Magnetically guided atherectomy

Abstract

Atherectomy device are guided by and manipulated by externally applied magnetic fields to treat total or partial occlusions of a patient's vasculature.

What is claimed is:  
     
         1 . A catheter for treating an occluded vessel comprising: 
 a catheter body having a proximal end and a distal end, said distal end terminating in a distal tip;    an energy source coupled to said distal tip for supplying energy to the distal tip for treating an occlusion;    a magnetically active element located proximate said distal tip responsive to externally applied magnetic fields whereby said externally applied magnetic fields direct and orient said distal tip.    
     
     
         2 . The catheter of  claim 1  wherein said magnetically active element forms at least a portion of said distal tip.  
     
     
         3 . The catheter of  claim 1  further including a lumen positioned in said catheter body extending form said proximal end to said distal end.  
     
     
         4 . The catheter of  claim 1  further including one or more electrical coils located proximate said distal tip for cooperation with a localization device.  
     
     
         5 . A sheath for use with a catheter of  claim 1  for treating a vessel occlusion comprising: 
 a sheath body having a proximal end and having a distal end;  
 a lumen extending from said proximal end to said distal end;  
 a magnetically active element located proximate said distal tip.  
 
     
     
         6 . A system for treating a vessel occlusion comprising: 
 a sheath, having a sheath body, said sheath body having a proximal end and having a distal end;    a lumen extending through said sheath body from said proximal end to said distal end;    a catheter having a catheter body having a proximal end and a distal end terminating in distal tip;    an energy source coupled to said distal tip;    a magnetically active element located proximate said distal tip of said catheter body.    
     
     
         7 . A system for treating a vessel occlusion comprising: a sheath, having a sheath body, said sheath body having a proximal end and having a distal end; 
 a lumen extending through said sheath body from said proximal end to said distal end;    a catheter having a catheter body having a proximal end and a distal end;    an energy source coupled to said distal tip for delivering therapeutic energy to a vessel occlusion;    a magnetically active element forming a portion of said distal tip of said sheath body.    
     
     
         8 . The catheter of  claim 1  including a first metallic element located proximate said distal tip adapted for coupling to a remote radio frequency energy source whereby RF energy coupled to said metallic element heats said metallic element.  
     
     
         9 . The catheter of  claim 8  wherein said metallic element forms one pole of a monopolar energy distribution system.  
     
     
         10 . The catheter of  claim 9  further comprising a second metallic element proximate said distal tip forming a pole of a bipolar energy distribution system.  
     
     
         11 . The catheter of  claim 1  including a thermally conductive element located proximate said distal tip adapted for coupling to a remote optical laser energy source whereby optical energy coupled to said thermally conductive element heats said thermally conductive element.  
     
     
         12 . The catheter of  claim 11  wherein said thermally conductive element is metallic.  
     
     
         13 . The catheter of  claim 1  further including an ultrasonic waveguide element located proximate said distal tip adapted for coupling to a remote ultrasonic frequency energy source.  
     
     
         14 . The catheter of  claim 1  further including a resistance heating element located proximate said distal tip adapted for coupling to a remote electrical energy source.  
     
     
         15 . The catheter of  claim 14  further including a resistance heating element located proximate said distal tip adapted for coupling to a remote AC elect5rical energy source.  
     
     
         16 . The catheter of  claim 14  further including a resistance heating element located proximate said distal tip adapted for coupling to a remote DC electrical energy source.  
     
     
         17 . The catheter of  claim 1  further including a fluid directing element located proximate said distal tip adapted for coupling to a remote hydraulic energy source, whereby fluid coupled to said device extracts occlusive material from locations near the distal tip.  
     
     
         18 . The catheter of  claim 3  further including a laser imaging device located in said lumen for observing an occlusion.  
     
     
         19 . The catheter of  claim 3  further including an ultrasonic imaging device located in said lumen for observing an occlusion.  
     
     
         20 . A system for treating total occlusions of a patient's vasculature comprising: 
 a catheter having an elongate body and a distal tip;    a heated element located proximate the distal tip of the catheter;    a magnetic element located proximate distal tip;    a magnetic surgery system for interacting with said magnetic element; said magnetic surgery system including a localization device to determine the location of the catheter distal tip within the body;    said magnetic surgery system including an occlusion visualization device for presenting an image to a user which depicts the location of the catheter tip.    
     
     
         21 . The system of  claim 20  wherein said visualization device is an ultrasonic imaging wire.  
     
     
         22 . The system of  claim 20  wherein said visualization device is a laser imaging wire.  
     
     
         23 . A system for treating occlusions of a patient's vasculature comprising: 
 a catheter having an elongate body and a distal tip;    a heated element located proximate the distal tip of the catheter;    a magnetic element located proximate the distal tip;    a magnetic surgery system for interacting with said magnetic element;    said magnetic surgery system including a localization device to determine the location of the catheter distal tip within the body;    said magnetic surgery system including a catheter location visualization device for presenting an image to a user which depicts the location of the catheter tip.    
     
     
         24 . The system of  claim 23  wherein said catheter location visualization device is a preoperative CT image.  
     
     
         25 . The system of  claim 23  wherein said catheter location visualization device is a preoperative MRI image.  
     
     
         26 . A method of treating a total vascular occlusion comprising the steps of: 
 inserting a catheter having a magnetic tip into the body;    directing the catheter to the location of the total occlusion;    imaging the catheter tip to confirm and direct therapy;    energizing said catheter to heat said distal tip;    manipulating said distal tip by the application of external magnetic fields, directing said catheter tip into said occlusion.