Thrombectomy and stenting system

Abstract

A design capable of both mechanical thrombectomy and stenting for treating occlusions in the cerebral vasculature provides for a three-catheter setup. The first outer catheter has the largest diameter and can serve as a guide catheter while also being a sheath for the other catheters. The second deployment catheter can be configured for the aspiration of occlusions and can include a stepped or recessed section proximal of the distal tip that can act as a housing for a braided expandable stent. The outer diameter of this stepped section can be lined with an inflation device on top of which the braided stent sits. Internal to the second deployment catheter is a microcatheter which can deliver mechanical thrombectomy devices to the target site to retrieve an occlusion in the vessel, after which the stent can be expanded and implanted in the vessel.

1 . A thrombectomy and stenting system for removing a clot from a blood vessel and stenting the blood vessel, the system comprising:
 a sheath member comprising a sheath lumen;   a deployment catheter oriented within the sheath lumen, the deployment catheter comprising a deployment catheter lumen and a deployment catheter outer surface;   a stenting device circumscribing the deployment catheter outer surface;   a microcatheter oriented in the deployment catheter lumen, wherein the microcatheter comprises a microcatheter lumen; and   a thrombectomy device,   wherein at least a portion of the thrombectomy device is oriented in the microcatheter lumen.   
     
     
         2 . The system of  claim 1 , wherein the deployment catheter further comprises:
 a deployment catheter outer diameter; and   a depressed region on the deployment catheter outer surface and proximate to a distal end of the deployment catheter comprising a depressed region outer diameter configured to be less than the deployment catheter outer diameter.   
     
     
         3 . The system of  claim 2 , wherein the stenting device circumscribes the depressed region of the deployment catheter. 
     
     
         4 . The system of  claim 1 , further comprising:
 an inflation device coupled to the deployment catheter outer surface,   wherein a portion of the stenting device circumscribes the inflation device, and   wherein the inflation device has an expanded condition configured to expand the stenting device.   
     
     
         5 . The system of  claim 1 , wherein the sheath lumen, the deployment catheter lumen and the microcatheter lumen are substantially concentric. 
     
     
         6 . The system of  claim 1 , wherein the thrombectomy device comprises an expandable clot retriever collapsible to fit within the microcatheter lumen and self-expandable upon exiting the microcatheter lumen. 
     
     
         7 . The system of  claim 1 , wherein the deployment catheter comprises a flexible portion approximate the stenting device. 
     
     
         8 . A method of using a thrombectomy and stenting system comprising:
 a sheath member, a deployment catheter, a stenting device comprising an inflation device and a stent, a microcatheter, and a thrombectomy device, the method comprising:   positioning the system approximate a lesion;   extending the thrombectomy device and a distal portion of the microcatheter towards an occlusive clot in a vasculature while maintaining the deployment catheter, the stenting device, and the sheath approximate the lesion;   capturing the occlusive clot with the thrombectomy device;   extending the sheath member, the deployment catheter, and the stenting device to cross the lesion;   retracting the sheath member from the lesion;   inflating the inflation device of the stenting device across the lesion; and   releasing the stent of the stenting device to cross the lesion.   
     
     
         9 . The method of  claim 8 , further comprising retracting the occlusive clot into the deployment catheter. 
     
     
         10 . The method of  claim 8 , further comprising positioning the deployment catheter within the sheath lumen. 
     
     
         11 . The method of  claim 8 , further comprising positioning the microcatheter within the deployment catheter. 
     
     
         12 . The method of  claim 8 , further comprising positioning the thrombectomy device within the microcatheter. 
     
     
         13 . The method of  claim 8 , further comprising disposing the stenting device on an outer surface of the deployment catheter. 
     
     
         14 . The method of  claim 8 , wherein inflating the stenting device comprises increasing the diameter of a first portion of a vasculature region comprising the lesion to at least 75% of the diameter of a second portion of the vasculature adjacent to the first portion. 
     
     
         15 . The method of  claim 8 , further comprising releasing the stent of the stenting device in proximity to the lesion by deflating the inflation device. 
     
     
         16 . The method of  claim 8 , further comprising:
 crossing the occlusive clot with the microcatheter and the thrombectomy device; and   retracting the microcatheter while maintaining the thrombectomy device across the occlusive clot.   
     
     
         17 . A thrombectomy and stenting system for removing a clot from a blood vessel and stenting the blood vessel, the system comprising:
 a sheath member comprising a sheath lumen;   a deployment catheter oriented within the sheath lumen comprising a deployment catheter lumen and a deployment catheter outer surface;   a stenting device coupled to the deployment catheter outer surface;   a microcatheter oriented in the deployment catheter lumen, wherein the microcatheter comprises a microcatheter lumen; and   a thrombectomy device, wherein at least a portion the thrombectomy device is oriented in the microcatheter lumen;   wherein the sheath member, deployment catheter and microcatheter are substantially concentric and configured to move independently of each other along an axis.   
     
     
         18 . The system of  claim 17 , wherein the deployment catheter further comprises a depressed region on the deployment catheter outer surface, wherein the depressed region comprises a dimension to be less than a dimension of another region of the deployment catheter outer surface adjacent to the depressed region. 
     
     
         19 . The system of  claim 18 , wherein the stenting device circumscribes the depressed region of the deployment catheter. 
     
     
         20 . The system of  claim 17 , further comprising:
 an inflation device coupled to the deployment catheter outer surface, wherein a portion of the stenting device circumscribes the inflation device.