Ischemic stroke device

Abstract

An ischemic stroke device includes a telescoping support member, a first or proximal expandable member connected to the telescoping support member, and a second or distal expandable member connected to the first expandable member. A proximal portion of the first expandable member is attached to a distal end of an outer shaft of the telescoping support member, and a distal end of the first expandable member is attached to a distal portion of an inner core wire of the telescoping support member. The proximal end of the second expandable member is permanently joined to the distal end of the inner core wire. The first expandable member everts to cover the second expandable member that is used to capture an obstruction or clot, prior to pulling the obstruction or clot into a catheter for removal from a patient's vasculature.

What is claimed is: 
     
         1 . Apparatus for removal of at least a portion of an obstruction from an obstructed blood vessel for treatment of ischemic stroke, comprising:
 a telescoping support member including an outer tubular shaft and an inner elongate member extending through said outer tubular shaft and slidable within said outer tubular shaft, said outer tubular shaft having a distal end, and said inner elongate member having a distal end and a proximal end;   a first expandable member having a proximal end and a distal end and a tubular body extending between the proximal and distal ends of the first expandable member, said proximal end of said first expandable member being attached to said distal end of said outer tubular shaft of said telescoping support member, and said distal end of said first expandable member being attached to a distal portion of said inner elongate member, said first expandable member having a radially compressed configuration and a radially expanded configuration, and said first expandable member having a longitudinally extended configuration with said proximal and distal ends of said first expandable member disposed at opposing ends of said first expandable member, and an everted configuration with said distal end of said first expandable member withdrawn within said tubular body of said first expandable member adjacent to said proximal end of said first expandable member; and   a second expandable member configured to be deployed into an obstruction within the blood vessel, said second expandable member having a closed distal end and a closed proximal end, and a tubular mesh body extending between the proximal and distal ends of the second expandable member, said closed proximal end of said second expandable member being permanently joined to said distal end of said inner elongate member of said telescoping support member, said tubular mesh body being configured to radially expand into contact with at least a portion of the obstruction such that a portion of the obstruction is dislodged to enhance blood flow through the blood vessel, said tubular mesh body including a plurality of interstices, at least a portion of the interstices being adapted to allow passage of at least one dislodged portion of the obstruction therethrough in a radial direction into the tubular mesh body.   
     
     
         2 . The apparatus of  claim 1 , wherein said tubular body of said first expandable member comprises a plurality strands defining a plurality of interstices therebetween. 
     
     
         3 . The apparatus of  claim 1 , wherein said tubular body of said first expandable member comprises a radiopaque band permanently attached to said distal end of said first expandable member. 
     
     
         4 . The apparatus of  claim 1 , wherein said tubular mesh body of said second expandable member comprises a plurality of strands. 
     
     
         5 . The apparatus of  claim 4 , wherein said plurality of strands form first and second meshes. 
     
     
         6 . The apparatus of  claim 4 , wherein each of said plurality of strands is oriented in at least one of a helical, longitudinal, and radial direction with respect to the tubular mesh body. 
     
     
         7 . The apparatus of  claim 1 , wherein said second expandable member is configured to dislodge the obstruction by fracturing a portion of the obstruction. 
     
     
         8 . The apparatus of  claim 1 , wherein said second expandable member is configured to dislodge the obstruction by extruding a portion of the obstruction. 
     
     
         9 . The apparatus of  claim 1 , wherein said second expandable member is at least partially constructed of a self-expanding material. 
     
     
         10 . The apparatus of  claim 1 , wherein said obstruction comprises a clot. 
     
     
         11 . The apparatus of  claim 1 , wherein said second expandable member includes at least one radiopaque portion. 
     
     
         12 . The apparatus of  claim 1 , wherein said second expandable member is at least partially adapted to elute a pharmaceutical agent. 
     
     
         13 . The apparatus of  claim 12 , wherein said pharmaceutical agent is adapted to at least partially lyse the at least one fragment. 
     
     
         14 . The apparatus of  claim 1 , wherein said tubular mesh body of said second expandable member includes a distal portion and a proximal portion, the distal portion of the tubular mesh body being formed of a first mesh, and the proximal portion of the tubular mesh body being made of a second mesh having a plurality of second interstices, at least one of the second interstices being adapted to selectively allow passage of at least one fragment therethrough. 
     
     
         15 . The apparatus of  claim 14 , wherein said first mesh is formed integrally with the second mesh. 
     
     
         16 . The apparatus of  claim 14 , wherein at least one of the first interstices is defined by a plurality of first strands, and at least one of the plurality of first strands is adapted to penetrate into the obstruction to longitudinally separate the at least one fragment from a remaining portion of the obstruction. 
     
     
         17 . The apparatus of  claim 14 , wherein at least one of the second interstices is defined by a plurality of second strands, at least one of the plurality of second strands is adapted to break the at least one fragment into a plurality of subfragments, and at least one of the second interstices is adapted to selectively allow passage therethrough of at least one subfragment to release the at least one subfragment from the second expandable member. 
     
     
         18 . The apparatus of  claim 14 , wherein at least one of the plurality of second interstices is smaller than at least one of the plurality of first interstices. 
     
     
         19 . The apparatus of  claim 14 , wherein a size of at least one of the plurality of second interstices is chosen on the basis of an allowable particulate size of the blood vessel. 
     
     
         20 . The apparatus of  claim 14 , wherein said tubular mesh body of said second expandable member is configured to compress at least a portion of the obstruction against a vessel wall of the blood vessel. 
     
     
         21 . The apparatus of  claim 1 , wherein movement of said inner elongate member in a proximal direction relative to said outer tubular shaft of the telescoping support member moves the first expandable member between said longitudinally extended configuration and said everted configuration such that said first expandable member covers/envelopes said second expandable member.