Rotational atherectomy system and methods of use

Abstract

An elongate tubular body extends between a rotatable cutter and a control. The cutter is connected to the control with a rotatable element. Material that has been processed by the cutter is drawn into the tubular body for disposal.

1 - 11 . (canceled) 
   
   
       12 . An intravascular medical device comprising:
 an elongate flexible tubular body having a proximal end, a distal end, and an outer diameter;   a housing coupled to the distal end of the elongate flexible tubular body, the housing comprising an opening;   a rotatable cutting element extending at least through a portion of the housing, the rotatable cutting element having a first state, in which the rotatable cutting element is substantially recessed within the housing, and a second state, in which the rotatable cutting element at least partially protrudes through the opening of the housing, wherein the rotatable cutting element is configured to axially displace longitudinally relative to the housing, the rotatable cutting element configured to remove material from a body lumen beyond the outer diameter of the elongate flexible tubular body, and configured to draw material through the opening and into the housing;   a flexible drive shaft connected to the rotatable cutting element extending through the elongate flexible tubular body; and   a control at the proximal end of the elongate flexible tubular body and comprising a drive motor configured to transmit rotation to the flexible drive shaft.   
   
   
       13 . The device of  claim 12 , wherein the rotatable cutting element comprises a plurality of discrete cutting surfaces 
   
   
       14 . The device of  claim 13 , wherein the plurality of cutting surfaces are spaced apart circumferentially along a curved surface of the rotatable cutting element. 
   
   
       15 . The device of  claim 12 , further comprising a deflecting element configured to cause the rotatable cutting element to rotate about an off-center axis relative to the body lumen. 
   
   
       16 . An intravascular medical device comprising:
 an elongate flexible tubular body having a proximal end and a distal end;   an elongate element extending through the elongate flexible tubular body having a rotatable tip at a distal end thereof, the rotatable tip comprising a plurality of discrete cutting surfaces.   
   
   
       17 . The intravascular medical device of  claim 16 , wherein the cutting surfaces are spaced apart circumferentially on a curved surface of the rotatable tip. 
   
   
       18 . The intravascular medical device of  claim 16 , further comprising an opening near a distal end of the elongate flexible tubular body configured to draw in intravascular material, wherein the rotatable tip is moveable relative to the elongate flexible tubular body at least partially out of the opening. 
   
   
       19 . An intravascular medical device comprising:
 an elongated tubular body having a proximal end and a distal end;   an opening near the distal end of the elongated tubular body configured to draw in intravascular material;   a cutter connected to a drive mechanism, the drive mechanism configured to transmit rotation to the cutter through at least a flexible drive shaft extending through the elongated tubular body;   wherein the cutter is moveable relative to the elongated tubular body at least partially out of the opening.   
   
   
       20 . The device of  claim 19 , wherein the cutter is configured to remove material from a body lumen beyond the outer diameter of the elongated tubular body. 
   
   
       21 . The device of  claim 19 , wherein the cutter is configured to draw in material through the opening from the distal end to the proximal end of the elongated tubular body. 
   
   
       22 . The device of  claim 19 , wherein the cutter is configured to axially displace longitudinally relative to the opening. 
   
   
       23 . The device of  claim 19 , wherein the opening is located at the distal end of the elongated tubular body. 
   
   
       24 . The device of  claim 19 , wherein the cutter is moveable longitudinally relative to the opening. 
   
   
       25 . A method of removing material from a body lumen, comprising:
 providing an elongate flexible tubular body having a proximal end and a distal end, a housing that is coupled to the distal end of the elongate flexible tubular body, a rotatable cutting element extending at least through a portion of the housing, wherein the rotatable cutting element is configured to axially displace longitudinally relative to the housing, and a flexible drive shaft connected to the rotatable cutting element;   advancing the distal end of the elongate flexible tubular body transluminally to the material;   displacing the rotatable cutting element along a longitudinal axis of the elongate flexible tubular body relative to an opening in the housing to at least partially protrude through the opening;   rotating the rotatable cutting element against the material to cut the material; and   drawing portions of the material through the opening and into the housing.   
   
   
       26 . The method of  claim 25 , wherein drawing portions of the material comprises drawing material from the distal end to the proximal end of the elongate flexible tubular body. 
   
   
       27 . The method of  claim 25 , wherein the opening in the housing is located at a distal end of the housing. 
   
   
       28 . The method of  claim 25 , wherein rotating the cutting element comprises removing material from a body lumen beyond the outer diameter of the elongate flexible tubular body. 
   
   
       29 . The method of  claim 28 , wherein rotating the cutting element comprises deflecting the cutting element to cause the cutting element to rotate about an off-center axis relative to the body lumen. 
   
   
       30 . The method of  claim 25 , wherein the rotatable cutting element is configured to displace longitudinally in a proximal-to-distal direction.