Methods and devices for treating stroke

Abstract

Methods and devices are disclosed herein that allow for infusion and aspiration through a single device. The device can be used to treat a stroke by delivering the device to the site of a blood clot and simultaneously or sequentially infusing a thrombolytic or other drug into the clot and aspirating the dissolving clot from the patient. The methods and devices can advantageously permit more efficient thrombolytic infusion and clot aspiration. Modular systems are also disclosed, as are methods of treating subdural hematoma or other conditions.

1 . A catheter system, comprising:
 an infusion catheter having an infusion lumen and at least one outlet port; and   an aspiration catheter having an aspiration lumen and at least one aspiration port, the aspiration catheter defining a channel in which the infusion catheter is slidably disposed.   
     
     
         2 . The system of  claim 1 , wherein the aspiration catheter defines a bullet-nose feature. 
     
     
         3 . The system of  claim 1 , further comprising an insertion stylet removably positioned in the infusion lumen of the infusion catheter. 
     
     
         4 . The system of  claim 1 , further comprising a TRA system. 
     
     
         5 . The system of  claim 4 , wherein the TRA system comprises a hydrophone or microphone disposed in a distal end of the infusion catheter, one or more leads extending from the hydrophone or microphone to a proximal end of the infusion catheter, and a reverberator configured to time-reverse a signal detected by the hydrophone or microphone and emit acoustic waves based on the time-reversed signal. 
     
     
         6 . The system of  claim 1 , wherein the aspiration catheter includes first and second steering wires to which tension can be applied to remotely steer a distal end of the aspiration catheter. 
     
     
         7 . The system of  claim 1 , wherein the aspiration lumen comprises first and second aspiration lumens, each having a C-shaped transverse cross-section. 
     
     
         8 . A method of treating a patient, comprising:
 advancing a catheter system to a treatment site within the patient;   delivering at least one of a drug and an irrigation fluid to the treatment site through an infusion catheter of the catheter system;   advancing an aspiration catheter of the catheter system distally with respect to the infusion catheter; and   aspirating material from the treatment site through an aspiration lumen of the aspiration catheter.   
     
     
         9 . The method of  claim 8 , wherein the treatment site comprises a clot in a brain of the patient. 
     
     
         10 . The method of  claim 8 , wherein the drug comprises a thrombolytic. 
     
     
         11 . The method of  claim 8 , wherein the aspirated material comprises clot material. 
     
     
         12 . The method of  claim 8 , wherein aspirating the material comprises steering the aspiration catheter within the treatment site. 
     
     
         13 . The method of  claim 8 , wherein delivering the drug comprises enhancing diffusion rate of the drug by applying acoustic energy to the treatment site. 
     
     
         14 . The method of  claim 8 , wherein delivering the drug comprises controlling the direction in which the drug is distributed using acoustic energy. 
     
     
         15 . The method of  claim 13 , wherein the acoustic energy is emitted from a TRA system. 
     
     
         16 . A modular catheter system, comprising:
 an aspiration catheter having a proximal aspiration housing with an aspiration port formed therein;   an infusion catheter slidably disposed within the aspiration catheter and having a proximal infusion housing with an infusion port formed therein; and   a cap housing configured to be selectively coupled to either of the aspiration housing and the infusion housing.   
     
     
         17 . The system of  claim 16 , further comprising an insertion stylet having a proximal insertion housing configured to be selectively coupled to the infusion housing. 
     
     
         18 . The system of  claim 16 , wherein the aspiration housing and the infusion housing define a catheter module and wherein the system includes a hand control module configured to be selectively coupled to the catheter module. 
     
     
         19 . The system of  claim 18 , wherein the hand control module includes a control for advancing or retracting the infusion catheter relative to the aspiration catheter. 
     
     
         20 . The system of  claim 18 , wherein the hand control module includes a control for steering the aspiration catheter. 
     
     
         21 . The system of  claim 16 , wherein the aspiration housing and the infusion housing define a catheter module and wherein the system includes a stereotactic module configured to be selectively coupled to the catheter module. 
     
     
         22 . The system of  claim 21 , wherein the stereotactic module includes a mating feature for attaching the stereotactic module to a stereotactic frame. 
     
     
         23 . The system of  claim 21 , wherein the stereotactic module includes a first control for advancing or retracting the infusion catheter relative to the aspiration catheter and a second control for steering the aspiration catheter.