阅读说明：本技术 轴向伸长的血栓捕获系统 (The thrombus capture systems of axial elongation ) 是由 坦赫·万·恩固因 迪伊·恩固因 唐·H·恩戈 于 2018-02-06 设计创作，主要内容包括：系统和方法能够从身体部位(包括但不限于循环系统)移除感兴趣的物质(包括血块),以用于治疗肺栓塞(PE)、深静脉血栓形成(DVT)、脑血管栓塞和其它血管阻塞。(System and method can remove interested substance (including clot) from physical feeling (the including but not limited to circulatory system), for treating pulmonary embolism (PE), Deep vain thrombosis (DVT), cerebral vessels embolism and other angiemphraxis.)

1. a kind of clot capture systems, comprising:

Anchor log,

Tubular body, including first end, second end and axial length therebetween, the first end has opening,

Wherein the tubular body and the anchor log are compressed with delivery configuration,

Wherein the tubular body and the anchor log can be deformed into deployed configuration, in the deployed configuration, the anchor log and The extension of shape memory tubular body first end, but shape memory tubular body second end and the most of of shape memory tubular body keep pressure Contracting, and the tubular body has the first extension axial length,

Wherein the shape memory tubular body can be deformed into capture configuration, in the capture configuration, the shape memory tubular Body has the second extension axial length for being greater than the first extension axial length, wherein the shape memory tubular body is with described It captures configuration and encapsulates the anchor log or part of it.

2. clot capture systems according to claim 1 further include two or more anchor logs.

3. clot capture systems according to claim 2, two of them anchor log has coaxial central longitudinal axis.

4. clot capture systems according to claim 1, wherein the anchor log is stent-like structure.

5. clot capture systems according to claim 1, wherein the anchor log is air bag.

6. clot capture systems according to claim 1, wherein the anchor log is disk.

7. clot capture systems according to claim 1, wherein the anchor log includes Nitinol.

8. clot capture systems according to claim 1, wherein the anchor log includes spherical envelope.

9. clot capture systems according to claim 1, wherein the anchor log is configured to entanglement clot.

10. clot capture systems according to claim 1, wherein the anchor log is connected to the shape memory tubular Body.

11. clot capture systems according to claim 1, wherein the anchor log is funnel.

12. clot capture systems according to claim 1, wherein the anchor log is from the distal-to-proximal of the anchor log It is tapered.

13. clot capture systems according to claim 1, wherein the shape memory tubular body includes center longitudinal axis Line, and wherein the anchor log deviates the central longitudinal axis.

14. clot capture systems according to claim 1, wherein in the second end of the shape memory tubular body is connected to Portion's propeller.

15. a kind of clot capture systems, comprising:

Anchor log；

Shape memory tubular body, including first end, second end and axial length therebetween, the first end has opening,

Wherein the shape memory tubular body and the anchor log are configured to be compressed during delivering,

Wherein the first end of the shape memory tubular body and the anchor log are configured in the second end and described The most of of shape memory tubular body keeps extending while compression, wherein the shape memory tubular body has the first cross The first extension axial length in section,

Wherein the shape memory tubular body is configured to axial elongation.

16. clot capture systems according to claim 15, further include propeller, wherein the shape memory tubular body The second end is connected to the propeller.

17. clot capture systems according to claim 15, wherein the anchor log and the shape memory tubular body quilt It is fixed together.

18. a kind of method using clot capture systems, comprising:

System described in claim 15 is located near clot；

Extend the shape memory tubular body and the anchor log；And

Shape memory tubular body described in axial elongation is to encapsulate the clot.

19. according to the method for claim 18, wherein the clot is in central nervous system.

20. a kind of method using clot capture systems, comprising:

System described in claim 1 is located near clot；

The shape memory tubular body and the anchor log are deformed into deployed configuration；

The shape memory tubular body and the anchor log are deformed into the capture configuration to encapsulate the anchor log.

21. a kind of clot capture systems, comprising:

Epitheca, including central lumen；

Double lumen shafts are configured to be located in the central lumen of the epitheca；

Internal propeller is configured in the first inner chamber for being located in double lumen shafts；

Anchor log propeller is configured in the second inner chamber for being located in double lumen shafts,

Anchor log is connected to the anchor log propeller,

Shape memory tubular body, including first end, second end and axial length therebetween, the first end has opening and attached The capture guiding piece being connected in a part of the opening,

Wherein the shape memory tubular body and the anchor log are compressed with the first configuration,

Wherein the shape memory tubular body can be deformed into the second configuration, in second configuration, the first end and described Guiding piece radial expansion is captured, but the second end and the major part of the shape memory tubular body are in double lumen shafts Intracavitary holding radial compression, and the shape memory tubular body has the first extension axial length of the first cross section, Wherein first cross section and the cross section of the capture guiding piece are essentially similar,

Wherein the shape memory tubular body can be deformed into third configuration, in the third configuration, the shape memory tubular Body has the second extension axial length for being greater than the first extension axial length, wherein the shape memory tubular body is with described Third configuration encapsulates the anchor log.

22. clot capture systems according to claim 21 further include two anchor logs.

23. clot capture systems according to claim 22, wherein described two anchor logs have coaxial center longitudinal Axis.

24. clot capture systems according to claim 21 further include three anchor logs.

25. clot capture systems according to claim 21, wherein the cross section is circular.

26. clot capture systems according to claim 21, wherein the anchor log includes Nitinol.

27. clot capture systems according to claim 21, wherein the anchor log is formed with the anchor log propeller Angle, wherein the angle ranging from about 90 degree.

28. clot capture systems according to claim 21, wherein the anchor log is formed with the anchor log propeller Angle, wherein the angle ranging from about 45 degree.

29. clot capture systems according to claim 21, wherein the anchor log is formed with the anchor log propeller Angle, wherein the angle is between 5 degree and 135 degree.

30. clot capture systems according to claim 21, wherein the diameter of the anchor log is less than when radial expansion The diameter of the shape memory tubular body.

31. clot capture systems according to claim 21, wherein a part of the anchor log propeller is crescent 's.

32. clot capture systems according to claim 21, wherein the capture guiding piece includes Nitinol.

33. clot capture systems according to claim 21, wherein the capture guiding piece includes central longitudinal axis, and And wherein double lumen shafts deviate the central longitudinal axis.

34. clot capture systems according to claim 21, wherein the second end of the shape memory tubular body is connected to The internal propeller.

35. a kind of clot capture systems, comprising:

Internal thruster element；

Shape memory tubular body, including first end, second end and axial length therebetween, the first end has opening and attached The capture guiding piece being connected at least part of the opening, the second end are connected to the internal thruster element,

Wherein the shape memory tubular body and the capture guiding piece are compressed with the first configuration,

Wherein the shape memory tubular body can be deformed into the second configuration, in second configuration, the first end and described Guiding piece radial expansion, but most of holding radial compression of the second end and the shape memory tubular body are captured, and The shape memory tubular body has the first extension axial length of the first cross section, wherein first cross section and institute The cross section for stating capture guiding piece is essentially similar,

Wherein the shape memory tubular body can be deformed into third configuration, in the third configuration, the shape memory tubular Body has the second extension axial length for being greater than the first extension axial length.

36. clot capture systems according to claim 35, wherein the capture guiding piece forms continuous ring.

37. clot capture systems according to claim 35, wherein the capture guiding piece forms discontinuous ring.

38. a kind of method using clot capture systems, comprising:

In the first configuration, system described in claim 35 is located near clot；

The shape memory tubular body is deformed into second configuration；And

The shape memory tubular body is deformed into the third configuration to encapsulate the clot.

39. according to the method for claim 38, wherein the clot is in CNS.

40. a kind of method using clot capture systems, comprising:

System described in claim 21 is located near clot；

The shape memory tubular body is deformed into second configuration；

Extend the anchor log；And

The shape memory tubular body is deformed into the third configuration to encapsulate the anchor log.

41. according to the method for claim 40, wherein be unfolded the anchor log include the anchor log is fixed on it is described In clot.

42. according to the method for claim 40, wherein by the shape memory tubular body be deformed into the third configuration with Encapsulating the anchor log further includes encapsulating the clot.

43. according to the method for claim 40, wherein the clot is nerve clot.

44. a kind of clot capture systems, comprising:

First tubular element, including central lumen；

Second tubular element；

From first tubular element or multiple axially-spaced anchor logs of the second tubular element radial outward expansion；With And

Shape memory tubular body, including first end, second end and axial length therebetween, the first end is opened with end Mouthful, the second end is attached to second tubular element,

Wherein at least part of the shape memory tubular body is compressed in first tubulose axle with the first delivery configuration In the central lumen,

Wherein the shape memory tubular body can be deformed into the second configuration, and in second configuration, the first end radially expands Exhibition, and the most of of the second end and the shape memory tubular body keeps radial compression described in first tubulose axle In central lumen, and the second end is positioned close to the first end, and the shape memory tubular body has the first extension Axial length,

Wherein the shape memory tubular body can be become by first tubulose axle relative to the movement of second tubulose axle Shape is third configuration, and in the third configuration, the shape memory tubular body, which has, is greater than the first extension axial length Second extension axial length, wherein the shape memory tubular body along its second extension axial length width and the shape The width for remembering tubular body along its first extension axial length is substantially the same.

Technical field

In some respects, the present invention relates to remove interested substance from physical feeling (the including but not limited to circulatory system) The system and method for (including clot), with for treat pulmonary embolism (PE), Deep vain thrombosis (DVT), cerebral vessels embolism and Other angiemphraxis.

Background technique

It should be understood that (it can be referred to as thrombus, thrombus to undesirable substance such as clot herein in blood vessel Property embolism or embolism) may partially or completely blocked coronary arteries, the cerebrovascular, lung, peripheral vein and peripheral arterial circulation The blood vessel of system realm leads to myocardial infarction, apoplexy, pulmonary embolism, Deep vain thrombosis and acra infraction respectively.

Known various therapies and device have dissolution, excision and/or aspirate thrombi embolism.For example, heparin and warfarin Equal anti-coagulants help to stablize clot and prevent being further formed for clot, and such as thrombus of urokinase, streptokinase and tPA is molten Solution agent helps to dissolve clot.These drugs can be transfused by whole body or infusion catheter-based is delivered to scheduled position. Although thrombolytic agent can effectively dissolve clot, they take a long time so that medicament dissolution clot；Therefore exist Patient may need to stay in hospital intensive care unit (ICU) during thrombolysis is transfused.The relatively long hospital stays can be significant Increase medical treatment cost.One major limitation of these thrombolytic agents be they may result in after encephalic, gastrointestinal tract, peritonaeum and Significant morbidity and mortality risk often threat to life and is caused in pericardium and other position bleedings, these positions.

Mechanically cutting and/or suction unit can be used to remove obturator.These mechanical techniques can be using chopping, suction Out or combinations thereof to remove clot.One advantage of mechanotherapy is that it directly can remove thrombus from blocking region and disappear immediately Except obstruction, and thrombolytic agent may be better than in some cases.But current mechanotherapy has some main limitations Property.Blood flow is very little or none in surgical procedure, therefore almost without the time before blood stream of patients's Mechanical instability.Slave The clast removed in tool treatment can advance to distal end, generate other embolism.Small device sizes cannot be removed in a short time A large amount of clots, therefore may to become Hemodynamics unstable by patient.

It is catheter-based to be removed from biggish blood vessel (such as pulmonary artery) compared with lesser blood vessel (such as coronary artery) Clot has limited success.It is percutaneously to remove pulmonary embolism using multiple technologies that conduit pulmonary embolism, which removes art,.Fragmentation thrombus Clot is broken into lesser fragment by resection, and wherein most leads to distal embolization to further downstream traveling.It sometimes with thrombolysis Agent is used in combination.By rheology (rheolytic) thrombectomy, high speed physiological saline jet stream generates Venturi effect, and will Clot fragment suction lead.This method has the risk for causing haemolysis.Finally, liposuction technique is led grumeleuse sucking by suction Pipe.All these technologies depend on the conduit for removing clot from blood vessel.User is removed or is decomposed using ductule big The clot of amount.Therefore this process is time-consuming and inefficient.Once clot is broken into fragment, fragment may be mobile to distal end and be generated Undesirable embolism.Rheology therapy will cause the risk of haemolysis.In addition, aspirating energy due to aspirating big embolism with ductule size Power is restricted.These limitations cause unnecessary threat to user in some cases and cause risk to patient.

In general, when endoceliac distal end working space is restricted, clot removal catheter-based also has very big Limitation.Conventional equipment may need completely axially and/or radially to be unfolded and extend just work, and therefore, will The flexibility that this device is used for the various clinical settings including different grumeleuses or other materials size to be removed is that have very much Limit.Therefore, these conventional equipments are limited for blood vessel distal void it may be the case that invalid.

It is readily apparent that having clot and other available institutes of patient for being not intended to substance in blood vessel and other body cavitys There is therapeutic choice that all there is limitation.The anticoagulant propagation for only limiting clot, but it is not removed actively.Thromboembolism treatment will lead to seriously The risk of bleeding.Conduit takes bolt that cannot efficiently control the removal of substance in big blood vessel.In addition, these devices need distal void It can just be fully deployed to work in distal void, therefore be invalid in compact distal void.Thrombectomy of patients with deep can To be highly effective, but very invasive, and there is high incidence and the death rate.In the presence of to direct mechanotherapy Demand, this mechanotherapy is effectively or more effective as the surgery embolism resection for removing big clot, but can be used Endovascular technology carries out and restores instant blood flow, and causes the incidence of complication lower.

Summary of the invention

In some embodiments, disclosed herein is the capture systems for the intracorporal selected material of body.The capture system System may include capture component, which is configured to that the unwanted material such as clot is isolated, it may include shape Shape memory body, the shape memory body are for example made of Web materials, and draw with the capture with distal openings is connected to The distal end of guiding element.The shape memory body can also include the proximal end for being connected to first axle and pipe between the proximal and distal ends Shape side wall.The capture component can be configured to, and when shape memory body proximal end is compressed in delivery system, guide capture Part and distal open end extension.The shape memory body can be from the first configuration with first axis length and with the second axis It is mobile to the second configuration of length.The shape memory body can be configured to from the first configuration proximally or distal end roll, reversion, Overturn and/or be changeably lengthened to the second configuration.Second axial length can be different from first axis length.In some cases Under, the width of the capture component can be substantially constant from the first configuration to the second configuration.The capture systems can also wrap Control line is included, which is configured as that capture component is independently moved to the second configuration from the first configuration.The first axle It can extend in the longitudinal axis of capture component.

In some embodiments, disclosed herein is a kind of materials, such as clot capture systems.The system may include having First outer tubular axis of central lumen, the first outer tubular axis include proximal part and distal portions, and the distal portions can Radially further to be extended than proximal part.The system can also include the second tubulose axle, be configured to be located in first axle In central lumen.The system can also include the third tubulose axle for being configured as being located in the central lumen of the second axis.It is described Shape memory tubular body may include first end, second end and axial length therebetween, and first end has the opening towards proximal end Be attached to the opening towards proximal end circumference on annular capture guiding piece, the capture guiding piece is operably attached to institute The second tubulose axle is stated, the second end is attached to the outer wall of the third tubulose axle.In the first delivery configuration, the shape note Recalling tubular body can be compressed in the central lumen of the second tubulose axle.The shape memory tubular body can be deformed into the second structure Type, wherein first end and capture guiding piece radial expansion be to dynamic folding point, but one section of second end and shape memory tubular body Extend in different directions, such as proximally passes through the dynamic folding point, and keep radial compression in the second tubulose axle In chambers, second end is located near first end, and shape memory tubular reticulate body has the first extension axial length.Shape Memory tubular body can be deformed into third configuration, and wherein shape memory tubular body has be greater than the first extension axial length second Axial length is extended, and shape memory tubular axis is along the width and the shape memory tubular of its second extension axial length Axis along its first extension axial length it is of same size or essentially identical.First tubulose axle may be configured to the phase in delivery configuration Second tubulose axle is reversibly coupled, and is axially movable in the second configuration relative to third tubulose axle.In some realities Apply in example, second extension axial length be about or at least about such as first axis length 105%, 110%, 115%, 120%, 125%, 130%, 150%, 200%, 250%, 300%, 350%, 400%, 450%, 500% or more.According to The capture systems of claim 1, wherein the shape memory body can be it is porous, semipermeable and non-porous, and including Braided Nitinol, woven or nonwoven web or nitinol wire.In some embodiments, the tubular body is coated or is not applied Hydrophilic or hydrophobing agent is covered, and can not include shape memory metal or material.In some embodiments, the tubular mesh body It is configured to reverse, overturn or rotate out relative to first axle, the second axis and/or third axis.The system can also include from catching The control line that guiding piece proximally extends is obtained, which terminates on the sheath on one of described axis or proximally extend To the proximal end of the system.In some embodiments, which includes suction element, is configured to and shape memory tubular body Proximal openings be operably connected.The system can also include mechanical thrombectomby element, such as chopper (macerator).The system can also include filter collection chamber, be configured to collect and filter to obtain from suction element Blood.The system may further include

Guiding catheter is extended, is configured to receive the capture component of kit form.The extension induction element may include Be open funnelform distal tip, the tip can be in some embodiments it is porous, to allow around funnel distal tip The blood flow at end.

It in some embodiments, may include: in having disclosed herein is a kind of material, such as clot capture systems First outer tubular axis of chambers；It is configured to the second tubulose axle being located in the central lumen of the first axle, institute Stating the second tubulose axle includes proximal part and distal portions, and the distal portions can radially further expand than the proximal part Exhibition；It is configured to be located in the third tubulose axle in the central lumen of second axis；Tubular mesh, including first end, second End and axial length therebetween, the first end is with the opening towards proximal end and is attached to the opening towards proximal end Circumference on annular capture guiding piece, the capture guiding piece, which is operationally attached, is connected to the second tubulose axle, second end connect It is connected to the outer wall of third tubulose axle.The tubular mesh can be compressed in the center of the second tubulose axle in delivery configuration It is intracavitary.Tubular mesh can also be deformed into the second configuration, wherein first end and capture guiding piece radial expansion, but second end Keep radial compression at the center of second tubulose axle with a part (such as fraction, half or major part) tubular mesh Interior intracavitary, the second end is approached the first end positioning, and the tubular mesh has the first extension axial length.Institute Third configuration can be deformed by stating tubular mesh, wherein the tubular mesh, which has, is greater than the first extension axial length Second extension axial length, wherein the tubular mesh along its second extension axial length width be substantially equal to institute Tubulose grid is stated along its first extension axial length, wherein the third tubulose axle extends distally through the shape memory The proximal openings of tubular body and described second axially expand length.In some embodiments, in the second configuration or third In construction, tubular mesh is not under tension or is not under tension substantially, to limit the axial work model of tubular mesh It encloses.

In some embodiments, the system for capturing the materials such as clot includes: the first exterior tube including central lumen Shape axis；It is configured to the second tubulose axle being located in the central lumen of the first axle, second tubulose axle includes close End part and distal portions, the distal portions can radially further be extended than the proximal part；It is configured to be located in institute State the third tubulose axle in the central lumen of the second axis；Tubular body including shape-memory material, including first end, second end with And axial length therebetween, the first end have opening towards proximal end and are attached to the circumference of the opening towards proximal end On annular capture guiding piece, it is described capture guiding piece via around second tubulose axle a part sheath operationally It is attached to second tubulose axle, the second end is attached to the outer wall of the third tubulose axle.The shape memory tubular body It can be compressed in delivery configuration in the central lumen of the second tubulose axle.By the second tubulose axle relative to the first tubulose axle Axial movement, the shape memory tubular body can be deformed into the second configuration, and wherein first end and capture guiding piece radially expand Exhibition, and second end and a part of shape memory tubular body keep radial compression in the central lumen of the second tubulose axle, second End is positioned close to first end, and the shape memory tubular reticulate body has the first extension axial length.Pass through the second tubulose Movement of the axis relative to third tubulose axle, the shape memory tubular body can be deformed into third configuration, wherein shape memory pipe Shape body has the second extension axial length for being greater than the first extension axial length, and wherein shape memory tubular axis is along its second extension The width of axial length is essentially identical along the width of its first extension axial length with shape memory tubular axis, wherein third tubulose Axial distal end extends through the proximal openings of the shape memory tubular body and second axially expands length.Pass through the second tubulose Movement of the axis relative to third tubulose axle, the shape memory tubular body can be deformed into the 4th configuration in some cases.Institute Stating shape memory tubular body can have the third extension axial length that axial length is extended greater than second, wherein shape memory pipe Shape axis is less than shape memory tubular axis along the width of its second extension axial length along the width of its third extension axial length.Institute Stating clot capture systems can also include the sheath comprising metal or polymer, and sheath can fluoroscopy or it is other at Partially or even wholly radiopaque or radioparent as under.

There is disclosed herein the methods for carrying out thrombectomy.This method may include for example: into the inside of blood vessel；It pushes away Pass through blood vessel into the thrombus acquisition equipment for including capture component；The thrombus acquisition equipment is positioned, so that the distal end of described device In the distal end of the thrombus；The thrombus that the capture component is activated to be isolated in the acquisition equipment, wherein the capture component It can be moved from the first configuration with first axis length with the second configuration with the second axial length, described second is axial Length is different from the first axis length, wherein the width of the capture component is from first configuration to described second Configuration does not change substantially；With suction, macerate and/or mechanically remove thrombus.

In some embodiments, the method for executing thrombectomy may include for example: enter internal blood vessel；It promotes The guiding catheter of extension passes through blood vessel；The guiding catheter of the extension is positioned, so that the distal end of described device is close to thrombus；It retracts The guiding catheter external component of the extension is to expand funnel tip and the expansible internal component of exposure；Promoting includes capture component Thrombus acquisition equipment be extended through guiding catheter；The thrombus acquisition equipment is positioned, so that the distal end of described device is described The distal end of thrombus or in the thrombus；And the actuating capture component is to be isolated the thrombus in acquisition equipment.The capture Component can be from the first configuration with first axis length and the second configuration with the second axial length is mobile, and second is axial Length is different from first axis length.The width of the capture component can be substantially constant from the first configuration to the second configuration Change.This method can also include that the capture component with thrombus is retracted into the guiding catheter funnel tip of extension and expansible interior In portion's main body.This method can also include retracting to the extension to thrombus acquisition equipment described in the axial elongation of distal end and by thrombus Guiding catheter funnel tip in.This method can also include the radial shortening thrombus acquisition equipment to compress thrombus and promote Into the removal of thrombus.

It in some embodiments, may include being configured as separation blood disclosed herein is a kind of clot capture systems The capture component of block.The system may include shape memory body, which has the distal end for being connected to capture guiding piece, The capture guiding piece includes distal end or proximal openings.Shape memory body can also include be connected to first axle proximal end and Side wall between proximally and distally.The capture guiding piece and the remote area of shape memory body open end can also complete or portions Divide ground recapture inside outer sheath.The capture component can be configured in delivery configuration when shape memory body proximal end is kept Remote area radial expansion that is compressed while making capture guiding piece and shape memory body open end.The capture component can be with The second configuration with the second axial length is moved to from the first configuration with first axis length.The shape memory body can To be configured as proximally rolling out from the first configuration, overturning, invert and/or be changeably elongated to the second configuration.Second Axial length can be different from first axis length.The width of the capture component in some cases can from the first configuration to Second configuration is substantially constant.

There is disclosed herein a kind of capture components for being configured as isolation clot comprising shape memory body, the shape Memory body includes proximal end and the distal end for being connected to capture guiding piece, and the capture guiding piece includes distal openings, is connected to one The proximal end of axis and side wall between the proximal and distal ends.Capture component can be configured as in delivery configuration in shape memory body Proximal end extend the capture guiding piece and distal end shape memory body open end when being compressed between first axle and the second axis, and And it can be moved from the first configuration with first axis length with the second configuration with the second axial length.The shape note Recall body may be configured to proximally to roll out from the first configuration/expansion, overturning, reversion and/or be changeably elongated to the second structure Type.Second axial length can be different from first axis length.In some cases, the width of the capture component is from the first structure Type is substantially constant to the second configuration.In addition, be once unfolded, the shape memory body can completely or partially recapture Inside outer sheath.The system can also include the sheath for being connected to control line, and the control line is connected to the second axis, second axis It is configured as capture component being moved to the second configuration from the first configuration.First axle and the second axis can be relative to capture component Off-axis.

There is disclosed herein the methods for carrying out thrombectomy.This method may include any number of following steps: into Enter the inside of blood vessel；The thrombus acquisition equipment including capture component is promoted to pass through blood vessel；The thrombus acquisition equipment is positioned, so that The distal end of described device is in the distal end of the thrombus；The thrombus that the capture component is activated to be isolated in the acquisition equipment, Described in capture component can from the first configuration with first axis length with the second configuration with the second axial length move Dynamic, second axial length is different from the first axis length, wherein the width of the capture component is from described the One configuration is not substantially changed to second configuration；And aspirate thrombi.

In some embodiments, the method may include any number of following steps: into the inside of blood vessel；It promotes The guiding catheter of the extension passes through blood vessel；The guiding catheter of the extension is positioned, so that the distal end of described device is close to thrombus； The guiding catheter external component of the extension is retracted to extend funnel tip and the expansible internal component of exposure；Promoting includes capture The thrombus acquisition equipment of component passes through the guiding catheter of the extension；The thrombus acquisition equipment is positioned, so that described device Distal end is in the distal end of the thrombus or in the thrombus；The blood that the capture component is activated to be isolated in the acquisition equipment Bolt, wherein the capture component can be from the first configuration with first axis length and with the second structure of the second axial length Type is mobile, and second axial length is different from the first axis length, wherein the width of the capture component is from the first structure Type is to the second being basically unchanged of configuration；With the guiding catheter funnel tip and expansible inside subject that thrombus is retracted into extension In.In some embodiments, then the capture guiding piece is retracted into institute first by the epitheca of recapture to delivery catheter It states in the guiding catheter funnel tip and expansible interior main body of extension.

In some embodiments, disclosed herein is a kind of clot capture systems.The system may include the first tubulose structure Part, first tubular element includes central lumen.The system may include the second tubular element.The system may include Shape memory tubular body, the shape memory tubular body include first end, second end and axial length therebetween, and described first End have it is open-ended, the second end is attached to second tubular element.In some embodiments, the shape memory pipe At least part of shape body is compressed in the central lumen of first tubulose axle with the first delivery configuration.In some embodiments In, the shape memory tubular body can be deformed into the second configuration, in second configuration, the first end radial expansion, and The second end and the most of of the shape memory tubular body keep radial pressure in the central lumen of first tubulose axle Contracting, and the second end is positioned close to first end, and the shape memory tubular body has the first extension axial length.One In a little embodiments, the shape memory tubular body can movement by first tubulose axle relative to second tubulose axle It is deformed into third configuration, in the third configuration, the shape memory tubular body, which has, is greater than the axial length of the first extension Second extension axial length of degree, wherein width and the shape of the shape memory tubular body along its second extension axial length It is substantially the same along the width of its first extension axial length that shape remembers tubular body.

The system may include the capture guiding piece for being attached to the first end opening.In some embodiments, institute Capture guiding piece is stated to be open at least partially around the first end.In some embodiments, the capture guiding piece is complete Partly surround the first end opening.The system may include surrounding the expansible covering member of the capture guiding piece Part.In some embodiments, expansible cladding element is distensible.The system may include from the capture guiding piece to The control line that proximal end extends.The system may include be attached to first tubulose axle and the shape memory tubular body The sheath of one end opening.In some embodiments, the shape memory tubular body is configured to relative to first tubulose Axis or second tubulose axle, which are reversed, overturn or rotated out, to be come.In some embodiments, the end of the shape memory tubular body Opening is towards proximal end.In some embodiments, the shape memory tubular body includes mesh.In some embodiments, The shape memory tubular body is configured to allow for fluid to flow through wherein.In some embodiments, the second tubular element packet Include central lumen.The system may include the extension induction element for being configured to receive capture component.In some embodiments, expand Exhibition induction element includes the funnelform distal tip of opening.In some embodiments, the funnelform distal tip of opening is It is porous to allow to flow.In some embodiments, the maximum length of shape memory tubular body about 0.5cm and about 125cm it Between.In some embodiments, shape memory tubular body can be deformed into the 4th configuration, in the 4th configuration, shape memory pipe Shape body, which has, axially expands length greater than the second third for axially expanding length, and wherein shape memory tubular body is extended along its third The width of axial length is less than shape memory tubular body along the width of its second extension axial length.

In some embodiments, disclosed herein is a kind of systems for capturing interested substance in body cavity.It is described System may include the first tubular element, and first tubular element includes central lumen.The system may include the second pipe Shape component.The system may include shape memory tubular body, the shape memory tubular body include first end, second end and Axial length therebetween, the first end have it is open-ended, the second end is attached on the outer wall of the second tubular element.In In some embodiments, shape memory tubular body is compressed in the central lumen of the first tubulose axle with the first delivery configuration.One In a little embodiments, shape memory tubular body can be deformed into the second configuration, in second configuration, first end opening and shape Remember being open along the axially extending first part's radial expansion of first direction slave first end to folding point for tubular body, works as shape The second part for remembering tubular body axially extends to shape memory tubular from folding point along the second direction opposite with first direction When the second end of body, second part is relatively radially compressed relative to first part, and second end is positioned close to first end.In some realities It applies in example, shape memory tubular body can be deformed into third configuration relative to the movement of the second tubulose axle by the first tubulose axle, In the third configuration, the axial length of first part increases by the first amount, and shape memory tubular body, which has, is greater than the first extension The second of axial length extends axial length, wherein width and shape of the shape memory tubular body along its second extension axial length The width for remembering tubular body along its first extension axial length is substantially the same.

In some embodiments, disclosed herein is a kind of clot capture systems.The system may include the first tubulose structure Part, first tubular element includes central lumen.The system may include the second tubular element.The system may include Shape memory tubular body, the shape memory tubular body include first end, second end and axial length therebetween, and described first End have it is open-ended, the second end is attached on the outer wall of the second tubular element.In some embodiments, shape memory pipe Shape body is compressed in the central lumen of the first tubulose axle with the first delivery configuration.In some embodiments, shape memory tubular Body can be deformed into the second configuration, in second configuration, the slave first end of first end opening and shape memory tubular body Opening along the axially extending first part's radial expansion of first direction to folding point, when shape memory tubular body second part from When folding point axially extends to second end along the second direction opposite with first direction, second part is relative to first part's radial direction Compression, second end are positioned close to first end.In some embodiments, shape memory tubular body can by the first tubulose axle relative to The movement of second tubulose axle and be deformed into third configuration, in the third configuration, the axial length of first part increases by first Amount, shape memory tubular body have the second extension axial length for being greater than the first extension axial length, wherein shape memory tubular Body along its second extension axial length width and shape memory tubular body along its first extension axial length width substantially It is identical.

In some embodiments, disclosed herein is a kind of clot capture systems.The system may include epitheca, described outer Sheath includes central lumen.The system may include double lumen shafts, and double lumen shafts are configured to be located in the center of epitheca It is interior intracavitary.The system may include internal propeller, and the internal propeller is configured to be located in the first of double lumen shafts It is interior intracavitary.The system may include anchor log propeller, and the anchor log propeller is configured to be located in double lumen shafts In second inner chamber.The system may include the anchor log for being connected to anchor log propeller.The system may include shape note Recall tubular body, the shape memory tubular body includes first end, second end and axial length therebetween, and the first end has It is open and is attached to the capture guiding piece of a part of the opening.In some embodiments, shape memory tubular body and anchoring Part is compressed with the first configuration.In some embodiments, shape memory tubular body can be deformed into the second configuration, in second structure In type, first end and capture guiding piece are radially expanded, but second end and the major part of shape memory tubular body are in double inner cavities Radial compression is kept in the inner cavity of axis, and shape memory tubular body has the first extension axial length of the first cross section, Wherein the first cross section and the cross section of capture guiding piece are essentially similar.In some embodiments, shape memory tubular body can It is deformed into third configuration, in the third configuration, shape memory tubular body has be greater than the first extension axial length second Extend axial length, wherein shape memory tubular body encapsulates anchor log with third configuration.

The system may include such as one, two or more anchor log.Anchor log can have any desired Configuration includes J-shaped hook shape to stablize clot or in conjunction with clot in order to remove in some cases.In some embodiments In, anchor log can penetrate clot or other materials to be captured, or do not penetrate but surround or it is stable in other ways or Reversibly at least part of the clot that fixation to be captured or other materials.In some embodiments, anchor log has coaxially Central longitudinal axis.The system may include the anchor log of three or more.In some embodiments, the cross section of anchor log It is round, oval, square, rectangle or other cross sections.In some embodiments, anchor log includes Nitinol.In some realities Apply in example, anchor log and anchor log propeller shape at an angle, wherein the angle ranging from about 90 degree.In some embodiments, Anchor log and anchor log propeller shape at an angle, wherein the angle ranging from about 45 degree.In some embodiments, anchor log with Anchor log propeller shape at an angle, wherein the angle is between 5 degree and 135 degree.In some embodiments, when radial expansion Zhan Shi, the diameter of anchor log are less than the diameter of shape memory tubular body.In some embodiments, a part of anchor log propeller It is half moon-shaped.In some embodiments, capture guiding piece includes Nitinol.In some embodiments, capture guiding piece includes Central longitudinal axis, and wherein double lumen shafts deviate central longitudinal axis.In some embodiments, shape memory tubular body Second end is connected to internal propeller.In some embodiments, capture guiding piece forms continuous ring.In some embodiments, Capture guiding piece forms discontinuous ring.

In some embodiments, disclosed herein is a kind of clot capture systems.The system may include internal propeller. The system may include shape memory tubular body, and the shape memory tubular body includes first end, second end and therebetween Axial length, the first end have opening and are attached at least part of capture guiding piece of the opening, and described second End is connected to internal propeller.In some embodiments, shape memory tubular body and capture guiding piece are compressed with the first configuration. In some embodiments, shape memory tubular body can be deformed into the second configuration, and in second configuration, first end and capture are drawn Guiding element radial expansion, but second end and the most of of shape memory tubular body keep radial compression, and shape memory tubular Body has the first extension axial length of the first cross section, wherein the cross section base of the first cross section and capture guiding piece It is similar in sheet.In some embodiments, shape memory tubular body can be deformed into third configuration, in the third configuration, shape Remembering tubular body has the second extension axial length for being greater than the first extension axial length.In some embodiments, capture guidance Part forms continuous ring.In some embodiments, capture guiding piece forms discontinuous ring.

There is disclosed herein a kind of methods using clot capture systems.The method may include following arbitrary numbers: System is located near clot in the first configuration；Shape memory tubular body is deformed into the second configuration；And shape is remembered Recall tubular body and is deformed into third configuration to encapsulate clot.The system may include internal propeller.The system may include Shape memory tubular body, the shape memory tubular body include first end, second end and axial length therebetween, and described first The capture guiding piece that there is opening and be attached at least part of the opening is held, the second end is connected to internal propulsion Device.In some embodiments, shape memory tubular body and capture guiding piece are compressed with the first configuration.In some embodiments, Shape memory tubular body can be deformed into the second configuration, in second configuration, first end and capture guiding piece radial expansion, but It is that second end and the most of of shape memory tubular body keep radial compression, and shape memory tubular body has the first cross The first extension axial length in section, wherein the first cross section and the cross section of capture guiding piece are essentially similar.In some realities It applies in example, shape memory tubular body can be deformed into third configuration, and in the third configuration, shape memory tubular body, which has, to be greater than Second extension axial length of the first extension axial length.In some embodiments, clot is in CNS.

There is disclosed herein a kind of methods using clot capture systems.The method may include following arbitrary numbers: System is located near clot；Shape memory tubular body is deformed into the second configuration；Extend the anchor log；And by shape Memory tubular body is deformed into third configuration to encapsulate anchor log.The system may include epitheca, and the epitheca includes in center Chamber.The system may include double lumen shafts, and double lumen shafts are configured to be located in the central lumen of epitheca.The system System may include internal propeller, and the internal propeller is configured in the first inner chamber for being located in double lumen shafts.The system System may include anchor log propeller, and the anchor log propeller is configured in the second inner chamber for being located in double lumen shafts.Institute The system of stating may include the anchor log for being connected to anchor log propeller.The system may include shape memory tubular body, described Shape memory tubular body includes first end, second end and axial length therebetween, and the first end has opening and is attached to The capture guiding piece of a part of the opening.In some embodiments, shape memory tubular body and anchor log are with the first configuration It is compressed.In some embodiments, shape memory tubular body can be deformed into the second configuration, in second configuration, first end It is radially expanded with capture guiding piece, but second end and the major part of shape memory tubular body are protected in the inner cavity of double lumen shafts Radial compression is held, and shape memory tubular body has the first extension axial length of the first cross section, wherein first is transversal Face and the cross section of capture guiding piece are essentially similar.In some embodiments, shape memory tubular body can be deformed into third structure Type, in the third configuration, shape memory tubular body has the second extension axial length for being greater than the first extension axial length, Wherein shape memory tubular body encapsulates anchor log with third configuration.In some embodiments, expansion anchor log includes by anchor log It is fixed in clot.In some embodiments, shape memory tubular body is deformed into third configuration to encapsulate anchor log further includes Encapsulate clot.In some embodiments, clot is nerve clot.

In some embodiments, disclosed herein is a kind of clot capture systems.The system may include the first tubulose structure Part, first tubular element includes central lumen.The system may include the second tubular element.The system may include From the first tubular element or multiple axially-spaced anchor logs of the second tubular element radial outward expansion.The system can wrap Including shape memory tubular body, the shape memory tubular body includes first end, second end and axial length therebetween, and described One end have it is open-ended, the second end is attached to the second tubular element.In some embodiments, shape memory tubular body At least part is compressed in the central lumen of the first tubulose axle with the first delivery configuration.In some embodiments, shape is remembered Recalling tubular body can be deformed into the second configuration, in second configuration, first end radial expansion, and second end and shape memory pipe The major part of shape body keeps radial compression in the central lumen of the first tubulose axle, and second end is positioned close to first end, and Shape memory tubular body has the first extension axial length.In some embodiments, shape memory tubular body can pass through the first pipe Shape axis relative to the second tubulose axle movement and be deformed into third configuration, in the third configuration, shape memory tubular body tool There is the second extension axial length for being greater than the first extension axial length, wherein shape memory tubular body is axial long along its second extension The width of degree is substantially the same along its first extension width of axial length with shape memory tubular body.

In some embodiments, disclosed herein is a kind of clot capture systems.The system may include anchor log.It is described System may include tubular body, and the tubular body includes first end, second end and axial length therebetween.First end can have There is opening.Tubular body and anchor log can be compressed with delivery configuration.Tubular body and anchor log can be deformed into deployed configuration, in institute It states in deployed configuration, anchor log and the extension of shape memory tubular body first end, but shape memory tubular body second end and shape Remember the most of of tubular body and keep compression, and tubular body has the first extension axial length.Shape memory tubular body is variable Shape is capture configuration, and in the capture configuration, shape memory tubular body has to be expanded greater than the second of the first extension axial length Open up axial length.Shape memory tubular body can be to capture configuration encapsulation anchor log or part of it.In some embodiments, institute The system of stating may include two or more anchor logs.In some embodiments, two anchor logs have coaxial center longitudinal Axis.In some embodiments, anchor log is stent-like structure.In some embodiments, anchor log is air bag.In some implementations In example, anchor log is disk.In some embodiments, anchor log includes Nitinol.In some embodiments, anchor log includes spherical shape Air bag.In some embodiments, anchor log is configured to entanglement clot.In some embodiments, anchor log is connected to shape note Recall tubular body.In some embodiments, anchor log is funnel.In some embodiments, anchor log is from the distal end of anchor log to close It holds tapered.In some embodiments, shape memory tubular body includes central longitudinal axis, and wherein anchor log deviation center is vertical To axis.In some embodiments, the second end of shape memory tubular body is connected to internal propeller.

In some embodiments, disclosed herein is a kind of clot capture systems.The system may include anchor log.It is described System may include shape memory tubular body, and the shape memory tubular body includes first end, second end and axial direction therebetween Length.First end can have opening.Shape memory tubular body and anchor log can be configured to be compressed during delivering.Shape The first end and anchor log of shape memory tubular body can be configured to keep in second end and the most of of shape memory tubular body It is extended while compression.Shape memory tubular body can have the first extension axial length for having the first cross section.Shape note Axial elongation can be configured to by recalling tubular body.In some embodiments, the system may include propeller, and wherein shape is remembered The second end for recalling tubular body is connected to propeller.In some embodiments, anchor log and shape memory tubular body are fixed on one It rises.

In some embodiments, disclosed herein is a kind of methods using clot capture systems.The method may include Any clot capture systems disclosed herein are located near clot.The method may include make shape memory tubular body and Anchor log extension.The method may include axial elongation shape memory tubular bodies to encapsulate clot.In some embodiments, blood Block is in central nervous system.

In some embodiments, disclosed herein is a kind of methods captured using clot.The method may include incite somebody to action this Any clot capture systems disclosed in text are located near clot.The method may include by shape memory tubular body and anchoring Part is deformed into deployed configuration.The method may include shape memory tubular body and anchor log are deformed into capture configuration to encapsulate Anchor log.

In some embodiments, disclosed herein is a kind of clot capture systems.In some embodiments, shape memory tubular Body can be deformed into the second configuration, in second configuration, first end and capture guiding piece radial expansion, but second end and shape Shape remembers the most of of tubular body and keeps compression in the first inner chamber of double lumen shafts, and shape memory tubular body has the First extension axial length of one cross section.In some embodiments, the first cross section and the cross section of capture guiding piece are basic It is upper similar.In some embodiments, the cross section of shape memory tubular body is circular.In some embodiments, anchor log exists When extension at an angle with anchor log propeller shape, wherein the angle ranging from about 90 degree.In some embodiments, anchor log exists When extension at an angle with anchor log propeller shape, wherein the angle ranging from about 45 degree.In some embodiments, anchor log exists When extension at an angle with anchor log propeller shape, wherein the angle ranging from about 5 degree.In some embodiments, wherein working as expansion Zhan Shi, the diameter of anchor log are less than the diameter of shape memory tubular body.In some embodiments, shape memory tubular body is deformable For the second configuration, in second configuration, first end and capture guiding piece radial expansion, but second end and shape memory pipe The most of of shape body keeps compression, and shape memory tubular body has the first extension axial length of the first cross section. In some embodiments, the first cross section and the cross section of capture guiding piece are essentially similar.In some embodiments, shape is remembered Recalling tubular body can be deformed into the second configuration, in second configuration, first end radial expansion, and second end and shape memory pipe The most of of shape body keeps compression in the central lumen of the first tubular element, and second end is positioned close to first end, and shape Shape, which remembers tubular body, has the first extension axial length.In some embodiments, shape memory tubular body is axial along the second extension The width of length is substantially the same along the first extension width of axial length with shape memory tubular body.In some embodiments, Disclosed herein is a kind of methods using clot capture systems.The method may include shape memory tubular body is deformed into Three configurations are to encapsulate clot.In some embodiments, clot is in central nervous system.In some embodiments, spread anchorage Part includes that anchor log is fixed in clot.In some embodiments, shape memory tubular body is deformed into third configuration to seal Dress anchor log further includes encapsulation clot.

In some embodiments, disclosed herein is a kind of clot capture systems.The system may include axis.The system It may include multiple axially-spaced anchor logs comprising collapsed configuration and expanded configuration.In some embodiments, multiple axial directions The anchor log separated is extended radially outwardly with expanded configuration from axis.The system may include shape memory tubular body, the shape Shape memory tubular body includes first end, second end and axial length therebetween.In some embodiments, first end may include Opening.In some embodiments, shape memory tubular body can be compressed into compressed configuration.In some embodiments, shape is remembered Recalling tubular body can be deformed into the first expanded configuration, in first expanded configuration, first end extension.In some embodiments, Second end and a part of of shape memory tubular body can be compressed with the first expanded configuration.In some embodiments, shape is remembered The first extension axial length can be had in the first expanded configuration by recalling tubular body.In some embodiments, shape memory tubular body It can be deformed into the second expanded configuration, in second expanded configuration, shape memory tubular body, which has, is greater than the first extension axially Second extension axial length of length.In some embodiments, shape memory tubular body surrounds multiple axis with the second expanded configuration To the anchor log separated.In some embodiments, multiple axially-spaced anchor logs include three or more anchor logs.One In a little embodiments, multiple axially-spaced anchor logs are coaxial.In some embodiments, multiple axially-spaced anchor log packets Include Nitinol.In some embodiments, the anchor log in multiple axially-spaced anchor logs extension when with anchor log propeller Shape at an angle, wherein the angle ranging from about 90 degree.In some embodiments, the anchoring in multiple axially-spaced anchor logs Part extension when with anchor log propeller shape at an angle, wherein the angle ranging from about 45 degree.In some embodiments, multiple The cross section of anchor log in axially-spaced anchor log is in extension less than the cross section of the first end of shape memory tubular body. In some embodiments, multiple axially-spaced anchor logs are connected to anchor log propeller.In some embodiments, shape memory The second end of tubular body is connected to internal propeller.

In some embodiments, disclosed herein is a kind of clot capture systems.The system may include axis.The system It may include anchor log, the anchor log includes collapsed configuration and expanded configuration.In some embodiments, anchor log is to extend structure Type extends outwardly from axis.The system may include shape memory tubular body, and the shape memory tubular body includes first end, Two ends and axial length therebetween.In some embodiments, first end can have opening.In some embodiments, shape Memory tubular body can be compressed into compressed configuration.In some embodiments, shape memory tubular body can be deformed into the first extension Configuration, in first expanded configuration, first end extension.In some embodiments, second end and shape memory tubular body A part can be compressed with the first expanded configuration.In some embodiments, shape memory tubular body can have the first extended axis To length.In some embodiments, shape memory tubular body can be deformed into the second expanded configuration, in second expanded configuration In, shape memory tubular body has the second extension axial length.In some embodiments, the second extension axial length is greater than first Extend axial length.In some embodiments, the first cross section is circular.In some embodiments, anchor log is in extension At an angle with anchor log propeller shape, wherein the angle is between 5 degree and 135 degree.In some embodiments, system can To include the second anchor log.In some embodiments, anchor log is coaxial.In some embodiments, shape memory tubular body Second end be connected to internal propeller.

In some embodiments, disclosed herein is a kind of clot capture systems.The system may include axis.The system It may include being configured to from the abducent anchor log of axis.The system may include shape memory tubular body, the shape note Recalling tubular body includes first end, second end and axial length therebetween.In some embodiments, first end can have out Mouthful.In some embodiments, shape memory tubular body can be compressed into compressed configuration.In some embodiments, shape memory Tubular body can be deformed into the first expanded configuration, in first expanded configuration, first end extension, and second end and shape memory A part of tubular body keeps compression.In some embodiments, shape memory tubular body can have in the first expanded configuration One extension axial length.In some embodiments, shape memory tubular body can be deformed into the second expanded configuration, expand described second It opens up in configuration, shape memory tubular body has the second extension axial length for being greater than the first extension axial length.In some implementations In example, shape memory tubular body surrounds anchor log with the second expanded configuration.In some embodiments, system may include the second anchor Determine part.In some embodiments, anchor log is axially-spaced along the longitudinal axis of axis.In some embodiments, anchor log is by structure Cause entanglement clot.In some embodiments, when expanded, the cross section of anchor log is less than the first end of shape memory tubular body Cross section.

In some embodiments, shape memory tubular body, which can have in the first expanded configuration from first end, extends to folding The first extension axial length in folded portion.In some embodiments, folding part forms shape memory tubular in the first expanded configuration The distal end of body.In some embodiments, in the first expanded configuration, first end and second end is close to distally.In some embodiments In, shape memory tubular body can surround the anchoring of at least one of multiple axially-spaced anchor logs with the second expanded configuration Part.In some embodiments, anchor log and anchor log propeller when anchor log extends, in multiple axially-spaced anchor logs Shape at an angle, wherein the angle ranging from about 90 degree.In some embodiments, multiple axially-spaced when anchor log extends Anchor log in anchor log and anchor log propeller shape at an angle, wherein the angle ranging from about 45 degree.In some implementations In example, when the extension of the first end of multiple axially-spaced anchor logs and shape memory tubular body, multiple axially-spaced anchorings The cross section of each of part is less than the cross section of the first end of shape memory tubular body.In some embodiments, shape is remembered Recalling tubular body includes the distal end in the first expanded configuration.In some embodiments, in the first expanded configuration, first end and Two ends are close to distally.In some embodiments, when shape memory tubular body extends, the cross section of shape memory tubular body is round Shape.In some embodiments, when anchor log extends, anchor log and anchor log propeller shape at an angle, wherein described Angle is between 5 degree and 135 degree.In some embodiments, the first anchor log and the second anchor log are coaxial.In some implementations In example, anchor log can be configured to extend.In some embodiments, shape memory tubular body is in the first expanded configuration It include dynamic folding point between one end and second end.In some embodiments, in the first expanded configuration, first end and second end Close to dynamic folding point.In some embodiments, wherein the first anchor log and the second anchor log are axial along the longitudinal axis of axis It separates.In some embodiments, when anchor log and first end extend, the cross section of anchor log is less than shape memory tubular body The cross section of first end.

In some embodiments, shape memory tubular body and at least one anchor log can be deformed into the second configuration, in institute It states in the second configuration, the extension of the first end of at least one anchor log and shape memory tubular body, and the of shape memory tubular body A part of two ends and shape memory tubular body keeps compression, so that second end is positioned close to first end, and first end and shape The holding compression of shape memory tubular body partly overlaps.In some embodiments, the holding of first end and shape memory tubular body Compression partly overlaps.In some embodiments, shape memory tubular body can be deformed into following configuration: its split shed is extended, And folding point, the first part are extended to from opening along the axially extending first part of first direction in shape memory body With the first extension axial length, with and shape memory body second part from folding point along opposite with first direction second Direction axially extends to the second end of shape memory body, so that the second part of shape memory tubular body is at least partly in shape Remember in the first part of tubular body and extends.In some embodiments, second part is compressed relatively relative to first part.In In some embodiments, second end is positioned close to first end.In some embodiments, the second part of shape memory tubular body is at least Partly extend in the first part of shape memory tubular body.

Detailed description of the invention

Fig. 1 show according to some embodiments of the present invention may include conduit system in material capture system and The example of various possible elements.

Fig. 2 shows the close-up illustrations of the thrombus capture systems of Fig. 1 and Fig. 2.

Fig. 3 shows the thrombus capture of the axial elongation in initial deployment configuration according to some embodiments of the present invention (ALTC) system, wherein ALTC device is extension.

Fig. 4 shows the ALTC system distal portions position in delivery configuration according to some embodiments of the present invention Close-up illustration indicates epitheca and nose.

Fig. 5 shows the thrombus capture dress of the axial elongation in initial, expanded positions according to some embodiments of the present invention The distal end set.

Fig. 6 shows the thrombus acquisition equipment of axial elongation according to some embodiments of the present invention, proximally retracts To be unfolded and extend.

Fig. 7 shows the thrombus acquisition equipment of axial elongation according to some embodiments of the present invention, be fully deployed and The funnel tip of guiding catheter is located inside ALTC device.

Fig. 8 and Fig. 9 shows the initial, expanded positions of ALTC device according to some embodiments of the present invention and suction is led The different views of the funnel tip of pipe.

Figure 10 shows the partially unfolded ALTC device according to some embodiments of the present invention.

Figure 11 shows ALTC device deployed configuration according to some embodiments of the present invention, wherein the funnel of suction catheter Tip is located inside ALTC device.

Figure 12 shows thrombus capture (ALTC) component of axial elongation according to some embodiments of the invention, wherein ALTC The distal end of device is in extension (expansion) configuration and is fixed to thrombus capture guiding device and capture bracing wire.In order to illustrate mesh , the proximal end is in contracted configuration and proximally extends.

Figure 13 shows the thrombus capture of the axial elongation in initial deployment configuration according to some embodiments of the invention Device.

Figure 14 show according to some embodiments of the invention may include bracket or mesh grid ALTC device thrombus capture Element.

Figure 15 A-C respectively illustrates the reality of the proximal part of ALTC system, the distal portions of ALTC system and ALTC system Apply example.

Figure 16 A shows the thrombus acquisition equipment of the axial elongation in delivery configuration according to some embodiments of the present invention Another embodiment.

Figure 16 B shows the thrombus acquisition equipment of the axial elongation in initial deployment configuration, wherein epitheca be contracted with Extend the thrombus acquisition equipment of axial elongation.According to some embodiments of the present invention, the ring is coupled to sheath, wherein it It is coupled to capture catheter shaft.

Figure 16 C shows the thrombus acquisition equipment of axial elongation according to some embodiments of the present invention, proximally retracts And it extends.

Figure 16 D show the elongation of the thrombus acquisition equipment of axial elongation according to some embodiments of the present invention with And in some cases in being fully deployed.

Figure 17 A-D shows the various configuration of ALTC device according to some embodiments of the invention.

Figure 18 A-B shows the embodiment of the distal portions of the thrombus capture systems of axial elongation, has and fills in ALTC The radial outside for the capture guiding piece set and the cladding element for capturing guiding piece for partially or completely surrounding ALTC device, as schemed institute Show, it can be ring-shaped.

Figure 19 A-19C shows one embodiment of the thrombus capture systems of axial elongation, is configured to allow for seal wire System is left in the forward direction distal end for Rule port for leaving system proximal end.

Figure 20 A shows the guiding catheter system of the extension in delivery configuration according to some embodiments of the invention.

Figure 20 B shows the guiding catheter system of extension according to some embodiments of the present invention, and wherein funnel tip is in Expanded position and disabler are located in the guiding catheter inner cavity of extension.

Figure 20 C shows the guiding catheter of extension according to some embodiments of the present invention, with funnel tip, extension it is remote End part and the proximal part not extended.

Figure 20 D shows disabler according to some embodiments of the invention.

Figure 21 A-C shows extension guiding catheter system according to some embodiments of the present invention comprising extension is led Pipe, outer cover and disabler.

Figure 21 D shows one embodiment according to some embodiments of the present invention, and wherein lid tip encapsulates described Extend the distal end of the outer cover of guiding catheter system.Figure 21 E-F shows the haemostatic valve for stopping blooding in guiding catheter system One embodiment.

Figure 22 shows the epitheca component of acquisition equipment according to some embodiments of the present invention.

Figure 23 and Figure 24 respectively illustrates epitheca component proximally and distally.

Figure 25 shows capture conduit tube component according to some embodiments of the invention.

Figure 26 shows the proximal end of capture conduit according to some embodiments of the invention.

Figure 27 shows the embodiment for the keycap component for keeping hypo tube propeller anti-rotational.

Figure 28 and Figure 29 shows suction catheter according to some embodiments of the present invention, may include funnel tip, conduit Axis and connector with sealing element.

Figure 30 shows the distal end of suction catheter according to some embodiments of the invention, indicates funnel tip and catheter shaft.

Figure 31 shows the proximal end of suction catheter according to some embodiments of the present invention, indicates the connector with sealing element And the access of the port and entrance irrigating catheter inner cavity for being used together with filter chamber.

Figure 32-41 shows different chopper design and shapes according to some embodiments of the present invention.

Figure 42 shows filter collection chamber according to some embodiments of the present invention, may include being connected to syringe Inflow port, be connected to suction catheter outflow port, plunger, for filtering clot or fragment and retaining mistake in the chamber Filter and chamber for collecting clot or fragment.

Figure 43 shows the clot in the left side for resting on pulmonary system according to some embodiments of the invention.

Figure 44 A and 44B respectively illustrate residing in left side pulmonary system and described catch according to some embodiments of the present invention Obtain the clot in device.

Figure 45 shows the initial deployment configuration of the thrombus acquisition equipment of axial elongation according to some embodiments of the invention, Its distal end for being located at thrombus obstruction region and funnel tip are located at the proximal end of thrombus obstruction.

Figure 46 shows the thrombus acquisition equipment of axial elongation according to some embodiments of the invention, proximally extend with Capture thrombus.

Figure 47 shows the thrombus acquisition equipment of the axial elongation of capture thrombus completely, and funnel tip is located at axial stretch Inside long thrombus acquisition equipment.

Figure 48 A shows the delivery configuration of capture conduit device according to some embodiments of the invention.

Figure 48 B shows the initial deployment position of the thrombus acquisition equipment of axial elongation according to some embodiments of the present invention It sets.

Figure 48 C illustrates the elongation of the thrombus acquisition equipment of axial elongation according to some embodiments of the present invention.

Figure 48 D illustrates the final expansion of the thrombus acquisition equipment of axial elongation according to some embodiments of the invention.

Figure 49 A and 49B illustrate the another of the thrombus acquisition equipment of axial elongation according to some embodiments of the present invention A embodiment, wherein guidewire lumen and capture conduit deviate the longitudinal axis of the thrombus acquisition equipment of the axial elongation.

Figure 50 A-50G shows the embodiment got back to thrombus in the extension guiding catheter, and wherein ALTC device is to remote End extends and generates additional space, and thrombus is re-distributed and can preferably be taken back to extension guiding catheter In.It is easy that the funnel tip and expansion for extending guiding catheter are also convenient for fetching thrombus.

Figure 51 shows one embodiment of the system for removing clot.

Figure 52 shows the distal end of the acquisition equipment of the system of Figure 51 in deployed configuration.

Figure 53 shows the distal end of the acquisition equipment of the system of Figure 51 in initial deployment configuration.

Figure 54 shows the distal end of the acquisition equipment of the system of Figure 51 in the second configuration.

Figure 55 shows the distal end of the acquisition equipment of the system of Figure 51 in third configuration.

Figure 56 shows the embodiment of the net element of the system of Figure 51.Net element can be by the metal material of such as Nitinol Material is made.Mesh element can be braiding or laser cutting.

Figure 57 shows the embodiment of the acquisition equipment element of the system of Figure 51.

Figure 58 A-58B shows the embodiment of the expansible loop member of the system of Figure 51.

Figure 59 shows the view of the acquisition equipment opening for the system of neural thrombus.

Figure 60 shows another view of the acquisition equipment opening of Figure 59.

Figure 61 shows the embodiment of system.

Figure 62 shows the distal end of the acquisition equipment system of the system of Figure 61.

Figure 63 shows the proximal end of the system of Figure 61.

Figure 64 shows the anchor elements of the system of Figure 61.

Figure 65 shows the distal end of the acquisition equipment of the system of Figure 61 and the side view of anchor log.

Figure 66 shows the distal end of the acquisition equipment of the system of Figure 61 and the top view of anchor log.

Figure 67 shows the front view of the distal end of the acquisition equipment of the system of Figure 61.

Figure 68 A shows the acquisition equipment of the system of Figure 61 in initial deployment configuration.

Figure 68 B shows the acquisition equipment of the system of Figure 61 and the first anchor log release dress when epitheca proximally bounces back It sets.

Acquisition equipment, the first anchor log and the second anchor log that Figure 68 C shows the system of Figure 61 when epitheca retraction are released Put device.

Figure 68 D shows when epitheca retraction the acquisition equipment of system of Figure 61, the first anchor log, the second anchor log and the Three anchor log release devices.

Figure 69 A shows the acquisition equipment of the system for Figure 61 that in initial deployment configuration and anchor log discharges completely.

Figure 69 B, which is shown, proximally to be extended to encapsulate the acquisition equipment of the system of Figure 61 of the first anchor log.

Figure 69 C, which is shown, proximally to be extended to encapsulate the acquisition equipment of the system of Figure 61 of anchor log.

Figure 70 A and 70B show the view of the embodiment of propeller locking system.

Figure 71 A-71D shows the view of the propeller locking device of the propeller locking system of Figure 70 A.

Figure 72 shows the method that ALTC device is assembled to capture guiding piece.

Figure 73 shows the embodiment of anchor log.

Figure 74 shows the embodiment of anchor log.

Figure 75 shows the distal end of the acquisition equipment system of the anchor log including Figure 73 in the blood vessel.

Figure 76 A shows the acquisition equipment of the system for Figure 75 that in initial deployment configuration and anchor log extends completely.

Figure 76 B, which is shown, proximally to be extended to encapsulate the acquisition equipment of the system of Figure 75 of a part of anchor log.

Figure 76 C, which is shown, proximally to be extended to encapsulate the acquisition equipment of the system of Figure 75 of anchor log.

Figure 77 A shows the acquisition equipment of the system for Figure 75 that in initial deployment configuration and anchor log extends completely.

Figure 77 B, which is shown, proximally to be extended to encapsulate the acquisition equipment of the system of Figure 75 of a part of anchor log.

Figure 77 C, which is shown, proximally to be extended to encapsulate the acquisition equipment of the system of Figure 75 of anchor log.

Figure 78 shows the distal end of the acquisition equipment system of the embodiment including anchor log.

Figure 79 shows the distal end of the acquisition equipment system of the embodiment including anchor log.

Figure 80 shows the acquisition equipment system of Figure 79 in the blood vessel.

Figure 81 shows the distal end of the acquisition equipment system of the embodiment including anchor log.

Figure 82 shows the distal end of the acquisition equipment system of the embodiment including anchor log.

Figure 83 shows the acquisition equipment system of Figure 82 in the blood vessel.

Figure 84 shows the distal end of the acquisition equipment system of the embodiment including anchor log.

Figure 85 shows the distal end of the acquisition equipment system of the embodiment including anchor log.

Figure 86 shows the acquisition equipment system of Figure 85 in the blood vessel.

Figure 87 shows acquisition equipment system in the blood vessel.

Figure 88 A-88R shows the embodiment of anchor log.

Figure 89 shows the embodiment of the system designed for removal clot.

Figure 90 shows the distal end of the system of Figure 89.

Figure 91 shows the distal end of the system of the embodiment including anchor log.

Figure 92 shows the distal end of the system of the embodiment including anchor log.

Figure 93 shows the distal end of the system of the embodiment including anchor log.

Figure 94, which is shown, proximally to be extended to encapsulate the acquisition equipment of the system of Figure 93 of anchor log.

Figure 95 shows the distal end of the system of the embodiment including anchor log.

Figure 96 A-96B shows the embodiment of expansible guiding catheter.

Specific embodiment

In some embodiments, the present invention provides can dermal delivery in vivo system and method, to extract and Clot, stone/calculus and/or foreign materials in body cavity are removed, the body cavity includes blood vessel, such as in the circulatory system Arteries or vein blood vessel.In some embodiments, the present invention also can be applied to non-vascular region, to treat such as gallbladder Calculus, kidney stone, choledocholithiasis etc..

The system can be via cutting method (cut-down approach), thoracoscopic approach or via other approach Dermal delivery, such as using conduit system 35, Fig. 1 is shown in which the perspective view of an embodiment.Fig. 1 also shows basis The example of the various possible elements that can be included in the material capture system of some embodiments of the present invention.Such as Fig. 1 It is shown, including in some embodiments be any number of in lower component, such as one, two or more: the first pipe Shape component, such as epitheca 1, the second tubular element, such as capture conduit 12, third tubular element, such as wire leading pipe 6, axially stretch Long thrombus acquisition equipment 8, suction catheter 2 and filter collection chamber 5.In some embodiments, epitheca 1 can be elongated tubular product Component has perforative central lumen, and has proximal end 1000 and distal end 1001.The distal end 1001 of epitheca 1 can operate Ground is connected to acquisition equipment (such as tubular mesh 8), can axially move relative to epitheca 1.In some embodiments, Epitheca 1 has the proximal part of relative stiffness, and the distal portions more flexible compared with the proximal part of relative stiffness, if must If wanting its can advantageously flexible extension to accommodate passing through for big clot and/or other materials.The proximal end 1000 of epitheca 1 can It is connected to proximal end wheel hub (hub) 1003, may include that any amount of suction pipe 2, capture conduit 12, wire leading pipe 6 and filter are received Collect room 5.The non-limitative example of (being not shown in Fig. 1) other optional elements include chopper tool (herein otherly Side's description) and discrete extension guiding catheter (being described elsewhere herein).In some embodiments, epitheca 1 has inner cavity, It is configured as accommodating suction catheter 2, and suction catheter 2 has the inner cavity for being configured as accommodating capture conduit 4 again, captures conduit 4 There is the interior of the thrombus acquisition equipment (ALTC device) 8 for being configured as accommodating wire leading pipe/guidewire lumen component 6 and axial elongation again Chamber, ALTC device have the inner cavity for being configured as accommodating the seal wire (not shown) passed through again.As herein defined, ALTC Device may include any structure, such as reticular structure, be configured as capturing the material in body position, and depend on Desired clinical effectiveness axial elongation and shortening in entire working range, and have or do not have in the entire working range There are radial shortening width or diameter.In some embodiments, epitheca 1 has to be configured to that conduit 12 will be captured and be coaxially contained in Internal diameter therein, and capture the inner cavity that conduit 12 has the main body for being configured as accommodating wire leading pipe 6 and ALTC device 8 again.In In some embodiments, ALTC device 8 may include grid reticular structure, have the opening towards proximal end at one end, which can By the non-shape memory metal of shape memory metal or polymer or such as stainless steel or other non-shape memory product systems At embodiment is being described in detail elsewhere herein.In some embodiments, such as in IVC and other embolism filters The conventional reticular structure used can be used together with the system and method for this paper.In some embodiments, thrombus acquisition equipment It can be configured to axially extend in entire working range in some embodiments, have or do not have in entire working range There is radial shortening described device.

Fig. 2 shows the close up views of the proximal end 1000 of the thrombus capture systems of Fig. 1.Epitheca 1 is shown, is configured as It is accommodated in some embodiments and passes through suction catheter 2 therein.Also show epitheca 1 can terminate in connector 17 and stop blooding it is close The proximal end of sealing 190, another one pipe such as suction catheter 2 (and/or capture conduit 4) can be coaxially inserted.It takes out The proximal end for inhaling conduit 2 can also include the inner cavity for having the connector 3 of sealing element and capture conduit 12 being allowed to be inserted into.Capture Conduit 4 can also include the connector for having sealing element 18 in its proximal end.Wire leading pipe 6 has to be passed through for accommodating conducting wire Inner cavity, can be configured to coaxially to cooperate in capture catheter shaft 12.Optional filter collection chamber 5 is also shown, in Chamber is fluidly connected to the inner cavity of suction catheter 2.Also show wheel hub 17 and irrigation ports 20.In some embodiments, it is not required to It aspirates (and thus in the system not including suction catheter 2), and grumeleuse or other materials can be filled by ALTC 8 are set mechanically, hydraulically and/or with shredding to be captured.

Fig. 3 shows the thrombus capture of the axial elongation in initial deployment configuration according to some embodiments of the present invention System 35, wherein 8 radial expansion of ALTC device.Also show the nose 7 in the distal end of ALTC device 8.Outer tube 1 is relative to capture The moving to axial of conduit 4 can permit the first end of ALTC device 8, and (such as the extension with the opening towards proximal end is close End, or be towards distal end or lateral opening in other embodiments) radial expansion configuration is deformed into from compressed configuration. In some embodiments, the proximal openings of ALTC device 8 include capture guiding piece 11, and the capture guiding piece 11 is in some implementations The part of radially expandable shape memory or the form of loopful shape ring structure are taken in example, once without outer tube 1, the annular Structure will be extended along a part for the ALTC device grid 8 for being attached to capture guiding piece 11.However, in shown configuration, The surface region of the grid of ALTC device and/or the signal portion of axial length remain the intraluminal pressure in capture conduit 4 Contracting configuration, because the other end of ALTC device grid 8 is nonetheless operable to be attached to the outer diameter of (such as being fixed on) wire catheter 6 On side wall.

Fig. 4 shows the distal end of the ALTC conduit system 35 in delivery configuration according to some embodiments of the present invention Close-up illustration, distal end 1001 and nose 7 including epitheca 1, can be noninvasive as shown in the figure and taper.

ALTC device 8 can play the role of fetching and capturing the substance of such as thromboembolism.Show capture conduit 4 And ALTC device 8, capture catheter shaft 12, bracing wire 10 and thrombus capture guiding piece 11.

Such as shown in figures 5-9, thrombus capture guiding piece 11 can be attached to one of such as open end of ALTC device 8 Divide and one, two or more captures bracing wire 10, wherein capture bracing wire is located in inside the side chamber of suction catheter 2 or other In embodiment the inner cavity outside and proximally extend.As shown, the distal end of capture bracing wire 10 can be guided in capture The proximal end of ALTC device 8 is connected at part 11.Capture bracing wire 10 can extend proximally through the length of epitheca 1, and can be with The proximal end of the bracing wire 10 is pushed or pulled on to allow the axial length of user's control (such as adjustment) ALTC device 8, for example, when On proximal direction when axial elongation ALTC device.In some embodiments, capture bracing wire 10 and capture guiding piece 11 are only It is attached to the element of the proximal end of ALTC device 8.In some embodiments, capture bracing wire 10 and capture guiding piece 11 can be made into Single component, such as a ring.In some other embodiments, using silk thread or polymer filament (such as superhigh molecular weight polyethylene Alkene, nylon, PET, PTFE) proximal staple of the capture guiding piece and ALTC device is in place.In some embodiments, ALTC The open end of device soft film or coating covering, are then folded on capture guiding piece 11 and suture with described group of fixation Part.In another embodiment, the open end of ALTC device 8, capture guiding piece 11 and suturing assembly polymerize coated with soft Object material.Another method of fixed wire termination is outer surface or the inner surface that polymer fabrics are applied to tubular structure On, and fixed with suture silk by suture.The fabric can be at least one, initially be wrapped in the inner surface of tubular structure Or on outer surface, opposite side is folded into then with fixed and protection wire ends.The two sides of fabric can be used suture and fix To tubular structure.The other way for securing the fabric to tubular structure, such as heat bonding, pressure can be used in some embodiments System, lamination, chemistry is fixed, is mechanically fixed and laser.The closed end of ALTC device could attach to the outer surface of wire leading pipe 6, seal wire The outer surface of pipe 6 can be positioned on the interior intracavitary of capture catheter shaft 12 again.Therefore, the axial elongation of ALTC device in a distal direction It can be realized for example, by wire leading pipe 6 and bracing wire 10 relative to capture 12 distal movement of catheter shaft.ALTC device is in proximal end Axial tension on direction can be realized for example, by capture wire drawing and the movement of capture conduit axial proximal.Thrombus capture is drawn Guiding element 11 can be formed by such as metal, shape memory or other suitable materials.In some embodiments, thrombus capture guidance Part 11 may include loop configurations and can be by with various geometries (such as round, ellipse, ellipse, pancake Deng) Nitinol shape-memory wire line formed.Thrombus capture guiding piece 11 can be formed as such as circular rings, vesica piscis, Z-shaped Deng different shape.In some embodiments, ring 11 can be formed as coil, multiple full circle, a full circle or part circular, Described in silk thread both ends formed two legs.Part circular can be formed as example from 180 degree to 359 degree or from 220 degree to 359 Degree.The leg may be constructed such that it is off-axis with the ring, so as to relative to the ring at right angle, acute angle or obtuse angle.It can To be bowed as shown in the figure, and part-toroidal or complete annular are formed, and can surround or form outer diameter in other ways, and And limit the most proximal end of ALTC device 8.In some embodiments, thrombus capture guiding piece 11 may include along ALTC device 8 Length positioning single ring or multiple rings, and be not necessarily present or opened with the end towards proximal end in ALTC device 8 Entire guiding piece 11 at mouth end.In some embodiments, thrombus capture guiding piece 11 does not include ring.ALTC device tubular structure Can be configured as compressed and be located in during introducing vascular system capture catheter shaft 12 in it is intracavitary, wherein capturing conduit Axis 12 is configured as being coaxially located in the tubular structure and thrombus capture guiding piece 11 and extends through them.

As shown in figure 5, the thrombus acquisition equipment (ALTC device) 8 of axial elongation can be substantially manage in some embodiments The reticular structure of the similar net of shape, it is foldable, expansible and be configured to for example in working range can axial elongation or shortening, Its diameter is kept or is kept substantially in working range simultaneously, it is intracorporal outer in the body including vascular system to fetch and capture Come substance or other unwanted substances, such as clot, thrombus and/or foreign substance.

For example, making ALTC device 8 suitable and as shown in fig. 6, conduit 12 can also be captured by pushing relative to guidewire shaft 6 When direction on (such as to distal end) elongation, thus allow the radial compression length of additional reservation tubular mesh 8 with from catching The inner cavity range radial outward expansion for obtaining conduit 12, with thrombus acquisition equipment 8 described in axial elongation and in entire working range Interior its constant or substantially invariable diameter of holding.The other end of the ALTC device 8 at its radial compression end can be fixed to wire leading pipe 6 Lateral wall.For example, the combination technique (Fig. 6) for being operatively attached to the movement of the capture bracing wire 10 of capture catheter shaft 12 can be by ALTC Device is located in endoceliac desired locations, and wire catheter 6 relative to capture catheter shaft 12 axial movement also by axis To elongating or shortening ALTC device 8, while keeping its diameter constant in working range.(expand when ALTC device 8 is in expansion Exhibition) configuration when, ALTC device 8 can also be stretched over the working range to extension axial length to reduce its diameter.

The thrombus acquisition equipment 8 that Fig. 7 shows axial elongation according to some embodiments of the present invention is fully deployed, so that Attachment position 128 distal end far from capture catheter shaft 12 of the ALTC device 8 on the outer diameter of guidewire lumen 6, and suction catheter Funnel tip 9 is positioned in ALTC.

Fig. 8 and Fig. 9 shows the initial, expanded positions of ALTC device 8 according to some embodiments of the present invention and optional The different views of the funnel tip of suction catheter 2.

Figure 10 shows the partially unfolded ALTC device according to some embodiments of the present invention, and wherein ALTC device 8 is by axis To elongation while keeping it constant perpendicular to the width of axial direction.

Figure 11 shows the deployed configuration configuration of ALTC device according to some embodiments of the invention, wherein suction catheter Funnel tip is located inside ALTC device.

As shown, guidewire lumen component 6 may include that nose 7, axis, inner cavity and proximal connector and seal wire can be inserted Enter port therein.In some embodiments, central lumen can have distal openings.Wire leading pipe 6 can be used in blood vascular system It navigates and tracks on seal wire in system.Wire leading pipe 6 can extend coaxially into the lumen of catheter shaft 12.Nose 7 can be formed Or be otherwise connected to the distal end of wire leading pipe 6 to facilitate the tracking system when system passes through vascular system, and It can be hurtless measure in some embodiments.Wire leading pipe 6 can be made of polymer material, such as, but not limited to polyimides, Nylon, polyurethane, Pebax (a kind of block polyetheramides elastomer), polyethylene, PET (polyethylene terephthalate), PTFE (polytetrafluoroethylene (PTFE)) or ePTFE (stretch the microporous membrane to be formed through extruding by raw material of polytetrafluoroethylene (PTFE)).In some embodiments In, wire leading pipe 6 can have radiopaque label along its length, be used to indicate position, initial deployment, the portion of ALTC device Divide expansion, final expansion, the percentage of length of run and/or above-mentioned any combination.

Figure 12 show axial elongation thrombus capture (ALTC) component 8, for the sake of clarity without no display epitheca, Capture conduit 4 or wire catheter 6.As shown, according to some embodiments of the present invention, ALTC device 8 has towards proximal end Opening 802 end 800 be in extension (expansion) configuration and be fixed to thrombus capture guiding piece 11 and capture bracing wire 10. For illustrative purposes, the reservation for not extending mesh 81 including end 804 is partially in contracted configuration, and towards attachment Position 128 proximally extends.

In some embodiments, the tubular mesh structure 8 can axially extend or shorten without reducing or real Reduce its diameter in active length/axial range in matter, because the radial expansion part of the tubular mesh structure is at it The smallest tension is not subjected to or is only subjected in axial elongation in axial working range or shortening.It is without being bound by theory, this Can at least partly realize because tubular mesh structure can by opening, overturning or in other ways extend or deform institute State the reservation part (such as the mesh 81 not extended) of the radial compression of tubular mesh and axial in entire working range Elongation.The extension " end " opposite with the end of radial expansion device containing capture guiding piece and proximal openings as a result, such as The dynamic folding point 88 of the radial expansion part of tubular mesh 8 can not be tubular mesh and be fixed to pipe at region 128 The absolute end of shape axis, but it is not fixed to the intermediate dynamic folding point 88 of tubulose axle at this point, and be therefore not subject to Or it is not subject to any tension substantially.Therefore, the reservation part of the radial compression of tubular mesh 81 is in different directions or on the contrary Direction (such as in some cases proximally) extend back and terminate at tubulose axle terminal fixed point it is (such as in place It sets at 128).If it is not above the active length of the tubulose axle of extension, in dynamic folding point 88 and entire conduit system Distally the distance between (such as nose) can elongation with the radial expansion part of tubular mesh 8 and radial compression Retain part to run out and increase.

Once the compression of tubular mesh 8, which retains part 81, nearly or completely expands to or almost reaches to it at 128 Actual end, and 8 axial elongation of tubular mesh exceeds its active length range, then and further axial elongation can start The tension for applying increase significantly in the tubular mesh structure 8 of completely axial extension shows it with its further axis To elongation and the configuration of radial contraction.

It is as highly beneficial in can be above with the disclosed tubular mesh structure with an open end elsewhere herein , because the relatively small axial component of tubular mesh can rise completely with radial expansion and in narrow working environment To the effect of capture embolism and/or other materials, such as in restricted body cavity, wherein only limited space is to be manipulated to The distal end of interested treatment position.If it is desire to the bigger axial length of the tubular mesh of radial expansion is needed, such as Relatively long thromboembolism is captured, then the compression of tubular mesh retains part and can be opened, turn up or with other sides Formula extends or is deformed into required specific axial length.With what can be saved in a compact fashion along the length of conduit system Compression, which retains part, can be very advantageously, to provide the tubular mesh of long effective capture length without entirely catching Obtaining system has long regular length as conventional filter/mesh, can be fixed on both ends, and therefore the One end and second end work when separating single specific axial distance and fully radial expansion.

As shown in figure 12, some or most of holding diameters of the axial length of ALTC device (such as tubular mesh structure 8) To compression, as between the outer diameter of wire catheter 6 and the internal diameter for the axis 12 for capturing conduit (distance therebetween is length L12B) Reservation part a part, wherein the radial expansion part of tubular mesh structure 8 is defined as along containing towards proximal end Opening 802 proximal end 800 and dynamic folding point between (distance therebetween is length L12A) axial length, and L12A and Absolute growth of the sum of L12B equal to tubular mesh 8.In the initial configuration, the length of the reservation part 81 of radial compression L12B can be the absolute growth of tubular mesh 8 about or at least about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90% or more.

The thrombus that Figure 13 shows the axial elongation in initial deployment configuration according to some embodiments of the present invention is caught Device 35 is obtained, wherein the radial expansion part of the mesh 8 between end 800 and dynamic folding point 88 and reservation compression section (not shown) proximally extends axially across the fixed point 128 on end 800 to the outer surface in guidewire shaft (not shown).Figure 14 The thrombus capture element 15 of ALTC device according to some embodiments of the invention is shown, may include bracket, braided fabric, woven Object, laser cutting or other meshes, such as reticular structure.Tubular mesh structure be not necessarily it is porous, and can be by nothing Hole or other layers of covering.ALTC device tubular mesh structure 8 can be made of any suitable polymeric material, such as, but not limited to poly- Ethylene glycol terephthalate (PET), polyethylene (PE), polypropylene (PP), nylon, silk, UHMWPE (superhigh molecular weight polyethylene Alkene), PTFE, Kevlar (Kevlar), cotton and/or metal material, including elastic material, Nitinol, stainless steel, Cobalt-chromium-nickel-molybdenum-ferroalloy or cobalt-chromium alloy, Chronichrome (chromium-chromium) or Elgiloy (the non magnetic conjunction of Ai Erjiluoyi Gold).In some embodiments, tubular structure can be by polymer and/or metal plain film, wire, polymer filaments or Weaving textile, extrusion, woven, weaving, laser cutting, chopping, film are cast and to be formed.In some embodiments, tubular structure can To carry out film casting with laser cut hole.The tubular structure can also be compiled by polymer and/or wire or any combination thereof It knits.In some cases, tubular structure can be made of the Nitinol silk screen with multiple strands.In addition, tubular structure It may include at least one strands made of very radiopaque material, such as the tantalum with platinum core, platinum, gold or NiTi Nola The filling pipe of system enables to observe the tubular structure under fluoroscopy.In some embodiments, tubular structure can be with Including the radiopaque label of one, two or more.Dependent on the diameter of ALTC device, the quantity of strands can be for for example 1 to 576 strand stock.In some embodiments, ALTC device can have the strands of 2,4,144,288 or other quantity.One In a little embodiments, ALTC device is configured with single line stock.The diameter range of the strands can be from such as 0.0002 English It is very little to 0.015 inch.In some embodiments, strands diameter is about 0.001 inch, and tubular structure can be not in certain parts It is permeable and other parts are permeable and/or combination thereof modes.Tubular structure can be do not have it is cated, or coating One layer, two or more layers antithrombotic agent such as heparin to prevent hemostasis-coagulation, or other therapeutic agents of coating.The tubular structure Hydrophilic agent or hydrophobing agent can be coated.The tubular structure can have different pore sizes to help to capture Microembolism or larger Pore size with allow be perfused or blood flow.Tubular structure can have uniform aperture over the entire length, or entirely grow With the combination of different pore size on degree.For example, the aperture of ALTC device can be sufficiently large to catch when being used as brain protection filter Clinically relevant infarct size, such as low as about 200,175,150,125,100,75,50 microns or smaller are obtained, while keeping filling Note or blood flow.During fetching, ALTC device 8 can be repositioned onto the specific part of the tubular structure with smaller aperture due simultaneously Fetch clot/thrombus.In some embodiments, ALTC device can be unfolded in clot and be embedded in capture for example neural blood Clot in guard system.During fetching, ALTC device can be sufficiently elongated to beyond the thrombus captured, in the blood of capture The distal end of bolt forms protection filter.This is clinically beneficial to pre- preventing thrombosis and shifts during taking-up, to prevent secondary Apoplexy.In some embodiments, the proximal end of ALTC device tubular structure 8 can be attached to the outer surface of wire leading pipe 6, such as close It is attached position 128.In some embodiments, the proximal end of ALTC device tubular structure can be wound by polymer filaments and suture simultaneously It is encapsulated with low durometer polymeric material, wire termination is fixedly secured to the axis, such as guidewire lumen component.It can make With the connection types of other installation line ends, for example, mechanically, heat or chemically adhesive polymer with the fixation line end.Another In one embodiment, adhesive can be used by ALTC device and be proximally secured to the outer surface of guidewire shaft, and be clipped in guidewire shaft Outer surface and lid pipe between.

Figure 15 A-C respectively illustrates the proximal part of clot capture systems, the distal portions of ALTC system and ALTC system Another embodiment.Figure 15 A schematically shows conduit system 35, and Figure 15 B shows and is operably connected to seal wire The distal end nose 7 of the distal end of axis 6 comprising the inner cavity passed through for seal wire.It one end of ALTC device 8 can be at one or more It is fixedly attached to guidewire shaft 6 at a position 128, and the other end 800 including proximal end or distal openings 802 is attached to such as ring The capture guiding piece 11 of 11 forms, and it can be via capture guiding piece 11 to proximally and distally moving axially.The ring can wrap Such as one, two or more straightway is included, is proximally extended to from ring 11 on capture catheter shaft 12, they pass through sheath 30 are proximally mounted on capture catheter shaft 12.May exist sheath 30 in some embodiments, rather than proximally prolongs always Extend through the bracing wire of the device.This can be economically advantageous in some cases and permission is in the proximal end of user Carry out more smooth control.The length that axially expands of tubular mesh 8 is shown as extending to dynamic folding point from end 800 88, the reservation length (not shown) for compressing tubular mesh proximally extends to it in fixed point along the lateral wall of guidewire shaft 6 Proximal end at 128.Figure 15 C shows the embodiment of the proximal end of system comprising one or more irrigation ports 13, epitheca 1 Wheel hub (hub) 55, capture conduit 12 wheel hub 155 and hypo tube propeller 14 and have be configured to slide seal wire therefrom Inner cavity most proximal end wheel hub 15.In some embodiments, hypo tube propeller 14 can be with third tubular element (such as wire leading pipe 6) coextensive, such as weld or be attached in other ways, and cause when being manipulated by operator wire leading pipe 6 in proximal end or remote The axial movement of extreme direction gap.In some embodiments, there may be lead from most proximal end wheel hub 15 to the monoblock type of distal end nose 7 Fiber tube 6.Third tubular element 14 may be configured to be placed on the interior intracavitary of the second tubular portion component (such as capture catheter shaft), Such as the proximal end at wheel hub 155.Second tubular element can be configured to be placed on the first tubular element (such as epitheca 1) It is interior intracavitary, such as the proximal end at wheel hub 55.In some embodiments, wheel hub 55 and wheel hub 155 may include complementary spiral shell Line or other reversible lock-in features, with allow epitheca 1 to be reversibly coupled to capture conduit 12 with allow two tubular elements that This is axially moved in phase.Separation wheel hub 55,155 can permit axial movement of the capture conduit 12 relative to epitheca 1, otherwise also So.

Referring still to Figure 15 A-C, in some embodiments shown in, if there is sheath 30, then without individual bracing wire The proximal end of system is proximally extended to from capture guiding piece 11.In some such embodiments, capture catheter shaft 12 relative to The axial movement of wire leading pipe axis 6 proximally promotes at least part of radial expansion of ALTC device 8 and determines ALTC device 8 Position is in body cavity.In some embodiments, the axial elongation of ALTC device 8 and/or shortening can by wire leading pipe 6 relative to The movement and/or capture conduit 12 for capturing conduit 12 are realized (wherein, not attached via sheath 30 relative to the movement of wire leading pipe 6 The other end for being connected to the ALTC device of capture conduit 12 is attached at attachment position 128).

Figure 16 A shows the thrombus capture dress of the axial elongation in delivery configuration according to some embodiments of the present invention Set another embodiment of 35 distal portions.

Figure 16 B shows the thrombus acquisition equipment of the axial elongation in initial deployment configuration, wherein epitheca 1 by for example to Proximal retraction with will include the axial elongation thrombus acquisition equipment (such as tubular mesh 8) the opening towards proximal end For 802 end radial expansion to dynamic folding point 88, effective extension that the dynamic folding point 88 is used as tubular mesh 8 is remote End.According to some embodiments of the present invention, it captures guiding piece 11 and relevant terminal line 10 is operably linked to sheath 30, and And the sheath 30 is connected to the outer wall of capture catheter shaft 12.The compression of tubular mesh retains length thereof (not shown) The absolute axial length for being included in the folding of ALTC device 8 (such as tubular mesh) for example about or at least about 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90% or more, it remains and is reversed, rolls and/or with it The inside of its mode radial compression and captured catheter shaft 12 surrounds, until the other end of wherein ALTC device 8 is in attachment The place on the outer diameter of conduit 6 is attached at position 128.As shown, length of the dynamic folding point 88 along tubular mesh 8 It is variation, the length of length thereof is retained dependent on the compression extended.Dynamic folding point 88 is " floating ", and not straight It is connected in guidewire shaft 6 and capture catheter shaft 12, and therefore when the expansion axial elongation of tubular mesh 8 towards close End axial movement.

In this way, the axial direction of extension tubular mesh 8 is stretched when the guidewire shaft 6 with distal end nose 7 is maintained at constant position Length causes the axial distance D between distal end nose 7 and dynamic folding point 88 to increase, therefore distance D3 is greater than D2, and D2 is greater than again D1.Furthermore as shown in fig 16b, the first end 800 of tubular mesh is the distal end for not extending end of tubular mesh, it is described not The lateral wall that end (at position 128) is fixed to wire leading pipe 6 is extended, but closer to proximal end movement and is being schemed in Figure 16 C Become the proximal end for not extending end of tubular mesh in 16D, and dynamic folding point 88 moves to the near end, but in Figure 16 D it Still it is located slightly away from the non-extended distal end of tubular mesh 8, wherein the axial length extended is even more big, or in some cases It is its maximum functional length.As described above, extension tubular mesh diameter/width remained unchanged between Figure 16 A-D or It is relative constant.After the compression for the tubular mesh for having changed into extension retains part depletion, continuing to axially expand can be led The drawing force in tubular mesh is caused to increase, so as to cause the configuration that radial contraction wherein takes place.

Figure 17 A-D shows the various configuration of ALTC device according to some embodiments of the invention.In delivery process, connection Capture guiding piece 11 (for example, being ring-shaped in some embodiments) to the extension end 800 of tubular mesh 8 can be configured For the intracavitary contraction during introducing vascular system in epitheca 1, and it is configured to radially expand first when epitheca 1 proximally retracts Exhibition, at the same the tubular mesh structure 81 of the reservation of ALTC device 8, proximally extend in guidewire shaft 6 from dynamic folding point 88 On fixed point 128 length keep be compressed in capture catheter shaft 12 inner cavity in.Dynamic folding point 88 is used as tubular mesh Effective extended distal end of object 8.And proximally pulling capture bracing wire 10 (or sheath 30 of diagram) and capturing catheter shaft 12 When further retracting the thrombus capture guiding piece 11, it is compressed in the tubulose of ALTC device 8 intracavitary in capture catheter shaft 12 Structure division extension and can for example, by proximally roll, overturn and/or invert and axial elongation ALTC device 8 and become Shape.It can be by the pipe of at least part ALTC device 8 previously as shown in Fig. 7 to Fig. 9, captured advance of the catheter shaft 12 to distal end Shape structure both shrinks are into capture 12 inner cavity of catheter shaft.Can the extending, roll out of ALTC device, axial elongation and in working range Keep the ability of substantially invariable diameter produced in the side wall of the radial expansion part of ALTC device 8 cavity (or depression) with Collect and capture the foreign matter such as clot/thrombus.In another embodiment, sheath 30 (Figure 16 A-D and 17A-D) can be used Bracing wire 10 will be captured for example to be permanently attached in a part of capture catheter shaft 12, so that two components operate together.It will Capture bracing wire 10 and the capture connection of catheter shaft 12 can permit user more effectively and easily manage acquisition equipment.At another In embodiment, capture guiding piece 11 takes annular and may be coupled to the sheath 30 for being coupled to capture catheter shaft 12.

Figure 18 A-B shows one embodiment of the distal portions of the thrombus capture systems of axial elongation, has The capture catheter shaft 12 of ALTC device or the radially outer of ring 11 and the cladding element 80 for partially or completely surrounding them, can be with As shown in the figure in a ring.In some embodiments, cladding element 80 can be used for protecting capture guiding piece, ALTC device and be controlled The one or more of the cavity wall of the inner cavity for the treatment of.Ring 80 is also configured to provide sealing to the cavity wall of such as blood vessel to prevent tubular reticulum The leakage for not needing material or migration or embolism around shape object 8.In some embodiments, lid 80 may also include skirt section.Lid Son 80 can be it is axially and/or radially expansible, such as expansible air bag, flexible polymer, gel, foam, fabric, shape note Recall material and/or including other materials.If lid 80 be it is expansible, can be configured to reversibly to shrink to allow It is flowed after complete process of performing the operation around the fluid of lid 80.Also as shown, sheath 30 is connected to one for being attached Or the capture guiding piece 11 of more wire rods 10.In some embodiments, sheath 30 may include being used as opposing rays to penetrate mark One or more holes 307 of note and/or sheath 30 can be made of radiopaque material.As it is shown as well, capture conduit 12 And wire leading pipe 6 can extend through tubular mesh 6 across dynamic folding point 88 from first end 800.For the sake of clarity, not The reservation part of compression tubular reticulum is shown.

Figure 19 A-C shows one embodiment of the thrombus capture systems of axial elongation, which is configured to allow for seal wire 350 leave system in the Rule for leaving system proximal end/nearest port 15 forward direction distal end.Once the proximal end of seal wire passes through respectively The hemostasis seal 55,155 of the reversible connection of 1 component of epitheca and capture conduit 12, the proximal end of seal wire can be by side wall Hole or slot 351 leave the system.In some embodiments, seal wire 350 is configured to laterally leave, i.e., laterally away from.In In some embodiments, keycap 36 is positioned in the distal end of hemostasis seal 55,155, and hemostasis seal 55,155 is again in axis 14 Proximal end, axis 14 may be used as being connected to wire leading pipe or the hypo tube propeller coextensive with wire leading pipe, and in some implementations It is made of metal in example.As shown, axis 34 may include the complete or partial axial sidewall channels from port 15 to wheel hub 155 351 and/or the discrete slot of one, two or more.

Such embodiment can be advantageous, for example, when delivery system total length increases, the shorter required length of utilization The seal wire of degree.In some embodiments, when the length of ALTC acquisition equipment increases, hypotube is also stretched to accommodate and therefore increase The big distance for being used to manage seal wire and system.Side guide wire means can be minimized the distance, cause preferably to operate, and lead The proximal end of silk 350 is not necessarily required to extend beyond the proximal end of whole system, such as port 15.Therefore in some embodiments, make Seal wire for a part of system can advantageously have the entire material capture system that distal end nose 7 is arrived with proximally port 15 Axial length is identical or even smaller total length, this is impossible in other cases.

Seal wire 350 can be located at hemostasis seal 55,155 areas adjacents in the course of surgery, therefore can be in user It does not need to look down in the case that the component is located at where and completes entire operation/operation.In this way, user can be held with one Firmly hemostasis seal 55,155 shells, while seal wire 350 and hypo tube propeller 14 are manipulated in general area with another hand, and Substantially without departing from the region.User can keep and manipulate hypo tube propeller 14 or keep and manipulate seal wire 350, Or both hypo tube propeller 14 and seal wire 350 are kept simultaneously.In some embodiments, the internal diameter for having reeded axis 14 is logical Seal wire 350 can be often greater than to allow 350 side of seal wire to leaving.Keycap 36 with boss profile can be with the groove of metal shaft 14 Cooperation, to prevent metal shaft 14 from rotating and axis 34 is still allowed for axially to slidably reciprocate.

In some embodiments, extension guiding catheter 50 (such as shown in Figure 20-21) be can be with clot capture systems The separate catheter being used together, and for assisted extraction ALTC device 8 (and relevant conduit system 35) and capture clot and Other unwanted materials.In some embodiments, extension guiding catheter 50 may include the first tubulose structure of such as epitheca 49 Part can be as shown in the figure such as with proximal end, distal end, proximally with the inner cavity of distal end extension and the port on proximal end With the longitudinal axis of epitheca 49 it is coaxial or deviate.Such as the second tubular element of inner catheter 54 can have proximal end, distal end and The inner cavity of distal end is proximally extended to, and can be configured as and be placed on the interior intracavitary of epitheca 49.Inner catheter 54 can also have Proximal port can be positioned on the expansible funnel tip 52 in removable obturator 51 in inner catheter inner cavity, distal end, in funnel point Hold expandable axle part 53, inner shaft 54 and the connector with sealing element 55 of 52 proximal ends.Disabler 51 can be used for helping to expand Exhibition conduit 50 is inserted into vascular system and navigates.Disabler 51 can by such as polyethylene, nylon, Pebax, polyurethane, PET or The polymer materials such as PTFE are made.In some embodiments, disabler 51 can have tapered distal end to help to draw extension Conduit 50 is introduced into vascular system or other body cavitys.Alternatively, the other embodiments of disabler 51 include being operably connected To the expandable member of such as air bag of distal end.The extension of expandable member, such as the inflation of air bag, can produce smooth point Hold transition.Sacculus can be made of the polymer material of nylon, polyurethane, PET etc..The inflation of sacculus can also block sacculus Device is fixed to guiding catheter, so that the tip of guiding catheter will be kept hinged when applying axial load to the proximal end of disabler axis. Such as the funnel tip 52 shown in Figure 20 B-C may include distal end funnel-like part, and neighbouring expansible close end Divide 53, wherein it is connected to the more proximal part of inner shaft 54.Funnel tip 52 in some embodiments can by polymeric material and/ Or metal material is made.It can be tubulose, braiding or woven.Braided configuration can be 1 × 1 or 1 in some cases × 2 or 2 × 1 or 2 × 2 or any combination thereof.In some embodiments, the range of stitch per inch (PPI) can be from 5 to 60. In some embodiments, which can be from a silk thread to 288 silk threads.Silk thread shape can be it is for example round, flat, Ellipse, rectangular or square.Wire diameter can be from such as 0.0005 inch to 0.015 inch.The thickness of flat silk thread can With can be from such as 0.001 inch to 0.030 inch from the width of such as 0.0005 inch to 0.010 inch, silk thread.Funnel point The distal portions at end 52 can have various shape or construction to allow preferably to extract clot or thrombus.In some embodiments, The distal portions of funnel tip 52 have biggish open end, it is contacted at this with vascular wall when expanded, and be transitioned into compared with The proximal part 53 of small opening.The diameter range of the open end of distal portions can be from about 5 millimeters to about 80 millimeter.In some realities It applies in example, funnel tip distal portions 52 also have along the opening of side or hole (perforation) to allow blood flow.Funnel is remote End part 52 can have one or more layers braiding layer.In some embodiments, funnel distal portions have two layers.Some one In the embodiment of layer, the silk thread end that the distalmost end open end of funnel does not have termination or exposes, so that silk thread end is located at leakage The proximal end of bucket component.The proximal part 53 of funnel tip be configured such that its can extend and receive ALTC device and Capture clot or thrombus.Proximal part 53 can be configured to extend to receive the object bigger than its internal diameter and extensive after passage It is multiple.Proximal part 53 may include PTFE internal layer and flexibility and/or low durometer polymeric material, for example, polyurethane, silicone, Tecoflex (a kind of thermoplastic polyurethane elastomer), Pebax 25D and/or 35D or braiding and/or non-woven such as Pebax/ Propel/BaSO4 outer layer.Proximal part 53 can also include other polymer materials compared with soft.Compound funnel tip It can be laminated by chopping coating, spraying or reflux technique or any combination thereof with proximal part.Braided material can be gold Category and/or polymer and/or combination thereof.Braided fabric configuration can be, for example, 1 × 1 or 1 × 2 or 2 × 1 or 2 × 2 or its any group It closes.The range of stitch per inch (PPI) can be from such as 5 to 60.The quantity can be for example from a silk thread to 288 silks Line.The shape of filament cross-sectional can be for example round, flat, oval, rectangular or square.Wire diameter can be from for example 0.0005 inch to 0.015 inch.The thickness of flat silk thread can be from such as 0.0005 inch to 0.010 inch, the width of silk thread Degree can be from such as 0.001 inch to 0.030 inch.In some embodiments, advantageous feature is that can extend and shrink and It will not be rugosity under compression.The range of internal diameter can be from such as 2F to 30F.In some embodiments, the range of internal diameter can be from Such as 6F to 18F.The length thereof of extension can be up to entire catheter length.In some embodiments, length is about 20cm.Leakage Bucket distal portions 52 and proximal part 53 can also be made for an element, and wherein braided configuration is continuous.With funnel tip The connection of proximal part 53 is continuous, and inner shaft 54 can be by being such as, but not limited to nylon, polyurethane, Pebax, polyethylene, PET, PTFE Or the material of ePTFE is made.Inner shaft 54 can be braiding or non-woven.Outer shaft 49 can play sliding and shrink funnel point The effect at end, and support is provided during introducing vascular system.Outer shaft 49 is retracted so that funnel tip is unfolded.Outer shaft 49 can be by all As the polymeric material of nylon, polyurethane, Pebax, polyethylene, PET, PTFE, ePTFE, FEP or combinations thereof is made.Outer shaft 49 Diameter range can be from such as 4F to 34F.The inside diameter ranges of outer shaft 49 can be from such as 3F to 32F.In some embodiments, institute It is essentially identical that internal diameter, which is stated, through lumen shaft.In some embodiments, the internal diameter of far-end is greater than proximal inner diameter.The change of internal diameter Change can be one, two or more positions.The outer diameter is essentially identical in the whole length of epitheca axis.In some embodiments In, the diameter of outer shaft 49 is about 22F or smaller.Outer shaft 49 may include far-end radiopaque marker or along The radiopaque filler of its shaft length to be visible under fluoroscopy.In some embodiments, outer shaft can be along axis Length different position and it is multiple can on deviation direction can deviation (such as pass through the one, two or more on distal end Bracing wire) to adapt to various zigzag paths, such as into atrium dextrum, right ventricle, main pulmonary artery and left pulmonary artery and right pulmonary artery To be used for pulmonary embolism application.

Referring still to Figure 20 A-20D, in some embodiments, extension guiding catheter 50 can be used for withdrawing clot or blood Bolt.Extension guiding catheter 50 and disabler 51 can introduce vascular system by silk thread and be advanced near treatment region.Obstruction Device 51 is removed.Extension guiding catheter external component 49 proximally retracts so that the funnel tip 52 of guiding catheter 50 with can expand Part 53 is opened up to extend.In some embodiments, guiding device outer shaft 49 is inserted into blood vessel together with disabler 51, once and outer shaft 49 are in desired position, then remove disabler 51.Interior guiding elements may include funnel tip 52, and 53 He of proximal part Inner shaft 54 is then inserted into outer shaft 49, the distal tip until reaching outer shaft 49.Then outer shaft 49 can be retracted (or push away Into inner shaft 54) to extend and be unfolded distal end funnel 52 and proximal part 53.The capture conduit system 35 is inserted into simultaneously by silk thread It is extended through the inner cavity of internal guide members 54.Once ALTC device 8 is unfolded and captures clot, the blood of ALTC device 8 and capture Block is retracted into funnel tip 52 and extension guidance inner part 53 together and (is shown in FIG. 50 later).When due at tip Larger clot position and when funnel tip encounters high-drag, guidewire lumen can be distally advanced to extend ALTC device.Elongation ALTC device can create exceptional space in ALTC device, so that clot volume be made to redistribute, draw to reduce in extension Lead the big clot collected at catheter tip.The distal portions of extension guiding catheter also allow bigger grumeleuse captured, because its Scalability increases the size of inner cavity.Continue to retract ALTC device and will extract extending the blood additionally captured in guiding catheter Block.Repeating elongation ALTC in the course of surgery will continue to redistribute clot in extension guiding catheter and fetch, and be conducive to change The processing and redistribution of kind thrombus.In some embodiments, external member may include capture conduit system 35 as described herein, and And it is configured as in the inner cavity for being reversibly placed on discrete extension guiding catheter system 50 as described herein and relative to described Inner cavity axial movement.

Figure 21 D shows one embodiment according to some embodiments of the present invention, wherein capping tip 710 encapsulates expansion Open up the distal end of the outer covering piece of guiding catheter system.In some embodiments, guiding catheter is a part of hemostasis guidance system, The system may include one or more disablers, interior shaft member, outer component and the haemostatic valve being placed in system shell.It is interior Shaft member may include non-expandable braiding proximal part, distal end expandable portion and braiding funnel distal end, can be as herein Described by other places.Interior shaft member can be placed in the interior intracavitary of outer component.Outer component can have such as braiding polymerization structure Type has flexible kink resistance distal portions.Inner shaft and outer component could attach to outer housing.Outer housing can guided for example The proximal end of conduit system.Haemostatic valve can be placed in outer housing.Haemostatic valve can be in some embodiments flexible plate valve.Only Blood valve can be configured to provide hemostasis and pre- antiseep, such as inside does not have whatever.In some embodiments, system can be matched It is set to and is used together with 0.035 " seal wire, 5Fr conduit, and including between about 12F and about 17F, such as from about 12F, 16F or 17F Size.Haemostatic valve may include two surfaces, upper and lower surfaces.Upper and lower surfaces can be phase in some embodiments To surface.Upper surface may include partly stepping up the gap of surface extension and thickness through lower surface is not outstanding gos deep into valve Depth.Lower surface may include the gap extended across lower surface and the thickness depth not outstanding goed deep into valve through upper surface Degree.In some embodiments, the diameter of valve is between about 0.50 " and about 1.00 ", such as from about 0.5 ", 0.6 ", 0.7 ", 0.8 ", 0.9 " or 1.0 ".In some embodiments, the thickness of valve is between about 0.050 " and about .0100 ", and such as from about 0.075 ".One In a little embodiments, the depth/thickness in gap can between about 0.020 " and about 0.060 ", such as from about 0.040 ".The midpoint in gap It can be in some cases at or near panel surface center.Upper gap and lower gap can point intersections for example in valve. Gap is extensible to exceed intersection point required distance, such as exceeds between intersection point about .001 " and about .010 ", or substantially .005 ".Some In embodiment, gap is arranged along valve permits insertion and removes the axis across it, while anti-Hemostatic Oral Liquid or air are returned across valve leakage It returns.Upper gap and lower gap can have the long axis intersected at a certain angle.Angle can in some embodiments between about 45 ° with about It between 135 °, or is in some cases about 45,60,75 or 90 °.

Figure 22-24 shows the epitheca component 1 of acquisition equipment according to some embodiments of the invention.As shown in figure 22, epitheca 1 The thrombus acquisition equipment (8 (not shown) of tubular mesh) that can be used for receiving, protection and delivering axial elongation arrives desired solution Degree is cutd open to set.As shown in figure 22, epitheca 1 may include soft hurtless measure distal tip, can be tubulose in some embodiments Shaft body, be configured to accommodate and locate reversibly to couple the second tubular element at its proximal end (all as described elsewhere herein Capture conduit) inner passage/inner cavity and proximal connector with sealing element 55 and flushing pipe/port 13.Epitheca 1 can To be made of suitable medical grade material, including but not limited to nylon, polyurethane, Pebax, polyethylene, PET, PTFE, ePTFE, PEEK, PEBAX/Propell and polypropylene.The polymer material may include radiopaque material, such as barium sulfate, alkali Formula waltherite or bismuth oxide, to observe under fluoroscopy.In some embodiments, radiopaque material can be with shape At the identification element that one, two or more is discrete, for example, distal tip, and/or along epitheca 1 length with rule Or irregular interval separates.The external diametrical extent of epitheca 1 can be from such as 3F to 30F.The internal diameter of housing 1 can be in such as 2F To 28F.In some embodiments, internal diameter substantially constant in such as lumen shaft of entire inner passage.In some realities Apply in example, the internal diameter of far-end be proximal end about or at least about 10%, 20%, 30%, 40%, 50% or more.Internal diameter Variation can be for example in a position or the variation of two or more position top bars or gradual change.In some embodiments In, outer diameter can be essentially identical with the whole length of conduit.In some cases, the active length of epitheca 1 can be from about 10cm to about 150cm.In some embodiments, the active length of epitheca 1 is about 135cm in some embodiments.Epitheca 1 Axis can be braiding or it is non-woven.In some embodiments, the axis of epitheca 1 can along shaft length at various locations with it is multiple Can on deviation direction deviation (such as passing through the one, two or more bracing wire on distal end) to adapt to various zigzag paths, example Such as enter left or right atrium, ventricle, main pulmonary artery and left or right pulmonary artery or such as great saphenous vein for pulmonary embolism application Vein, superficial femoral vein, the total vein of stock, SVC, IVC or other up or down limbs, internal organ or remove application for deep vein thrombosis Other superficial veins or Deep venou.The distal end of the axis of epitheca 1 can be configured in some cases deviation up to 360 degree.In addition, outer The distal tip of sheath 1 can be configured to towards vascular wall or far from vascular wall deviation or biasing.The distal tip of epitheca 1 can be with Including the radiopaque label of one, two or more to indicate terminal position.Alternatively, distal tip may include radiopaque Material, such as barium sulfate, basic bismuth carbonate or bismuth oxide.Figure 23 and 24 respectively illustrates the distal end of epitheca component and close End.As shown in figure 26, epitheca 1 proximally by sealing element be connected to epitheca connector 55 be connected in parallel to capture guide coupling with And irrigation ports 13.

Figure 25 shows capture conduit tube component 12 according to some embodiments of the invention, shows catheter shaft 12 and epitheca 1. Figure 26 shows the proximal end of capture conduit according to some embodiments of the invention, shows to have to be operably connected to and rinses end The connector of the sealing element 155 of mouth 13.

Figure 27 shows one embodiment of 36 feature of keycap for preventing or inhibiting the rotation of hypo tube propeller 14.Such as Shown in figure, keycap 36 can be with inner cavity so that the tubular element that hypo tube propeller 14 passes through.In some embodiments In, the inner cavity is non-circular, and/or has non-circular region, or be configured to prevent or limit rotation in other ways Turn.In some embodiments, as shown, the inner cavity includes tooth or the other protrusions into inner cavity, to prevent hypotube from pushing away The undesirable rotation of dynamic device.In some embodiments, the inner cavity or part of it have square, rectangle, triangle, ellipse Circle, pentagon, hexagon or other non-circular geometries, and it is configured as limitation rotation.

In some embodiments, such as indicated by figs. 28-29, optional suction catheter 2 can be used for aspirating in ALTC device 8 Thrombus.Suction catheter 2 may include distal end funnel tip 9, elongated shaft body 16 and with sealing element 3 in some embodiments Proximal connector.Figure 30 shows the close-up illustration that can connect in the funnel tip 9 of 16 far-end of suction catheter axis, to help It fetches thrombus and allows effective suction.Funnel tip 9 can be made of such as polymer and/or metal material.In some realities It applies in example, it can be tubulose, braiding or woven.Funnel tip 9 can have various constructions to allow preferably to take It returns and aspirates.In some embodiments, funnel tip 9 has funnel shaped as shown in the figure, has the first larger distal end Diameter, transition portion and the second smaller proximal diameter.Suction catheter axis 16 generate a path, for make the thrombus being sucked to It advances and leaves the main body and enter optional filter collection chamber in some embodiments in proximal end.The axis can have not Same diameter, length and/or geometry, to help to remove the substance of such as clot.Suction catheter axis can be by suitable material Material is made, such as, but not limited to nylon, polyurethane, Pebax, polyethylene, PET, PTFE, ePTFE, PEEK and polypropylene.One In a little embodiments, the distal end of suction catheter axis is expansible to adapt to a large amount of clot.Suction catheter 2 can be attached to filtering The proximal end of device collecting chamber 5 is to realize Biochemical analyzer (or removal).In some embodiments, suction catheter axis 16 is along shaft length At one, two or more position can deviation, to adapt to various zigzag paths, such as into atrium dextrum, right ventricle, main lung Artery and left and right pulmonary artery.Also show proximal end irrigation ports 13.

In some embodiments, mechanical thrombectomy tool, such as chopper 19 shown in Figure 32-41, can rise To the effect for destroying and breaking the thrombus in ALTC device 8.Chopper 20 may include destructor 19, axis 22 and with sealing element 21 proximal connector.Distal end adjustable handle knob 23 is also displayed as just in 19 proximal end of destructor.Destructor 19 can connect To the distal end of axis 22.According to desired clinical effectiveness, chopper 20 can have the various end effectors as shown in Figure 35-41 The configuration at tip, the proximally and distally ball (figure for breaking the thrombus in ALTC device 8, including spherical (Figure 36), with narrow waist 37), multiple proximally and distally balls with narrow waist and each ball deviate one for example, about 90 ° of angle (Figure 38), have from Center hub radially outward radiates the petal design (Figure 39) of flap, half petal design (Figure 40) or substantially vertical with axis 22 To the linear design (Figure 41) of axis vertical take-off.Destructor 19 is shunk and one during being inserted through 2 system of suction catheter Denier is left conduit and is just extended.Destructor 19 can be made of metal materials such as such as stainless steel, Nitinol, cochromes.It can be with By can be manually rotated, manipulating and/or electric handle starts chopper.

In order to shred thrombus, chopper 19 is inserted into suction catheter 2 and is positioned in ALTC device 8.Using manual technique The luer connector 21 for being applied to chopper 19 by rotating luer connector 21 makes the rotation of destructor 20 to break thrombus. Alternatively, chopper 19 can be used together with electric handle (not shown).Destructor 20 is set to axially penetrate through ALTC device 8 Whole length can help to destroy thrombus.

Filter collection chamber 5 (Figure 42) can play the role of suction and collect clot.Filter collection chamber 5 may include example Such as collecting chamber 325, filter 324, plunger 323, flow into port 327 and outflow port 326.Filter collection chamber 5 can have The outflow port 326 for being connected to 2 connector of suction catheter and attachable syringe or similar device are with the inflow end for suction Mouth 327.Collecting chamber 325 has the filter system 324 resided in room 325 to allow filtering blood and thrombus.Room 325 also has There is plunger 323, the room 325 is filled for injecting the fluid of such as salt water, and the blood of filtering is back into vascular system In.Plunger 323 may be used as the sealing element on the side of the room.

In order to which from the system aspirate thrombi, suction catheter 2 is connected to filter collection chamber 5 (Figure 42).Big syringe It is connected to the proximal end of filter collection chamber 5.Applying suction using syringe causes thrombus and clot to move to filter collection chamber 5 In.Once all thrombus are contained in room 5, close plug, separation syringe and filled with salt water, and syringe is connected again It is connected to filter collection chamber 5.Alternatively, it can be used extension and the syringe of external saline filling salt water is filled into suction In syringe.It is injected by syringe and salt water is pushed into the room 325, cause plunger 323 that blood is pushed back blood vessel.The room 325 will return to blood and stay in thrombus in room 325.Alternatively, the blood that filter collection chamber 5 can be separated without will filter Liquid returns to system.Once thrombus is removed, suction catheter 2 is retracted into epitheca 1.ALTC device 8 is retracted into epitheca 1 In, and whole system is removed from body.

Conduit system as described herein can be used for various indications according to desired clinical effectiveness.In some embodiments In, the use is not limited to venous system, and can be applied to other arteries, vein or non-vascular region, such as neural blood Pipe, peripheral blood vessel, angiocarpy, interim embolization protective device, arteria carotis protection, In for cardiovascular surgery such as valve replacement Lung preversation during deep vein thrombosis resection or embolism resection) or taking-up implantation material, medical device or other materials.

Figure 43 shows the clot for residing in left side pulmonary system.Show right pulmonary artery 251, left pulmonary artery 252, cavity of resorption Pulmonary embolism 256 in vein 253, left common iliac artery 254, right common iliac artery 255, left pulmonary artery 252 and superior vena cava 257.

Figure 44 A and 44B illustrate respectively according to some embodiments of the present invention reside in left side pulmonary system and acquisition equipment In clot.Other than the anatomical features shown in Figure 43, guiding catheter 264, right ventricle 266 and atrium dextrum 267 are also shown. As shown in Figure 44 B, acquisition equipment described and illustrated herein can be used advantageously when distal void is very limited, because The device works in wide work axial range, as discussed elsewhere herein.

Figure 45-47 shows the capture in accordance with some embodiments to endovascular thrombus.Figure 45 shows the blood of axial elongation The initial deployed configuration of bolt acquisition equipment (such as tubular mesh) 8, it is whole with end 800, dynamic folding point 88 and proximal end The radial compression part (not shown) for terminating in a little reservation at 128, the radial compression part is shown as to fix at point 128 Ground is connected on the lateral wall of guidewire lumen 6.According to some embodiments of the present invention, the expansion of tubular mesh 8 is located at The distal end of 73 closed area of thrombus and extension guiding catheter 50, the extension guiding catheter 50 include having proximal end expandable portion Distal end funnel tip 52, inner catheter 54 and outer catheter 49, or suction catheter funnel tip is located at blood in some embodiments The proximal end of bolt obstruction 73.In some embodiments, according to whether suction, can be used expansion as described elsewhere herein Open up guiding catheter 50 or suction catheter.The interior sheath 54 and epitheca 49 of extension guiding catheter 50 are also shown in proximal end.Along appropriate side To for example axially start capture bracing wire 10 together (or in the foregoing implementation with casing individually or with capture conduit 12 In example, together with the capture conduit for being connected to epitheca (not shown)), axial elongation or the shortening of ALTC device 8 can be caused, this Depending on desired clinical effectiveness.Figure 46 shows the tubular mesh 8 of axial elongation according to some embodiments of the present invention Expandable portion is proximally extended to capture thrombus, wherein relatively radial compression section correspondingly shortens.Figure 47 is shown completely The thrombus acquisition equipment of the axial elongation of thrombus is captured, and extends guiding catheter funnel tip or alternatively suction catheter leakage Bucket tip is located inside the thrombus acquisition equipment of axial elongation.In the embodiment using suction, pass through the subsequent of suction catheter 2 Suction can be performed to remove clot or thrombus.ALTC device can be extended to the whole length with covering conduit system most Long length, such as from about 0.5cm to about 125cm.In some embodiments, ALTC device can extend to about or at least big About 2,3,4,5,6,7,8,9,10,11,12,13,14,15,20 centimetres or more.Depending on blood vessel diameter, ALTC device it is outer Diameter can be in some embodiments in the range of about 1 millimeter to about 80 millimeters.For example, for inferior caval vein, superior vena cava, under Big blood vessel, the diameter such as drop and aorta ascendens can achieve about 60,70,80,90,100 millimeters or more.Neural blood vessel system In thin vessels can have and for example as low as about or be less than about 5,4.5,4,4.5,3,2.5,2,1.5,1,0.5 millimeters or more Small diameter.The diameter of ALTC device can achieve reduction or elongate the similar effect of ALTC assembly dia.In some embodiment party It in formula, does not use or does not need to aspirate, and ALTC device encapsulates the clot, the clot can be mechanically withdrawn into capture In conduit.In some embodiments, ALTC device can be used for treating the clot in such as arteria carotis or cerebral artery or venous circulation. Blood vessel to be treated may include moving in such as Willie ring (Circle of Willis), left common carotid artery or right common carotid artery or neck Arteries and veins, arteria cerebri anterior, arteria communicans anterior, arteria cerebri media, posterior communicating artery, carotid siphon section, basal arteries, vertebral artery or Ophthalmic artery or its any branch.In some embodiments, ALTC device can be used for treating such as femoral vein, arm vein, lung quiet Arteries and veins, mammary gland vein, cerebral veins, venae cerebri, brain sinus vein, renal vein, portal vein, jugular vein or another vein.

Figure 48 A show according to some embodiments of the present invention may include foregoing feature clot capture systems 35 another delivery configuration.Figure 48 B shows the first of the thrombus acquisition equipment of axial elongation according to some embodiments of the invention The wheel hub 55 of beginning expanded position and capture conduit 155 can reverse connection with the wheel hub 55 of epitheca.Figure 48 C is shown according to the present invention Some embodiments axial elongation thrombus acquisition equipment expansion further elongation, wherein the compression section retained 81 corresponding shortening.As shown, the wire leading pipe 6 with nose 7 is held in place and is reversibly attached to the capture conduit of epitheca It can proximally recall.Figure 48 D show the thrombus acquisition equipment of axial elongation according to some embodiments of the present invention its most Final expansion in big active length.

In some embodiments, system disclosed herein and device can be used for for example through apex of the heart chamber, thoracoscope, abdominal cavity General percutaneous surgery, cutting operation or the Minimally Invasive Surgery of mirror or other operations, such as, but not limited to through femoral artery, trans-radial And/or jugular vein access.The technology can also be applied to arterial system, including neural blood vessel, angiocarpy and peripheral blood vessel application, And it is used as embolization protective device, such as cardiovascular surgery, such as valve replacement or reparation.In some embodiments, thrombus is cut Except system can deliver in the downstream (such as before the arch of aorta) of aortic root, and there is proximal end and the closure of opening The shape memory reticular structure (such as ALTC device) of variable-length of distal end extend before index cardiovascular surgery to catch Obtain downstream embolism, calcification or other fragments.In some embodiments, for example, surgery systems can be deployed to prevents in depth Embolism during venous thrombectomy or pulmonary embolism resection.In another embodiment, which can be used in urgency Embolism is prevented during property ishemic stroke or is fetched.System and methods described herein can be also used for non-vascular dissection knot Structure, such as gallbladder tube structure to capture cholecystolithiasis, choledocholithiasis and pancreatic stones, such as capture in ureter or bladder Kidney stone, or ovum or other materials are captured in fallopian tubal, or in gastrointestinal tract, such as esophagus, Stomach duodenum, jejunum, return To capture such as foreign matter in intestines or colon.This document describes use venous system to enter pulmonary artery to treat some realities of pulmonary embolism Apply mode.The technology also can be applied to other regions of vascular system.It initially punctures to enter femoral vein.Short access seal wire It is inserted into femoral vein.Next, being inserted into 5F or 6F guiding device sheath appropriate.Seal wire is changed to 180cm, 260cm or 300cm to lead Silk, and be advanced through inferior caval vein, atrium dextrum, right ventricle and pulmonary artery and block treatment region to enter.Length may be needed longer Guiding device/guiding catheter with pass through tricuspid valve and pulmonary valve.Once seal wire passes through obstruction treatment region, 5F or 6F guiding device Sheath is replaced by long guiding catheter and is proximally located near congested areas.Conduit system 35, which is inserted on silk thread and passes through, draws Conduit and it is distally advanced congested areas.Conduit system 35 can also utilize the deflectable feature of epitheca, without using drawing It navigates in vascular system in the case where conduit.Next, the nose 7 of conduit system passes through obstruction treatment region and positions In the distal end of obstruction treatment region.Epitheca 1 is retracted so that thrombus capture guiding piece 11 is unfolded.Epitheca 1 is withdrawn past thrombus and determines Position is in the proximal end of thrombus (congested areas).Suction catheter 2 is distally advanced in the outside of epitheca 1, and towards congested areas Proximally-located, if using suction.

In order to fetch and capture the substance of such as clot or thrombus etc, thrombus capture guiding piece 11 is by proximally pulling Capture bracing wire 10 and retracts, while push/pull capture conduit 12 with axial elongation ALTC device 8 cross thrombus and substantially not Reduce the diameter of device.As needed, capture catheter shaft 12 is distally advanced while pulling and capturing bracing wire will allow ALTC 8 axial elongation of device is to capture thrombus.In addition, suction catheter 2 expansible funnel tip 9 (or extension guiding catheter funnel Tip) it can be positioned at the proximal end of congested areas, to support and minimize thrombus movement.This operation is continued until all Thrombus is all in ALTC device 8.Once thrombus is completely in ALTC device 8, ALTC device 8 is pulled out from congested areas can be with Blood flow is recovered immediately thrombus is included in ALTC device 8 simultaneously.

In some embodiments, capture catheter shaft 12 and wire leading pipe 6 be configured to side by side adjacent positioned at (such as offset and not Coaxially, and be not passed through opening 802 or tubular mesh 6 other radial expansion parts) reach ALTC device 8 and capture guidance Part (such as shown in Figure 49 A and 49B).It also shows dynamic folding point 88, the radial compression part 81 retained and is fixed at 128 To the compression end of the outer wall of wire leading pipe 6.

Figure 50 A-50G, which is shown, gets back to thrombus in extension guiding catheter, and wherein ALTC device to elongate distal end and generates Additional space, and thrombus is re-distributed and can preferably be taken back in extension guiding catheter.Extension is led The funnel tip 52 and expansion 53 of pipe are also convenient for fetching for thrombus.Such as when ALTC device (such as tubular mesh 8) is caught When obtaining internal clot, ALTC device 8 can be advantageously axially stretched and radial compression is more than that its active length (such as works as reservation Radial compression part when extending completely, and/or promoted by the distal end of wire leading pipe 6), effectively radially to squeeze clot To reduce its diameter/width.Fresh clot is usually soft and deformable.Applying axial tension to ALTC device can squeeze Fluid in clot out to reduce the size of clot, and clot is more easily removed from vascular system.Such as scheme Shown in 50A-50G, the ability of ALTC device dynamic elongation additionally provides another clinically effective method, by dividing again The volume of cloth clot or thrombus eliminates the burden of big clot.For example, for current intervention device, such as filter and basket Object, when clot or thrombus are collected and get back in the conduit of such as guiding catheter or sheath, clot or thrombus can be gathered in one It rises or collects in filter or the bottom of basket becomes big " spherical " shape, and prevent big " spherical " thrombus from entering guidance The inner cavity of conduit or sheath.When breathe/aspirate using the guiding catheter of smaller internal diameter, it may occur that similar effect. However, ALTC device can be extended from distal end concatenation, (such as schemed with generating additional length and space in ALTC device Shown in 50B, 50D and 50F).By extending the distal end of ALTC device, clot or thrombus redistribute in ALTC device, thus The spherical size of clot, thrombus or other materials is reduced, preferably to fetch (Figure 50 C, 50E, 50G) guiding catheter is intracavitary. These steps can repeat about or at least about 2,3,4,5 or more recycle, until all clot and thrombus are all with pressure The form of contracting is got back in conduit.In addition, as shown in Figure 50 A and 50C, using having and the consistent expansible distal end of ALTC device Partial extension guiding catheter can permit more effective clot or thrombus removes.The validity of ALTC device 8 can be extreme It is further proved under vascular condition, wherein only minimum or no available distal void is complete for conventional thrombectomby conduit It axially expands to function.Distal void except the distal end of thrombectomby system can be less than about in some cases 3cm, 2cm, 1cm, 5mm or smaller.In other words, ALTC device 8 can be delivered with the first compressed configuration, and by epitheca Compression.When removing epitheca, ALTC device 8 can be transformed into radial expansion configuration and be configured as capture thromboembolism, Even if device may be at being compressed axially configuration.Then can be by ALTC device 8, such as fully functional axis is played relative to it To reduction length, axially expand at least about 1.25x, 1.5x, 2x, 2.5x, 3x, 3.5x, 4x, 4.5x, 5x, 5.5x, 6x, 6.5x, 7x, 8x, 9x, 10x or more, while still being kept constant in entire working range or substantially invariable radial expansion diameter, Such as in some embodiments between about 1cm and about 50cm, between about 1cm and about 20cm, about 1cm and about 10cm it Between, between about 1cm and about 5cm or between about 1cm and about 3cm.In some embodiments, ALTC device 8 is in delivery process In and/or there is on its entire work axial length the proximal end of opening.When ALTC device noumenon is maintained at capture catheter shaft 12 When interior, thrombus capture guiding piece 11 can advantageously in compact space initial deployment.Then, thrombus captures guiding piece to close End is retracted to start to spread out ALTC device 8.ALTC device 8 it is potential axially expand length be not necessarily it is limited, and one The whole length of conduit system is extended in a little embodiments.ALTC device 8 can fold simultaneously during introducing vascular system It is contained in capture catheter shaft 12 and epitheca 1, and extends when epitheca 1 proximally retracts ALTC device 8 is unfolded.Capture is led Pipe axis 12 can be made of suitable material, such as, but not limited to nylon, polyurethane, Pebax, polyethylene, PET, PTFE, EPTFE, PEEK, polypropylene.It is advantageous in some embodiments and it is possible that as previously mentioned, capture catheter shaft 12 is along shaft Length at various locations with it is multiple can on deviation direction can deviation, to adapt to various zigzag paths, for example, into atrium dextrum, Right ventricle, main pulmonary artery, left and right pulmonary artery.

The perspective view of another embodiment of capture systems is shown in Figure 51.Figure 51 also shows more according to the present invention Embodiment, it may include the non-limiting example of the various possible elements in material capture system.As shown in Figure 51, some It include any number of (such as one, two, or more) in embodiment with lower component: thrombus acquisition equipment or ALTC device 201, with any one of elements illustrated herein, such as propeller line or internal propeller 202, the first tubular element, Such as sheath 203, ring or capture pieces 204 and connector 205.ALTC device 201 could attach to capture guiding piece 204.In some implementations In example, capture guiding piece 204 includes metal material, such as Nitinol.Capturing guiding piece 204 can be in for example shown loop type, Or it is any close-shaped, including ellipse, oval or polygon.Capturing guiding piece 204 can be in opening shape form, such as any line Property or non-linear partial.Together with ALTC device 201 can couple with capture guiding piece 204 and (such as suture).It ALTC device 201 and catches Obtaining guidance 204 can be packaged in soft polymeric material.Capture guiding piece 204 can be connected to epitheca 203 via connector 205. The proximal end (not shown) of ALTC device 201 can be connected to internal propeller 202.

Epitheca 203 can be the elongated tubular member with the central lumen across it in some embodiments, and have close Both 2001, bo of end 2000 and distal end are shown in Figure 51.The distal end 2001 of epitheca 203 can be operatively coupled to catch Device (such as tubular mesh as described herein) is obtained, can be moved axially relative to epitheca 203.Proximal end 2000 may include appointing (such as one, two, or more) of what number is with lower component: hemostasis component 206, irrigation ports 207 and constriction 208.Outside Sheath 203 proximally extends and can be connected to hemostasis component 206.Internal propeller 202 proximally extends and can be connected to Rule.In In some embodiments, internal propeller 202 can have inner cavity to allow seal wire to pass through.In some embodiments, internal propeller 202 be solid shafting.

Figure 52 shows the distal end 2001 of the ALTC device 201 in deployed configuration.It in some embodiments, is in initial deployment structure The ALTC device 201 of type has low profile.A part of ALTC device 201 is extension, and remaining length of ALTC device 201 For contraction and contained in epitheca 203, as discussed previously.In some application methods, ALTC device 201 can be shrinking and logical It crosses epitheca or guiding catheter (not shown) is tracked to expected treatment region.In some embodiments, guiding catheter can be proximally Retraction is with initial deployment ALTC device 201 and capture guiding piece 204.For example, guiding catheter retraction may make capture to guide Part 204 extends.Capturing guiding piece 204 can include compression or constrained configuration when in guiding catheter.In the initial deployment phase Between, capture guiding piece 204 is discharged from constrained position to middle position.In middle position, capture guiding piece 204 is ALTC device 201 generate circumference.In the case where ring or other circular in configuration, capture guiding piece 204 can produce constant diameter.In other shapes Or in the case where configuration, capture guiding piece 204 can produce constant cross-section.Alternatively or in combination, in other application methods, ALTC device 201 can be distally advanced so that ALTC device 201 is unfolded from guiding catheter.

In some cases, an only small fractional part for ALTC device 201, as the axial length of device is less than about 50%, it 45%, 40%, 35%, 30%, 25%, 20%, 15%, 10%, 5% or smaller can initially use and fully functional. Fraction can correspond to the amount for allowing to capture the ALTC device 201 that guiding piece 204 shows middle position.In capture guiding piece During 204 expansion, one section of ALTC device 201 can be retained in epitheca 203.ALTC device 201 can be followed from capture guiding piece 204 to epitheca 203 curve.So that epitheca 203 is bounced back extending ALTC device 201, while maintaining to be provided by capture guiding piece 204 Constant diameter or section.

Figure 53 shows the embodiment of the ALTC device 201 in initial deployment configuration.As shown in Figure 53, ALTC device 201 can be in some embodiments overall tubular structure, and being in some cases can be in the mesh grid of 203 interior folding of epitheca Structure.ALTC device 201 can be extended to the diameter provided by capture guiding piece 204 or section.ALTC device 201 can be by from outer Sheath 203 discharges ALTC device 201 and axial elongation or shortening, such as in working range.ALTC device 201 can axial elongation or contracting It is short, while maintaining or substantially maintaining diameter or the section provided by capture guiding piece 204.ALTC device 201 is deployable with shape At the overall tubulose or cylindrical with the axial length changed.ALTC device 201 can axial elongation shorten to fetch and Capture includes the intracorporal foreign matter or other unwanted substances of vascular system, such as clot, thrombus and/or foreign matter.In some realities It applies in example, epitheca is not present and loader can be used for preparing the ALTC device 201 delivered with cross-sectional configuration.

As shown, such as in Figure 54 and 55, ALTC device 201 can axial elongation.Figure 54 is shown in the second configuration ALTC device 201.ALTC device 201 is in the second configuration, wherein the ALTC device 201 of expansion and extension is than initial deployment configuration It is longer in the axial direction.Remaining 201 length of ALTC device shunk resides at 203 inside of epitheca and shorter than initial deployment structure Type.Epitheca 203 can bounce back with axial elongation ALTC device 201.When epitheca 203 bounces back, capture guiding piece 204 bounces back, because It captures guiding piece 204 and is connected to epitheca 203 via connector 205.When capturing guiding piece 204 and bouncing back, ALTC device 201 is from receipts Contracting part 208 advances to expansion.Epitheca 203 can proximally bounce back with axial elongation ALTC device 201.Alternatively or combine Ground, in other application methods, capture guiding piece 204 can bounce back with axial elongation ALTC device 201, and epitheca 203 is such as made to bounce back. The diameter of ALTC device 201 or section can be kept constant between initial deployment configuration and the second configuration or substantially constant.

Alternatively or in combination, in other application methods, internal propeller 202 is distally advanced to promote ALTC device 201 proximal end.As described herein, the proximal end of ALTC device 201 is connected to internal propeller 202.In the second configuration, inside is pushed away It is distally advanced into device 202 to discharge a part of ALTC device 201 from epitheca 203.

Figure 55 shows the embodiment of the ALTC device 201 in third configuration.ALTC device 201 is in third configuration, wherein The ALTC device 201 of expansion and extension is longer in the axial direction than initial deployment configuration.Remaining ALTC device 201 shunk Length resides at 203 inside of epitheca and shorter than the second configuration.Epitheca 203 can proximally bounce back with axial elongation ALTC device 201. The diameter of ALTC device 201 or section can be kept constant between the second configuration and third configuration or substantially constant.Alternatively or In combination, in other application methods, in third configuration, internal propeller 202 is largely distally advanced. In three configurations, internal propeller 202 is distally advanced to discharge the longer portion of ALTC device 201 from epitheca 203.

Figure 56 shows material capture, such as the embodiment of net element 209.Net element 209 can be ALTC device 201 Component.Net element 209 can be to provide the structure mesh of suitable shape as described herein.Net element 209 may include Nitinol or other materials.Basket element can be braiding, braiding, linear or laser cutting.Net element 209 may include being connected to Capture the first end of guiding piece 204.Net element 209 can be including welding, fixing clamp, convex via suture or other machinery method Edge, bonding, lamination etc. are connected to capture guiding piece 204.It is poly- that net element 209 and capture guiding piece 204 can be packaged in soft In condensation material.The second end of net element 209 can be connected to internal propeller 202.Second end can be folded inward in be connected to Portion's propeller 202.Second end can be inverted to be connected to internal propeller 202.Second end 202 can be in the pipe structure of ALTC device 201 Pipe is formed in type.

Figure 57 shows the embodiment of ALTC device 201.When ALTC device 201 is unfolded (such as initial deployment configuration, the Two configurations, third configuration etc.), ALTC device 201 has expansion.Expansion have constant diameter as described herein or Section.Expansion or part thereof is connected to capture guiding piece 204.Expansion is via capture guiding piece 204 and connector 205 It is connected to epitheca 203.ALTC device 201 has constriction 208.Constriction 208 can reside within the interior intracavitary of epitheca 203. When expansion is in deployed configuration, constriction 208 can be remained in epitheca 203.Constriction 208 or part thereof can couple To internal propeller 202.Constriction 208 is overturn as shown.During 201 axial elongation of ALTC device, constriction 208 A part can produce in distal area to be converted between constriction 208 and expansion.

Figure 58 A and 58B show the embodiment of capture guiding piece 204.Figure 58 A shows capture guiding piece 204.Figure 58 B Capture guiding piece 244 is shown, may include any of the component for capturing guiding piece 204.Capture guiding piece 204 can be formed Continuous shape.Capturing guiding piece 204 may include leg support component 210.Leg support component 210 can will capture guiding piece 204 from axial side To being converted into periphery shape.Periphery shape can be the circle as shown in Figure 58 A.Capture guiding piece 204 can form continuous loop.It catches Obtaining guiding piece 244 may include discontinuous circumference.As shown in Figure 58 B, capture guiding piece 244 may include discontinuous ring.Capture is drawn Guiding element 204,244 can be made of metal material.In some embodiments, capture guiding piece 204,244 is by shape-memory material shape At.In some embodiments, capture guiding piece 204,244 is formed by Nitinol.Capturing guiding piece 204,244 can be by spring like material Material, as metal is formed.Capturing guiding piece 204,244 can be round, ellipse, semicircle or any combination thereof.Capture guiding piece 204,244 may include preformed curve.Preformed curve can be formed during manufacture capture guiding piece 204,244. Preformed curve can be the neutrality or expanded configuration of capture guiding piece 204,244.After discharging bridle, guiding piece is captured 204,244 will show preformed curve.Capture guiding piece 204,244 can have any curved shape.Capture guiding piece 204,244 can have single curvature radius or the multiple portions with different curvature radius.Capturing guiding piece 204,244 can part It is considered as spring loaded based on the material and shape for capturing guiding piece 204,244.In some embodiments, anchor log can be one It include non-continuous shapes in a little situations, such as hook with sharp or non-invasive part or tip.

Capture guiding piece 204,244 can have two or more leg support components 210.Leg support component 210 can be in delivery period Between it is adjacent in guiding catheter or adjacent.Leg support component 210 can during being delivered with contracted configuration relatively flat row or side by side.It shrinks Leg support component 210 can define the diameter or section different compared to the complete extension of capture guiding piece 204,244 or neutral configuration. In some embodiments, shrinking leg support component 210 enables capture guiding piece 204,244 shrinking tool when in guiding catheter There are small diameter or section.For example, when capturing the extension completely of guiding piece 204,244, the circle of guiding piece 204,244 is captured Define diameter in shape part.For non-circular capture guiding piece 204,244, when circle can extended completely by capturing guiding piece 204,244 Uniform section.When shrinking leg support component 210, the circular portion of capture guiding piece 204,244 is defined less than previous extension configuration Diameter.Capture guiding piece 204 may include a part and both ends as shown in Figure 58 A, form continuous ring configuration.Capture is drawn Guiding element 244 may include the multiple portions as shown in Figure 58 B and form discontinuous ring.

During extension, leg support component 210 can make to capture the outside offset of guiding piece 204,244 to show capture guiding piece 204,244 neutral configuration.Leg support component 210 can be in the neutral configuration of capture guiding piece 204,244 with relative to each other Certain angle positioning.Leg support component 210 may include one or more bending sections to promote the folding of capture guiding piece 204,244. One or more bending sections aloow capture guiding piece 204,244 along the longitudinal axis of guiding catheter with low profile configuration folding It is folded.

Figure 59 shows the one aspect of the opening of ALTC device 201.ALTC device 201 or part thereof of end are attached to Capture guiding piece 204.Although capture guiding piece 204 is shown in Figure 59, any capture guiding piece or its component can be connected to The end of ALTC device 201.The end of ALTC device 201 and capture guiding piece 204 form component.Component can be encapsulated in soft To form polymer coated or ring 245 in polymeric material.It is polymer coated can fully enclosed component or part of it.In illustrated reality It applies in example, the end of polymer coated encapsulation ALTC device 201 and a part of capture guiding piece 204.It is polymer coated to encapsulate tool There is the circular portion of constant or substantially constant diameter capture guiding piece 204.It is polymer coated to encapsulate entire ALTC device 201, Or its any a part.The region for polymer coated vacancy/be not present allows to be easily moved.For example, between leg support component Region can vacancy.Area of absence can promote capture guiding piece 204 and shrink.In some embodiments, it is optionally coated with poly- Close coating.In some embodiments, polymer coated a part for forming ring or ring.It is polymer coated to be coated to material capture member Outside part, such as net element 208.It is polymer coated to be coated to inside net element 208.It is polymer coated to be coated to entire basket Mesh element 208 is to encapsulate net element 208.

Figure 60 shows the one aspect of the opening of ALTC device 201.ALTC device 201 may include central longitudinal axis.Outside Sheath 203 may include longitudinal axis.Internal propeller 202 can extend along the longitudinal axis of epitheca 203.The center of ALTC device 201 Longitudinal axis can be deviated from the longitudinal axis of epitheca 203.The central longitudinal axis of ALTC device 201 can be from internal propeller 202 Longitudinal axis offset.Capture guiding piece 204 can define the offset.For example, the central longitudinal axis of ALTC device 201 It may include the central point of the circle generated by capture guiding piece 204.The central point of capture guiding piece 204 can be deviated from epitheca 203.Such as Described herein, the end of ALTC device 201 is connected to internal propeller 202.ALTC device 201 from epitheca 203 by discharging A part of ALTC device 201 and axial elongation.The ALTC device 201 of release follows inside propeller as shown in Figure 59 202 a part.The release part of ALTC device 201 is bent outwardly and shows the diameter of capture guiding piece 204.ALTC device 201 can form overturning shape, and wherein a part of ALTC device 201 is shunk and ALTC device 201 near internal propeller 202 A part extend to capture guiding piece 204 diameter or section.In some embodiments, the shape of ALTC device 201 can class The pipe being similar in pipe.In some embodiments, ALTC device 201 can be considered telescopic.

The perspective view of another system is shown in Figure 61.The proximal end of Figure 62 display system and the distal end of Figure 63 display system. The sub-component of Figure 64 display system.Figure 61-64 is also shown according to some embodiments of the present invention, it may include in material capture system The non-limiting example of various possible elements in system.As shown in Figure 61, in some embodiments include it is any number of (such as One, two or more) with lower component: anchor elements 221, core filaments and basket assembly 222, anchor log and propulsion component 223, proximal catheter component 224 and distal catheter component 225.Anchor elements 221 may include about or at least about one, two, Three, four, five or more are configured to fasten the anchor log 241 of clot.Anchor log and propulsion component 223 include one A or multiple anchor logs 241 and anchor log propeller 240.Anchor log can be connected to propeller as described herein.Core filaments and basket Component 222 may include core filaments 242 and ALTC device 201.Proximal catheter component 224 may include with one, two or more The axis of inner cavity, such as dual lumen shaft 243.Figure 61 shows the dual lumen shaft 243 of system.Dual lumen shaft 243 could attach to as described herein Stop blooding shell 206.Dual lumen shaft 243 can be connected to capture guiding piece 204 via connector 205.Shown embodiment shows double Chamber axis, but it is also covered by other configurations.In some embodiments, axis has single inner cavity.In some embodiments, axis is multi-cavity Axis.Axis can have about or a greater than about inner cavity, two inner cavities, three inner cavities, four inner cavities, five inner cavities, six inner cavities, seven A inner cavity etc..In some embodiments, anchor log 241 is single ring.In some embodiments, anchor log 241 is continuous loop.In In some embodiments, anchor log 241 has closed perimeter.In some embodiments, anchor log 241 has open perimeter.One In a little embodiments, anchor log 241 forms circular shape.In some embodiments, anchor log 241 forms ellipse.In some realities It applies in example, anchor log 241 forms any round sealed shape.

Figure 62 is shown including core filaments and basket assembly 222, anchor log and propulsion component 223 and proximal catheter component 224 System proximal end.Core filaments and basket assembly 222 and anchor log and propulsion component 223 can reside in the independence of dual lumen shaft 243 In chamber.System may include core filaments 242.Core filaments 242 may include any of component or serve as internal propeller 202.Core filaments 242 Propeller locking device 246 can be connected to.Anchor log propeller 240 can extend across propeller locking device 246.Propeller lock Determining device 246 can move along the axis of anchor log propeller 240.In some embodiments, propeller locking device 246 can limit anchor Determine the extension of part 241.In some embodiments, propeller locking device 246 can by make anchor log and propulsion component 223 with Propeller locking device 246 is adjacent and provides tactile response when anchor log 241 is unfolded.

Figure 63 shows distal catheter component 225.Distal catheter component 225 may include any in elements illustrated herein It is a.Distal catheter component 225 may include ALTC device 201.Distal catheter component 225 may include outer shaft 203 and capture guiding piece Connector 205 between 204.

Figure 64 shows anchor elements 221.Anchor elements 221 may include one or more anchor logs 241.Anchor log Component 221 can include about or an at least about anchor log, two anchor logs, three anchor logs, four anchor logs, five anchorings Part, six anchor logs, seven anchor logs, eight anchor logs, nine anchor logs, ten anchor logs are greater than ten anchor logs 241. Shown embodiment shows three anchor logs, but is also covered by other configurations.Anchor elements 221 may include anchor log propeller 240.Anchor log propeller 240 may include the slender member comprising axis.Anchor log propeller 240 can be in dual lumen shaft 243 to close End extends.Anchor log propeller 240 or part thereof can be proximally through proximal catheter component 224.Anchor log propeller 240 or its Part can be proximally through propeller locking device 246.Anchor log propeller 240 or part thereof may be connected to Luer hub.Anchor Determining part component 221 may be included in dual lumen shaft 243.One or more anchor logs 241 can join in the distal end of anchor log propeller 240 It connects.One or more anchor logs 241 can be an anchor log or multiple anchor logs 241.Anchor log can be connected in series to anchoring Part propeller 240, and be regularly or irregularly spaced apart.In some embodiments, diameter of the anchor log 241 in extension is small Diameter when capture guiding piece 204 is in extension.In some embodiments, diameter of the anchor log 241 in extension is less than ALTC Diameter of the device 201 in extension.Anchor log 241 can be designed to cooperate when ALTC device 201 extends in ALTC device 201 It is interior.In some embodiments, anchor log can form symmetrically or non-symmetrically ring-shaped to surround and stablize a part of clot.One In a little embodiments, anchor log can be mesh or knitting element.In some embodiments, anchor log can be balloon.In some realities It applies in example, mesh grid and the combination of balloon may be present.In some embodiments, anchor log 241 can have thin attached by it The part that long component extends radially outwards.

Figure 65 shows the distal end of ALTC device 201 and the side view of anchor log 241.Anchor log 241 may include or similar In any of the component of capture guiding piece 204,244 as described herein.Each anchor log 241 can form continuous shape, or Discontinuous shape is formed in other embodiments.Each anchor log 241 may include leg support component 228.Leg support component 228 can be by anchor Determine part 241 and is converted into periphery shape from axial direction.Periphery shape can be the circle as shown in Figure 64.Anchor log 241 can shape At continuous loop.Anchor log 241 may include discontinuous circumference, such as discontinuous ring.Anchor log 241 can be made of metal material.One In a little embodiments, anchor log 241 is formed by shape memory metal, such as Nitinol.Anchor log 241 can be round, ellipse, semicircle Shape or any combination thereof.Each anchor log 241 may include preformed curve.Two or more anchor logs 241 can have Identical preformed curve.Two or more anchor logs 241 can have different preformed curves.It is pre-formed Curve can be formed during manufacturing anchor log 241.Preformed curve can be the neutrality or expanded configuration of anchor log 241. After discharging bridle, anchor log 241 can show preformed curve.The preformed curve of anchor log 241 can be with The preformed curve for capturing guiding piece 204 is similar.Anchor log 241 can have the curvature different from guiding piece 204 is captured half Diameter.As described herein, anchor log 241 can have than capturing 204 smaller diameter of guiding piece.Alternatively, anchor log can have and catch Obtain the identical or bigger diameter of guiding piece.In some embodiments, anchor log includes the element with barb to be attached to clot.In In some embodiments, anchor log is non-invasive and does not include any with barb or other sharp surfaces.

Anchor log 241 can have two or more leg support components 228.Leg support component 228 can guide during delivering It is adjacent or adjacent in conduit and relatively parallel.Leg support component 228 can during being delivered with contracted configuration relatively flat row or side by side. Contraction leg support component 228 is comparable to define different-diameter or section in the complete extension of anchor log 241 or neutral configuration.Some In embodiment, shrinking leg support component 228 allows anchor log 241 shrinking when in guiding catheter with small diameter or section. For example, when anchor log 241 extends completely, the circular portion of anchor log 241 defines diameter.For non-circular anchor log 241, anchor log 241 can define section in complete extension.When shrinking leg support component, the circular portion of anchor log 241 is defined Less than the diameter of previous extension configuration.Anchor log 241 may include the part as shown in Figure 64 to form continuous ring configuration. Anchor log 241 may include the multiple portions similar with capture guiding piece 244 shown in Figure 58 B.Anchor log 241 have relative to The shape that two or more leg support components 228 are bent outwardly.

Anchor log 241 may include expanding location as shown in figure 65.In the case where shape-memory material, expanding location It can be the middle position of material.Anchor log 241 can be configured to be folding or bending over during delivering.Anchor log 241 can deliver Period shows low profile configuration.Spread anchorage part 241 can have any shape, including circle, annular, ellipse etc..Anchoring Part 241 is removing bridle, as extended to its pre-form shape after epitheca 203, delivery catheter or other restraining structures.

The expanding location of anchor log 241 can be defined by angle, θ.In some embodiments, from leg support component 228 to anchor log 241 circular portion measurement angle θ.In some embodiments, from the horizontal to vertical extension measurement angle θ of anchor log 241. In some embodiments, the expansion measurement angle θ from dual lumen shaft 243 to anchor log 241.In some embodiments, angle, θ It determines the vertical of anchor log 241 or is substantially vertically oriented.Each anchor log 241 in multiple anchor logs 241 can have identical Angle, θ.If anchor log 241 is arranged in a series of, angle, θ can be equably identical.Two or more anchor logs 241 can have There are equal angular θ, or the angle in mutual about 30,25,20,15,10,5,4,3,2,1 or more low-angle.

Each anchor log 241 in multiple anchor logs 241 can have different angle θ.Two or more anchor logs 241 can With different angle θ.If anchor log 241 is arranged in a series of, the anchor log 241 of the series can also have angle, θ Difference variation.For example, the first anchor log 241 can have a first angle θ, such as from about or at least about 45 °, such as in some cases Between about 0 ° and 90 °, between about 15 ° and 75 ° or between about 30 ° and 60 °.Then or close to anchor log 241 There can be second angle θ, such as 135 °.Then or there can be third angle θ close to anchor log 241, such as 45 °.The series can be after Continue and replaces between 45 ° and angle needed for 135 ° or other.In some embodiments, the anchor log of the series can have difference Diameter.

In some embodiments, two or more anchor logs 241 can form mirror image.In some embodiments, two or More anchor logs 241,241 can extend from dual lumen shaft 243, so that the circular portion of an anchor log 241 substantially projects On the circular portion of another anchor log 241.In some embodiments, two or more anchor logs 241 can be upper identical in orientation Or it is substantially the same.In some embodiments, two or more anchor logs 241 can be coaxial.In some embodiments, two or More anchor logs 241 have being differently directed relative to dual lumen shaft 243.In some embodiments, two or more are anchored Part 241 is not coaxial.In some embodiments, the first anchor log 241 has the circular portion for extending through the first anchor log 241 First axle and the second anchor log 241 have the second axis of the circular portion for extending through the second anchor log 241.In some embodiments In, first axle and the second axis can deflections.In some embodiments, first axle and the second axis are vertical.In some embodiments, First axle is parallel with the second axis.In some embodiments, first axle and the second axis are coaxial.

In some embodiments, angle, θ can be within the scope of 5 ° to 175 °.The example of angle, θ include 5 °, 10 °, 15 °, 20°、25°、30°、35°、40°、45°、50°、55°、60°、65°、70°、75°、80°、85°、90°、95°、100°、105°、 110 °, 115 °, 120 °, 125 °, 130 °, 135 °, 140 °, 145 °, 150 °, 155 °, 160 °, 165 °, 170 °, 175 ° etc., and simultaneously Enter the range of any two aforementioned value.The example of angle, θ can be in 0-20 °, 20-40 °, 40-60 °, 60-80 °, 80-100 °, 100- In 120 °, 120-140 °, 140-160 °, 160-180 ° etc. of range.In some embodiments, angle, θ may be about 90 °.In In this embodiment, anchor log 241 can be roughly vertical relative to dual lumen shaft 243.In some embodiments, angle, θ may be about 45°.In this embodiment, anchor log 241 can form acute angle relative to dual lumen shaft 243.In some embodiments, angle, θ can be About 135 °.In this embodiment, anchor log 241 can form obtuse angle relative to dual lumen shaft 243.

Anchor log and propulsion component 223 or part thereof can move in dual lumen shaft 243.In some embodiments, it is anchored Part and propulsion component 223 can the intracavitary coaxial movements in dual lumen shaft 243.Anchor log and propulsion component 223 can be relative to Core filaments and basket assembly 222 independently move.In some embodiments, anchor log and propulsion component 223 can be with core filaments and basket group Part 222 is mobile simultaneously.In some embodiments, anchor log and propulsion component 223 can relative to dual lumen shaft 243 to distal end or to Advance proximal end.In some embodiments, anchor log and propulsion component 223 do not influence the movement of ALTC device 201.One or more A anchor log 241 can be moved independently of ALTC device 201.As described herein, one or more anchor logs 241 can be relative to solid It is mobile to determine ALTC device 201.As described herein, ALTC device 201 can be mobile relative to fixed anchor log 241.

Figure 66 shows the distal end of ALTC device 201 and the top view of anchor log 241.One or more anchor logs 241 can It is connected to distal end propeller 226.In some embodiments, the supporting leg extension 228 of anchor log 241 is connected to distal end propeller 226.In some embodiments, the expansion measurement angle θ from distal end propeller 226 to anchor log 241.In illustrated reality It applies in example, each anchor log 241 is connected to distal end propeller 226.The movement of distal end propeller 226 causes the anchoring being coupled It is mobile while part 241.In alternative embodiments, two or more distal end pushers 226 are provided.Two or more distal ends Each of pusher 226 controls the movement of one or more anchor logs 241.Two or more distal end pushers 226 can It independently moves, so that two or more anchor logs 241 can independently move.Cover other configurations.Distal end propeller 226 can It is connected to crescent propeller 227.In some embodiments, crescent propeller 227 can be distally advanced device 226 and provide just Property.Distal end propeller 226 and crescent propeller 227 can be attached via welding, bonding, mechanical disturbance etc..

Figure 67 shows the distal end of ALTC device 201 and the front view of anchor log 241.Dual lumen shaft 243 is shown in cross section. In some embodiments, dual lumen shaft 243 provides the inner cavity for anchor log and propulsion component 223 and is used for core filaments and basket group The inner cavity of part 222.Two inner cavities are separable, so that the movement of a component does not influence the movement of another component.Cover other structures Type.

Core filaments and basket assembly 222 include core filaments 242.Display core filaments 242 are placed in an inner cavity of dual lumen shaft 243.Core Silk 242 may include any of the feature or function of internal propeller 202 as described herein.Compress basket or compression ALTC device 201 are placed in the inner cavity of dual lumen shaft 243 identical with core filaments 242.Compression ALTC device 201 can have contraction as described herein Any of the feature or function of part 208.Show the outer shaft of dual lumen shaft 243.

Anchor log and propulsion component 223 may include distal end propeller 226 and crescent propeller 227 as described herein. Crescent propeller 227 can be connected to anchor log propeller 240 as described herein.In some embodiments, distal end propeller 226, crescent propeller 227 and anchor log propeller 240 integrally or are integrally formed.In some embodiments, it distally pushes away It is a part of anchor log propeller 240 into device 226.The crescent shape of crescent propeller 227 can prevent crescent propulsion Device 227 rotates in dual lumen shaft 243.Crescent propeller 227 shows the inner cavity of dual lumen shaft 243.

Anchor log 241 can be connected to anchor log propeller 240 so that the movement of anchor log propeller 240 cause one or The movement of multiple anchor logs 241.Anchor log 241 can be connected to distal end propeller 226, so that the movement of distal end propeller 226 is drawn Play the movement of one or more anchor logs 241.In some embodiments, anchor log 241 may be welded to distal end propeller 226.Anchor Determine part 241 and is arranged such that anchor log 241 is coaxial along central longitudinal axis 230.As shown in the embodiment illustrated, due to The coaxial property of anchor log 241, an only visible anchor log from front view.

ALTC device 201 extends as shown in figure 67.The outer diameter 232 of anchor log 241 is smaller than basket or ALTC device 201 Internal diameter 233 so that ALTC device 201 capture anchor log 241.Depending on the axial length of ALTC device 201, ALTC device 201 can capture one or more anchor logs.The axial length of ALTC device 201 can be based on ALTC device 201 from dual lumen shaft 243 Release is to adjust.When the longer portion of ALTC device 201 is released, 201 axial elongation of ALTC device.As described herein, In When ALTC device 201 extends, ALTC device 201 is held in constant diameter or section.In ALTC 201 axial elongation of device, catch Obtain the shape that guiding piece 204 maintains extension ALTC device 201.The diameter for capturing guiding piece 204 is less than the outer diameter of anchor log 241 232。

Capture guiding piece 204 may act as centralizer to determine the center of system in the blood vessels.Capturing guiding piece 204 can For the diameter or cross sectional shape similar with blood vessel.In some application methods, when capturing the extension of guiding piece 204, capture guidance Part 204 is less than the diameter of blood vessel.In some application methods, when capturing the extension of guiding piece 204, capture guiding piece 204 is substantially Equal to the diameter of blood vessel.In some application methods, when ALTC device 201 extends, ALTC device 201 is less than the straight of blood vessel Diameter.In some application methods, when ALTC device 201 extends, ALTC device 201 is substantially equal to the diameter of blood vessel.Some In application method, ALTC device 201 contacts the vascular wall of blood vessel.In some application methods, ALTC device 201 does not contact blood vessel Wall.

Capturing guiding piece 204 may include central longitudinal axis 231.In some embodiments, dual lumen shaft 243 can be vertical from center It is deviated to axis 231.In some embodiments, dual lumen shaft 243 can be with the coaxial (not shown) of central longitudinal axis 231.Anchor log 241 may include central longitudinal axis 230.In some embodiments, dual lumen shaft 243 can be deviated from central longitudinal axis 230.One In a little embodiments, dual lumen shaft 243 can be with the coaxial (not shown) of central longitudinal axis 230.In some embodiments, anchor log 241 Central longitudinal axis 230 can from capture guiding piece 204 central longitudinal axis 231 deviate.In some embodiments, anchor log 241 central longitudinal axis 230 can be with the coaxial (not shown) of central longitudinal axis 231 of capture guiding piece 204.In some implementations In example, dual lumen shaft 243 can be located at the adjacent edges of capture guiding piece 203.Cover other configurations.

Figure 68 A-69C is shown according to some embodiments, captures endovascular clot.Figure 68 A is shown in initial deployment The ALTC device 201 of configuration.As shown in Figure 68 A, ALTC device 201 can be overall in initial deployment in some embodiments The reticular structure of upper half spherical shape.Reticular structure is initial foldable in guiding catheter or epitheca 203.Guiding catheter is by ALTC device 201 are delivered to the required position of patient's body.Capture guiding piece 204 is released from the constrained condition in guiding catheter or epitheca 203 It puts.Capture guiding piece 204 is extended to cross sectional shape.In some embodiments, capture guiding piece is extended to round or annular Shape.

ALTC device 201 is extended to the diameter provided by capture guiding piece 204 or section.In some application methods, ALTC device 201 is extended by removing bridle.ALTC device 201 can be discharged from guiding catheter.Guiding catheter can bounce back with Allow to capture guiding piece 204 to extend.In some application methods, ALTC device 201 can be by the retraction of dual lumen shaft from dual lumen shaft Release in 243.As described herein, an end section of ALTC device 201 is connected to capture guiding piece 204.ALTC device 201 It may include the tubular mesh with distal end.ALTC device 201 may include dynamic folding point as described herein, so that from double After chamber axis 243 discharges, tubular reticulum becomes overturning.ALTC device 201 may include in the point for being connected to internal propeller 202 to close Hold the reservation radial compression part in the dual lumen shaft terminated.In some application methods, the expansion of ALTC device 201 is located at Clot distal end.Epitheca 203 be located at clot proximal end, close to or within.

Figure 68 B shows the ALTC device 201 in initial deployment configuration.As described herein, core filaments and basket assembly and anchor Determining part and propulsion component can independently activate.When epitheca 203 proximally bounces back, the first anchor log 241 is releasable.First anchor Determining part 241 may include shape-memory material, so that the first anchor log 241 shows expanded configuration.First anchor log 241 can expand Exhibition, so that the first anchor log 241 is defined by angle, θ.First anchor log 241 is extended to expanded configuration from low profile configuration.Low wheel Wide configuration aloows anchor log 241 to be resided in epitheca 203 during delivering.In some other or substitution application method In, the first anchor log 241 can the release when anchor log propeller 240 is distally advanced.

The anchor log of release can be firmly-fixed to clot.In some application methods, the first anchor log 241 can become to twine It ties in clot.In some application methods, the first anchor log 241 can be resident for clot.In some application methods, first Anchor log 241 can be designed to push clot.In some application methods, the first anchor log 241 can be designed to be run through The sweeping of clot.Sweeping can be on circular arc of angle, θ or part thereof.Sweeping can make clot or part thereof broken.

Figure 68 C shows the ALTC device 201 in initial deployment configuration.When epitheca 203 proximally bounces back, the second anchoring Part 241 is releasable.In some application methods, the second anchor log 241 can be released when anchor log propeller 240 is distally advanced It puts.Second anchor log 241 may include shape-memory material, so that the second anchor log 241 shows expanded configuration.Second anchor log 241 is expansible, so that the second anchor log 241 is defined by angle, θ.As described herein, the first anchor log 241 and the second anchor log 241 can have the identical or different orientation about angle, θ.

Figure 68 D shows the ALTC device 201 in initial deployment configuration.In some application methods, third anchor log 241 It can be discharged when epitheca 203 proximally bounces back.In additional or alternate embodiment, third anchor log 241 can be promoted in anchor log Release when device 240 is distally advanced.Third anchor log 241 may include shape-memory material, so that third anchor log shows expansion Open up configuration.Third anchor log 241 is expansible, so that third anchor log 241 is defined by angle, θ.As described herein, the first anchor log 241, the second anchor log 241 and third anchor log 241 can have the identical or different orientation about angle, θ.

First anchor log 241, the second anchor log 241 and third anchor log 241 can be designed to be fixed to clot.Anchor log 241 arrangement can be designed to promote to engage with clot.For example, the number of anchor log, the spacing of anchor log, anchor log Sectional dimension, the shape of anchor log, anchor log relative to the orientation of anchor log propeller, angle, θ, supporting leg extension shape, Shape-memory material shows the rapidity of neutral shape, the hardness of material and other factors can be optimized to promote anchor log 241 with the engagement of clot.

ALTC device 201 and anchor log 241 can proximally bounce back to remove clot.In some application methods, ALTC dress Deported embolism or clast during removing clot can be captured by setting 201.In some application methods, ALTC device 201 is located at blood Pipe downstream is to capture clast.The curved distal end of ALTC device 201 may act as net.In some application methods, anchor log 241 can be broken Bad clot enables to more easily remove clot.In some application methods, the sweeping of expansion anchor log 241 can make clot It splits off.

Figure 69 A-69C shows the axial elongation sequence of ALTC device 201 in accordance with some embodiments.Two-chamber sheaths 243 It can bounce back with axial elongation ALTC device 201.When two-chamber sheaths 243 bounce back, capture guiding piece 204 bounces back, because capture is drawn Guiding element 204 is connected to two-chamber sheaths 243 via connector 205.When capturing the retraction of guiding piece 204, constriction 208 becomes expanding Open up part.Two-chamber sheaths 243 can proximally bounce back with axial elongation ALTC device 201.Alternatively or in combination, in other uses In method, capture guiding piece 204 can bounce back with axial elongation ALTC device 201, and such as bounce back two-chamber epitheca 243.ALTC device 201 Diameter or section initial deployment configuration and 69B and 69C shown in Figure 69 A shown in keep permanent between expanded configuration It is fixed.In additional or substitution application method, core filaments 242 be can be actuated with axial elongation ALTC device 201.Core filaments 242 can dispose In in dual lumen shaft 243.The actuating (such as axially along appropriate direction) of core filaments 242 will discharge the constrained part of ALTC device 201. The movement of core filaments 242 can cause axial elongation or the shortening of ALTC device 201.

Figure 69 A shows the system after anchor log 241 is unfolded.In some application methods, anchor log 241 is in axial direction It is unfolded before extending ALTC device 201.In some application methods, the one or more steps of anchor log and axial elongation is discharged It can carry out in any order.In some application methods, the first anchor log of expansion and then axial elongation ALTC device 201 are to cover The first anchor log of lid.In some application methods, be unfolded the first and second anchor logs, subsequent axial elongation ALTC device 201 with Cover the first anchor log or the second anchor log.In some application methods, the first, second, and third anchor log is unfolded, with rear axle To elongation ALTC device 201 to cover the first anchor log, the second anchor log or third anchor log.In some embodiments, two Or more step can carry out simultaneously.In some application methods, while the first anchor log and axial elongation ALTC device is unfolded 201 to cover the first anchor log.In some application methods, while the first and second anchor logs and axial elongation ALTC is unfolded Device 201 is to cover the first anchor log or the second anchor log.In some application methods, while being unfolded first, second, and third Anchor log and axial elongation ALTC device 201 are to cover the first anchor log, the second anchor log or third anchor log.

Figure 69 B shows the axial elongation of the expansion of ALTC device 201.ALTC device 201 is proximally extended to catch Obtain the clot fixed by the first anchor log 241.The compression of ALTC device 201 or constrained part in dual lumen shaft 243 reciprocally Shorten.Two-chamber sheaths 243 can bounce back with axial elongation ALTC device 201, as described herein.ALTC device 201 can encapsulate first Anchor log 241.First anchor log 241 may be sized just to cooperate after axial elongation ALTC device 201 in ALTC device In 201.

Figure 69 C shows the axial elongation of the expansion of ALTC device 201.ALTC device 201 is proximally extended to catch Obtain the clot fixed by the first anchor log 241, the second anchor log 241 and third anchor log 241.The compression of ALTC device 201 or Reciprocally shorten in dual lumen shaft 243 constrained part.Figure 69 C shows axial elongation ALTC device 201 and is enough to capture completely Clot.ALTC device 201 and anchor log 241 can proximally bounce back to remove clot.

ALTC device 201 can by from sheath discharge ALTC device 201 (its can in sheath 243 have one, two or more A inner cavity) and axial elongation, such as in working range.ALTC device 201 can axial elongation or shortening, while maintain or substantially The diameter provided by capture guiding piece 204 or section are provided.ALTC device 201 can axial elongation or shorten to fetch and capture packet The intracorporal foreign matter or other unwanted substances for including neural blood vessel system, such as clot, thrombus and/or foreign matter.

ALTC device 201 as described herein may be sized to cooperate the blood vessel in neural blood vessel system, including herein In it is other place pointed by it is any intravascular.As an example, ALTC device 201 can be used for treating artery, vein and non- Intravascular space or region.In some embodiments, device can be configured to treatment cerebral venous sinus occlusion and cavernous sinus thrombosis.Thrombus (commonly referred to as clot) is the production of the blood coagulation caused by the aggregation blood platelet and red blood cell occluding vascular that are connected by fibrin Object.Thrombus can advance (embolism), such as propagate towards heart, lung or other organs.Apoplexy, myocardial infarction can be reduced by removing thrombus And/or the risk of pulmonary embolism.ALTC device 201 is extending to have the maximum length of the whole length of covering anchor log 241, example Such as from about 0.01mm to about 100mm.Depending on blood vessel diameter, the outer diameter of ALTC device 201 can be in some embodiments between about Within the scope of 0.01 millimeter to about 10 millimeters.The diameter of ALTC device can realize reduction or extend the similar effect of ALTC assembly dia Fruit.In some embodiments, portion utilizes or needs to aspirate, and ALTC device encapsulates clot, and the clot can mechanically be drawn It is back in capture conduit.In some embodiments, as disclosed herein mechanical thrombectomy system and method can with control It treats agent and is applied in combination and/or is coated with therapeutic agent, such as one or more antithrombotics or anti-platelet agents, such as heparin, leech Element, warfarin, dabigatran (dabigatran) and/or Enoxaparin；TPA, streptokinase or urokinase, antiproliferative, it is such as peaceful Foreign taxol (taxol (Taxol)), rapamycin (sirolimus (Sirolimus)), Zuo Tamosi (zotarolimus) or Tacrolimus (tacrolimus)；And analog, depend on required clinical effectiveness.

Figure 70 A and 70B show the view of the embodiment of propeller locking system.Propeller locking system can be with this paper institute Any system stated is used together.Figure 70 A is also shown according to some embodiments of the present invention, it may include in material capture system In various possible elements non-limiting example.As shown in Figure 70 A, in some embodiments include it is any number of (such as One, two or more) with lower component: hemostasis seal 260, propeller locking device 261 and propeller 262.Stop blooding close Sealing 260 may include multiple sealing elements at the position spaced apart in propeller locking system.Hemostasis seal 260 can class It is similar to sealing element shown in Figure 21 E and 21F.Propeller locking device 261 may include propeller locking device described herein Any of 246 component.Propeller 262 may include any of the component of internal propeller 202.Propeller 262 can Any of component including core filaments 242 as described herein.Propeller 262 may include anchor log propeller as described herein Any of 240 component.

Referring initially to system shown in Figure 70 A-B, propeller 262 may include internal propeller 202 as described herein Any of component.Propeller 262 can proximally extend to distal end.In some embodiments, nose of the propeller from conduit Extend to proximal end.In some embodiments, propeller 262 is single shaft.In some embodiments, propeller 262 include one or Multiple subassemblies.Propeller 262 may include the inside guidewire lumen axis that proximal end extends distally toward.Propeller 262 may include The propeller pipe proximally extended.Internal guidewire lumen axis could attach to propeller pipe to form unitary construction.Cover other structures Type.Propeller 262 may include any material for being suitable for axial elongation ALTC device 201 as described herein.In some implementations In example, propeller 262 or its component include metal, such as stainless steel or titanium.In some embodiments, propeller pipe may include stainless Steel.

Propeller 262 can coaxially position in axis.In some embodiments, propeller 262 is placed in jackshaft.Seal wire Lumen shaft and propeller tube assembly coaxially position in jackshaft.Propeller pipe extends to except jackshaft.Propeller pipe can It is coaxially slided relative to jackshaft to elongate or shorten ALTC device 201.During clinical use, if there is no for pushing away Into the locking mechanism of device 262, then user may prematurely activate unintentionally propeller pipe or jackshaft, ALTC will be unfolded in this Device 201.Propeller locking device 261 helps that propeller pipe is fastened to jackshaft during being inserted into conduit.Propeller lock Determining device 261 can unlock after extracting ALTC device 201.Propeller locking device 261 can be ready to extend in user It is unlocked when ALTC device 201.

In some substitutions and other embodiment, guidewire lumen axis and propeller tube assembly in epitheca 203 coaxially Positioning.Propeller pipe extends to except epitheca 203.Propeller pipe can coaxially be slided relative to epitheca 203 to elongate or shorten ALTC device 201.In some embodiments, propeller pipe extends to except epitheca 203, as shown in Figure 51.In clinical use Period, if there is no the locking mechanism for propeller 252, then user may prematurely activate unintentionally propeller pipe Or epitheca 203, ALTC device 201 will be unfolded in this.Propeller locking device 251 facilitates propeller pipe during being inserted into conduit It is fastened to epitheca 203.Propeller locking device 261 can unlock after extracting ALTC device 201.Propeller locking device 261 It can the unlock when user gets out elongation ALTC device 201.

Referring now to system shown in Figure 62, propeller 262 may include any in the component of core filaments 242 as described herein It is a.Propeller 262 may include any of the component of anchor log propeller 240 as described herein.Propeller 262 can be proximally Extend to distal end.Propeller 262 may include the inside guidewire lumen axis that proximal end extends distally toward.Propeller 262 may include The propeller pipe proximally extended.Cover other configurations.

Propeller 262 coaxially positions in axis.In some embodiments, propeller 262 is placed in the centre of dual lumen shaft 243 In axis.Guidewire lumen axis and propeller tube assembly coaxially position in jackshaft.Propeller pipe extends to except jackshaft.It pushes away It can coaxially be slided relative to jackshaft into device pipe to elongate or shorten ALTC device 201.During clinical use, if do not deposited In the locking mechanism for propeller 262, then user may prematurely activate unintentionally propeller pipe or dual lumen shaft 243 Jackshaft, ALTC device 201 will be unfolded in this.Propeller locking device 261 facilitates during being inserted into conduit that propeller pipe is tight Gu to jackshaft.Propeller locking device 261 can unlock after extracting ALTC device 201.Propeller locking device 261 can be User gets out unlock when elongation ALTC device 201.

In some substitutions or Additional examples of composition, propeller 262 is placed in the upper axis of dual lumen shaft 243.Guidewire lumen axis It is coaxially positioned in upper axis with propeller tube assembly.Propeller pipe extends to except upper axis.Propeller pipe can be relative to Upper axis is coaxially slided so that anchor log 241 is unfolded.During clinical use, if there is no the locking for propeller 262 Mechanism, then user may prematurely activate unintentionally propeller pipe or dual lumen shaft 243, anchor log 241 will be unfolded in this.It promotes Device locking device 261 helps that propeller pipe is fastened to dual lumen shaft 243 later during being inserted into conduit.Propeller locking device 261 can unlock after extracting ALTC device 201.Propeller locking device 261 can solve after extracting the first anchor log 241 Lock.Propeller locking device 261 can the unlock when user gets out expansion anchor log 241.

The method may include one or more of following steps in any order.Delivery catheter can be prepared.Delivering Conduit can be prepared in patient's bedside.Delivery catheter can be according to one or more instruction preparation.In some application methods, propeller 261 lockable of locking device is in place.Propeller locking device 261 can lock in place on propeller 262.In some embodiments In, propeller locking device 261 is in place by the rotation locking of locking closure 263.In some embodiments, propeller locking device 261 can be locked and rotating clockwise.In some embodiments, propeller locking device 261 can be and rotating counterclockwise Locking.

In some application methods, seal wire is located at patient's body.In some application methods, the inside of propeller 262 is led Silk lumen shaft can guide on seal wire.In some application methods, the propeller pipe of propeller 262 can guide on seal wire.In In some application methods, system is advanced on seal wire.In some application methods, delivery catheter advances to what expection was treated Region.In some application methods, delivery catheter retraction.In some application methods, epitheca 203 is bounced back so that ALTC dress is unfolded Set 201.

In some application methods, propeller locking device 251 is unlock.In some application methods, propeller lock Determine device 261 to unlock and rotating locking closure 263 counterclockwise.In some application methods, propeller locking device 261 passes through edge Opposite direction rotates locking closure 263 and unlocks.After the unlock of propeller locking device 261, ALTC device 201 is extending.Some In application method, ALTC device is extended by axially actuated jackshaft.In some application methods, ALTC device passes through axial direction It activates propeller pipe and extends.In some application methods, ALTC device is extended by axially actuated epitheca.In some uses In method, ALTC device is extended by axially actuated dual lumen shaft.Propeller locking device 261 can be used for propeller pipe is on-demand It is pasted to jackshaft.

Figure 71 A-71D shows the view of the propeller locking device 261 of the propeller locking system of Figure 70 A.Such as figure It include any number of (such as one, two or more) shown in 71A-71D, in some embodiments with lower component: locking closure 263, collet chuck 264 and lock body 265.Locking closure 263 and lock body may include matching thread.In the embodiment illustrated, locking closure 263 wraps It includes internal screw thread and lock body 265 includes external screw thread.Collet chuck 264 is placed between locking closure 263 and lock body 265.Propeller 252 or its portion Divide and is designed to be placed in collet chuck 264.Propeller 252 can extend across opening in locking closure 263, across collet chuck 264 and pass through Opening in lock body 265.Locking closure 263 further includes the ramp type surface for being designed to interact with collet chuck.When rotation locking closure 262 When, collet chuck 264 can be engaged with ramp type surface.It further rotates and collet chuck may make to shrink or be fastened on propeller 252.Cover Other configurations.

Figure 72 shows the flow chart of the embodiment of method 300.In some embodiments, method can be by ALTC device 201 End be assembled to capture guiding piece 204.The method may include one or more of following steps in any order.Step Rapid 301 may include mixing thermoplastic material and/or polyurethane, such as Pellethane solution.Solution uses such as thermoplastic poly Urethane, such as Pellethane and such as cyclic ester, mix such as tetrahydrofuran (THF).Pellethane and tetrahydrofuran (THF) mixture ratio can be in such as 1:1 and about 1:20 (Pellethane:THF) range.Pellethane and tetrahydro furan The ratio muttered may be, for example, about, at least about or no more than about 1:1,1:2,1:3,1:4,1:5,1:6,1:7,1:8,1:9,1:10,1: 11,1:12,1:13,1:14,1:15,1:16,1:17,1:18,1.19,1:20, or the range including any two aforementioned value.Step Rapid 302 may include trimming ALTC device 201.It the end of ALTC device 201 can be through rectangular trimming.Step 302 may include immersing ALTC device 201 is loaded in mandrel.Immersing mandrel can be made of polymerization and/or metal material, such as HDPE, PTFE, stainless steel. Mandrel can be not coated or coated easily fabricated to allow.Step 303 may include immersing ALTC device 201 in solution.It will The ALTC device immersed in mandrel is mounted on to be slowly immersed in Pellethane/THF solution.Step 303 may include dry ALTC Device 201.ALTC device 201 can be hung to allow drying, or dry using other mechanism.Step 304 can be related to remove ALTC device 201.Step 304 can be related to cut down excessive Pellethane.The dipping end of ALTC device 201 can encapsulate and fix basket The conductor wire end of mesh element 209 is not so that move.Dipping end can prevent the conductor wire end exposure of net element 209.ALTC device 201 It is removed from mandrel is immersed.The excessive Pellethane of the adjacent edges of ALTC device 201 is cut in.

Step 305 may include punching press or generating one or more holes in other ways in Pellethane coating.ALTC The impregnation zone of device 201 can be stamped to generate hole in pre-position to allow to place capture guiding piece.Cover in coating The middle other methods for generating hole.Step 306 may include that will capture guiding piece 204 to be inserted into punching hole.Guiding piece 204 will be captured It is inserted into punching hole.Capture guiding piece 204 may pass through the braiding of two or more holes.Capturing guiding piece can be from ALTC device 201 Side walk to the other side of ALTC device 201.Step 307 may include folding the edge of ALTC device to cover capture guidance Part 204.The dip coated edge of ALTC device 201 covers the wire loop of capture guiding piece 204 through folding.Folding can be protected and prevent Only the conductor wire end of the encapsulation of net element 209 is from protrusion.Step 308 may include suture ALTC device 201 and capture guiding piece 204.ALTC device 201 is seamed to capture guiding piece 204 using suture material.Suture material may include such as PET, PTFE, Known other materials in HMWPE or fields.Step 309 may include the perimeter suture in ALTC device.Step 309 may include suturing back stitching in perimeter.

Step 310 may include will be in ALTC device load to forming spindle.When stitching is completed, ALTC device 201 is then It is loaded on forming spindle.Step 311 may include the edge ALTC of thermoforming suture.Step 311 may include using appropriate heating Come the ALTC device edge of thermoforming suture.Forming spindle can be polymerization or metal material, such as PTFE, stainless steel.Step 312 It may include dipping ALTC device and acquisition equipment.ALTC device and acquisition equipment can immerse the Pellethane from step 301 In solution.ALTC device and acquisition equipment can immerse in another solution.Impregnation technology may include drawing ALTC device 201 and capture Guiding element 204 immerses in Pellethane/THF solution.Dipping can fix the component of ALTC device 201 and acquisition equipment 204.Step 312 may include extremely immersing the component load of ALTC device 201 and acquisition equipment 204 in mandrel.Immersing mandrel can be and step 302,303 identical immersion mandrel.Immersing mandrel can be different mandrels.For this step 312 immersion mandrel can by polymerization and/ Or metal material, such as HDPE, PTFE, stainless steel be made.Mandrel for this step 312 can be not coated or coated to permit Perhaps easily fabricated.In some application methods, material membrane or thin slice can be additionally or alternatively used for one or more impregnation steps. Film can be extruding polymerization film.Thin slice can be soft polymer, such as the thin slice of pellethane, polyurethane, tecothane. Film or thin slice can be used and be placed on the end of ALTC device.In some application methods, material membrane or thin slice can be in addition used So that the edge thermoforming of ALTC device 201.Film or thin slice can be heat fusing.Film or thin slice can be laminated together.Cover it Its manufacturing method.

Figure 73-94 shows the embodiment of anchor log.Anchor log as described herein, which can combine or substitute anchor log 241, to be made With.One or more anchor log as described herein is capable of forming anchor log assembly 221 as described herein.Anchor elements 221 It may include the pact or at least about one, two, three, four, five or more anchor log for being configured to fastening grumeleuse.In In some embodiments, two or more anchor logs in anchor elements 221 can be identical.In some embodiments, Two or more anchor logs in anchor elements 221 can be different.In some embodiments, anchor elements 221 In two or more anchor logs can be selected from anchor log as described herein.In some embodiments, anchor log is in extension Diameter be less than extension when ALTC device 201.In some embodiments, anchor log can be designed to when extension ALTC device It is matched with when 201 in ALTC device 201.In some embodiments, anchor log can be designed to and the substantially phase of ALTC device 201 With or greater than the ALTC device.In some embodiments, the distal end of ALTC device 201 has noninvasive extension flexible, Its distal end for forming system.In some embodiments, the distal end of ALTC device 201 has anchor log.In some embodiments, anchor Determining part can have any shape of a part of winding grumeleuse.In some embodiments, anchor log, which can have, makes grumeleuse A part of stable any shape.In some embodiments, anchor log can have to grumeleuse and provide any shape of radial support Shape.In some embodiments, anchor log can have to grumeleuse and provide any shape axially supported.In some embodiments, Anchor log can have any shape for keeping a part of grumeleuse mobile, such as to distally shifting to ALTC device 201 or separate ALTC Device 201 shifts to proximal end.In some embodiments, anchor log can rotate.In some embodiments, anchor log can be moved axially It moves with break up clots.

System as described herein may include guidewire lumen 6, can be distally advanced to extend ALTC device 201.Ginseng See Fig. 5, epitheca 1, which has, is configured to capture the internal diameter that conduit 12 is coaxially accommodated therein, and capture conduit 12, the capture Conduit has the lumen for being configured to accommodate wire leading pipe 6 and 8 main body of ALTC device again.System as described herein may include promoting Device 202 or core filaments 242.Alternatively or in combination, in other application methods, the end of ALTC device 201 and internal propeller 202 connections.In the second configuration, internal propeller 202 is distally advanced so that a part of ALTC device 201 is discharged from sheath Out.As internal propeller 202 is distally advanced, a part of collapsed portion 208 becomes the extension of ALTC device 201 Point.As internal propeller 202 is distally advanced, ALTC device 201 is axially extending.In additional or substitution application method, Core filaments 242 can be activated so that ALTC device 201 is axially extending.Core filaments 242 can be positioned in dual lumen shaft 243.Core filaments 242 Actuating (as axially actuated in suitable direction) constraint portions of ALTC device 201 will be discharged.The movement of core filaments 242 can Cause 201 axially-extending of ALTC device or shortening.In some embodiments, system as described herein may include fixed leads Silk.In some embodiments, system as described herein can be promoted along seal wire.In some embodiments, system as described herein System can be slided along seal wire.In some embodiments, system as described herein may include be configured to along seal wire along Lumen.In some embodiments, seal wire is axis.In some embodiments, seal wire has lumen.In some embodiments, it leads Silk is needle.In some embodiments, seal wire is solid.In some embodiments, seal wire is flexible.In some embodiments, The effect of seal wire is the system for guiding patient's body.In some embodiments, the effect of seal wire is one or more of expanding unit A component.

System may include dual axially extending basket and anchor log acquisition equipment as described here.Anchor log can be shape At any configuration of various geometry (not shown), such as shelf-like, sacculus, coil, ring, silk thread form, as described herein Embodiment.In some application methods, anchor log can play the role of fastening embolism, thrombus or fragment and remove.In In some application methods, anchor log can play the role of broken embolism, thrombus or fragment.In some embodiments, ALTC is filled 201 are set to move together or translate with one or more anchor logs.In some embodiments, ALTC device 201 and one or more Anchor log independently or is dividually moved or is translated.In some embodiments, one or more anchor logs can be with another anchor It is mobile as a unit to determine part.In some embodiments, one or more anchor logs can be with another anchor log independently Or it is moved away.

Figure 73 shows one embodiment of anchor log 401.Anchor log 401 may include appointing for anchor log as described herein What feature.In some embodiments, anchor log 401 may include symmetrical ring-type.In some embodiments, anchor log 401 can To include asymmetric ring-type.In some embodiments, anchor log 401 may include polygon or substantially polygon.Some In embodiment, anchor log 401 includes substantially hexagon.In some embodiments, anchor log 401 has constant diameter.Some In embodiment, anchor log 401 has two or more diameters.In the embodiment illustrated, anchor log 401 has staggered Larger diameter and small diameter.In some embodiments, small diameter be it is larger-diameter be greater than 50%, small diameter is larger Diameter is greater than 60%, small diameter be it is larger-diameter be greater than 70%, small diameter be it is larger-diameter be greater than 80%, it is smaller Diameter be it is larger-diameter be greater than 90%, small diameter is approximately equal to larger diameter etc..It should also be understood that anchor log can have it is various Length.For example, anchor log, which can have, is sufficient to make anchor log the partially unfolded to accommodate the length of grumeleuse length.In addition, The rest part of anchor log compresses together with delivery catheter and can extend when needed and extend longer to accommodate length Grumeleuse.

In some embodiments, anchor log 401 can be the net, braid over braid or other reticular structures of silk or line.Some In embodiment, anchor log 401 can have pilotaxitic texture.In some embodiments, anchor log 401 can be by parallel or axial silk Or the formation of line 402.Parallel or axial silk or line can couple or be otherwise attached at junction 403.Junction 403 can It is linked together two or more silks or line 402.In some embodiments, junction 403 can staggeredly be formed netted Structure.In some embodiments, anchor log 401 forms spiral.In some embodiments, anchor log 401 forms double helix.One In a little embodiments, anchor log 401 forms helical structure.In some embodiments, anchor log 401 forms irregular netted.In In some embodiments, 401 formation rule of anchor log is netted.In some embodiments, anchor log 401 forms the knot sufficiently connected Structure.Anchor log 401 may include repetition shape or gridiron pattern shape, such as triangle, rectangular or hexagon.Anchor log, which can be used, to swash Light cutting.

Anchor log 401 may include flexible tip 404.Flexible tip 404 can play the role of noninvasive soft tip.Anchoring The opposite ends of part 401 are attached to anchor log propeller 240 and are worked with similar fashion as described herein.Flexible tip 404 can be placed in epitheca 203 as described herein.Anchor log propeller 240 can be placed in dual lumen shaft 243 as described herein It is interior.Anchor log propeller 240 can be placed in any lumen of any device as described herein, axis or conduit.Anchor log energy It is enough to be deviated to ALTC device.Anchor log can be coaxial with ALTC device.Anchor log propeller 240 and anchor log 401 can couple Together, so that the movement of anchor log propeller 240 causes anchor log 401 mobile.In some embodiments, flexible tip 404, Anchor log 401 and anchor log propeller 240, which are inserted into conduit, forms " control wire " configuration.Anchor log propeller 240 can pass through Seal wire is directed to place anchor log 401.

Figure 74 shows one embodiment of anchor log 405.Anchor log 405 may include anchor log as described herein (packet Include anchor log 401) any feature.In some embodiments, anchor log 405 can be the net of wire rod or yarn, braid over braid, swash Light cutting or other reticular structures 406.In some embodiments, anchor log is made of a silk or line.In some embodiments In, anchor log 405 can be formed by parallel or axial silk or line 406.Parallel or axial silk or line can couple at junction 407 Or it is otherwise attached to.Junction 407 can be such that two or more silks or line 406 are linked together.In some embodiments In, junction 407 staggeredly can form reticular structure.In some embodiments, junction 407 can make all silks or line 406 are linked together.In some embodiments, junction 407 is capable of forming multiple discrete sub-segments.In the embodiment shown In, anchor log 405 may include three subdivisions formed by two junctions 407.Cover other configuration (such as anchor logs 405 include two subdivisions formed by a junction 407, and anchor log 405 may include being formed by three junctions 407 Four subdivisions, anchor log 405 include five subdivisions etc. formed by four junctions 407).In the illustrated embodiment, Anchor log 405 has alternate larger diameter and small diameter, is formed by junction 407.In some embodiments, smaller Diameter is less than larger-diameter 50%, and small diameter is less than larger-diameter 40%, and small diameter is less than larger-diameter 30%, Small diameter is less than larger-diameter 20%, and small diameter is less than larger-diameter 10% etc..It should also be understood that anchor log is not limited to Individual metal, and other materials are not limited to, such as polymer material PTFE, PET, nylon (Nylon), polyethylene, PEEK, gather Propylene, polyimides.

Figure 75 shows the distal end of the acquisition equipment system including anchor log 401.The system can be placed in blood vessel 408 It is interior.The blood vessel can be any target blood of patient's body.In some embodiments, blood vessel is located in central nervous system Or coronary artery or peripheral vessel, it is such as described elsewhere herein.The system is placed in obstruction 409 or other fragments or substance Near source.In some embodiments, obstruction is blood clot.In some embodiments, obstruction is neural blood clot.In some realities It applies in example, obstruction is embolism.In some embodiments, obstruction is allochthon.

Figure 75 is shown in which the system that anchor log 401 and ALTC device 201 are unfolded.In some application methods, release Anchor log 401 and axially extending one or more steps can occur in any order.In some application methods, in ALTC Before 201 axially-extending of device, anchor log 401 is unfolded.In some embodiments, anchor log only forms single ring.In some realities It applies in example, single ring is worked in the mode similar with anchor log 401.In some application methods, anchor log 401 passes through anchoring The axial movement of part propeller 240 and be unfolded.Anchor log propeller 240 can make anchor log 401 from sheath as described herein (such as Two-chamber sheath 243) in release.In some application methods, anchor log 401 and then axially-extending ALTC device 201 is unfolded To cover anchor log 401.In some application methods, before 201 axially-extending of ALTC device is to cover anchor log 401, exhibition Open anchor log 401.In some application methods, before 201 axially-extending of ALTC device is to cover anchor log 401, partly Anchor log 401 is unfolded.In some application methods, before 201 axially-extending of ALTC device, anchor log 401 is not unfolded.One In a little application methods, after 201 axially-extending of ALTC device, anchor log 401 is unfolded.In some application methods, in ALTC Partly after axially-extending, anchor log 401 is partly unfolded in device 201.In some application methods, anchor log 401 is unfolded And axially-extending ALTC device 201 simultaneously.In some application methods, anchor log 401 is unfolded and independently axially extends ALTC Device 201.In some application methods, fixed anchor log 401 and axially-extending ALTC device 201.In some application methods, Fixed ALTC device 201 and expansion or spread anchorage part 401.In some application methods, if covered by ALTC device 201, Anchor log 401 is then only unfolded.In some application methods, if ALTC device 201 provides distal embolic protection, anchor is only unfolded Determine part 401.Anchor log as described herein can by it is as described herein it is any in a manner of work.

In some application methods, ALTC device 201 is positioned at 401 distal end of anchor log.In some application methods, ALTC Device 201 is positioned at the downstream of blood flow direction.Blood flow direction is indicated in Figure 75 with red arrow.In some application methods, ALTC device 201 is positioned at the distal end of obstruction or grumeleuse.In some application methods, ALTC device 201 is located to capture resistance Patch section.In some application methods, during grumeleuse removal, ALTC device 201 provides distal embolic protection.In some application methods In, ALTC device 201 is alternatively positioned at 401 proximal end of anchor log.In some application methods, ALTC device 201 is positioned at 401 upstream of anchor log.In some application methods, two or more ALTC devices 201 are alternatively used.In some uses In method, an ALTC device 201 is positioned at distal end and an ALTC device 201 is positioned at proximal end.In some application methods In, two ALTC devices 201 can move towards each other.In some application methods, two ALTC devices 201 can be in centre It meets position.System as described herein may include one or more ALTC devices 201.System as described herein may include as One or more ALTC devices 201 of positioning described herein.Anchor log 401 can be positioned at ALTC device in some embodiments 201 distal end (not shown).

In some application methods, anchor log 401 is positioned at 201 distal end of ALTC device.In some application methods, anchoring Part can play the role of stopping embolism.In some application methods, anchor log 401 is positioned at blood flow direction downstream, or at it Blood flow direction upstream is positioned in its embodiment.Blood flow direction is indicated by an arrow in Figure 75.In some application methods, anchoring Part 401 is positioned at the distal end of obstruction or grumeleuse.In some application methods, anchor log 401 is located to capture obstruction segment.In In some application methods, ALTC device 201 removes Declotting through extending.In some application methods, it is alternatively used two Or more anchor log 401.In some application methods, one, two or more anchor log 401 is positioned at ALTC device 201 distal end and one, two or more anchor log 401 are positioned at the proximal end of the ALTC device.In some users In method, two anchor logs 401 can move towards each other.In some application methods, two anchor logs 401 can be in interposition It sets and meets.System as described herein may include one, two or more anchor log 401.System as described herein can wrap Include the one, two or more anchor log 401 positioned as described herein.

In some embodiments, anchor log is unfolded adjacent to grumeleuse.In some embodiments, anchor log is opened up in grumeleuse It opens.In some embodiments, anchor log is unfolded in grumeleuse distal end.In some embodiments, anchor log is unfolded close to grumeleuse.One In a little application methods, anchor log 401 is unfolded in obstruction or grumeleuse.In some application methods, anchor log 401 is located to twine Around obstruction.In some application methods, anchor log 401 is positioned at the distal end of obstruction or is positioned at the downstream of blood flow direction.One In a little application methods, anchor log 401 can move to the near end and pass through obstruction.In some application methods, anchor log 401 is positioned In obstruction proximal end or be positioned at the upstream of blood flow direction.In some application methods, anchor log 401 can it is mobile to distal end and Across obstruction.In the illustrated embodiment, obstruction or grumeleuse can flow through anchor log 401.In the illustrated embodiment, obstruction or Grumeleuse can be anchored the capture of part 401.In some application methods, anchor log 401 moves after the expansion.For example, anchor Determining part 401 can be mobile to distal end, therefore keeps obstruction mobile to distal end.Anchor log 401 can move to the near end, therefore make to block It moves to the near end.In some embodiments, anchor log 401 can rotate.After anchor log 401 is unfolded, obstruction and anchor log 401 It can be moved together as a unit.After anchor log 401 is unfolded, obstruction, anchor log 401 and ALTC device 201 can be made It is moved together for a unit.In some application methods, after 201 axially-extending of ALTC device, anchor log 401 is mobile. In some application methods, before 201 axially-extending of ALTC device, anchor log 401 is mobile.

Figure 76 A-76C shows the axially-extending program of ALTC device 201 in accordance with some embodiments.ALTC device 201 Can by it is as described herein it is any in a manner of extend.In some application methods, it can be prolonged by the contraction of confinement element (such as sheath) Long ALTC device 201.When sheath is shunk, capture guiding piece 204 extends.After capture guiding piece 204 extends, ALTC device 201 a part extension.In some application methods, the sheath two-chamber sheath 243 can shrink and prolong ALTC device 201 axially It is long.In some embodiments, for two-chamber sheath 243, in some cases, constraining epitheca necessary to described device may not In the presence of.In some embodiments, two-chamber sheath 243 constrains ALTC device 201.In some embodiments, the constraint of two-chamber sheath 243 anchoring Part.In some embodiments, the load of two-chamber sheath 243 has ALTC device 201.In some embodiments, the load of two-chamber sheath 243 has one A or multiple anchor logs.In some embodiments, ALTC device 201 and one or more anchor logs are carried on the single-chamber of single-chamber sheath In.In some embodiments, ALTC device 201 and one or more anchor logs are carried in the single-chamber of two-chamber sheath.In some realities It applies in example, ALTC device 201 and one or more anchor logs are carried in the chamber out of the ordinary of sheath.In some embodiments, ALTC is filled 201 are set to promote from the single-chamber of single-chamber sheath with one or more anchor logs.In some embodiments, ALTC device 201 and one Or multiple anchor logs are promoted from the single-chamber of two-chamber sheath.In some embodiments, ALTC device 201 and one or more anchor logs It is promoted from the chamber out of the ordinary of sheath.In some embodiments, device is carried in advance in sheath/guiding piece/microtubular.In some cases Under, guiding piece/microtubular can effectively serve as sheath.

In some embodiments, ALTC device 201 maintains the diameter of capture guiding piece 204.In some application methods, ALTC device 201 can be extended by the extension of such as elements such as propeller 202 or core filaments 242.Alternatively or in combination, at it In its application method, internal propeller 202 is distally advanced so that the end of ALTC device 201 promotes.As described herein, ALTC The end of device 201 couples with internal propeller 202.In the second configuration, internal propeller 202 is distally advanced so that ALTC A part of device 201 is released from sheath.When internal propeller 202 is distally advanced, a part of collapsed portion 208 Become the expansion of ALTC device 201.When internal propeller 202 is distally advanced, 201 axially-extending of ALTC device.

Figure 76 A shows the system after anchor log 401 is unfolded.It is axial in ALTC device 201 in some application methods Before extension, anchor log 401 is unfolded.Extended acquisition guiding piece 204 and a part for extending ALTC device 201.Figure 76 A is shown Axially-extending device or ALTC device 201, wherein expansible anchor log 401 is positioned close to the open end of ALTC device 201.One In a little embodiments, expansible anchor log 401 can be independently moved, while so that ALTC device 201 is static, expansible anchoring Part 401 can proximally or distal end is shunk.In some embodiments, alternatively, anchor log 401 and ALTC device 201 can It is moved together as a unit.In some embodiments, ALTC device 201 and expansible anchor log 401 are collapsed with delivering configuration It falls into.In some embodiments, ALTC device 201 and expansible anchor log 401 are extended when being unfolded in target blood.

Figure 76 B shows the axially-extending of the expansion of ALTC device 201.In some application methods, ALTC device 201 proximally extend to encapsulate anchor log 401.In some application methods, anchor log 401 has captured obstruction or grumeleuse. In some application methods, ALTC device 201 proximally extends to encapsulate obstruction or grumeleuse.In some application methods, ALTC Device 201 proximally extends to encapsulate the only a part of anchor log 401.When ALTC 201 axially-extending of device, ALTC device 201 collapsed portion 208 shortens.In some application methods, ALTC device 201 does not extend proximally to encapsulate anchor log 401 A part.In some application methods, ALTC device 201 and anchor log 401 are still in Figure 76 A during removing Declotting Shown in position.

Figure 76 C shows the axially-extending of the expansion of ALTC device 201.ALTC device 201 proximally extends to catch Obtain the grumeleuse that anchor log 401 is fastened.In some application methods, ALTC device 201 proximally extends with external entire anchoring Part 401.When ALTC device 201 extends, the collapsed portion 208 of ALTC device 201 shortens.For example, collapsed portion 208 exists Axial length in Figure 76 C is less than Figure 76 B.The ALTC device 201 that Figure 76 C shows axially-extending is enough completely to capture solidifying Block.In some application methods, ALTC device 201 and anchor log 401 can proximally be shunk to remove Declotting.In some uses In method, when being configured shown in Figure 76 A, ALTC device 201 and anchor log 401 can proximally be shunk.Some In application method, when ALTC 201 not external entire anchor log 401 of device, ALTC device 201 and anchor log 401 can be to close It shrinks at end.

The ALTC device 201 for being unfolded and having extended in Figure 76 C is for example in length than being unfolded in Figure 76 B and extending ALTC device 201 is longer.Collapsed portion 208 be present in epitheca 203 or the inside of dual lumen shaft 243 and in Figure 76 C ratio in Figure 76 B In it is shorter.The diameter of ALTC device 201 or cross section are able to maintain constant or substantially constant during axially-extending.ALTC dress The diameter or cross section for setting 201 in some cases being capable of the configuration of the initial deployment shown in Figure 76 A and institutes in 76B and 76C It is kept constant between the extension configuration shown.In some embodiments it is possible to carry out two or more steps simultaneously.Make some With in method, in order to cover anchor log 401 simultaneously, anchor log 401 is partly unfolded and 201 axially-extending of ALTC device.

Figure 77 A-77C shows other views of system.Anchor log 405 or any anchor log as described herein can with The similar mode of anchor log 401 is unfolded.In some embodiments, 201 axially-extending of ALTC device, wherein expansible anchor log 401 position close to the open end of ALTC device 201.In some embodiments, ALTC device 201 passes through expansible anchor log 401 Extension.In some embodiments, it is remote to provide to be positioned at the distal end of obstruction, grumeleuse, embolism and/or allochthon for ALTC device 201 End protection.In some embodiments, ALTC device 201 is positioned at the downstream of distal end or blood flow direction.In some embodiments, may be used The expansion in obstruction of spread anchorage part 401.In some embodiments, ALTC device 201 passes through expansible anchor log 401 and obstruction Proximally shrink.In some embodiments, obstruction is removed.In some embodiments, ALTC device 201 is positioned at the remote of obstruction End is to provide distal embolic protection.In some embodiments, expansible anchor log 401 is unfolded and is shunk in obstruction to remove resistance Plug, while ALTC device 201 is in place.In some embodiments, ALTC device 201 is with after-contraction to remove embolism.In some realities It applies in example, expansible anchor log 401 and ALTC device 201 are shunk as a unit to remove obstruction.In some embodiments, ALTC device 201 is shunk by expansible anchor log and obstruction and removes whole device.

Figure 78 shows another embodiment of anchor log 410.Anchor log 410 may include appointing for anchor log as described herein What feature.In some embodiments, anchor log 410 may include sacculus.Balloon material can have compliance, semi-compliant, Or without compliance.In some embodiments, anchor log 410 may include spherical balloon.In some embodiments, anchor log 410 It may include oblong sacculus.In some embodiments, anchor log 410 may include one or more forming ends, including Cone, square, spherical shape, taper etc..In some embodiments, anchor log 410 may include dog bone shape, wherein increasing diameter Sacculus or stairstepping sacculus proximally and distally region have two or more different-diameters.In some embodiments, anchor Determine the sacculus that part 410 may include axially or radially upper offset.In some embodiments, anchor log 410 may include any shape Shape, including conical sacculus, taper sacculus, stairstepping sacculus, square sacculus, polygon sacculus etc..In some embodiments, The sacculus being capable of serial or parallel connection or in circumferential or radial.Other balloon features are disclosed in the U.S. submitted on the 7th of September in 2007 In patent application the 11/851st, 848, the U.S. Patent application is on July 23rd, 2013 with U.S. Patent No. 8491623 (" Vogel ") is open, and which is incorporated herein by reference in its entirety.In some embodiments, anchor log 410 has diameter. In some embodiments, anchor log 410 tool there are two types of or more than two kinds diameters.In some embodiments, small diameter be greater than compared with The 50% of major diameter, small diameter are greater than larger-diameter 60%, and small diameter is greater than larger-diameter 70%, and small diameter is big In larger-diameter 80%, small diameter is greater than larger-diameter 90%, and small diameter is approximately equal to larger diameter etc..In some realities It applies in example, two or more anchor logs 410 have same shape.For example, two or more anchor logs 410 can be in It is spherical.In some embodiments, two or more anchor logs 410 can be identical.In some embodiments, two or more Multiple anchor logs 410 have different shape.For example, the first anchor log 410 can spherical in shape and the second anchor log 410 can To be in oblong.In some embodiments, two or more anchor logs 410 have different diameters or cross section.Figure 78 Show the ALTC device 201 with single sacculus.In some embodiments, sacculus can be independently relative to ALTC device 201 is mobile.In some embodiments, sacculus and ALTC device 201 can also be shunk as a unit.For example, Figure 79 Show 410 located in series of sacculus.In some embodiments sacculus can side by side, in parallel, circumferential direction and/or radial positioning.In addition, In some embodiments, the shape of sacculus and diameter can be configured, so that there are gaps between sacculus to allow potential blood Liquid stream is dynamic.

In some embodiments, anchor log 410 can extend.In some embodiments, by extending medium (such as gas or liquid Body) it is supplied to anchor log 410.In some embodiments, anchor log 410 can extend and form rigid body.In some embodiments In, anchor log 410 can be extended so that power is transferred to obstruction, such as the power of compression or mobile obstruction.In some embodiments, it is anchored Part 410 can tighten.Extending medium can be removed from anchor log 410.In some embodiments, anchor log 410 has coarse Or texture outer surface.In some application methods, anchor log 410 is wound by obstruction as described herein or grumeleuse.In some realities It applies in example, anchor log 410 has smooth outer surface.In some embodiments, anchor log 410 can compress obstruction or grumeleuse, To get through blood vessel.Anchor log 410 can apply compressing force to obstruction during anchor log 410 extends.In some embodiments, Anchor log 410 can voluntarily be unfolded.In some embodiments, anchor log 410 may include shape-memory material to be unfolded to be anchored Part 410.

Figure 79 shows one embodiment comprising multiple anchor logs, such as the first anchor log 410, the second anchor log 410, Third anchor log 410 and the 4th anchor log 410.The system may include one or more anchor logs 410.In the implementation shown In example, the system comprises four anchor logs 410, and cover other configuration (such as two anchor logs, three anchor logs, five A anchor log, six anchor logs, seven anchor logs, eight anchor logs, nine anchor logs, ten anchor logs etc.).In some implementations In example, two or more anchor logs 410 extend simultaneously.For example, anchor log 410 can couple, and allow fluid to It is flowed between anchor log 410.In some embodiments, two or more anchor logs 410 independently extend.For example, energy Enough distinguish supply fluid to each anchor log to be used to extend, or including shared extended cavity.In some embodiments, two or more The multiple series connection of anchor log 410 extensions.In some embodiments, two or more anchor logs 410 extension in parallel.In some implementations In example, two or more anchor logs 410 tighten simultaneously.In some embodiments, two or more anchor logs 410 are independently Tighten.In some embodiments, two or more anchor logs 410 series connection is tightened.In some embodiments, two or more Anchor log 410 is in parallel to be tightened.Two or more anchor logs 410 can be coupled by extended cavity 411.Extended cavity 411 can allow stream Body delivers so that anchor log extends.

Figure 79 shows ALTC device 201, wherein a series of sacculus are positioned close to the open end of ALTC device 201.One In a little embodiments, it is mobile that sacculus can be independently relative to ALTC device 201.In some embodiments, sacculus and ALTC device 201 It can also be shunk as a unit.In some embodiments, sacculus serves as the anchor log of winding grumeleuse as described herein.In In some embodiments, the effect of sacculus is compression grumeleuse to get through target blood.Cover other functions of sacculus.In some implementations In example, sacculus has uniform size and shape, and located adjacent one another can position to increased or decrease diameter, or some There is different shape in embodiment.

System after Figure 80 shows the expansion of anchor log 410, in the blood vessel 408 containing obstruction 408.Make some With in method, before 201 axially-extending of ALTC device, anchor log 410 extends.In some application methods, make anchor log 410 One or more steps in expansion or extension and axially-extending can carry out in any order.In some application methods, make The extension of anchor log 410 and then axially-extending ALTC device 201 are to cover anchor log 410.In some application methods, two or More anchor logs 410 can extend before 201 axially-extending of ALTC device.In some application methods, by anchor log 410 It is fixed, so that anchor log 410 is without extension.In some application methods, before axially-extending ALTC device 201, make one Or multiple anchor logs 410 tighten.In some application methods, after axially-extending ALTC device 201, make one or more anchors Determine the extension of part 410.In some application methods, make the extension of anchor log 410 and simultaneously axially-extending ALTC device 201.Some In application method, extends anchor log 410 and independently axially extend ALTC device 201.In some application methods, if by ALTC device 201 covers, then extends anchor log 410.

Figure 80 shows the ALTC device 201 for being positioned at blocking remote.Figure 80 shows the sacculus extended in obstruction.In In some embodiments, one or more anchor logs 410 are positioned at the distal end of obstruction before extension.After extension, one or more A distal end anchor log 410 can push obstruction to proximal end.In some embodiments, one or more anchor logs 410 are before extension It is positioned at the proximal end of obstruction.After extension, obstruction can be pushed to the ALTC device of distal end by one or more distal end anchor logs 410 201。

In some application methods, ALTC device 201 is positioned at the distal end of anchor log 410.In some application methods, ALTC device 201 provides distal embolic protection during grumeleuse removes, similar to the filter under some cases.In some application methods In, the extension in obstruction of anchor log 410.In some application methods, anchor log 410 is located to winding obstruction.Make some With in method, anchor log 410 moves after the expansion.In some application methods, anchor log 410 is mobile simultaneously.Make some With in method, anchor log 410 is independently moved, or collaboration movement in some cases.In some application methods, anchor log 410 is mobile to distal end, therefore keeps obstruction mobile to distal end.In some application methods, anchor log 410 is moved to ALTC device 201 It is dynamic.After anchor log 410 is unfolded, obstruction and anchor log 410 can be moved together as a unit.In some application methods In, after axially-extending ALTC device 201, anchor log 410 is mobile.In some application methods, axially-extending ALTC device 201 Before, anchor log 410 is mobile.

Figure 81 shows the embodiment of anchor log 415.Anchor log 415 may include any spy of anchor log as described herein Point.In some embodiments, anchor log 415 may include disc.In some embodiments, anchor log 415 can archwise, such as It is round or cyclic annular or oval.In some embodiments, anchor log 415 can have constant or variable diameter.In some implementations In example, anchor log 415 can be in any shape, including polygon, ellipse etc..In some embodiments, anchor log 415 can In totally flat shape or there is flat surface.In some embodiments, anchor log 415 being capable of concavity, convex or another curved Curved shape.For example, the second surface that the first surface 416 of anchor log 415 can be concave and opposed with first surface 417 can be concave.For example, the first surface 416 of anchor log 415 can be in convex and opposed with first surface the Two surfaces 417 can be in convex.In some embodiments, anchor log 415 can have smooth outer surface.In some embodiments In, anchor log 415 may include roughening or perforated outer surface.Anchor log can be pasted when contacting with surface (such as vascular wall) It closes.

In some embodiments, anchor log 415 can be similar to anchor log 241 and be unfolded.In some embodiments, anchor log 415 can voluntarily be unfolded.In some embodiments, anchor log 415 may include the shape memory material that anchor log 415 is unfolded Material.In some embodiments, anchor log 415 can extend.In some embodiments, extending medium (such as gas or liquid) is supplied It should be to anchor log 415.In some embodiments, anchor log 415 can tighten.Figure 81 shows ALTC device 201, wherein individually Disc is positioned close to ALTC device 201.In some embodiments, expansible disc can be independently relative to the shifting of ALTC device 201 It is dynamic.In some embodiments, expansible disc and ALTC device 201 can also be shunk as a unit.In some embodiments Middle anchor log 415 is adjacent with ALTC device 201, side by side or is biased to the ALTC device.In some embodiments, anchor log 415 It is coaxial or be embedded in ALTC device with ALTC device.

Figure 82 shows one embodiment comprising the first anchor log 415, the second anchor log 415, third anchor log 415, 4th anchor log 415, the 5th anchor log 415 and the 6th anchor log 415.The system may include one, two or more Anchor log 415.In the illustrated embodiment, the system comprises six anchor logs 415, and cover other configurations (for example, about, At least about or no more than about two anchor logs, three anchor logs, four anchor logs, five anchor logs, seven anchor logs, eight anchors Determine part, nine anchor logs, ten anchor logs etc.).In some embodiments, anchor log 415 includes spiral or helical structure.It lifts For example, the first anchor log 415 can engage to form spiral with the second anchor log 415.Spiral shape anchor log is disclosed in for example On November 27th, 2014 PCT/IB2014/066389 submitted Fig. 6 A in, the PCT on June 4th, 2015 be used as WO 2015/079401 (" Yachia ") is open, and which is incorporated herein by reference in its entirety.

In some embodiments, two or more anchor logs 415 are unfolded simultaneously.In some embodiments, two or more Multiple anchor logs 415 are independently unfolded.For example, the first anchor log 415 and the second anchor log 415 can independently be unfolded. In some embodiments, two or more anchor logs 415 series connection expansion.For example, the first anchor log 415 can be second It is unfolded before anchor log 415.In some embodiments, two or more anchor logs 415 expansion in parallel.Figure 82 shows ALTC A series of device 201, wherein expansible discs are positioned close to ALTC device 201.In some embodiments, expansible disc can be solely It is on the spot mobile relative to ALTC device 201.In some embodiments, expansible disc and ALTC device 201 can also be used as one Unit is shunk.

Figure 83 shows the system in the blood vessel 408 containing obstruction 409.In some application methods, open up anchor log 415 Opening or extending can carry out with one or more steps in axially-extending in any order.It is axial in some application methods Extend before ALTC device 201, anchor log 415 is unfolded.In some application methods, in axially-extending ALTC device 201 to cover Before lid anchor log 410, one or more anchor logs 415 are unfolded.In some application methods, in axially-extending ALTC device After 201, one or more anchor logs 415 are unfolded.In some application methods, expansion anchor log 415 is and at the same time axial prolong Long ALTC device 201.In some application methods, if covered by ALTC device 201, anchor log 415 is only unfolded.Figure 83 shows The expansible disc for having gone out to be positioned at the ALTC device 201 of the distal end of obstruction and being unfolded in the obstruction.Shown in Figure 81 Single disc embodiment being capable of the expansion in obstruction in a similar manner.In some application methods, ALTC device 201 is positioned at anchor Determine the distal end of part 415.In some application methods, ALTC device 201 provides distal embolic protection during grumeleuse removes.Make some With in method, anchor log 415 is unfolded in obstruction or grumeleuse.In some application methods, anchor log 415 moves after the expansion It is dynamic.

Figure 84 shows one embodiment of anchor log 420.Anchor log 420 may include appointing for anchor log as described herein What feature.In some embodiments, anchor log 420 may include funnel.In some embodiments, anchor log 420 may include circle Ring shaped opening.In some embodiments, anchor log 420 can be apered to small diameter or cross from larger diameter or cross section Section.In some embodiments, anchor log 420 can be tapered along the length of anchor log 420.In some embodiments, it is anchored Part 420 can be in any generally conical shape.In some embodiments, anchor log 420 may include inflection point.In some implementations In example, anchor log 420 may include radially outer horn mouth.In some embodiments, anchor log 420 or its surface are in recessed Shape.In some embodiments, anchor log 420 or its surface are in convex.In some embodiments, anchor log 420 can have light Sliding outer surface.In some embodiments, anchor log 420 may include roughening or perforated outer surface.In some embodiments, Anchor log 420 is adjacent with ALTC device 201, side by side or is biased to the ALTC device.In some embodiments, anchor log 420 with ALTC device is coaxial or is embedded in the ALTC device.

In some embodiments, anchor log 420 is configured to net or braid over braid, laser cutting or supporting structure.Anchor log 420 Funnel shaped can aid in some cases withdrawal and comprising obstruction or grumeleuse.In some embodiments, anchor log 420 Design feature comprising facilitating funnel shaped expansion, such as withstands the edge 421 of funnel-shaped opening.In some embodiments, anchor Determining part 420 may include pillar, the pillar include shape memory or self-expanding material, as Nitinol (nitinol) or its Its supporting structure, net and/or ribbon.In some embodiments, anchor log 420 can be similar to anchor log 241 and be unfolded.Some In embodiment, anchor log 420 can voluntarily be unfolded.In some embodiments, anchor log 420 may include expansion anchor log 420 Shape-memory material.Anchor log 420 may include edge 421.Edge 421 may include capture guiding piece as described herein Any feature.

In some embodiments, the proximal openings of anchor log 420 include edge 421, and the edge is in some embodiments The form taken is radially expandable shape-memory portions or loopful shape ring structure.Edge 421 is once be detached from or from constraint Element (any sheath or pipe as described herein) releases, and extends.In some embodiments, edge 421 and net, single fisherman's knot A part connection of structure or covering 422.In some other embodiments, the proximal end of edge 421 and covering 422 is able to use Silk or polymer filaments (such as ultra-high molecular weight polyethylene, nylon, PET, PTFE) suture are in place.In some embodiments, it covers Cover material 422 includes low durometer polymeric material.

Edge 421 and/or covering 422 can be formed by such as metal, shape memory or other suitable materials.Some In embodiment, edge 421 may include ring configuration and by various geometries (as round, oval, oval, flat and Its analogous shape) Nitinol shape-memory wire formed.Edge 421 is capable of being shaped to different shape, such as annulus, oval loop, z shape Deng.In some embodiments, edge 421 is capable of being shaped to coil, multiple full circle or part circle, and wherein silk thread end forms two Lead.Part circle can be such as 180 degree to 359 degree or 220 degree to 359 degree.The lead can be configured to Off-axis, enable it relative to ring at right angle, acute angle or obtuse angle.It can it is arched and formed shown in part ring or whole Ring, and can be external or outer diameter be formed in other ways, and limit the most proximal end of anchor log 420.Anchor log 420 is some It may include the single ring or multiple rings along 422 length positioning of covering in embodiment.Anchor log 420 can be configured can be It compresses and is positioned in axocoel during introducing vascular system, wherein anchor log 420, which is configured, can be positioned coaxially at obstruction or grumeleuse It is interior.In some application methods, anchor log 420 be configured it is deployable, to wind obstruction or grumeleuse.

Figure 84 shows the ALTC device 201 with expansible funnel-like anchor log.In some embodiments, infundibulate anchor Determine part to position close to ALTC device 201.In some embodiments, infundibulate anchor log can be independently relative to ALTC device 201 It is mobile.In some embodiments, alternatively, anchor log and ALTC device 201 can be mobile as a unit.

Figure 85 shows one embodiment comprising multiple anchor logs, such as the first anchor log 420, the second anchor log 420, Third anchor log 420, the 4th anchor log 420 and the 5th anchor log 420.The system may include one or more anchor logs 420.In the illustrated embodiment, the system comprises five anchor logs 420, and cover it is other configuration (such as two anchoring Part, three anchor logs, four anchor logs, six anchor logs, seven anchor logs, eight anchor logs, nine anchor logs, ten anchorings Part etc.).In some embodiments, two or more anchor logs 420 are unfolded simultaneously.In some embodiments, two or more A anchor log 420 is independently unfolded.For example, the first anchor log 420 and the second anchor log 420 can independently be unfolded.In In some embodiments, the series connection expansion of two or more anchor logs 420.For example, the first anchor log 420 can be in the second anchor Determine to be unfolded before part 420.In some embodiments, two or more anchor logs 420 expansion in parallel.Figure 85 show have can Extend the ALTC device 201 of funnel-like anchor log.In some embodiments, infundibulate anchor log is positioned close to ALTC device 201. In some embodiments, it is mobile to be independently relative to ALTC device 201 for infundibulate anchor log.In some embodiments, it can replace Dai Di, anchor log and ALTC device 201 can be mobile as a unit.

Figure 86 shows system and obstruction 409 in blood vessel 408.In some application methods, one or more anchors are unfolded Determining one or more steps in part 420 and axially-extending can carry out in any order.In some application methods, one or Multiple anchor logs 420 are unfolded before 201 axially-extending of ALTC device.In some application methods, anchor log 420 be 201 axially-extending of ALTC device is to cover expansion before anchor log 420.In some application methods, one or more anchor logs 420 are unfolded after 201 axially-extending of ALTC device.In some application methods, expansion anchor log 420 is and at the same time axial Extend ALTC device 201.In some application methods, anchor log 420 is unfolded and independently axially extends ALTC device 201. In some application methods, if covered by ALTC device 201, anchor log 420 is only unfolded.In some application methods, ALTC device 201 is positioned at 420 distal end of anchor log.In some application methods, ALTC device 201 provides during removing Declotting Distal embolic protection.In some application methods, anchor log 420 is unfolded in obstruction or grumeleuse.In some application methods, anchor log 420 move after the expansion.

Figure 86 shows one embodiment, wherein 420 face forward of anchor log.Anchor log 420 can be from distal end 423 to close End 424 is inwardly tapered.The edge 421 of each anchor log 420 can be positioned at the distal end 423 of each anchor log 420.Figure 87 is shown System with anchor log 420, the anchor log are unfolded in the blood vessel 408 comprising obstruction 409.Figure 87 shows a reality Example is applied, wherein anchor log 420 is towards rear.Anchor log 420 can proximally 424 be inwardly tapered to distal end 423.Each anchor log 420 edge 421 can be positioned at the proximal end 424 of each anchor log 420.In some embodiments, anchor log 420 has single Configuration, such as the face forward as shown in fig. 86 of all anchor logs 420, all anchor logs 420 are as shown in Figure 87 towards rear. In some embodiments, two or more anchor logs 420 have different configuration, such as 420 face forward of the first anchor log, and Second anchor log 420 is towards rear.In some embodiments, anchor log 420 can be in face forward and towards cutting between rear It changes.In some embodiments, anchor log 420 can be configured to face forward and towards between rear proximally or distal end roll Dynamic, reversion overturns and/or changeably extends.In some embodiments, one or more anchor logs 420 can be configured in face Forwards and towards switching between rear.In some embodiments, one or more anchor logs 420 are capable of fixing as face forward Or towards rear.Figure 86 and 87 shows the ALTC device 201 for being positioned at the distal end of obstruction.Figure 86 and 87 is shown in obstruction The expansible infundibulate anchor log of expansion.

Anchor log as described herein can have any shape.Cover other expansible shapes and/or geometric form anchor log. In some embodiments, anchor log is capable of being shaped to coiled type.In some embodiments, anchor log is capable of being shaped to ring-type.In In some embodiments, anchor log is capable of being shaped to trilobes.In some embodiments, one or more anchor logs are filled to ALTC Set 201 offsets.In some embodiments, anchor log can be coaxial with ALTC device 201, and wherein anchor log can be attached to ALTC The axis of device 201.In some embodiments, this configuration allows anchor log and axially-extending device mobile as a unit.

On January 21st, 2015 submit and on August 9th, 2016 with U.S. Patent No. 9408620 disclosed in United States Patent (USP) Apply for No. 14/602,014 (" Rosenbluth ")；It submits on October 20th, 1996 and special with the U.S. on April 20th, 1999 No. 5895398 U.S. Patent Application Publication the 08/723,619th (" Wensel ") of benefit；On November 12nd, 1997 submit and At on September 7th, 1999 with No. 5947985 U.S. Patent Application Publications of U.S. Patent No. the 08/968146th (" Imran ")； It submits on January 8th, 2001 and on December 16th, 2003 with No. 6663650 U.S. Patent Application Publications of U.S. Patent No. the No. 09/756476 (" Sepetka ")；It submits and on January 11st, 2005 with U.S. Patent No. 6840950 on 2 20th, 2001 Number U.S. Patent Application Publication the 09/789332nd (" Sanford ")；On October 20th, 2009 submitted and in January, 2012 10 with No. 8092486 U.S. Patent Application Publications of U.S. Patent No. the 12/581,960th (" Berrada ")；2006 10 It months 13 days submits and in August in 2012 28 days with No. 8252017 U.S. Patent Application Publications the 11/580th of U.S. Patent No., No. 546 (" Paul ")；It submits and disclosed on October 30th, 2012 is with U.S. Patent No. 8298252 on September 22nd, 2009 U.S. Patent Application No. 12/564892 (" Krolik ") is all incorporated herein by reference in its entirety.

In some embodiments, grumeleuse therapeutic device described in Rosenbluth et al. can substitute anchoring as described herein Part uses, or is applied in combination with anchor log as described herein.Referring now to Figure 88 A-88H, the embodiment of anchor log 425 is disclosed. Referring to Figure 88 A, the radially extending portion 426 between the substantially cylindrical section 427 of anchor log 425 is by the triangle with rounding The cylinder dish type of cross section limits.Radially extending portion 426 referring to Figure 88 B, between the substantially cylindrical section 427 of anchor log 425 It is to be limited by the cylinder dish type of the triangular cross section with rounding, wherein disk diameter increases along the length of anchor log 425 Add, to form conical outer range.Radial extension referring to Figure 88 C, between the substantially cylindrical section 427 of anchor log 425 Dividing 426 is limited by the cylinder dish type with rectangular cross section.Referring to Figure 88 D, the substantially cylindrical section 427 of anchor log 425 it Between radially extending portion 426 be by having the cylinder dish type of linear (non-rounding) triangular cross section to limit.Referring to figure 88E, some radially extending portions 426 between the substantially cylindrical section 427 of anchor log 425 are by the circle with circular cross section Column dish type and other shapes with rectangular cross section limit.Referring to Figure 88 F, between the substantially cylindrical section 427 of anchor log 425 Radially extending portion 426 replaces between the cylinder dish type with T shape cross section and toroidal cross section.Referring to Figure 88 G, anchor Determining the radially extending portion 426 between the substantially cylindrical section 427 of part 425 is limited by partial cylinder dish type.Referring to Figure 88 H, Radially extending portion 426 between the substantially cylindrical section 427 of anchor log 425 is by the periphery generation by anchor log 425 Tab and convex block or protuberantia limit.In some embodiments, the surface face that anchor log as described herein is provided along anchor log Product is greater than the anchor log in uniform cylinder.In some application methods, increased surface area helps to handle and/or withdraw Obstruction or grumeleuse.

In some embodiments, anchor log 425 can have general cylindrical, during use, cross for blood solidifying Block provides flowing inner cavity.However, anchor log 425 is not limited to general cylindrical.For example, the shape can be in along its axis Generally conical, substantially spill or substantially convex, as long as such shape provides aforementioned inner cavity for blood flow.In some embodiments In, anchor log 425 also has a succession of radially extending portion 426 separated by general cylindrical part 427.In some embodiments In, grumeleuse processing unit 425 can be it is porous, so as to allow blood across its flowing.In some embodiments, anchor log 425 are made of net or braided material.The material can be elastic material, as Nitinol or alternative materials, such as cobalt chromium are closed Gold.In some embodiments, anchor log 425 can be made of silk screen, silk braid or bracket.In some embodiments, anchor log 425 can voluntarily extend.

In some embodiments, anchor log radial expansion and protrude into grumeleuse.In some application methods, anchor log is at least A part expands to the distal end of grumeleuse.Some as shown in the figure such as this paper, at least one anchor log in multiple anchor logs can The distal end of grumeleuse is positioned at after anchor log extension.In some application methods, after anchor log extension, the blood stream of grumeleuse is flowed through It is dynamic to restore.More specifically, blood now freely moves through the net of anchor log and leaves the anchor log of grumeleuse distal end.Cause This, corrects the acute pathologies of obstruction, to improve the oxygenate blood circulation of patient immediately.The extension of anchor log as described herein, Grumeleuse material can be impacted or be cut to extension or expansion.This winding can enhance the subsequent removal of grumeleuse, and reason is grumeleuse Each section be collected between radially extending portion 426；Form the mesh of radially extending portion 426；Along the diameter of anchor log 425 To longitudinal cylindrical section 427 between extension 426；And/or anchor log 425 itself is internal.

In some application methods, the expansion of anchor log 425 to the inner surface of grumeleuse force general cylindrical to extending out Zhan Li.In some application methods, this power pushes outwardly on grumeleuse material and establishes inner cavity, restores to flow by it for blood. In some application methods, the variation for extending to the outside power and capable of having generation magnitude along the axis of anchor log of general cylindrical, It is partly due to the shape of anchor log.In some embodiments, the expansion of anchor log makes anchor log relative to the system The angular orientation of axis change.In some application methods, this angle variation or torsion can improve or enhance grumeleuse material To the adhesiveness of anchor log 425.

It may include the processing dress of grumeleuse disclosed in Rosenbluth in system with ALTC device 201 as described herein It sets.ALTC device 201 can surround the grumeleuse processing unit similar to anchor log described herein.Grumeleuse processing unit has extended it Afterwards, ALTC device 201 can axially-extending to capture grumeleuse.In one embodiment, grumeleuse processing unit and ALTC device 201 Proximally direction retracts simultaneously.Then whole system is extracted out.

The grumeleuse and allochthon removal device of Wensel can substitute anchor log as described herein and use, or with it is described herein Anchor log be applied in combination.Referring now to Figure 88 I-88J, the embodiment of anchor log 428 is disclosed.Anchor log 428 can be grumeleuse Capture coil.In some embodiments, coil is made of flexible solid elasticity or elastic material, with shape memory, Such as it can be deformed into straight posture and be then return to static coil configuration.In some embodiments, coil be by The solid nitinol wires that for example, about 0.0005 inch to about 0.038 inch of diameter are made.Nitinol is in some cases due to it Super-elasticity and its shape memory and it is preferred that.It is also possible, however, to use also with elasticity or super-elasticity and with its of shape memory Its solid material, such as some synthetic plastics, metal alloy.Coil diameter can become according to the size of institute's occluding vascular.Institute That states diameter can range from about 1mm (thin vessels) to about 30mm (big blood vessel, such as pulmonary artery or inferior caval vein).Coil length It can change, but according to proximal end to distal direction, usually within the scope of about 3 to about 300mm.Since Nitinol coil has superlastic Property, therefore coil just can be made to extend to completely straight configuration using the smallest power and then re-form it when power removal Naturally static configuration.In some embodiments, coil is made of solid binary phase materials, and shape is after heating or electric current pass through It changes.In some embodiments, coil is in cone.

In some embodiments, anchor log as described herein may include shape memory body.Anchor log may include individually Silk or multiple silks.Anchor log may include one or more rings.Anchor log may include one or more spirals.In some implementations In example, ring and/or spiral are from the proximal end of anchor log to the diameter that distally can have increase.In some embodiments, ring and/or Spiral is from the proximal end of anchor log to the diameter that distally can have reduction.In some embodiments, ring and/or spiral are from anchor log Proximal end can have the diameter of variation to distal end.

The equipment of Imran can substitute anchor log as described herein and use, or be applied in combination with anchor log as described herein. Referring now to Figure 88 K, one embodiment of anchor log 429 is disclosed.Anchor log 429 can include brush.The brush is in flexibility It is formed in the distal end of elongated tubular member.Brush include by suitable soft material (such as nylon) is formed it is multiple radially extend it is rigid Hair, and the outer diameter of brush is corresponding generally to the lumen diameter limited by wall.The distal end is provided with multiple random alignments Aperture, the aperture between bristle so as to by perfusion liquid be supplied to brush.By the aperture supply perfusion liquid and In the case where being aspirated by suction hole, brush can be rotated by the proximal extremity of rotation therapy conduit.By back and forth Mobile conduit, bristle can engage in the whole length of chamber with wall to remove short grained patch.As little particle is gone It removes, they can be extracted chamber by suction hole.

The obstruction removal device of Sepetka can substitute anchor log as described herein and use, or with anchoring as described herein Part is applied in combination.Referring now to Figure 88 L-88M, blocking removal device 430 has the joint element 431 extended from insertion element 432. Joint element 431 can be moved to expanding location from collapse position.When joint element 431 is contained in sheath or other elements, connect It closes element 431 and relatively straight configuration is presented.Joint element 431 has the distal portions for forming relative closure structure, so as to Obstruction or its any part are intercepted and captured in enough captures, to prevent obstruction or part thereof migration.Joint element has proximal part, described Proximal part is formed with coil more smaller than distal portions.Proximal part is engaged with obstruction as described below.Joint element 431 preferably have multiple labels, to provide instruction for the degree that joint element extends from sheath.For example, label can be with When instruction joint element 431 exposes¹/₂、³/₄Or it is completely exposed.In this way, user can quickly propel joint element 431 release from sheath by sheath without exposure unintentionally and by joint element 431.Controllable connect can also be provided using label Close 431 diameter of element, because it is known that the diameter of joint element corresponds to different location, and different location corresponds to label.It can be with Blood vessel size is determined using marking, wherein by observing when joint element 431 is engaged with vascular wall and connecing using marker determination The size for closing element 431 positions joint element 431.

Joint element 431 is preferably made of elastic material (such as Nitinol), and in some cases, has about 0.005-0.018 inches, about 0.005-0.010 inches or about 0.008 inch of diameter.Joint element 431 can have circular Noninvasive tip, to prevent stopping loss blood trouble pipe and helping to promote by blood vessel and/or sheath.It is preferred that with radiopaque silk thread (as having Have the platinum band of 0.004 inch in width and 0.002 inch thickness) joint element 431 is wound to improve radiation impermeability.Described device It is preferred that voluntarily extending, but can also be extended with actuator.The preferably thin fibril of actuator, extension bits can be moved to for device by tensing it It sets.The advantage is that fibril extends through lumen identical with device, thus minimize device overall dimension.It should be understood that at this About in the entire discussion of device and method, any anchor log as described herein can be extended text using actuator, rather than from Row extension.Block the coil that there is the first section of removal device diameter to be greater than the second section shown in Figure 88 M.Third section Also there is the coil greater than the second section, the second section is between the first section and third section.Blocking removal device can be with With multiple alternate away minor segments and macroportion, block the ability engaged so as to enhance obstruction removal device with various.Resistance Plug removal device can have there are four the sections that the macroportion with relatively large coil and three have smaller coil, but cover tool There are other configurations of different number sections.

The expandable element of Sanford can substitute anchor log as described herein and use, or with anchor log group as described herein It closes and uses.Referring now to Figure 88 N, anchor log 433 is illustrated.Anchor log 433 can include the spiral shape connecting with the entrance of anchor log Expanded ring.Expanded ring has proximally and distally.The distal end is capable of fixing to seal wire.Alternatively, it can be embedded in the entrance of anchor log Resilient expansion material.Anchor log can include oblique " sail " in its inlet.The sail serves as extension mechanism and is exposed to blood flow to work as When spread anchorage part.In some embodiments, the entrance of anchor log is coated with hydrogel coating, and the hydrogel coating connects with blood It is swollen after touch and plays the role of extending filter inlet.

The filter device of Berrada can substitute anchor log as described herein and use, or with anchor log group as described herein It closes and uses.Referring now to Figure 88 O, anchor log 434 can be overturning filter.Overturning filter includes flexible netted filtering body.It crosses Filter body can be formed by multiple silks or line, can pass through a variety of methods (such as woollen yarn knitting, knitting, braiding, spiral wound and reversed Winding) it is used to form netted filtering body.The net can be fused in some or all fibers or tow crosspoint.The net can also Electrospinning forms, and is formed by thin slice or film, and the thin slice or film have through laser drill, punching press, selective dissolution Component etc. is formed by hole.The tow can be formed by materials such as such as silk threads, and the material can be wire or polymerization Object silk.The silk thread can have substantially circular cross section or can have the rectangular, rectangle of any number or not advise Then cross-sectional profiles.The network optimization is selected from row extension.Voluntarily extension net can completely or partially by voluntarily extend Nitinol, Ai Erluoyi elgiloy (Elgiloy), titanium or stainless steel wire etc. and a combination thereof are formed.Voluntarily extension net can also be by work Journey polymer (such as liquid crystal polymer, PEEK, polyimides, polyester etc.) formation.Preferred net is formed by nitinol wires, Can thermal finalization at desired expanded configuration.The network optimization choosing energy thermal finalization is at desired biased shape.Another net is It is elastomeric, and desired expanded configuration is pre-formed by mechanical overstress.The network optimization gated plating, core filaments, Tracer silk or with good X-ray absorption feature (compared to human body) filler be made for it is radiopaque.The net can be It is partially or completely radiopaque.

It can be found that the filtering body has multiple holes or opening between filtering body tow or silk thread.In filtering body Hole has average pore size, wherein individual apertures can become according to the position in filtering body.The filtering body is close in filtering body Proximal openings are also formed in end regions.It is also believed that filtering body has internal in filtering body and has limit outside filtering body Fixed outside.The overturning shape of filter, which is defined, overturns surface region or cavity sidewalls as the overturning cavity on boundary or recessed using filtering body Face region and filtering body distalmost end range.Figure 88 O is inspected it can be found that proximal loop is relative to distal loop axial translation while protecting It holds filtering body diameter unanimously and can change the overturning degree of filtering body.The filtering material for occupying distal-most region therefore can basis The overturning degree of filter and become, the different location of the filtering body of distalmost end becomes according to overturning degree.The length of distal cavities It will increase with overturning and increase.

The filter device of Paul can substitute anchor log as described herein and use, or combines and make with anchor log as described herein With.Referring now to Figure 88 P-88Q, anchor log 435 and anchor log 436 are overturn.Anchor log 435 is overturn and the spill of forming face proximally Geometry.Filter-portion can be by moving to the near end control line, thus pulling back the first end of filter-portion It is overturn to the rest part of filter-portion.In addition, filter-portion can also be made of shape-memory material, so that filtering There are two types of the geometries defined for device part tool.For example, Web materials can be made of marmem, to make net Shape material at the first temperature, under non-rollover states be biased to straight tube-like geometry.First temperature is for example, by flowing through guiding Element, the fluid control for flowing through medical apparatus.Under second temperature (such as endovascular environment temperature), filter-portion is biased to face Spill geometry proximally.When filter-portion is biased to the spill geometry towards proximal end, filter-portion overturning, Filter-portion 1 is caused to extend against blood vessel.While medical apparatus is extended against blood vessel, filter-portion is used for The embolism for being detached from narrow zone, possible fragmentation is collected, to prevent the relatively thin vessels in such embolic occlusive medical apparatus downstream.It turns over When turning, the first end of filter-portion deviates and is pressed against blood vessel, forces fluid to flow through and is formed by filter-portion The spill geometry towards proximal end.Therefore, embolism is retained in the remote area of the spill geometry towards proximal end. Medical apparatus keeps this extended mode during intervening step to capture any fragmentation embolism for being detached from stenosis area.It is complete to intervene step At later, medical apparatus can be removed.It, can further proximally traction control in order to which embolism is retained in filter-portion Line, to pull filter-portion against guide element.

For anchor log 436, control line extends through the tubulose geometry of filter-portion.Correspondingly, it controls Line forms frame structure along the length of filter-portion.Control line can be by synthetic material, stainless steel or marmem (such as Nitinol) is made.The shape memory characteristics of control line can be used for supporting the first end of filter-portion against intravascular Wall.Support filter-portion against vascular wall ensure fluid by flow through by the filter-portion overturn formed towards close Thus the spill geometry at end promotes medical apparatus to retain embolism.

The cage of Krolik can substitute anchor log as described herein and use, or be applied in combination with anchor log as described herein. Referring now to Figure 88 R, anchor log 437 may include dipping cage.In general, dipping cage include closed proximal end or first end and Open distal end or second end.The cage may include extending between first and second end and/or around the cage Thus multiple pillars on periphery define the cylindrical or other outer tubular wall including multiple holes.

The open distal end of the cage may include multiple to distal end element outstanding or distal tip 438.The cage includes extremely Few two distinct types of pillar.For example, the cage may include being extended continuously substantially along the length of the cage Multiple relatively thick pillars, such as the first helical structure between first and second end.In addition, the cage may include multiple Relatively thin pillar can make adjacent thick pillar link together.As illustrated, thin pillar is basic not as good as thick pillar It is upper continuous, but can helically be extended with discontinuous pattern and/or be circumferentially extended around the cage.Optionally, Bao Zhizhu It can have bending or other features, such as opposite thinning or perforated portion, to keep post bends more relatively easy than thick pillar. Hole can be limited by the space between thick pillar and thin pillar, thus limit the expectation aperture of the cage.

Distal tip 438 in open end can provide substantially noninvasive distal end to the cage, such as to prevent to institute It states cage and is deployed in the wall of body cavity therein and cause to stab or other injuries.Additionally or alternatively, distal tip 438, which can have, is enough The flexibility for allowing distal tip helically to reverse and/or interlock with one another during use.Distal tip 438 can contribute to engage And/or the endoceliac clogged material of removal.Alternatively, distal tip 438 may include being spaced apart along the length of distal tip A succession of slit or dent, such as it can permit distal tip and winds and/or capture with distal tip or with other sides to each other The clogged material of formula engagement is wound to promote to remove.For example, when rotating the cage, distal tip 438 and clogged material can To be intertwined, such as make other distal tips and/or a part of of clogged material that can enter slit and distal tip 438 Become to interlock with one another.

Distal end promote during, the propulsion and rotation of the cage can carry out simultaneously, for example, manually or using drive Moving axis.This can promote the distal tip 438 of the cage to track along the inner wall of body cavity, such as when promoting the cage, with spiral side Formula tracking.When encountering thrombus or other clogged materials, distal tip 438 can pass through between the substance and body lumen wall, by The substance is positioned in cage by this.In some application methods, anchor log as described herein is rotated.In some application methods In, anchor log as described herein is translated.

The distal tip 438 of the cage can contribute to separate substance and/or be trapped in cage.For example, distal tip Edge the distal end leading edge of the cage can be provided, be not substantially smooth cylinder, but define running surface.Therefore, it revolves When turning the cage, the distal tip 438 of the cage can serve as saw and contacting repeatedly with the substance, so as to increase By substance from the chance for removing and/or being trapped in body lumen wall in cage.In order to further ensure that the leading edge of the cage non-required Passing through between substance and body lumen wall, distal tip 438 and/or leg edge can also act as the scraper sheared along body lumen wall, with Coherent substance is sucked in the cage.Therefore, pillar can cut or in other ways by the boundary between body cavity and clogged material Face separation.

The mode that distal tip 438 can make them substantially be bonded with the cylinder of the cage is formed, such as is limited straight Diameter is similar to the rest part of extended cage, but alternatively, distal tip 438 can be radially outwardly diverging from, such as to ensure Distal tip 438 passes through between body lumen wall and clogged material and/or enhances distal tip to be engaged against body lumen wall.Alternatively, far End point 438 can deviate into be extended radially inwardly relative to the center longitudinal axis of equipment, such as is extended laterally inward, such as to prevent Significant damage risk is caused to body lumen wall.

System as described herein is intended for the blood vessel of any size.The system can be in the blood vessel with following diameter Middle expansion: about 10 μm, 20 μm, 30 μm, 40 μm, 50 μm, 60 μm, 70 μm, 80 μm, 90 μm, 100 μm, 200 μm, 300 μm, 400 μ m、500μm、600μm、700μm、800μm、900μm、1mm、2mm、3mm、4mm、5mm、6mm、7mm、8mm、9mm、10mm、 11mm、12mm、13mm、14mm、15mm、16mm、17mm、18mm、19mm、20mm、21mm、22mm、23mm、24mm、25mm、 Between 1mm and 8mm, 10 μm between 1mm, 100 μm between 1mm, 100 μm between 10mm etc..The diameter or cross of anchor log Section can be about 10 μm, 20 μm, 30 μm, 40 μm, 50 μm, 60 μm, 70 μm, 80 μm, 90 μm, 100 μm, 200 μm, 300 μm, 400μm、500μm、600μm、700μm、800μm、900μm、1mm、2mm、3mm、4mm、5mm、6mm、7mm、8mm、9mm、10mm、 It is 11mm, 12mm, 13mm, 14mm, 15mm, 16mm, 17mm, 18mm, 19mm, 20mm, 21mm, 22mm, 23mm, 24mm, 25mm, small In 10mm, be less than 1mm, less than 100 μm, less than 10 μm etc..The diameter of ALTC device 201 or cross section can be about 10 μm, 20 μ m、30μm、40μm、50μm、60μm、70μm、80μm、90μm、100μm、200μm、300μm、400μm、500μm、600μm、700μ m、800μm、900μm、1mm、2mm、3mm、4mm、5mm、6mm、7mm、8mm、9mm、10mm、11mm、12mm、13mm、14mm、 15mm, 16mm, 17mm, 18mm, 19mm, 20mm, 21mm, 22mm, 23mm, 24mm, 25mm, less than 10mm, less than 1mm, be less than 100 μm, less than 10 μm etc., or the range of any two value being incorporated in aforementioned value.It is expected that the system will have different sizes can It is selected for user based on obstruction and target blood.

The perspective view of another embodiment of capture systems is shown in Figure 89.Figure 89 is also shown according to more as described herein The non-limiting example for the various possible elements that can include in the substance capture systems of embodiment.It is some as shown in Figure 89 Include any number (such as one, two or more) in embodiment with lower component: thrombus acquisition equipment has this paper institute The ALTC device 201 for any feature stated, such as promote that silk or internal propeller 202, (such as epitheca is (in figure for the first tubular element Do not show)) and anchor log, any anchor log as described herein.Figure 89 shows anchor log 450.In some embodiments, ALTC device 201 can be attached to anchor log 450.In some embodiments, anchor log 450 serves as capture guidance as described herein Part 204.In some embodiments, anchor log 450 includes metal material, such as Nitinol.Anchor log 450 can be in the form of the following: Such as ring or any close-shaped including oval, oval or polygon as shown in the figure.The be in form of anchor log 450 can be with It is opening shape, such as any linearly or nonlinearly section.ALTC device 201 and anchor log 450 can be linked together, and such as be sutured Together.ALTC device 201 and anchor log 450 can be encapsulated with low durometer polymeric material.Anchor log 450 can be with epitheca 203 connections.The proximal end of ALTC device 201 can couple with internal propeller 202 as described herein.Anchor log 450 can have There is any feature of anchor log as described herein (including anchor log 401).

Anchor log 450 is connectable to anchor log propeller 451.Anchor log propeller 451 in some embodiments can be with It is elongated tubular member, proximally and distally (is showed in Figure 89) with the central lumen across it and having.Anchor log The distal end of propeller 451 can be operably connected to anchor log 450 (such as pipe network as described herein).In some embodiments In, anchor log 450 can be fixed or static relative to anchor log propeller 451.In some embodiments, 450 phase of anchor log Anchor log propeller 451 can be moved axially.The proximal end can include any number (such as one, two or more It is a) with lower component: hemostasis component 206, flushing hole 207 and collapse section 208.Anchor log propeller 451 proximally extends and energy It is enough to couple with hemostasis component 206.Anchor log propeller 451 proximally extends and can couple with female Luer (luer).In In some embodiments, anchor log propeller 451 can have the lumen for allowing seal wire to pass through.In some embodiments, anchor log Propeller 451 is solid shaft.

Figure 89 also illustrates the distal end of the ALTC device 201 in expansion configuration.In some application methods, ALTC device 201 it is a part of axially extending, while the residue length of ALTC device 201 is collapsed and is contained in foregoing intrathecal.In In some application methods, ALTC device 201 can be collapsed and be tracked by sheath or guiding catheter (not shown) to scheduled Processing region.In some embodiments, guiding catheter can proximally be shunk in initial deployment ALTC device 201 and voluntarily may be used Spread anchorage part 450.For example, the contraction of guiding catheter can cause anchor log 450 to extend.Anchor log 450 is when in guidance It may include the configuration compressed or constrained when in conduit.During initial deployment, anchor log 450 is discharged from restrained position To neutral position.In neutral position, anchor log 450 establishes the periphery of ALTC device 201.In the feelings of ring or other circular configurations Under condition, anchor log 450 can generate constant diameter.In the case where other shapes or configuration, anchor log 450 can generate perseverance Fixed cross section.Alternatively or in combination, in other application methods, ALTC device 201 can from guiding catheter Xiang Yuanduan It promotes, ALTC device 201 is unfolded.

In some cases, the only sub-fraction of ALTC device 201, such as described device axial length are less than about 50%, 45%, 40%, 35%, 30%, 25%, 20%, 15%, 10%, 5% or smaller can initially be unfolded.The one small portion Divide the amount that can correspond to the ALTC device 201 for allowing anchor log 450 to take neutral position.During the expansion of anchor log 450, The length of ALTC device 201 can be maintained in epitheca 203.ALTC device 201 can be followed from anchor log 450 to epitheca 203 bending.Retracting epitheca 203 can make ALTC device 201 elongated, while keep the constant diameter provided by anchor log 450 Or cross section.In some embodiments, the proximal end of ALTC device 201 is fixed relative to anchor log 450.In some embodiments, ALTC device 201 can be by discharging 208 axial elongation of compression section, as described herein.In some application methods, ALTC 201 axial elongation of device.In some application methods, ALTC device 201 does not have axial elongation.ALTC device 201 may be used as Distal embolic protection, without extending axially further.In some embodiments, ALTC device 201 is unfolded before anchor log 450. In some embodiments, ALTC device 201 is unfolded after anchor log 450.

Figure 89 shows the system including double ALTC devices 201 and anchor log 450.Anchor log is used to replace Nitinol.In In some application methods, ALTC device 201 and anchor log 450 retract together.In some application methods, 201 He of ALTC device Anchor log 450 is mobile as a unit.In some embodiments, it is distally made of the device of axial elongation, wherein open end It is attached to expansible anchor log.ALTC device 201 includes proximal openings.In some embodiments, capture guiding piece 204 is by anchor Determine part (such as anchor log 450) substitution.The proximal openings of ALTC device 201 are connected to anchor log 450, so that 201 He of ALTC device Anchor log moves together.In some embodiments, the distal end of the device of axial elongation is fixed to the propeller proximally extended 202.ALTC device 201 may be coupled to propeller 202.Propeller 202 can push compression section 208 to draw from sheath 451 Play the axial elongation of ALTC device 201.Propeller 202 is extended to the proximal end of the system controlled by user.Some In embodiment, the proximal end of expansible anchor log is attached the propeller pipe 451 proximally extended, and is attached to hemostasis shell.One In a little embodiments, the proximal end of anchor log 450 is connected to anchor log propeller 451.Anchor log propeller 451 can proximally extend simultaneously It is attached to hemostasis shell, as described herein.The system can be designed for thrombectomy.The system may include distal end Basket or ALTC device 201 and anchor log 450.Anchor log 450 can be made of linear, laser cutting or stent-like structure. The material can be such as shape memory, stainless steel, cochrome.

Figure 90 shows the distal end of the system of Figure 89.The system comprises ALTC devices 201 and expansible anchor log 450. In some embodiments, ALTC device 201 and anchor log 450 are fixed and as a unit movements.In some embodiments In, the distal attachment of expansible anchor log 450 to the open end of ALTC device 201.In some embodiments, anchor log 450 Proximal end is attached to catheter shaft 451.In some embodiments, the distal end of ALTC device 201 extends through anchor log 450.Some In embodiment, the distal end of ALTC device 201 extends through anchor log 450 at center or along longitudinal axis.In some embodiments In, the distal end of ALTC device 201 extends through anchor log 450 along the axis for the longitudinal axis for deviateing anchor log 450.ALTC dress The distal end for setting 201 can be compression section 208 as described herein.In some embodiments, the distal end connection of ALTC device 201 To propeller line 202.In some embodiments, ALTC device 201 be distally connected to propeller line 202 or it is as described herein its Its device.

In some embodiments, alternatively, the distal end of expansible anchor log 450 is separated with the open end of ALTC device 201. In some embodiments, the proximal end of expansible anchor log 450 is attached to the distal end of catheter shaft.In some embodiments, ALTC is filled 201 main body is set to extend centrally through anchor log 450 and be attached to propeller 202.Propeller 202 can be accommodated in propeller In pipe 451, sheath 203, double inner cavity sheaths 243 or other confining parts as described herein.Anchor log 450 is designed to pushing away It is collapsed in into device pipe 451.ALTC device 201 is designed to collapse in propeller pipe 451.In some application methods, ALTC device 201, which can be moved by the proximal end of propeller pipe 451 from propeller pipe 451, to be discharged.It, can in some application methods Anchor log 450 is discharged to move by the proximal end of propeller pipe 451.In some application methods, ALTC device 201 can lead to It crosses the distal movement of propeller 202 and is discharged from propeller pipe 451.In some application methods, propeller 202 can be passed through Distal movement discharges anchor log 450.

Figure 91 shows another embodiment of capture systems, can have any feature as described herein.Capture systems Including anchor log 452.Anchor log 452 can have anchor log as described herein, any feature including anchor log 405.Anchoring The a part of of part 452 can be contained in propeller pipe 451.In some embodiments, ALTC device 201 can be as described herein It is attached to anchor log 452.

Figure 92 shows another embodiment of capture systems, can have any feature as described herein.Capture systems Including anchor log 453.In some embodiments, ALTC device 201 can be attached to anchor log 453 as described herein.Some In embodiment, anchor log 453 is formed as supporting structure.Anchor log 453 may include multiple pillars.Each pillar can be at one Or ALTC device 201 is connected at multiple positions.In an illustrated embodiment, each pillar is connected to ALTC at two positions Device 201, it is contemplated that other configurations are (for example, a position, three positions, four positions, five positions, Duo Gewei It sets).In some embodiments, pillar can be with spaced at equal intervals.In some embodiments, pillar is not spaced at equal intervals.Some In embodiment, pillar may include zigzag pattern or bending section 454.In some embodiments, bending section 454 can improve capture system The flexibility of system.In some embodiments, bending section 454 can permit capture systems rotation.In some embodiments, bending section 454 can be located at the near proximal ends of anchor log 453.In some embodiments, bending section 454 can be located at the remote of anchor log 453 Near end.In some embodiments, the pillar of anchor log 453 helps to fetch and accommodate obturator or clot.In some implementations In example, pillar includes shape memory or from expansion material, such as Nitinol.In some embodiments, anchor log 453 can be certainly Extension.

Figure 93-94 shows another embodiment of capture systems, can have any feature as described herein.Capture System includes anchor log 455.In some embodiments, the pillar 456 of anchor log 455 can be straight.In some embodiments In, pillar 456 may include straight part.In some embodiments, near proximal ends of the straight part in anchor log.Figure 93-94 Show the axial elongation of the expansion of ALTC device 201.ALTC device 201 proximally extends.The compression of ALTC device 201 Or constraint portions shorten in propeller pipe 241.In some embodiments, propeller pipe 241 can be retracted with axial elongation ALTC device 201, as described herein.ALTC device 201 and anchor log 455 can be used as a unit and retract.Figure 93 is shown The device of axial elongation in initial configuration and expansible anchor log.Figure 94 shows the device and expansible anchor of axial elongation Determine part, wherein the device of axial elongation is stretched.

Figure 95 shows another embodiment of capture systems, can have any feature as described herein.Capture systems Including anchor log 457.In some embodiments, a part of anchor log 457 is connected to ALTC device 201.Anchor log 457 can be with Including one or more distal tips 458.In some embodiments, one or more distal tips 458 are not connected to ALTC dress Set 201.Distal tip 458 may be used as distal tip as described herein.

Distal tip 458 can provide the distal end of substantially hurtless measure, for example, to prevent from being deployed in it to anchor log 457 In body lumen wall cause puncture or other damages.Distal tip 458 can help to that obstructive material is engaged and/or removed in body cavity Material.Alternatively, distal tip 458 can be entangled with one another and/or captures with by distal tip 458 or engage in other ways Clogging material tangles, to promote to remove.Distal tip 458 can promote the separation and/or capture of material.Anchor log 457 Distal tip 458 can serve as saw and contacting repeatedly with material, this can increase material from body lumen wall remove and/or by Capture the chance in anchor log 457.In order to further ensure that the leading edge of anchor log 457 unwanted material and body lumen wall it Between pass through, the material sucking anchor log 457 that distal tip 458 and/or edge are also used as shearing along body lumen wall that will adhere to In blade.Therefore, the interface between body cavity and blocking material can be cut or be separated in other ways to distal tip 458.Far End tip 458 can be formed such that they, substantially conforming to the cylindrical shape of ALTC device 201, are filled for example, limiting with ALTC Set the 201 similar diameter of rest part.In some embodiments, distal tip 458 can be biased radially outward, or biasing with It extends radially inwardly.It is contemplated that other configurations of distal tip 458.

In some embodiments, system described herein includes fixed ALTC device 201.In some embodiments, ALTC device 201 is inserted into patient's body with initial configuration.For example, capture guiding piece 204 as described herein can be fixed to So that ALTC device 201 takes initial configuration.In some embodiments, ALTC device 201 does not extend.In some embodiments, The axial length of ALTC device 201 is fixed.In some embodiments, anchor log is fixed.In some embodiments, will Anchor log is to extend or expanded configuration is inserted into the patient.In some embodiments, anchor log not patient's body extension or it is swollen It is swollen.In some embodiments, anchor log has fixed shape or configuration.In some embodiments, the system is wrapped in front end Include clot destructor or resectoscope.In some embodiments, clot destructor is mobile to decompose clot to distal end.In some implementations In example, clot destructor is a part of anchor log.In some embodiments, clot destructor is individual device.

Figure 96 A-96B shows expansible guiding catheter 460.Guiding catheter 460 includes expansible distal end, described to expand The distal end of exhibition is configured to be positioned at patient's body far from user.Guiding catheter 460 at least distally can have at least One double braiding layer including outer layer and internal layer.In some embodiments, expansible guiding catheter 460 may include the double-deck knot Structure.In some embodiments, expansible guiding catheter 460 may include external braid 461.In some embodiments, external Braiding layer 461 coats the material just like one or more polymeric materials.In some embodiments, expansible guiding catheter 460 can To include inner carcass 462.In some embodiments, inner carcass 462 is not coated with polymeric material.In some embodiments In, a part of inner carcass 462 is not coated.In some embodiments, the distal portions of inner carcass 462 are not applied It covers.In some embodiments, the length of inner carcass 462 is not coated.In some embodiments, inner carcass 462 Whole length is not coated.In some embodiments, a part of external braid 461 is coated.In some embodiments, outside The distal portions of portion's braiding layer 461 are coated.In some embodiments, the length of external braid 461 is coated.In some realities It applies in example, the whole length of external braid 461 is coated.In some embodiments, external braid 461 is in the course of surgery It keeps by polymer-coated or encapsulation.

In some embodiments, external braid 461 is coated with polymer.Polymer can be any material, including Pellethane, silicone, Tecoflex, Tecothane, Latex, Pebax.The polymer can function similarly to sliding layer Effect.Polymer can promote conduit relative to the sliding of target blood.In some embodiments, inner carcass 462 is not Coated with polymer, but reticular structure shown in retaining.Inner carcass 462 is advantageously provided relative in conduit cavity The surface contact and/or reduced friction of surface area, reduction that object reduces.For example, the reticular structure of inner carcass 462 with Solid inner wall is smaller compared to the surface area of the object in contact inner cavity.Inner carcass 462 allows to fetch conduit, one or more Anchor log, obturator or ALTC device 201 are easier to slide axially when proximally extracting out from inner cavity.More as described herein In application method, ALTC device 201 can axially be stretched on one or more anchor logs before being retracted into guiding catheter 406 It is long.In some application methods as described herein, ALTC device 201 can be before being retracted into guiding catheter 406 in such as blood Axial elongation on the obturator of block.In some application methods as described herein, when ALTC device 201 is retracted into guiding catheter When in 460, ALTC device 201 can provide distal embolic protection.

In some embodiments, guiding catheter 460 has funnel shaped in distal end.In some embodiments, distally refer to Guiding catheter 460 or its component part farthest away from user in use, and proximal end refers to guiding catheter 460 or its portion Closest to the part of user in part.In some embodiments, the distal end of guiding catheter 460 is positioned at patient's body, and proximal end Outside the patient's body.

In some embodiments, expansible guiding catheter 460 may include any spy of ALTC device 201 described herein Sign.In some embodiments, mesh can be made of metal material, such as individually non-resilient line.In some embodiments, Mesh can be made of elastic element.In some embodiments, mesh can be made of the combination of elasticity and non-resilient line. In some embodiments, double braided fabrics can be made of polymer or metal material.In some embodiments, metal material can be with It is Nitinol, stainless steel, steel, marmem, elastic alloy, Nitinol etc..In some embodiments, litzendraht wire is straight Diameter can in the range of 0.0005 " to 0.030 ", such as 0.0005 ", 0.001 ", 0.0015 ", 0.002 ", 0.0025 " or 0.003 ", 0.0005 " -0.0015 " between, 0.001 " -0.002 " between, in .0015 " -0.0025 " between, In 0.002 " -0.003 " between etc..It is expected for weaving other configurations of linear diameter.Litzendraht wire can be woven with any pattern.In In some embodiments, guiding catheter 460 may include at least one polymeric layer.At least one described polymeric layer can apply Onto any surface of litzendraht wire.Litzendraht wire may include one or more weave patterns, such as the first of guiding catheter 460 The first wave pattern in part and the second wave pattern in the second part of guiding catheter 460.Weave pattern can be It covers on typical and is covered on underlying pattern, such as two, two underlie；It is covered on one, one underlies.Woven pattern can come From tubular braid.In some embodiments, guiding catheter 460 may include multi-layer braided line.

Litzendraht wire can form mesh.In some embodiments, the cross section of line can be any shape, including circle Shape, polygon, ellipse etc..The shape of line can be flat, square, band-like, round etc..In some embodiments, editor-in-chief Knitting angle can be within the scope of 10 degree to 170 degree.In some embodiments, total braid angle is 0 degree, 10 degree, 20 degree, 30 degree, 40 Degree, 50 degree, 60 degree, 70 degree, 80 degree, 90 degree, 100 degree, 110 degree, 120 degree, 130 degree, 140 degree, 150 degree, 160 degree, 170 degree, Between 180 degree, 0-45 degree, between 45-90 degree, between 90-135 degree, between 135-180 degree etc..In some embodiments, it weaves Object density can be in 5PPI to 60PPI range.In some embodiments, braid density be less than 5PPI, 5PPI, 10PPI, 15PPI、20PPI、25PPI、30PPI、35PPI、40PPI、45PPI、50PPI、55PPI、60PPI、65PPI、70PPI、 Between 75PPI, 80PPI, 0-20PPI, between 20-40PPI, between 40-60PPI, between 60-80PPI etc..In some embodiments In, internal diameter can be in 1F to 30F range.In some embodiments, internal diameter be less than 1F, 1F, 2F, 3F, 4F, 5F, 6F, 7F, 8F、9F、10F、11F、12F、13F、14F、15F、16F、17F、18F、19F、20F、21F、22F、23F、24F、25F、26F、 Between 27F, 28F, 29F, 30F, 31F, 32F, 33F, 34F, 35F, 0F-5F, between 5F-10F, between 15F-20F, 20F-25F Between, between 25F-30F, between 30F-35F etc..In some embodiments, outer diameter can be in 2F to 33F range.Some In embodiment, outer diameter be less than 1F, 1F, 2F, 3F, 4F, 5F, 6F, 7F, 8F, 9F, 10F, 11F, 12F, 13F, 14F, 15F, 16F, 17F、18F、19F、20F、21F、22F、23F、24F、25F、26F、27F、28F、29F、30F、31F、32F、33F、34F、35F、 Between 0F-5F, between 5F-10F, between 15F-20F, between 20F-25F, between 25F-30F, between 30F-35F etc..

In some embodiments, expansible guiding catheter 460 may include axis.In some embodiments, expansible guidance Conduit 460 may include the axis extended under compression.In some embodiments, expansible guiding catheter 460 may include pressing The lower axis extended of contracting.In some embodiments, expansible guiding catheter 460 may include discharging the axis extended when constraint.In In some embodiments, expansible guiding catheter 460 may include the axis extended due to temperature.In some embodiments, can expand Exhibition guiding catheter 460 may include extending so that the axis of neutral configuration is presented.

In some embodiments, expansible guiding catheter 460 may include inverted structure.In some embodiments, it weaves One end of object starts from proximal end and extends to distal end, and in far-end, it is folded inward and extends back into proximal end.In some embodiments In, double braided fabrics proximally extend to distal end.In some embodiments, it can be continuously in the braided fabric of far-end.One In a little embodiments, it can be in the braided fabric of far-end discontinuous.In some embodiments, one end of braided fabric is proximally opened Begin and extend to distal end, it is folded inward and extends back into proximal end region in far-end.In some embodiments, the one of braided fabric End proximally starts and extends to distal end, it is foldable outwardly and extends back into proximal end region in distal end.461 He of external braid Inner carcass 462 is concentric.

In some embodiments, outer braid object 461 is encapsulated by polymeric material.In some embodiments, polymeric layer can With uniform wall thickness.In some embodiments, polymeric layer can have uniform density.In some embodiments, polymer Layer can have uniform wall thickness on entire catheter length.In some embodiments, polymeric layer can have non-uniform wall It is thick.In some embodiments, the proximal end of conduit wall thickness is thicker than the wall thickness of far-end.In some embodiments, polymeric material is whole It can have identical pliability (hardometer) on a catheter length.In some embodiments, polymeric material is long in entire conduit There can be different or a variety of pliabilitys (hardometer) on degree.In some embodiments, polymeric material is expansible.In some realities It applies in example, polymeric material is flexible.In some embodiments, outer layer of composite material is expansible.In some embodiments, Polymeric material can be any elastomeric material, for example, polyurethane, Pellethane, silicone, Tecoflex, Tecothane, Latex, Pebax and/or combination thereof.In some embodiments, polymer can be connected by any method known in the art It is connected to braided material.In some embodiments, can will polymer-coated, molding, dipping or heat fusion on braided fabric.

In some embodiments, guiding catheter 460 has funnel shaped in distal end.In some embodiments, guiding catheter It is packed that outer braid object proximally arrives the distal end near funnel.In some embodiments, outwardly and inwardly braiding layer is not or not funnel By polymer encapsulated.In some embodiments, funnel outer braid object is by polymer encapsulated.In some embodiments, internal to compile Tissue layer can use polymer encapsulated, and outer layer does not have then.

Guiding catheter 460 may be used as entering system.In some embodiments, guiding catheter 460 is with compression diameter configuration It is introduced into.In some embodiments, after introduction, guiding catheter 460 can be adapted to larger-diameter outer by radial expansion Section's instrument such as ALTC device 201 and/or anchor log as described herein are from wherein passing through.

Guiding catheter 460 can be used for the target position in patient's body and form and expand into region.In some embodiments In, guiding catheter 460 is delivered and is extended with minor diameter configuration.In some embodiments, only distal end or funnel end are extended.In In some embodiments, guiding catheter 460 can change the size for the inner cavity that guiding catheter 460 is inserted, such as by being pressed against blood Tube wall expands blood vessel.Guiding catheter 460 may include facilitate it is polymer coated with vascular wall sliding contact.

In some embodiments, the expansion by the way that guiding catheter 460 can be caused that ALTC device 201 passes through guiding catheter 460 Exhibition.In some embodiments, the ALTC device 201 collapsed can be sized to be suitble in guiding catheter 460.In some realities It applies in example, the ALTC device 201 of extension can be sized to be suitble in guiding catheter 460.In some embodiments, expand The ALTC device 201 of exhibition can be retracted by guiding catheter 460.In some embodiments, the anchor log of one or more extensions Can be sized to be suitble in guiding catheter 460.Uncoated inner carcass 462 reduces guiding catheter 460 and wears Cross the sliding contact between any part therein.

In some embodiments, guiding catheter 460 may be used as the casing of variable size.In some embodiments, it guides Conduit 460 may be used as tissue expander.In some embodiments, guiding catheter 460 can be compressed axially period in braided fabric Change shape.In some embodiments, axial shortening can cause the radial expansion of guiding catheter 460.In some embodiments, Can the amount based on compressing force changeably extend guiding catheter 460.In some embodiments, guiding catheter 460 is to extend certainly 's.In some embodiments, guiding catheter 460 is for example, by bracing wire, release, application compressing force, application tension etc. from constraint Mechanism extension.In some embodiments, guiding catheter 460 is shape-memory material.

In some embodiments, guiding catheter 460 can promote to remove the obstruction in the vascular system of patient.In some realities It applies in example, guiding catheter 460 can surround the one or more anchor logs become entangled in clot.In some embodiments, clot Surface can with partially due to guiding catheter 460 inner surface and easily slided in guiding catheter.In some embodiments, Guiding catheter 460 can with partially due to guiding catheter 460 outer surface and easily slided in target blood.In some realities It applies in example, guiding catheter 460 can collapse after fetching one or more anchor logs.In some embodiments, guiding catheter 460 can surround the ALTC device 201 for itself encapsulating obturator.In some embodiments, partially due to guiding catheter 460 it is interior The outer surface on surface, ALTC device 201 can easily be slided in guiding catheter.In some embodiments, guiding catheter 460 It can be collapsed after fetching ALTC device 201.

The system and method used can be used in combination or modified with system and method as described herein is found in such as 2005 On April 7, in submits and is disclosed as No. 11/101,224 United States Patent (USP) of No. 8475487 United States Patent (USP) on July 2nd, 2013 Apply (" Bonnette ")；On October 27th, 2008 submits and is disclosed as No. 20100268264 beauty on October 21st, 2010 The 12/738th, No. 702 U.S. Patent application (" Bonnette ' 264 ") of state's patent disclosure, the patent is to be cited in full text Mode is incorporated herein.

In some application methods, by ALTC device 201 and thrombectomy catheter (such asThrombectomby Art device) it is used in combination, or suction catheter may be used to remove embolic debris.It is as described herein in some application methods One or more anchor logs and thrombectomy catheter or suction catheter, such asThrombectomy device, which combines, to be made With.It usesThe thrombus that (a kind of rheology crossing current thrombectomy catheter) can have removal diameter to be greater than conduit diameter Capability.But the breakdown strength of described device is reduced with the radial distance with conduit.Therefore, in certain diameter To at distance, clot may ratioThe destructive power that flow pattern generates of flowing over is strong.In organized thrombus, Softer thrombus is likely less than with the radial distance of conduit.

In some cases, the ability of water jet thrombectomy may be restricted.But such as by using herein The anchor log can unexpectedly and synergistically improve water jet ablation to increase mechanical damage.With can be separately through machinery Blender or hemolytic crossing current thrombectomy catheter removing are compared, by by mechanical stirring (for example, flexible and expansible anchor Determine the close contact of component and ALTC device 201 and thrombus) and rheology thrombectomy catheterIn conjunction with can be with Remove various thrombus.

The another aspect of some embodiments of the device of the disclosure and it is characterized in the embolic debris big and small with capture Ability device.The other side of the device of the disclosure and the dress for being characterized in a kind of ability with temporary capture clast Set, the clast can then by manually suction or by usingThrombectomy device and conduit remove, Or it can be handled by thrombolysis.The other side of the device of the disclosure and be characterized in it is a kind of have clast soaking is arrived Clinically inappreciable size (area depending on body) or the big of pharmacological treatment or removal can be carried out by another device The device of small ability, such asThrombectomy device and conduit.The another aspect of the device of the disclosure and it is characterized in It is a kind of with the ability for macerating the non-embolic debris such as fixed thrombus etc and device to be pulled through to such obturator Device.

The system and method used can be used in combination or modified with system and method as described herein is found in such as 2014 On March 17, in submits and is disclosed as No. 14/774,735 beauty of No. 20160022290 U.S. Publication on January 28th, 2016 State's patent application (" Johnson ")；On January 15th, 2013 submits and is disclosed as No. 20140005712 on January 2nd, 2014 13/741st, No. 845 U.S. Patent application (" Martin ") of U.S. Patent Publication, the patent is in entirety by reference It is incorporated herein.

Intravascular ultrasound disclosed in Johnson (IVUS) energy converter can be incorporated into system as described herein.One In a little embodiments, intravascular ultrasound (IVUS) energy converter can be added to or be integrated in delivery system and method.Pressure passes Sensor can be used for measuring the pressure of each position in vascular system, this can be used for determining blood flow, and intravascular ultrasound (IVUS) changes Energy device can be used for measuring fluid flow and/or provide intravascular imaging.In some embodiments, pressure sensor and/or IVUS Energy converter can be incorporated into seal wire at one or more positions (for example, the distal end of seal wire or distal portions), and be tied It closes in the centre and proximal part of seal wire.Seal wire with pressure sensor and/or IVUS energy converter can be as common seal wire It equally uses, to help the delivery apparatus that navigates in the blood vessels, it is additional to help to navigate to be provided with pressure measurement and ultrasonic imaging Benefit so that device be made to place position visualization, and monitors and ensures correct device expansion.In some embodiments, IVUS is changed Energy device generates image slice when it is advanced and retracted, and then can fit together these image slices to form vascular system The three-dimensional reconstruction of system and/or the device in vascular system.In some embodiments, there is pressure sensor and/or IVUS transducing The seal wire of device can with below for have fixed to another conduit pressure sensor and/or IVUS energy converter conduit institute The similar mode of description is fixed on conduit.

The use of ultrasonic image-forming system can permit operator saturating without fluoroscopic examination or the less fluorescence of use Delivery apparatus in the case that inspection is looked into reduce the radioactive exposure to patient, while allowing to carry out vascular system more acurrate Assessment, facilitate the placement of device and to allow to confirm that device is placed correct.Imaging can be used for assisting filter or other devices Expansion.By provide for example on the device of expansion fetch feature and retrieval device fetch feature (on such as snare Ring) visualization, imaging can be also used for assisting fetching the device being unfolded.It can be before expansion, after expansion And/or to vascular system and implantation object location imaging during expansion.Imaging can be used during fetching.Imaging can be used for helping It helps and filter or device is located in vascular system.Imaging can be used for that expanded position is imaged and determines filter or other dresses The appropriate size set.Imaging can be used for helping estimation time.

Although above-mentioned imaging system has been described mainly as based on ultrasound, can alternatively or additionally use Other imaging systems.For example, imaging system can be based on intravascular ultrasound (IVUS), forward sight IVUS (FLIVUS), optical coherence Tomoscan (OCT), piezoelectricity micromachined ultrasonic transducer (PMUT) and/or FACT.

Other components of Martin description also can be incorporated into system described herein.It can be by all or part of device It is designed as increasing its ability for adhering to obturator.For example, line may be coupled to energy source (for example, RF, ultrasound or thermal energy) with " weldering Connect " arrive obturator.Peripheral part can be made to be deformed into obturator to device application energy simultaneously " to be embedded in " in obturator.It is alternative Ground, described device can assign positive charge to obturator, sufficiently to make obturator partial liquefaction, consequently facilitating removal.Another In a version, negative electrical charge can be applied to establish thrombus and nested described device further to obtain better pulling force.It can To make line by using one or more hydroaropic substances or by the way that the chemical substance of chemical bond can be generated on obturator surface It is more tacky.Alternatively, long filament can reduce the temperature of obturator to condense or adhere on obturator.

The another aspect that can be applied to the version of device can be configuration device and (either traverse long filament or surrounding Part) preferably to adhere to obturator.A kind of such mode include using be adhered to certain clots (or cause to block its Its material) coating.For example, line can be coated with the hydrogel or adhesive for being integrated to thrombus.Correspondingly, when the fixed clot of device When, the validity of device removal obstruction can be improved in the combination of the mechanical structure of additive and device.Coating can also be with capture Part or conduit are combined to improve the ability (for example, hydrophilic coating) of device encapsulation and removal obturator.

Such improvement is also possible to mechanical or structure.Any part of capture portion may have hook, fibre Dimension or barb, these hooks, fiber or barb can be caught in obturator when device surrounds obturator.Hook, fiber or barb can To be merged into any part of device.However, in some embodiments importantly, such feature will not interfere practitioner from The ability of body removal described device.

In addition to additives, described device can be connect with RF, microwave, magnetic, heat, low temperature or other power supplys, to allow electricity, electricity Stream, ultrasound or RF energy are transmitted by described device and cause the other cohesions for condensing or causing clot or other obturators.

Method described herein can also be included in the pre-treatment obturator for attempting removal obturator.Such processing can be with Including so that obturator shrink or keep it harder in order to removal purpose and apply chemical agent or medicament.Such reagent packet Include but be not limited to chemotherapy drugs or solution；Decomposition agent, such as tPA, urokinase or streptokinase；Anti-coagulants, mild formalin Or aldehyde solution.

According to the above instruction, various other modifications, reorganization and alternate design are certainly possible to.It is therefore understood that It is that can implement the present invention in a manner of being different from specifically describing herein.It is contemplated that being able to carry out reality disclosed above The specific features of example and the various combinations of aspect or sub-portfolio are applied, and is still fallen in one or more schemes of the invention. In addition, herein in regard to the disclosure of any special characteristic of embodiment, aspect, method, property, characteristic, quality, attribute, element etc. Content can be used for all other embodiment set forth herein.It is understood, therefore, that the various spies of the disclosed embodiments Aspect of seeking peace can be combined with each other or be substituted to form the different mode of disclosed invention.Therefore, disclosed herein hair Bright range intention should not be limited by above-mentioned specifically disclosed embodiment.Moreover, although the present invention is easy to carry out various modifications And alternative form, but its specific example has been illustrated in the accompanying drawings and is described in detail herein.It is understood, however, that It is that the present invention is not limited to particular forms disclosed or methods, on the contrary, covering is fallen into described various embodiments by the present invention Spirit and scope in all modifications, equivalents, and substitutions scheme.Any method disclosed herein is not needed with described suitable Sequence executes.Method disclosed herein includes certain action that practitioner takes；But they also may include any third party couple The instruction of these behaviors is either expressed or is implied.For example, the movement for such as " being inserted into conduit through Femur blood vessel " includes " instruction Conduit is inserted into through Femur blood vessel ".Range disclosed herein also covers its any and all overlapping, subrange and combination.Such as " extremely It is more ", " at least ", " being greater than ", " being less than ", " between " etc. language include cited number.Terminology used in this article it It is preceding such as " about ", the number of " about " and " substantially " include cited number (such as about 10%=10%), and It is also represented by the amount close to the quantity, desired function still can be performed or realizes desired result.For example, term " about ", " about " and " substantially " can refer within the quantity is less than 10%, less than 5% within, less than 1% within, be less than Within within 0.1% and less than 0.01%.