Anchoring delivery system and methods

Abstract

An anchoring delivery system for use in an intracranial artery is provided including a tethering device having an elongated tether and an anchor coupled to a distal end of the tether. The anchor is deployable from a low profile configuration to a higher profile configuration to fix the distal end of the tether at an anchoring site in an anchoring vessel. The tethering device is configured to be used with a guide-sheath having a lumen configured to receive the tether. Related devices, systems, and methods are also described.

1 - 25 . (canceled) 
     
     
         26 . A neurovascular catheter for performing a medical procedure at a treatment site in a cerebral vessel of a patient, the catheter comprising:
 an elongate control element configured to advance the neurovascular catheter comprising a proximal portion and a distal portion comprising a flat ribbon; and   a distal luminal portion extending along a longitudinal axis having a proximal end region coupled to the control element,   wherein the distal luminal portion has a side wall defining a single, inner lumen, the side wall comprising:
 a tubular inner liner; 
 a reinforcement structure wound around and bonded to the tubular inner liner; and 
 an outer jacket surrounding the reinforcement structure, 
   wherein a distal end of the elongate control element is coupled to the proximal end region of the distal luminal portion sandwiched between layers of the side wall, and   wherein the proximal end region of the distal luminal portion includes an outer diameter sized to form a seal with the sheath.   
     
     
         27 . The catheter of  claim 26 , wherein the distal luminal portion has a transition section near where the distal luminal portion couples to the elongate control element. 
     
     
         28 . The catheter of  claim 27 , wherein the transition section has an angled cut. 
     
     
         29 . The catheter of  claim 28 , wherein the proximal opening is formed within the transition section and the proximal end region of the distal luminal portion is coupled to the distal end region of the control element adjacent the transition section. 
     
     
         30 . The catheter of  claim 26 , wherein a proximal end of the elongate flexible control element is coupled to a tab. 
     
     
         31 . The catheter of  claim 26 , further comprising a reversible coupling feature on the control element for organizing the control element of the neurovascular catheter and a component used with the catheter engaged by the reversible coupling feature. 
     
     
         32 . The catheter of  claim 26 , wherein the flat ribbon has a rectangular cross-sectional dimension that is wider than it is thick. 
     
     
         33 . The catheter of  claim 26 , wherein a maximum cross-sectional dimension of the flat ribbon is 0.025″. 
     
     
         34 . The catheter of  claim 26 , wherein the neurovascular catheter has a length that when inserted through a sheath positioned at a transfemoral access site so a distal end region of the catheter is located within a middle cerebral artery the proximal end region of the distal luminal portion remains outside the aortic arch. 
     
     
         35 . The catheter of  claim 26 , further comprising a catheter advancement element sized to be positioned within the inner lumen of the catheter, wherein a tapered distal tip of the catheter advancement element extends distal to a distal end of the neurovascular catheter during delivery of the catheter. 
     
     
         36 . A catheter system comprising the catheter of  claim 26  and a sheath having a central lumen and proximal hemostasis valve configured to couple with a single source of suction, wherein the inner lumen of the neurovascular catheter is sized to insert through the central lumen of the sheath forming a contiguous lumen suitable to remove occlusive material through the contiguous lumen upon application of suction by the single source of suction. 
     
     
         37 . A neurovascular catheter, comprising:
 an elongate control element configured to advance the catheter, the control element comprising a proximal end region, and a distal end region comprising a flat ribbon; and   a distal luminal portion extending along a longitudinal axis having a proximal end region coupled to the distal end region of the control element,   wherein the distal luminal portion has a side wall defining a single, inner lumen extending between a proximal opening into the inner lumen at the proximal end region of the distal luminal portion and a distal opening from the central lumen at the distal end region of the distal luminal portion, the side wall comprising:
 a tubular inner liner having an outer surface coated with a compound suitable for bonding; 
 a reinforcement structure that is a helical coil bonded to the coated outer surface of the tubular inner liner; and 
 an outer jacket surrounding the helical coil, 
   wherein the distal end region of the elongate control element is coupled to the proximal end region of the distal luminal portion sandwiched between layers of the side wall.   
     
     
         38 . A neurovascular catheter as in  claim 37 , wherein a distal end of the flat ribbon has a feature that facilitates a mechanical joint during a weld. 
     
     
         39 . A neurovascular catheter as in  claim 38 , wherein the feature comprises a textured surface, protruding feature, or cut-out feature. 
     
     
         40 . A neurovascular catheter as in  claim 37 , wherein the distal luminal portion and the flat ribbon are joined by a weld bond, a mechanical bond, or an adhesive bond. 
     
     
         41 . A neurovascular catheter as in  claim 37 , wherein a distal end of the flat ribbon is skived, ground or cut. 
     
     
         42 . A neurovascular catheter as in  claim 37 , wherein a region of overlap between a distal end of the ribbon and the proximal end region of the distal luminal portion is at least about 1 cm. 
     
     
         43 . A neurovascular catheter as in  claim 37 , wherein the distal luminal portion has a transition section near where the distal luminal portion couples to the elongate control element. 
     
     
         44 . A neurovascular catheter as in  claim 43 , wherein the transition section has an angled cut. 
     
     
         45 . A neurovascular catheter as in  claim 44 , wherein the proximal opening is formed within the transition section and the proximal end region of the distal luminal portion is coupled to the distal end region of the control element adjacent the transition section. 
     
     
         46 . A neurovascular catheter as in  claim 37 , wherein a proximal end of the distal luminal portion is angled in an oblique manner relative to a longitudinal axis of the catheter. 
     
     
         47 . A neurovascular catheter as in  claim 46 , wherein the proximal end and the proximal opening into the lumen are at an angle other than 90 degrees to the longitudinal axis of the catheter. 
     
     
         48 . A neurovascular catheter as in  claim 37 , wherein the outer jacket is formed from a plurality of tubular segments positioned coaxially about the helical coil. 
     
     
         49 . A neurovascular catheter as in  claim 48 , wherein a proximal one of the plurality of tubular segments has a durometer of at least about 60D and a distal one of the plurality of tubular segments has a durometer of no more than about 35D. 
     
     
         50 . A neurovascular catheter as in  claim 37 , wherein the tubular liner comprises polytetrafluoroethylene. 
     
     
         51 . A neurovascular catheter as in  claim 37 , wherein the helical coil comprises a shape memory material. 
     
     
         52 . A neurovascular catheter as in  claim 51 , wherein the helical coil comprises Nitinol. 
     
     
         53 . A neurovascular catheter as in  claim 48 , wherein the outer jacket is formed from at least five discrete tubular segments. 
     
     
         54 . A neurovascular catheter as in  claim 48 , wherein the outer jacket is formed from more than five discrete tubular segments. 
     
     
         55 . A neurovascular catheter as in  claim 54 , wherein a difference in durometer between a proximal one of the tubular segments and a distal one of the tubular segments is at least about 20D. 
     
     
         56 . A neurovascular catheter as in  claim 55 , wherein the difference is at least about 30D. 
     
     
         57 . A neurovascular catheter as in  claim 37 , wherein the distal luminal portion is non-expandable. 
     
     
         58 . A neurovascular catheter as in  claim 37 , wherein a proximal end region of the elongate flexible control element is a tab. 
     
     
         59 . A neurovascular catheter as in  claim 37 , wherein the control element further comprises a reversible coupling feature configured to engage with a component used with the catheter to aid in organization of the catheter and the component. 
     
     
         60 . A neurovascular catheter as in  claim 37 , wherein a distal end of the tubular segment is angled in an oblique manner relative to the longitudinal axis. 
     
     
         61 . A neurovascular catheter as in  claim 37 , wherein the flat ribbon has a rectangular cross-sectional dimension that is wider than it is thick. 
     
     
         62 . A neurovascular catheter as in  claim 37 , wherein a maximum cross-sectional dimension of the flat ribbon is 0.025″. 
     
     
         63 . A neurovascular catheter as in  claim 37 , wherein a length of the distal luminal portion is sufficient to reach from a transfemoral access site to a middle cerebral artery so that the proximal end region of the distal luminal portion remains outside the aortic arch.