Thrombectomy methods

Abstract

Methods and apparatuses for removing material (e.g., clot) from within a body, including inverting thrombectomy apparatuses. These methods and apparatuses may include methods and apparatuses for reusing portion of the devices, method and apparatuses for loading and reloading the inverting thrombectomy apparatuses, and methods and apparatuses for improving and enhancing the ability of the inverting thrombectomy apparatuses to remove clot. In particular, described herein are expandable scraper devices that may be used in conjunction with the inverting thrombectomy apparatuses descried herein, or on their own.

What is claimed is: 
     
         1 . An expandable scraper device for use within a lumen of a vessel, the expandable scraper device comprising:
 an elongated shaft; and   an expandable basket coupled to the elongated shaft, the expandable basket having an unexpanded configuration and an expanded configuration, wherein when in the expanded configuration and disposed against a wall of the vessel lumen, the expandable braided basket is configured to apply a maximum scraping force against the wall of the vessel lumen of 1.5 pounds of force or less.   
     
     
         2 . The expandable scraper device of  claim 1 , wherein the expandable basket is an expandable braided basket. 
     
     
         3 . The expandable scraper device of  claim 2 , wherein the expandable braided basket is loosely braided so that it deforms along the long axis to limit the maximum scraping force to 1.5 pounds or less. 
     
     
         4 . The expandable scraper device of  claim 2 , wherein expandable basket comprises a braid of between 20 and 60 nickel titanium wires each having a diameter of between 0.15 mm and 0.35 mm. 
     
     
         5 . The expandable scraper device of  claim 1 , further including a control on a handle of the expandable scraper device configured to expand or contract the expandable basket. 
     
     
         6 . The expandable scraper device of  claim 5 , wherein the control is configured to maintain a pull force of between about 0.2 and 1.5 pounds of force. 
     
     
         7 . The expandable scraper device of  claim 5 , wherein the control on the handle of the expandable scraper device comprises a finger slider to manually adjust expansion of the expandable basket to maintain a pull force between about 0.2 and 1.5 pounds of force. 
     
     
         8 . The expandable scraper device of  claim 1 , wherein the expandable basket is biased to return to the unexpanded configuration in an unconstrained state. 
     
     
         9 . The expandable scraper device of  claim 1 , wherein the expandable basket has a length from 3 to 10 cm in the unexpanded configuration. 
     
     
         10 . The expandable scraper device of  claim 1 , wherein the shaft includes an inner elongate member which extends between a distal end of the expandable basket and a proximal end of the expandable basket, and when the basket is in the expanded configuration, the inner elongate member is positioned within the expandable braided basket and is offset from a midline of the expandable basket. 
     
     
         11 . The expandable scraper device of  claim 1 , wherein the shaft includes a guidewire lumen. 
     
     
         12 . The expandable scraper device of  claim 1 , wherein the shaft includes an inner elongate member slidably disposed within an outer elongate member, the expandable basket coupled at a proximal end to a distal end region of the outer elongate member and at a distal end to a distal end region of the inner elongate member. 
     
     
         13 . An expandable scraper device for use within a lumen of a vessel, the expandable scraper device comprising:
 an elongated shaft including an inner elongate member slidably disposed within an outer elongate member;   expandable braided basket coupled at a proximal end to a distal end region of the outer elongate member and at a distal end to a distal end region of the inner elongate member, the expandable braided basket having an unexpanded configuration and an expanded configuration, wherein when in the expanded configuration and disposed against a wall of the vessel lumen, the expandable braided basket is configured to apply a maximum scraping force against the wall of the vessel lumen of 1.5 pounds of force or less; and   
       a handle on the shaft, the handle including a control configured to expand or contract the expandable braided basket to maintain a pull force between about 0.2 and 1.5 pounds. 
     
     
         14 . The expandable scraper device of  claim 13 , wherein the expandable braided basket is biased to return to the unexpanded configuration in an unconstrained state. 
     
     
         15 . The expandable scraper device of  claim 13 , wherein the expandable braided basket has a length of between 3 and 10 cm in the unexpanded configuration. 
     
     
         16 . The expandable scraper device of  claim 13 , wherein the expandable braided basket is loosely braided so that it deforms along the long axis to limit the maximum scraping force to 1.5 pounds or less. 
     
     
         17 . The expandable scraper device of  claim 13 , wherein the expandable braided basket includes between 20 and 60 nickel titanium wires each having a diameter of between 0.15 mm and 0.35 mm. 
     
     
         18 . The expandable scraper device of  claim 13 , wherein the inner elongate member extends between a distal end of the expandable braided basket and a proximal end of the expandable braided basket and is positioned within the expandable braided basket offset from a midline of the expandable braided basket when the expandable braided basket is in the expanded configuration. 
     
     
         19 . An expandable scraper device for use within a lumen of a vessel, the expandable scraper device comprising:
 an elongated shaft including an inner elongate member slidably disposed within an outer elongate member;   an expandable braided basket coupled at a proximal end to a distal end region of the outer elongate member and at a distal end to a distal end region of the inner elongate member, the expandable braided basket having an unexpanded configuration and an expanded configuration, and wherein the inner elongate member extends between a distal end of the expandable braided basket and a proximal end of the expandable braided basket and is positioned within the expandable braided basket offset from a midline of the expandable braided basket when the expandable braided basket is in the expanded configuration.   
     
     
         20 . The expandable scraper device of  claim 19 , wherein a handle on the shaft, the handle including a control configured to expand or contract the expandable braided basket to maintain a pull force between about 0.2 and 1.5 pounds and when in the expanded configuration and disposed against a wall of the vessel lumen, the expandable braided basket is configured to apply a maximum scraping force against the wall of the vessel lumen of 1.5 pounds of force or less.