oftip member1186 is slightly smaller thaninner diameter1190 ofelongate shaft1120.
In a preferred embodiment,tip lumen1188 oftip member1186 has alumen diameter1196 and guidewire1104 has aguidewire diameter1194. In a particularly preferred embodiment,lumen diameter1196 is similar toguidewire diameter1194. In a more particularly preferred embodiment,lumen diameter1196 is slightly larger thanguidewire diameter1194.
The position oftip member1186 shown inFIG. 21 may be referred to as an extended position.Tip member1186 offilter retrieval catheter1102 preferably also has a retracted position.Distal portion1148 ofshaft lumen1128 andtip member1186 are preferably configured such that a filter may be partially or completely disposed withindistal portion1148 ofshaft lumen1128 whentip member1186 is in the retracted position.
Whentip member1186 is in the extended position, tapereddistal portion1184 oftip member1186 preferably extends distally fromdistal portion1148 ofshaft lumen1128.Filter retrieval catheter1102 preferably includes adistal stop mechanism1123 that is preferably biased to retaintip member1186 in the extended position. In the embodiment ofFIG. 21,distal stop mechanism1123 includes anannular bead1135 formed bywall1126 ofelongate shaft1120 and atrailing edge1139 oftip member1186. As shown inFIG. 21, trailingedge1139 preferably seats againstannular bead1135 whentip member1186 is in the extended position.
FIG. 22 is an additional partial cross-sectional view offilter retrieval system1100 ofFIG. 21. In the embodiment ofFIG. 22,tip member1186 is disposed in the retracted position andfilter1146 is partially disposed withindistal portion1148 ofshaft lumen1128.Tip member1186 andfilter1146 may be urged intodistal portion1148 ofshaft lumen1128, for example, by graspingguidewire1104 and applying a distally directed pushing force to elongateshaft1120. Awire gripper1150 may assist a physician in graspingguidewire1104. In the embodiment ofFIG. 22,wire gripper1150 is disposed about aproximal portion1106 ofguidewire1104.Wire gripper1150 includes ahandle1152 and a plurality ofjaws1154 for graspingguidewire1104. A knurl nut fitting1156 is used to selectively urgejaws1154 againstguidewire1104.Wire gripper1150 may be used to assist a surgeon in graspingproximal portion1106 ofguidewire1104.
Filter retrieval catheter1102 preferably includes aproximal stop mechanism1129. In the embodiment ofFIG. 22,proximal stop mechanism1129 includesannular bead1135 formed bywall1126 ofelongate shaft1120 and aflange1133 oftip member1186. As shown inFIG. 22,flange1133 preferably seats againstannular bead1135 whentip member1186 is in the retracted position. InFIG. 22, it may be appreciated thatannular bead1135 may deflect whentip member1186 is moved from the extended position to the retracted position. In a particularly preferred embodiment,proximal stop mechanism1129 is adapted to provide a hard stop that may be sensed by a physician usingfilter retrieval catheter1102 in a surgical procedure. This hard stop provides tactile feedback indicating thattip member1186 has been successfully placed in the retracted position.
InFIG. 22, it may be appreciated thatfilter1146 has been urged into a contracted configuration. As described above,filter retrieval catheter1102 preferably includes aproximal stop mechanism1129 that is adapted to stop relative movement betweentip member1186 andelongate shaft1120 whentip member1186 is in the retracted position. In a particularly preferred embodiment, the relative movement required to movetip member1186 from the extended position to the retracted position is similar to the relative movement required to urgefilter1146 intodistal portion1148 ofshaft lumen1128 and into a contracted configuration. Also in a particularly preferred embodiment,proximal stop mechanism1129 is adapted to provide a hard stop that provides tactile feedback indicating thattip member1186 has been successfully placed in the retracted position andfilter1146 has been successfully urged into a contracted configuration. When a physician feels this hard stop, he or she will know thatfilter1146 has been urged into a retracted position, and the likelihood that a physician will attempt to withdrawfilter1146 fromblood vessel1130 while it is in an expanded condition is reduced.
FIG. 23 is a partial cross-sectional view of afilter retrieval system1200 in accordance with an exemplary embodiment of the present invention.Filter retrieval system1200 includes afilter retrieval catheter1202.Filter retrieval catheter1202 includes anelongate shaft1220 and atubular member1234. Afirst end1236 oftubular member1234 is fixed to awall1226, and asecond end1238 oftubular member1234 is preferably fixed to atip member1286 offilter retrieval catheter1202.Tip member1286 is slidingly disposed within adistal portion1248 of ashaft lumen1228 defined byelongate shaft1220.
Filter retrieval catheter1202 includes adistal guidewire port1242 defined bytip member1286 and aproximal guidewire port1244 extending throughwall1226 ofelongate shaft1220. Various embodiments ofproximal guidewire port1244 are possible without deviating from the spirit and scope of the present invention. For example,proximal guidewire port1244 may be defined bywall1226 of proximal portion1270 ofelongate shaft1220. By way of a second example,proximal guidewire port1244 may be defined byfirst end1236 oftubular member1234.Tubular member1234 defines aguidewire lumen1240 which is in fluid communication withproximal guidewire port1244 anddistal guidewire port1242.
Tubular member1234 preferably includes a longitudinallycollapsible portion1237 disposed betweenfirst end1236 andsecond end1238. In the embodiment ofFIG. 23,collapsible portion1237 is in an extended state andtip member1286 disposed in an extended position.Collapsible portion1237 preferably also has a contracted state. In a preferred embodiment,tip member1286 is disposed in a retracted position whencollapsible portion1237 is in a contracted state.Distal portion1248 ofshaft lumen1228 andtip member1286 are preferably configured such that a filter may be partially or completely disposed withindistal portion1248 ofshaft lumen1228 whentip member1286 is in the retracted position. Whentip member1286 is in the extended position, tapereddistal portion1284 oftip member1286 preferably extends distally fromdistal portion1248 ofshaft lumen1228.
FIG. 24 is an additional partial cross-sectional view offilter retrieval system1200 ofFIG. 23. In the embodiment ofFIG. 24,tip member1286 is disposed in the retracted position andcollapsible portion1237 oftubular member1234 is in a contracted state. Also in the embodiment ofFIG. 24,filter1246 is partially disposed withindistal portion1248 ofshaft lumen1228.
One method in accordance with the present invention may include the steps of graspingguidewire1204 near the proximal end thereof and applying a distally directed pushing force to elongateshaft1220 near the proximal end thereof. This application of force to proximal portions offilter retrieval catheter1202 may be used to urgecollapsible portion1237 oftubular member1234 into a contracted state, to urgetip member1286 andfilter1246 intodistal portion1248 ofshaft lumen1228, and to urgefilter1246 into a contracted configuration. Awire gripper1250 may assist a physician in graspingguidewire1204. In the embodiment ofFIG. 24,wire gripper1250 is disposed about aproximal portion1206 ofguidewire1204.Wire gripper1250 includes ahandle1252 and a plurality ofjaws1254 for graspingguidewire1204. A knurl nut fitting1256 is used to selectively urgejaws1254 againstguidewire1204.
Having thus described the preferred embodiments of the present invention, those of skill in the art will readily appreciate that yet other embodiments may be made and used within the scope of the claims hereto attached. Numerous advantages of the invention covered by this document have been set forth in the foregoing description. It will be understood, however, that this disclosure is, in many respects, only illustrative. Changes may be made in details, particularly in matters of shape, size, and arrangement of parts without exceeding the scope of the invention. The invention's scope is, of course, defined in the language in which the appended claims are expressed.