Debulking Catheters and Methods

Abstract

A method of removing material from a blood flow lumen includes providing a device having a cutting element and an opening, the cutting element being movable relative to the opening. The method then includes advancing the device through a patient's vascular system to the blood flow lumen. Finally, the method involves moving the cutting element and the opening relative to the blood flow lumen so that a continuous piece of material is severed by the cutting element and directed into the opening as the cutting element and opening move through the blood flow lumen, the continuous piece of severed material being directed into the device for removal from the patient. The method may include providing a device having a rotatable cutter that, in some embodiments, is not parallel to the longitudinal axis of the device, is movable, has retracted and deployed positions, or any combination thereof. The method may further include forcing the opening toward the wall of the vascular site after the advancing step and before the moving step.

1 . A system for removing material collected within an atherectomy device during an atherectomy procedure performed at a vascular location comprising:
 an elongate body including a containment chamber, the elongate body having first and second openings in communication with the containment chamber;   a torque transmitting element contained within the elongate body, the torque transmitting element being rotatable relative to the elongate body;   a cutting element coupled to the torque transmitting element, the cutting element being configured to be rotated by the torque transmitting element to cut material from the vascular location, the cutting element being oriented to direct the material cut from the vascular location through the first opening and into the containment chamber; and   a material removal device configured to be coupled to the elongate body and to a source of fluid pressure to deliver fluid pressure to the first opening to expel cut material within the containment chamber through the second opening.   
     
     
         2 . The system of  claim 1  wherein the second opening is movable from a closed positon to an open position, wherein the elongate body includes a guidewire lumen and wherein the presence of a guidewire in the guidewire lumen prevents the second opening from being moved from the closed position to the open position. 
     
     
         3 . The system of  claim 2  wherein the elongate body includes a rotatable section configured to be rotated to selectively move the second opening to the open position, the presence of a guidewire in the guidewire lumen preventing rotation of the rotatable section. 
     
     
         4 . The system of  claim 1  wherein the containment chamber and the second opening are positioned distal to the first opening. 
     
     
         5 . The system of  claim 1  wherein the cutting element and the first opening are selectively movable toward a wall of a body lumen at the vascular location. 
     
     
         6 . The system of  claim 1  wherein the cutting element is movable relative to the elongate body between a stored position and a cutting position, a portion of the cutting element being exposed out of the first opening when the cutting element is in the cutting position. 
     
     
         7 . The system of  claim 1  wherein the cutting element is configured to be advanced into the containment chamber. 
     
     
         8 . The system of  claim 1  further comprising a pusher element sized and configured to be introduced into at least one of the first and second openings to force material out of the other of the first and second openings. 
     
     
         9 . The system of  claim 1  further comprising a storage container configured to receive material expelled from the containment chamber. 
     
     
         10 . The system of  claim 9  wherein the storage container is configured to be attached to the containment chamber. 
     
     
         11 . The system of  claim 1  wherein the removal device is configured to isolate the first opening from the second opening. 
     
     
         12 . A system for removing material collected within an atherectomy device during an atherectomy procedure at a vascular location comprising:
 an elongate body including a containment chamber and having first and second openings in communication with the containment chamber;   a torque transmitting element contained within the elongate body, the torque transmitting element being rotatable;   a cutting element coupled to the torque transmitting element, the cutting element being configured to be rotated by the torque transmitting element when cutting material from the vascular location, the cutting element being oriented to direct the material cut from the vascular location through the first opening and into the containment chamber; and   a removal element sized to be inserted within one of the first and second openings and configured to be movable within the containment chamber to push material out the containment chamber through the other of the first and second openings.   
     
     
         13 . The system of  claim 12  wherein the second opening is movable from a closed positon to an open position, wherein the elongate body includes a guidewire lumen and wherein the presence of a guidewire in the guidewire lumen prevents the second opening from being moved from the closed position to the open position. 
     
     
         14 . The system of  claim 13  wherein the elongate body includes a rotatable section configured to be rotated to selectively move the second opening to the open position, the presence of a guidewire in the guidewire lumen preventing rotation of the rotatable section. 
     
     
         15 . The system of  claim 12  wherein the second opening is positioned distal to the first opening. 
     
     
         16 . The system of  claim 12  wherein the cutting element and the first opening are selectively movable toward a wall of a body lumen at the vascular location. 
     
     
         17 . The system of  claim 12  wherein the cutting element is movable relative to the elongate body between a stored position and a cutting position, a portion of the cutting element being exposed out of the first opening when the cutting element is in the cutting position. 
     
     
         18 . The system of  claim 12  wherein the cutting element is configured to be advanced into the containment chamber to move material out of the second opening. 
     
     
         19 . The system of  claim 12  further comprising a storage container configured to receive material expelled from the containment chamber. 
     
     
         20 . The system of  claim 19  wherein the storage container is configured to be attached to the containment chamber.