Apparatus and methods for material capture and removal

Abstract

Catheters, kits, and methods are provided for removing material from a body lumen. The catheters and methods may be used in a variety of body lumens, including but not limited to coronary and other arteries. In general, the catheter has a cutting element that cuts material while the material is engaged by a material capture device on the catheter body. Preferably, the material capture device tensions the material during cutting, which reduces the amount of cutting force required. The material capture device typically follows a path that draws material into the catheter body. Preferably, but not necessarily, the material capture device may be arranged on the catheter body to advance along a path outwardly from the catheter body into the material and then inwardly towards the catheter body to tension the material. The cutting element on the catheter body moves between a first position and a second position to cut the material while in tension.

1 - 16 . (canceled)  
   
   
       17 . A catheter as in claim  1  wherein said material capture device comprises: 
 a penetrating member rotatably mounted on said cutting element; and    an abutment disposed on said catheter body to engage one end of the penetrable member and cause rotation of the penetrating member from a first, open position to a second, closed position.    
   
   
       18 . A catheter as in  claim 17  further comprising a tether coupled to said penetrating member to control positioning of the penetrating member.  
   
   
       19 . A catheter as in claim  1  wherein said material capture device comprises a penetrating member rotatably mounted on said catheter body and fixedly secured relative to said slidable cutting element; 
 a pushing element mounted on said cutting element to engage said penetrating member to move said member between a first position to a second tissue-engaging position.    
   
   
       20 . A catheter as in claim  1  wherein said material capture device is configured to be deployed from an aperture in the side wall of the catheter body.  
   
   
       21 . A catheter as in  claim 20  wherein said cutting element includes an material imaging device mounted to be in an imaging position when said aperture is closed by said cutting element.  
   
   
       22 . A catheter as in claim  1  wherein said cutting element includes a first cutting blade having at least one penetrating point.  
   
   
       23 . A catheter as in claim  1  wherein said cutting element has a first cutting blade opposed to a second cutting blade for removing said material.  
   
   
       24 . A catheter as in claim  1  wherein said cutting element comprises a tubular inner cutter slidably mounted within an outer cutter of the catheter body, said inner cutter coupled to a drive wire actuated by a user.  
   
   
       25 . A catheter as in claim  1  wherein said material capture device extends an extension distance outward from the catheter body to engage material, said extension distance equal to the diameter of the catheter body.  
   
   
       26 . A catheter as in claim  1  wherein said material capture device includes a barbed distal tip to retain material on the capture device.  
   
   
       27 . A catheter as in claim  1  wherein said cutting element further comprises a material imaging device.  
   
   
       28 . A catheter as in  claim 27  wherein said material imaging device comprises an ultrasound transducer array.  
   
   
       29 . A catheter as in claim  1  wherein said material capture device comprises means for penetrating said material.  
   
   
       30 . A catheter as in  claim 29  wherein said means for penetrating material comprises a curved needle biased outwardly from the catheter body.  
   
   
       31 . A catheter as in  claim 29  wherein said means for penetrating material comprises a penetrating member rotatably mounted about a pivot pin on said cutting element.  
   
   
       32 . A catheter as in  claim 29  wherein said means for penetrating material is configured to engage a raised portion on said catheter body to move said means to engage material and then retract material into the catheter body.  
   
   
       33 . A catheter as in  claim 32  wherein said raised portion comprises a cam surface having a plurality of tracks, wherein each track has a funneled entrance to guide said penetrating member therein.  
   
   
       34 . A catheter for removing material from the wall of a body lumen, said catheter comprising: 
 a catheter body having a proximal end and a distal end;    a side aperture on the catheter body;    a cutting blade adapted to advance past the aperture to sever material which intrudes through the aperture; and    a penetration member mounted to extend through the aperture to penetrate material in advance of the cutting blade and to draw material into the catheter body as the cutting blade is advanced past the aperture.    
   
   
       35 . A catheter as in  claim 34  further comprising a cam surface mounted on said catheter body, said cam surface having a surface configured to guide said penetration member into said material when said blade is advanced.  
   
   
       36 . A catheter for removing material from a body lumen, said catheter comprising: 
 a catheter body having a proximal end and a distal end;    a material capture device arranged on said catheter body to advance along a path radially outwardly from the catheter body into said material and then inwardly towards the catheter body to tension said material; and    a cutting element on said catheter body moving between a first position and a second position to cut said material while said material is in tension.    
   
   
       37 - 58 . (canceled)