Claims
- 1. An apparatus for removing stenotic material from within a stent located within a body vessel, said apparatus comprising:
a stenotic material removal mechanism for removing stenotic material from within the stent, sensor means associated with said stenotic material removal mechanism for sensing proximity or contact between said stenotic material removal mechanism and the stent, whereby said sensor means is used to determine an unsafe condition or an appropriate endpoint for removal of stenotic material from within the stent based on the sensed proximity or contact between said stenotic material removal mechanism and the stent for effective recanalization of the body vessel.
- 2. The apparatus of claim 1 further comprising a control means for controlling a depth to which said stenotic material removal mechanism removes the stenotic material from within the stent.
- 3. The apparatus of claim 2 wherein said control means comprises a mechanism for diametrically expanding said stenotic material removal mechanism.
- 4. The apparatus of claim 1 further comprising a means for directing said stenotic material removal mechanism to remove stenotic material from a selected area within the stent.
- 5. The apparatus of claim 1 further comprising a means for diametrically expanding said stenotic material removal mechanism.
- 6. The apparatus of claim 1 wherein said stenotic material removal mechanism comprises at least one longitudinally oriented blade.
- 7. The apparatus of claim 1 wherein said stenotic material removal mechanism comprises a plurality of longitudinally oriented blades.
- 8. The apparatus of claim 7 wherein said longitudinally oriented blades are resiliently biased to expand radially outward from a central axis of said stenotic material removal mechanism.
- 9. The apparatus of claim 1 wherein said stenotic material removal mechanism comprises a plurality of helically configured blades.
- 10. The apparatus of claim 9 wherein said helically configured blades are resiliently biased to expand radially outward from a central axis of said stenotic material removal mechanism.
- 11. The apparatus of claim 1 wherein said stenotic material removal mechanism comprises a rotating blade.
- 12. The apparatus of claim 1 wherein said stenotic material removal mechanism comprises a rotating abrasive tool.
- 13. The apparatus of claim 1 wherein said stenotic material removal mechanism comprises a cage-like network of filaments.
- 14. The apparatus of claim 1 further comprising a monitoring means associated with said sensor means for monitoring the proximity or contact between said stenotic material removal mechanism and the stent.
- 15. The apparatus of claim 14 wherein said sensor means comprises at least one electrical conductor on an exterior of said apparatus and said monitoring means comprises a leakage current detector for detecting a leakage current when said at least one electrical conductor contacts said stent.
- 16. The apparatus of claim 14 wherein said sensor means comprises a first electrical conductor and a second electrical conductor on an exterior of said apparatus and said monitoring means comprises a leakage current detector for detecting a leakage current when said first electrical conductor and said second electrical conductor contacts said stent.
- 17. The apparatus of claim 14 wherein said sensor means comprises at least one electrical conductor within said apparatus and said monitoring means comprises a means for detecting a change in electrical impedance when said at least one electrical conductor approaches said stent.
- 18. The apparatus of claim 14 wherein said sensor means comprises a first electrical conductor and a second electrical conductor within said apparatus and said monitoring means comprises a means for detecting a change in electrical impedance when said first electrical conductor and said second electrical conductor approach said stent.
- 19. The apparatus of claim 14 wherein said monitoring means produces a signal indicative of the proximity or contact between said stenotic material removal mechanism and the stent.
- 20. The apparatus of claim 14 wherein said monitoring means includes means for deactivating said stenotic material removal mechanism when a predetermined level of proximity or contact between said stenotic material removal mechanism and the stent is detected.
- 21. The apparatus of claim 1 wherein said stenotic material removal mechanism is positioned at a distal portion of a first elongated catheter shaft.
- 22. The apparatus of claim 21 wherein said first elongated catheter shaft includes a lumen for passage of a guidewire therethrough.
- 23. The apparatus of claim 21 further comprising a second elongated catheter shaft positioned coaxially around said first elongated catheter shaft.
- 24. The apparatus of claim 23 wherein said second elongated catheter shaft includes an internal lumen for aspiration of stenotic material removed from within the stent.
- 25. The apparatus of claim 1 further comprising a stenotic material collection mechanism for collecting stenotic material removed from within the stent.
- 26. The apparatus of claim 25 wherein said stenotic material collection mechanism comprises an embolic filter positioned in operative association with said stenotic material removal mechanism.
- 27. The apparatus of claim 26 wherein said embolic filter is positioned coaxially with said stenotic material removal mechanism.
- 28. The apparatus of claim 25 wherein said stenotic material collection mechanism is positioned internally to said stenotic material removal mechanism.
- 29. An apparatus for removing stenotic material from within a stent located within a body vessel, said apparatus comprising:
a catheter shaft having a proximal end and a distal end, a stenotic material removal mechanism, and means coupled to the stenotic material removal mechanism for increasing a depth to which the stenotic material removal mechanism removes the stenotic material from within the stent, wherein said means is limited to prevent further increase in depth when or before the stenotic material removal mechanism engages the stent.
- 30. The apparatus of claim 29 wherein said means deactivates said stenotic material removal mechanism when or before the stenotic material removal mechanism engages the stent.
- 31. The apparatus of claim 29 wherein said means includes a sensor for sensing contact between said stenotic material removal mechanism and the stent.
- 32. The apparatus of claim 29 wherein said means includes a sensor for sensing proximity between said stenotic material removal mechanism and the stent.
- 33. The apparatus of claim 29 wherein said means includes sensor means for sensing contact and proximity between said stenotic material removal mechanism and the stent.
- 34. The apparatus of claim 29 wherein said means includes a mechanism for diametrically expanding said stenotic material removal mechanism.
- 35. The apparatus of claim 29 further comprising a means for directing said stenotic material removal mechanism to remove stenotic material from a selected area within the stent.
- 36. The apparatus of claim 29 wherein said stenotic material removal mechanism comprises at least one longitudinally oriented blade.
- 37. The apparatus of claim 29 wherein said stenotic material removal mechanism comprises a plurality of longitudinally oriented blades.
- 38. The apparatus of claim 29 wherein said stenotic material removal mechanism comprises a plurality of helically configured blades.
- 39. The apparatus of claim 29 wherein said stenotic material removal mechanism comprises a rotating blade.
- 40. The apparatus of claim 29 wherein said stenotic material removal mechanism comprises a rotating abrasive tool.
- 41. The apparatus of claim 29 wherein said stenotic material removal mechanism comprises a cage-like network of filaments.
- 42. An apparatus for removing stenotic material from within a body vessel, said apparatus comprising:
a stenotic material removal mechanism for removing stenotic material from within the body vessel, said stenotic material removal mechanism having a plurality of elongated blades, and a stenotic material collection mechanism for collecting stenotic material removed from within the body vessel, said stenotic material collection mechanism including an expandable filter medium enclosed and supported by said plurality of elongated blades.
- 43. The apparatus of claim 42 further comprising a means for diametrically expanding said stenotic material removal mechanism.
- 44. The apparatus of claim 42 wherein said elongated blades are resiliently biased to expand radially outward from a central axis of said stenotic material removal mechanism.
- 45. A method for removing stenotic material from within a stent located within a body vessel, said method comprising:
operating a stenotic material removal mechanism to remove stenotic material from within the stent; sensing proximity or contact between said stenotic material removal mechanism and the stent; and determining an appropriate endpoint for removal of stenotic material from within the stent based on the sensed proximity or contact between said stenotic material removal mechanism and the stent for effective recanalization of the body vessel.
- 46. The method of claim 45 further comprising controlling a depth to which said stenotic material removal mechanism removes the stenotic material from within the stent.
- 47. The method of claim 45 comprising diametrically expanding said stenotic material removal mechanism.
- 48. The method of claim 45 comprising directing said stenotic material removal mechanism to remove stenotic material from a selected area within the stent.
- 49. The method of claim 45 further comprising producing a signal indicative of the proximity or contact between said stenotic material removal mechanism and the stent.
- 50. The method of claim 45 further comprising deactivating said stenotic material removal mechanism when a predetermined level of proximity or contact between said stenotic material removal mechanism and the stent is detected.
- 51. The method of claim 45 further comprising monitoring the proximity or contact between said stenotic material removal mechanism and the stent.
- 52. The method of claim 51 wherein said sensor means comprises at least one electrical conductor on an exterior of said stenotic material removal mechanism and wherein the step of monitoring comprises detecting a leakage current when said at least one electrical conductor contacts the stent.
- 53. The method of claim 51 wherein said sensor means comprises a first electrical conductor and a second electrical conductor on an exterior of said stenotic material removal mechanism and wherein the step of monitoring comprises detecting a leakage current when said first electrical conductor and said second electrical conductor contacts the stent.
- 54. The method of claim 51 wherein said sensor means comprises at least one electrical conductor positioned on said stenotic material removal mechanism and wherein the step of monitoring comprises detecting a change in electrical impedance when said at least one electrical conductor approaches the stent.
- 55. The method of claim 51 wherein said sensor means comprises a first electrical conductor and a second electrical conductor positioned on said stenotic material removal mechanism and wherein the step of monitoring comprises detecting a change in electrical impedance when said first electrical conductor and said second electrical conductor approach the stent.
- 56. The method of claim 45 further comprising aspirating stenotic material removed from within the stent.
- 57. The method of claim 45 further comprising collecting stenotic material removed from within the stent.
- 58. The method of claim 45 further comprising inserting said stenotic material removal mechanism into the body vessel on an elongated catheter.
- 59. The method of claim 58 further comprising introducing said stenotic material removal mechanism on said elongated catheter into the body vessel through a percutaneous puncture.
- 60. A method for removing stenotic material from within a stent located within a body vessel, said method comprising:
engaging a stenotic material removal mechanism to remove a portion of stenotic material from within the stent; expanding the stenotic material removal mechanism to remove additional portions of the stenotic material; and limiting the expansion of the stenotic material removal mechanism when or before the stenotic material removal mechanism engages the stent.
- 61. The method of claim 60 comprising diametrically expanding said stenotic material removal mechanism.
- 62. The method of claim 60 further comprising deactivating said stenotic material removal mechanism when or before the stenotic material removal mechanism engages the stent.
- 63. The method of claim 60 further comprising directing said stenotic material removal mechanism to remove stenotic material from a selected area within the stent.
- 64. The method of claim 60 further comprising sensing proximity or contact between said stenotic material removal mechanism and the stent.
- 65. The method of claim 64 further comprising deactivating said stenotic material removal mechanism when a predetermined level of proximity or contact between said stenotic material removal mechanism and the stent is detected.
- 66. The method of claim 60 further comprising aspirating stenotic material removed from within the stent.
- 67. The method of claim 60 further comprising collecting stenotic material removed from within the stent.
- 68. The method of claim 60 further comprising inserting said stenotic material removal mechanism into the body vessel on an elongated catheter.
- 69. The method of claim 68 further comprising introducing said stenotic material removal mechanism on said elongated catheter into the body vessel through a percutaneous puncture.
- 70. A catheter kit comprising:
(a) a catheter including: a catheter shaft having a proximal end and a distal end, a stenotic material removal mechanism, wherein said removal mechanism is expandable, and (b) instructions for use setting forth the following steps: percutaneously introducing the stenotic material removal mechanism into a restenosed stent in a blood vessel; engaging the stenotic material removal mechanism to remove a portion of stenotic material from within the restenosed stent; expanding the stenotic material removal mechanism to remove additional portions of the stenotic material; and limiting the expansion of the stenotic material removal mechanism when or before the stenotic material removal mechanism engages the stent; and (c) a package holding the catheter and the instructions for use.
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] This patent application is a division of application Ser. No. 08/857,659, filed May 16, 1997, which is a continuation-in-part of co-owned, copending patent application, Ser. No. 08/798,722, filed Feb. 12, 1997, the entire disclosures of which are incorporated herein by reference.
Divisions (2)
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Number |
Date |
Country |
Parent |
09260935 |
Mar 1999 |
US |
Child |
09784625 |
Feb 2001 |
US |
Parent |
08857659 |
May 1997 |
US |
Child |
09260935 |
Mar 1999 |
US |
Continuation in Parts (1)
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Number |
Date |
Country |
Parent |
08798722 |
Feb 1997 |
US |
Child |
08857659 |
May 1997 |
US |