Methods and systems for treatment of acute ischemic stroke

Abstract

A system of devices for treating an artery includes an arterial access sheath adapted to introduce an interventional catheter into an artery and an elongated dilator positionable within the internal lumen of the sheath body. The system also includes a catheter formed of an elongated catheter body sized and shaped to be introduced via a carotid artery access site into a common carotid artery through the internal lumen of the arterial access sheath. The catheter has an overall length and a distal most section length such that the distal most section can be positioned in an intracranial artery and at least a portion of the proximal most section is positioned in the common carotid artery during use.

What is claimed is: 
     
         1 . An aspiration catheter system comprising:
 an outer catheter comprising a tubular body with a central lumen having an inner diameter, a proximal end and a distal opening, wherein the outer catheter is attachable to an aspiration line that connects to an aspiration source to apply aspiration; and   an inner catheter comprising a distal portion and a proximal tether extending proximally from a point of attachment between the proximal tether and the distal portion, wherein the distal portion has a single inner lumen,   wherein the inner catheter is configured to slide within the central lumen of the tubular body to change the relative position of the inner catheter within the central lumen and provide for at least a portion of the distal portion to extend outward from the distal opening of the tubular body such that an overlap region is formed between the inner catheter and the outer catheter,   wherein an aspiration lumen is collectively formed by the single inner lumen of the inner catheter and the central lumen of the outer catheter, and   wherein a proximal end region of the inner catheter comprises an inclined surface flaring outward in a proximal direction, wherein the inclined surface is formed in a thickened portion of the catheter wall that is sized to contact the inner diameter of the central lumen to provide sealing sufficient to transmit aspiration force from the aspiration source to a distal opening of the inner catheter to capture a thrombus.   
     
     
         2 . The aspiration catheter system of  claim 1 , wherein the inclined surface is biased outward and compressible against the inner diameter of the outer catheter. 
     
     
         3 . The aspiration catheter system of  claim 1 , wherein the inner diameter of the central lumen of the tubular body is about 0.086″ to about 0.088″ and corresponds to a 6 French sheath size. 
     
     
         4 . The aspiration catheter system of  claim 3 , wherein the inner diameter of the single inner lumen of the inner catheter is about 0.035″ to about 0.060″ or about 0.070″ to about 0.095″. 
     
     
         5 . The aspiration catheter system of  claim 1 , wherein the inner catheter comprises a radiopaque marker near the proximal end region and a radiopaque marker near the distal opening. 
     
     
         6 . The aspiration catheter system of  claim 1 , wherein the point of attachment is positioned within a transition zone that bridges a flexibility of the proximal tether to a flexibility of the inner catheter. 
     
     
         7 . The aspiration catheter system of  claim 6 , wherein the proximal tether within the transition zone comprises a flattened distal end region. 
     
     
         8 . The aspiration catheter system of  claim 6 , wherein the proximal end region of the inner catheter within the transition zone comprises a reinforcement structure. 
     
     
         9 . The aspiration catheter system of  claim 1 , wherein the inclined surface forms a single compressible external surface feature. 
     
     
         10 . The aspiration catheter system of  claim 1 , wherein the proximal end region having the inclined surface has a substantially uniform inner diameter. 
     
     
         11 . The aspiration catheter system of  claim 1 , wherein the inclined surface forms a sealing element positioned on an external surface of a proximal end of the inner catheter. 
     
     
         12 . An aspiration catheter system comprising:
 an access catheter comprising a tubular body with a central lumen having an inner diameter, a proximal end and a distal opening, wherein the access catheter is attachable to an aspiration line that connects to an aspiration source via the connector; and   an aspiration catheter comprising a distal portion and a proximal tether extending proximally from a point of attachment between the proximal tether and the distal portion, wherein the distal portion has a single inner lumen,   wherein the aspiration catheter is configured to slide within the central lumen of the tubular body to change the relative position of the aspiration catheter within the central lumen and provide for at least a portion of the distal portion to extend outward from the distal opening of the tubular body such that an overlap region is formed between the aspiration catheter and the access catheter,   wherein an aspiration lumen is collectively formed by the single inner lumen of the aspiration catheter and the central lumen of the access catheter, and   wherein a proximal end region of the aspiration catheter wall thickens to form an inclined surface that flares outward so as to increase the outer diameter of the proximal end region, the inclined surface forms a sealing element positioned on an external surface of the proximal end region of the aspiration catheter that seals against the inner diameter of the access catheter.   
     
     
         13 . The aspiration catheter system of  claim 12 , wherein the inclined surface forms a compressible external surface feature. 
     
     
         14 . The aspiration catheter system of  claim 12 , wherein the aspiration catheter comprises a radiopaque marker near the proximal end region and a radiopaque marker near the distal opening. 
     
     
         15 . The aspiration catheter system of  claim 12 , wherein the point of attachment is positioned within a transition zone that bridges a flexibility of the proximal tether to a flexibility of the aspiration catheter. 
     
     
         16 . The aspiration catheter system of  claim 15 , wherein the proximal tether within the transition zone comprises a flattened distal end region. 
     
     
         17 . The aspiration catheter system of  claim 16 , further comprising the aspiration source comprising a syringe having a volume of at least 30 cc, and wherein a flow rate of at least about 321 mL/min is established when an aspiration pressure through the aspiration lumen is applied by the syringe. 
     
     
         18 . The aspiration catheter system of  claim 16 , wherein the inclined surface forms a single compressible external surface feature. 
     
     
         19 . The aspiration catheter system of  claim 16 , wherein the proximal end region having the inclined surface has a substantially uniform inner diameter. 
     
     
         20 . The aspiration catheter system of  claim 16 , wherein the access catheter having the central lumen is a single-lumen access catheter. 
     
     
         21 . The aspiration catheter system of  claim 16 , wherein the inclined surface forms a sealing element positioned on the external surface of a proximal end of the aspiration catheter. 
     
     
         22 . A method of performing a medical procedure at a treatment site in a blood vessel of a patient, the method comprising:
 introducing through an insertion site of the patient an access catheter comprising a tubular body with a central lumen having an inner diameter, a proximal end and a distal opening, wherein the access catheter is attachable to an aspiration line that connects to an aspiration source;   sliding an interventional catheter within the central lumen of the tubular body to change a relative position of the interventional catheter within the central lumen, the interventional catheter comprising a distal portion and a proximal tether extending proximally from a point of attachment between the proximal tether and the distal portion, wherein the distal portion has a single inner lumen,   advancing the interventional catheter through the access catheter until a distal opening of the interventional catheter is located at an occlusion in the vasculature and an overlap region is formed between the interventional catheter and the access catheter, wherein an aspiration lumen is collectively formed by the single inner lumen of the interventional catheter and the central lumen of the access catheter, and wherein a proximal end region of a wall of the interventional catheter thickens to form an inclined surface that flares outward so as to increase the outer diameter of the proximal end region, the inclined surface forms a sealing element positioned on an external surface of the proximal end region of the interventional catheter that seals against the inner diameter of the access catheter; and   transmitting aspiration force from the aspiration source to the distal opening of the interventional catheter to capture the occlusion.   
     
     
         23 . The method of  claim 22 , further comprising advancing a treatment device into the single inner lumen of the interventional catheter so that the treatment device resides at or near the occlusion. 
     
     
         24 . The method of  claim 23 , wherein the treatment device is a retrievable stent device configured to capture the occlusion. 
     
     
         25 . The method of  claim 22 , wherein the aspiration source is a syringe or a pump. 
     
     
         26 . The method of  claim 22 , further comprising advancing the access catheter into a carotid artery prior to sliding the interventional catheter within the central lumen. 
     
     
         27 . The method of  claim 22 , wherein the inclined surface forms a compressible external surface feature. 
     
     
         28 . The method of  claim 22 , wherein the interventional catheter comprises a radiopaque marker near the proximal end region and a radiopaque marker near the distal opening. 
     
     
         29 . The method of  claim 22 , wherein the point of attachment is positioned within a transition zone that bridges a flexibility of the proximal tether to a flexibility distal portion of the interventional catheter and the proximal tether within the transition zone comprises a flattened distal end region. 
     
     
         30 . The method of  claim 22 , wherein the proximal end region having the inclined surface has a substantially uniform inner diameter and the inclined surface forms a sealing element positioned on the external surface.