Atherectomy catheters and occlusion crossing devices

Abstract

An atherectomy catheter includes an elongate flexible catheter body, a cutter near the distal end of the catheter body, a drive shaft connected to the cutter and extending within the catheter body, an imaging element near the distal end of the catheter body.

What is claimed is: 
     
         1 . An atherectomy catheter device, the device comprising:
 an elongate body having a drive shaft extending longitudinally within the elongate body;   an optical coherence tomography fiber running along a central longitudinal axis of the drive shaft; and   a handle attached to a proximal end of the elongate body, the handle including:
 a fiber holding chamber configured to rotate with the drive shaft, the fiber holding chamber having an inner region into which the fiber extends; and 
 a fiber coupling region configured to couple the fiber to a light source, 
   wherein the fiber and the drive shaft are configured to move axially within the handle relative to the fiber holding chamber and fiber coupling region, and wherein the fiber is configured to bend within the fiber holding chamber as the fiber and the drive shaft move axially.   
     
     
         2 . The device of  claim 1 , wherein the handle further includes a drive shaft tensioning spring configured to apply a controlled tensile load on the drive shaft when the drive shaft is moved proximally. 
     
     
         3 . The device of  claim 1 , wherein the fiber holding chamber is configured to rotate with the fiber. 
     
     
         4 . The device of  claim 1 , further comprising a hollow distal tip extending from a distal end of the elongate body. 
     
     
         5 . The device of  claim 4 , further comprising a cutter configured to extend into the hollow distal tip to pack tissue into the hollow distal tip. 
     
     
         6 . The device of  claim 4 , wherein the hollow distal tip is configured to bend away from the elongate body. 
     
     
         7 . The device of  claim 1 , wherein the drive shaft is rotatable within the elongate body. 
     
     
         8 . The device of  claim 1 , wherein the fiber runs an entire length of the drive shaft. 
     
     
         9 . The device of  claim 1 , wherein the fiber holding chamber is cylindrical. 
     
     
         10 . The device of  claim 1 , further comprising a reflective element configured to radially direct light from the fiber out of the elongate body. 
     
     
         11 . The device of  claim 1 , wherein drive shaft is connected to a cutter having a cutting edge. 
     
     
         12 . The device of  claim 1 , wherein the fiber is configured to float freely within the drive shaft. 
     
     
         13 . An atherectomy catheter device, the device comprising:
 an elongate body having a hollow distal tip extending from a distal end of the elongate body;   a drive shaft extending longitudinally within the elongate body and configured to rotate with respect to the elongate body;   an optical coherence tomography fiber running along a central longitudinal axis of the drive shaft; and   a handle attached to a proximal end of the elongate body, the handle including:
 a fiber holding chamber configured to rotate with the drive shaft, the fiber holding chamber having an inner region into which the fiber extends; and 
 a fiber coupling region configured to couple the fiber to a light source, 
   wherein the fiber and the drive shaft are configured to move axially within the handle relative to the fiber holding chamber and fiber coupling region, and wherein the fiber is configured to bend within the fiber holding chamber as the fiber and the drive shaft move axially.   
     
     
         14 . The device of  claim 13 , wherein the fiber holding chamber is configured to rotate with the fiber. 
     
     
         15 . The device of  claim 13 , wherein the drive shaft is configured to move proximally or distally to bend the hollow distal tip away from the elongate body. 
     
     
         16 . The device of  claim 13 , further comprising a cutter configured to extend out of a cutting window opposite a hinge region of the device. 
     
     
         17 . The device of  claim 13 , further comprising a cutting and imaging assembly, wherein the drive shaft is configured to rotate the cutting and imaging assembly relative to the elongate body. 
     
     
         18 . The device of  claim 17 , wherein the cutting and imaging assembly is configured to rotate relative to the hollow distal tip. 
     
     
         19 . The device of  claim 13 , further comprising a balloon wrapped around portions of the elongate body and the hollow distal tip while leaving a distal cutting edge exposed, wherein the balloon is configured to urge the distal cutting edge against a vessel wall and occlude blood flow therearound. 
     
     
         20 . The device of  claim 13 , wherein the handle further includes a drive shaft tensioning spring configured to apply a controlled tensile load on the drive shaft when the drive shaft is moved proximally.