Atherectomy devices, systems, and methods

Abstract

The devices and methods generally relate to treatment of occluded body lumens. In particular, the present devices and method relate to removal of the occluding material from the blood vessels as well as other body lumens.

1 . A method of treating a blood vessel, the method comprising:
 providing a catheter sized and configured to be introduced into the blood vessel, the catheter including a tissue cutting assembly at or near a distal end of the catheter, the tissue cutting assembly including a rotatable cutter for debulking the tissue from the blood vessel,   providing a control handle coupled to the catheter assembly, the control handle including steering means for steering the tissue cutting assembly,   introducing the catheter into a vascular access artery,   advancing the catheter into a femoral artery, a profunda femoris artery, an artery in the hunter's canal, a popliteal artery, a tibial artery, a peroneal artery, a dorsalis pedis artery, a medial plantar artery, a lateral plantar artery, or a digital artery,   positioning the tissue cutting assembly at or near a target site in the femoral artery, the profunda femoris artery, the artery in the hunter's canal, the popliteal artery, the tibial artery, the peroneal artery, the dorsalis pedis artery, the medial plantar artery, the lateral plantar artery, or the digital artery,   operating the steering means by applying a first force to the steering means, the first force causing the distal portion of the catheter to deflect in a radial direction,   operating the steering means by applying a second force to the steering means, the second force causing the distal portion of the catheter to rotate in an arcuate path while the distal portion is deflected in the radial direction,   advancing the catheter distally to sweep the target site thereby allowing the rotatable cutter to debulk tissue from the target site in the arcuate path, and   removing the debulked tissue from the target site, thereby treating the blood vessel.   
   
   
       2 . A method according to  claim 1 :
 further including introducing the catheter into the iliac artery using an 8Fr or smaller introducer.   
   
   
       3 . A method according to  claim 2 :
 wherein the catheter is sized and configured to allow contrast injection while residing in the 8Fr or smaller introducer.   
   
   
       4 . A method according to  claim 1 :
 wherein introducing the catheter into the iliac artery includes no more than one introducing the catheter into the iliac artery.   
   
   
       5 . A method according to  claim 1 :
 wherein the catheter is sized and configured for thrombectomy and/or atherectomy.   
   
   
       6 . A method according to  claim 1 :
 wherein the tissue cutting assembly is sized and configured for removing tissue including acute thrombus, organized thrombus, atheroma, fibrous plaque, and calcified plaque.   
   
   
       7 . A method according to  claim 1 :
 wherein the vascular access artery comprises an iliac artery, a femoral artery, or a popliteal artery.   
   
   
       8 . A method of treating a blood vessel, the method comprising:
 providing a catheter sized and configured to be introduced into the blood vessel, the catheter including a tissue cutting assembly at or near a distal end of the catheter, the tissue cutting assembly including a rotatable cutter for debulking the tissue from the blood vessel,   providing a control handle coupled to the catheter assembly, the control handle including steering means for steering the tissue cutting assembly,   introducing the catheter into a vascular access artery,   advancing the catheter into a femoral artery, a profunda femoris artery, an artery in the hunter's canal, a popliteal artery, a tibial artery, a peroneal artery, a dorsalis pedis artery, a medial plantar artery, a lateral plantar artery, or a digital artery,   positioning the tissue cutting assembly at or near a target site in the femoral artery, the profunda femoris artery, the artery in the hunter's canal, the popliteal artery, the tibial artery, the peroneal artery, the dorsalis pedis artery, the medial plantar artery, the lateral plantar artery, or the digital artery,   operating the steering means by applying a first force to the steering means, the first force causing the distal portion of the catheter to deflect in a radial direction,   moving the catheter axially thereby allowing the rotatable cutter to debulk tissue from the target site, and   removing the debulked tissue from the target site, thereby treating the blood vessel.   
   
   
       9 . A method of treating a blood vessel, the method comprising:
 providing a catheter sized and configured to be introduced into the blood vessel, the catheter including a tissue cutting assembly at or near a distal end of the catheter, the tissue cutting assembly including a rotatable cutter for debulking the tissue from the blood vessel,   providing a control handle coupled to the catheter assembly, the control handle including steering means for steering the tissue cutting assembly,   introducing the catheter into a brachial artery,   advancing the catheter into a profunda brachii artery, a superior ulnar collateral artery, an inferior ulnar collateral artery, a radial artery, an ulnar artery, or the humeral branches,   positioning the tissue cutting assembly at or near a target site in the profunda brachii artery, the superior ulnar collateral artery, the inferior ulnar collateral artery, the radial artery, the ulnar artery, or the humeral branches,   operating the steering means by applying a first force to the steering means, the first force causing the distal portion of the catheter to deflect in a radial direction,   moving the catheter axially thereby allowing the rotatable cutter to debulk tissue from the target site, and   removing the debulked tissue from the target site, thereby treating the blood vessel.