Lead extraction methods and apparatus

Abstract

According to one aspect, a device for assisting in removing an implanted lead is provided. The device comprises a body portion having a center adapted to accommodate the lead, a cutting component coupled to the body portion to assist in separating tissue from the lead, and at least one anchoring component disposed at least partially within the body portion, the at least one anchoring component capable of providing pressure on the lead that resists movement of at least part of the body portion along the lead at least in part by applying fluid pressure.

What is claimed is: 
     
         1 . A method for assisting in removing an implanted electrical lead using a device adapted to accommodate the implanted electrical lead, the method comprising:
 advancing the device along the lead to where the device encounters tissue adhered to the lead;   applying fluid pressure to a proximal anchoring component of the device to anchor a proximal portion of the device to the lead at a first location along the lead proximate the tissue;   applying fluid pressure to an expansion component comprising a piston mechanism having a piston, the expansion component coupled to a separating component, wherein applying the fluid pressure to the expansion component forces the piston forward to cause the separating component to separate at least some of the tissue from the lead; and   applying fluid pressure to a distal anchoring component arranged on a distal side of the expansion component to anchor a distal portion of the device to the lead.   
     
     
         2 . The method of  claim 1 , further comprising releasing fluid pressure from the proximal anchoring component subsequent to applying fluid pressure to the distal anchoring component to allow the proximal portion of the device to advance along the lead. 
     
     
         3 . The method of  claim 2 , further comprising releasing fluid pressure from the expansion component. 
     
     
         4 . The method of  claim 3 , wherein applying fluid pressure to the expansion component stretches a spring, and wherein releasing the fluid pressure from the proximal anchoring component and the expansion components allows the spring to contract to advance the proximal portion of the device along the lead. 
     
     
         5 . The method of  claim 3 , further comprising again applying fluid pressure to the proximal anchoring component of the device to anchor the proximal portion of the device to the lead at a second location further advanced along the lead than the first location. 
     
     
         6 . The method of  claim 5 , further comprising releasing fluid pressure from the distal anchoring component. 
     
     
         7 . The method of  claim 6 , further comprising, subsequent to releasing fluid pressure from the distal anchoring component and again applying fluid pressure to the proximal anchoring component, again applying fluid pressure to the expansion component to force the piston forward to cause the separating component to separate at least some further tissue from the lead. 
     
     
         8 . The method of  claim 7 , further comprising, subsequent again applying fluid pressure to the expansion component, again applying fluid pressure to the distal anchoring to anchor the distal portion of the device to the lead. 
     
     
         9 . The method of  claim 6 , further comprising repeating acts of applying fluid pressure to the proximal anchoring component, applying fluid pressure to the expansion component, applying fluid pressure to the distal anchoring component, releasing fluid pressure from the proximal anchoring component, releasing fluid pressure from the expansion component, and releasing fluid pressure from the distal anchoring component until the device has separated the tissue adhered to the lead. 
     
     
         10 . The method of  claim 1 , wherein anchoring the distal portion achieves anchoring the separating component to the lead. 
     
     
         11 . The method of  claim 1 , wherein:
 applying fluid pressure to the proximal anchoring component comprises applying fluid pressure to the proximal anchoring component via a first tube coupled to the first anchoring component;   applying fluid pressure to the expansion component comprises applying fluid pressure to the expansion component via a second tube coupled to the expansion component; and   applying fluid pressure to the distal anchoring component comprises applying fluid pressure to the distal anchoring component via a third tube coupled to the distal anchoring component, and   wherein the first tube, the second tube and the third tube are separate to allow for fluid pressure to be applied independently to the proximal anchoring component, the expansion component and the distal anchoring component, respectively.   
     
     
         12 . A method of assisting in removing an implanted electrical lead using a device adapted to accommodate the implanted electrical lead, the method comprising:
 advancing a device along the lead to where the device encounters tissue adhered to the lead;   anchoring a proximal portion of the device to the lead at a first location proximate the tissue by applying fluid pressure to a proximal anchoring component of the device;   subsequent to anchoring the proximal portion of the device to the lead, forcing a separating component forward against tissue adhered to the lead by applying fluid pressure to a piston mechanism having a piston coupled to the separating component, the fluid pressure forcing the piston forward to cause the separating component to separate at least some tissue from the lead; and   subsequent to forcing the separating component forward against the tissue, anchoring the separating component to the lead by applying fluid pressure to a distal anchoring component arranged on a distal side of the piston mechanism.   
     
     
         13 . The method of  claim 12 , advancing the proximal portion of the device along the lead at least in part by releasing fluid pressure from the proximal anchoring component subsequent to applying fluid pressure to the distal anchoring component. 
     
     
         14 . The method of  claim 13 , further comprising releasing fluid pressure from the piston mechanism. 
     
     
         15 . The method of  claim 14 , wherein applying fluid pressure to the piston mechanism stretches a spring coupled to the piston mechanism, and wherein releasing the fluid pressure from the proximal anchoring component and the piston mechanism allows the spring to contract to advance the proximal portion of the device along the lead. 
     
     
         16 . The method of  claim 13 , further comprising anchoring the proximal portion of the device to the lead at a second location further advanced along the lead than the first location by again applying fluid pressure to the proximal anchoring component. 
     
     
         17 . The method of  claim 16 , further comprising releasing the separating component by releasing fluid pressure from the distal anchoring component. 
     
     
         18 . The method of  claim 17 , further comprising, subsequent to again anchoring the proximal portion of the device to the lead, again forcing the separating component forward against tissue adhered to the lead by applying fluid pressure to the piston mechanism to force the piston forward to cause the separating component to separate at least some further tissue from the lead. 
     
     
         19 . The method of  claim 18 , further comprising, subsequent to again forcing the separating component forward against tissue, again anchoring the separating component to the lead by applying fluid pressure to the distal anchoring component. 
     
     
         20 . The method of  claim 12 , wherein:
 fluid pressure is applied to the proximal anchoring component via a first tube coupled to the first anchoring component;   fluid pressure is applied to the piston mechanism via a second tube coupled to the piston mechanism; and   fluid pressure is applied to the distal anchoring component via a third tube coupled to the distal anchoring component, and   wherein the first tube, the second tube and the third tube are separate to allow for fluid pressure to be applied independently to the proximal anchoring component, the piston mechanism and the distal anchoring component, respectively.