Method of treatment for aortic dissection

Abstract

A method and system for treatment for a body vessel having a dissection flap formed from a wall of the body vessel, which longitudinally separates a natural body vessel lumen into a true lumen and a false lumen. One or more cuts are formed in the dissection flap with the cutting device or system including cutting blades. An expandable device is inserted within the true lumen, and expanded to reappose the dissection flap against the wall of the body vessel where the dissection flap was detached from the wall such that the false lumen is closed. A variety of cut patterns are disclosed.

We claim: 
     
         1 . A cutting system comprising a first cutting device and a separate second cutting device each having a major surface and being disposed at the distal ends of respective lines, the cutting devices incorporating one or more electromagnets and means for actuating the electromagnets via one or both lines, the arrangement being such that, when the devices are located with their major surfaces facing each other, actuation of the electromagnets causes the devices to move towards each other, at least the major surface of the first device incorporating at least one cutting blade which, with a sheet located between the devices, and upon movement of the devices towards each other, co-operates with the other major surface so as to perform a cutting action on the sheet. 
     
     
         2 . The cutting system of  claim 1 , wherein the major surface of the second device has at least one blade recess, the at least one recess of the second device being arranged in a mirror image pattern with a corresponding blade of the first device. 
     
     
         3 . The cutting system of  claim 1 , wherein at least one of the first cutting device and second cutting device comprises a repel mechanism. 
     
     
         4 . The cutting system of  claim 3 , wherein the repel mechanism comprises a leaf spring, the repelling spring force of which is less than the magnetic coupling force of the electromagnets. 
     
     
         5 . The cutting system of  claim 1 , wherein the at least one cutting blade is retractable. 
     
     
         6 . The cutting system of  claim 1 , wherein the first and second cutting devices each have a guidewire bore. 
     
     
         7 . The cutting system of  claim 6 , wherein the lines comprise cannulas having respective lumens, and the guidewire bores are each in communication with the lumen of their respective cannula. 
     
     
         8 . The cutting system of  claim 1 , wherein each of the first and second cutting devices has an imageable indicator. 
     
     
         9 . The cutting system of  claim 1 , wherein the electromagnets on one of the first and second cutting devices are configured to be aligned with corresponding electromagnets or other magnetic elements on the other of the first and second cutting devices. 
     
     
         10 . The cutting system of  claim 1 , wherein the cutting system is configured to produce cuts in the sheet in a predetermined pattern, and the at least one cutting blade is arranged in the pattern or a part of the pattern. 
     
     
         11 . A system for treating a body vessel, the body vessel having a dissection flap formed from a wall of the body vessel, the dissection flap longitudinally separating the body vessel lumen into a true lumen and a false lumen, the system comprising:
 a first cutting device configured to be positioned in one of the true lumen and the false lumen along the dissection flap;   a second cutting device configured to be positioned in the other one of the true lumen and the false lumen along the dissection flap opposite the first cutting device;   wherein the first cutting device and the second cutting device are cooperatively operative and configured to form a first cut in the dissection flap.   
     
     
         12 . The system of  claim 11 , wherein the first and second cutting devices are cooperatively operative and configured to form a second cut in the dissection flap, and wherein the second cut is longitudinally and/or circumferentially offset from the first cut. 
     
     
         13 . The system of  claim 11 , wherein the first and second cutting devices are cooperatively operative and configured to form a third cut in the dissection flap, wherein the third cut is circumferentially offset from the first cut and/or the second cut and preferably longitudinally overlaps with portions of the first cut and/or the second cut. 
     
     
         14 . The system of  claim 13 , wherein the second cut is longitudinally offset from the first cut and the third cut is circumferentially offset from and longitudinally overlap with portions of the first cut and of the second cut. 
     
     
         15 . A The system of  claim 11 , wherein the first and second cutting devices are electrically operable devices.