Systems and methods for thrombolysis and delivery of an agent

Abstract

A system for removing intracranial blood or thrombus including a probe having a supply channel and an aspiration channel, the aspiration channel having a distal end and a proximal end, the supply channel having a distal end and a wall, the aspiration channel having an opening at or adjacent its distal end and an interior wall surface, an orifice adjacent the distal end of the supply channel and in fluid communication with the interior of the aspiration channel, wherein the orifice is configured to create a spray pattern when pressurized fluid is pumped through the supply channel such that the spray pattern impinges on the interior wall surface of the aspiration channel, and an ultrasound device at or adjacent the opening of the aspiration channel, and configured to operate at a frequency of between about 1 kHz and about 20 MHz.

What is claimed is: 
     
         1 . A system for removing intracranial blood or thrombus comprising:
 a probe having a supply channel and an aspiration channel, the aspiration channel having a distal end and a proximal end, the supply channel having a distal end and a wall, the aspiration channel having an opening at or adjacent its distal end and an interior wall surface;   an orifice adjacent the distal end of the supply channel and in fluid communication with the interior of the aspiration channel, wherein the orifice is configured to create a spray pattern when pressurized fluid is pumped through the supply channel such that the spray pattern impinges on the interior wall surface of the aspiration channel; and   an ultrasound device at or adjacent the opening of the aspiration channel, and configured to operate at a frequency of between about 1 kHz and about 20 MHz.   
     
     
         2 . The system of  claim 1 , further comprising a trocar configured to receive the probe. 
     
     
         3 . The system of  claim 2 , further comprising a visualization device, the trocar comprising a visualization channel configured to receive the visualization device. 
     
     
         4 . The system of  claim 1 , wherein the pressurized fluid comprises a pharmacologic agents, microbubbles or nanobubble. 
     
     
         5 . The system of  claim 1 , wherein the spray pattern comprises a jet. 
     
     
         6 . The system of  claim 1 , wherein the spray pattern comprises at least two jets. 
     
     
         7 . The system of  claim 1 , wherein the interior wall surface of the aspiration lumen includes a deflecting element configured to at least partially create a substantially distally-oriented flow of the spray pattern. 
     
     
         8 . The system of  claim 1 , wherein the orifice is configured to direct the spray pattern obliquely in relation to a longitudinal axis of the aspiration lumen. 
     
     
         9 . The system of  claim 8 , wherein the orifice is configured to angle the spray pattern at least partially distally in relation to a longitudinal axis of the aspiration lumen. 
     
     
         10 . A method for removing intracranial blood or thrombus from a patient comprising:
 advancing an ultrasound device through the trocar to a treatment location within an intracranial space;   transmitting ultrasound energy at one or more frequencies between about 1 kHz and about 20 MHz from the ultrasound device; and   removing the blood or thrombus from the patient through a probe having a supply channel and an aspiration channel, the aspiration channel having a distal end and a proximal end, the supply channel having a distal end and a wall, the aspiration channel having an opening at or adjacent its distal end and an interior wall surface, an orifice adjacent the distal end of the supply channel and in fluid communication with the interior of the aspiration channel, wherein the orifice is configured to create a spray pattern when pressurized fluid is pumped through the supply channel such that the spray pattern impinges on the interior wall surface of the aspiration channel, wherein the blood or thrombus is removed through the aspiration channel.   
     
     
         11 . The method of  claim 10 , further comprising pumping the pressurized fluid through the supply channel, the pressurized fluid comprises a pharmacologic agents, microbubbles or nanobubble. 
     
     
         12 . The method of  claim 11 , further comprising cooling a head or neck. 
     
     
         13 . The method of  claim 12 , wherein the cooling comprises coiling to between 30° C. or 35° C. 
     
     
         14 . The method of  claim 12 , wherein cooling the head or neck comprises systemic cooling by infusing ice-cold saline using an intravenous approach. 
     
     
         15 . The method of  claim 12 , wherein cooling the head or neck comprises focused cranial cooling. 
     
     
         16 . The method of  claim 10 , further comprising placing an introducer through an aperture formed in the patient's skull. 
     
     
         17 . The method of  claim 16 , further comprising placing a trocar through the introducer. 
     
     
         18 . The method of  claim 17 , wherein advancing the ultrasound device comprises advancing the ultrasound device through the trocar. 
     
     
         19 . The method of  claim 17 , wherein the spray pattern comprises a jet. 
     
     
         20 . The method of  claim 17 , wherein the interior wall surface of the aspiration lumen includes a deflecting element configured to at least partially create a substantially distally-oriented flow of the spray pattern.