Plaque removal device with rotatable cutting element

Abstract

An elongate tubular body with a rotatable cutting element is provided. An opening is provided near the distal end of the tubular body, and the cutting element may be partially exposed through the opening. The cutting element is configured to remove plaque from the wall of a body lumen. A distal segment may coupled to the distal end of the tubular body and may have a distal port for slidably receiving a guidewire therethrough.

1 - 10 . (canceled) 
     
     
         11 . A plaque removal device, comprising:
 an elongate flexible tubular body having a proximal end and a distal end and defining a lumen extending therethrough;   an opening near the distal end of the elongate flexible tubular body, wherein the opening has an axial length and is oriented to face at least partially toward a wall of a body lumen;   a rotatable cutting element coupled to a drive shaft extending through the lumen of the tubular body, the rotatable cutting element having a first state in which the rotatable cutting element is substantially recessed within the tubular body and a second state in which the rotatable cutting element is partially exposed through the opening, wherein the rotatable cutting element in the second state is configured to remove plaque from the wall of the body lumen;   a distal segment coupled to the distal end of the tubular body extending distally beyond the opening, the distal segment having a distal port for slidably receiving a guidewire therethrough; and   a guidewire lumen extending throughout the length of the distal segment from the distal port to a proximal port positioned distal to the proximal end of the tubular body.   
     
     
         12 . The device of  claim 11 , wherein the proximal port is proximal to the opening. 
     
     
         13 . The device of  claim 11 , wherein the rotatable cutting element comprises a plurality of angled cutting blades. 
     
     
         14 . The device of  claim 11 , wherein the opening has an axial length between about 0.5 to about 3.0 mm. 
     
     
         15 . The device of  claim 11 , wherein the guidewire lumen is separate from the lumen of the tubular body. 
     
     
         16 . The device of  claim 11 , wherein the guidewire lumen is provided at least partially along a side of the device opposite from the side of the device toward which the opening near the distal end of the elongate flexible tubular body faces. 
     
     
         17 . A plaque removal device, comprising:
 an elongate flexible tubular body having a proximal end and a distal end;   an opening near the distal end of the elongate flexible tubular body having an axial length oriented to face at least partially toward a wall of a body lumen;   a rotatable cutting element disposed within the tubular body, the rotatable cutting element configured to remove plaque from the wall of the body lumen;   a distal segment extending distally beyond the opening, the distal segment having a distal port for slidably receiving a guidewire therethrough; and   a guidewire lumen extending throughout the length of the distal segment from the distal port to a proximal port positioned distal to the proximal end of the tubular body.   
     
     
         18 . The device of  claim 17 , wherein the rotatable cutting element is axially movable out of the opening. 
     
     
         19 . The device of  claim 17 , wherein the rotatable cutting element has a first state in which the cutting element is substantially recessed within the tubular body and a second state in which the cutting element is partially exposed through the opening. 
     
     
         20 . The device of  claim 17 , wherein the rotatable cutting element comprises a cutting tip less than about 1.5 mm long. 
     
     
         21 . The device of  claim 17 , wherein the opening has an axial length between about 0.5 to about 3.0 mm. 
     
     
         22 . The device of  claim 17 , wherein the distal end of the tubular body has a different hardness compared to the proximal end of the tubular body. 
     
     
         23 . A plaque removal device comprising:
 an elongate flexible tubular body having a proximal end and a distal end;   an opening near the distal end of the tubular body, wherein the opening has an axial length and is oriented to face at least partially toward a wall of a body lumen;   a rotatable cutting element at least partially recessed within the tubular body, the rotatable cutting element actuatable between a first state in which the rotatable cutting element is substantially recessed within the tubular body and a second state in which the rotatable cutting element at least partially protrudes through the opening, wherein the rotatable cutting element in the second state is configured to remove plaque from the body lumen and draw the plaque into the device through the opening.   
     
     
         24 . The device of  claim 23 , further comprising a distal segment extending distally beyond the opening. 
     
     
         25 . The device of  claim 24 , wherein the distal segment is relatively rigid compared to the tubular body. 
     
     
         26 . The device of  claim 24 , wherein the distal segment comprises a distal port and a proximal port, the distal port configured to slidably receive a guidewire therethrough. 
     
     
         27 . The device of  claim 23 , further comprising:
 a flexible torque tube connected to the rotatable cutting element extending through the tubular body, and   a control at the proximal end of the tubular body and comprising a drive motor configured to transmit rotation to the torque tube.