Methods and apparatus for retrograde percutaneous endovascular filter and embolectomy/thrombectomy device

Abstract

Methods and apparatus for a percutaneous retrograde endovascular filter and embolectomy/thrombectomy device (RET-D) according to various aspects of the present technology include a constraining sleeve housing a deployable filter and a set of closure struts positioned at the end of a flexible tube. The RET-D is deployed into a target vessel in retrograde fashion through a conventional hemostasis sheath such that the open end of the filter engages the antegrade flow of blood. The closure struts are configured to prevent loss of filtered debris when the filter is closed according to where the closure struts are positioned relative to an end of the constraining sleeve.

1 . A method of performing a percutaneous retrograde endovascular filtering and embolectomy/thrombectomy, comprising:
 creating percutaneous access to the vessel by inserting a needle into the target vessel in retrograde fashion;   inserting a wire through the needle and into the target vessel;   positioning a hemostasis sheath into the target vessel over the wire and dilating the vessel;   removing the dilator from the hemostasis sheath;   inserting a constraining sleeve housing a filter device into a first end the hemostasis sheath over the wire and extending the constraining sleeve towards a second end of the hemostasis sheath;   deploying the filter device by extending the filter device outward from the constraining sleeve and into the target vessel through the hemostasis sheath in retrograde fashion causing a set of deployable struts to expand a filter against an internal wall of the target vessel, wherein:
 a base of the filter is open to a first end of a lumen of the filter device; 
 a first end of each strut is coupled to an expandable end of the filter; 
 the first end of each strut expands outwardly to open the filter when the filter device is extended from the constraining sleeve; 
   capturing a desired material with the filter device;   partially withdrawing the filter device back into the constraining sleeve to close the expandable end of the filter; and   removing constraining sleeve and the filter device from the hemostasis sheath.   
     
     
         2 . A method of performing a percutaneous retrograde endovascular filtering and embolectomy/thrombectomy according to  claim 1 , wherein:
 a lower section of each strut extends outwardly away from the base of the filter to a mid-portion; and   an upper section of each strut extends inwardly from the mid-portion towards a central axis of the filter when the filter device is in the deployed position.   
     
     
         3 . A method of performing a percutaneous retrograde endovascular filtering and embolectomy/thrombectomy according to  claim 2 , wherein partially withdrawing the filter devices comprises pulling at least a portion of the lower section of each strut back into hemostasis sheath to engage the mid-portion of each strut to draw the first end of each strut towards the central axis of the filter. 
     
     
         4 . A method of performing a percutaneous retrograde endovascular filtering and embolectomy/thrombectomy according to  claim 1 , further comprising aspirating the captured material from the first end of the lumen. 
     
     
         5 . A method of forming a percutaneous vessel anastomosis according to  claim 1 , wherein the filter comprises a nitinol mesh. 
     
     
         6 . A method of forming a percutaneous vessel anastomosis according to  claim 1 , wherein the filter comprises a porous polymer matrix. 
     
     
         7 . A system for percutaneous retrograde endovascular filtering and embolectomy/thrombectomy, comprising:
 a constraining sleeve;   a filter device positioned within the constraining sleeve, comprising:
 a flexible tube; 
 a filter positioned, comprising:
 a base open to a first end of the flexible tube; and 
 an expandable open end; and 
 
 a set of deployable struts disposed peripherally around the filter, wherein each strut comprises:
 a first end coupled to the expandable open end of the filter and configured to:
 expand outwardly to open the filter when the filter device is in the deployed position; 
 contract to close the filter when the filter device is in the partially withdrawn position; 
 
 a second end of each strut coupled to the flexible tube proximate the base of the filter; and 
 a curved mid-portion spaced apart from and not connected to the filter. 
 
   
     
     
         8 . A system for percutaneous retrograde endovascular filtering and embolectomy/thrombectomy according to  claim 9 , wherein:
 a lower section of each strut extends outwardly away from the base of the filter to the curved mid-portion; and   an upper section of each strut extends inwardly from the curved mid-portion towards a central axis of the filter when the filter device is in the deployed position.   
     
     
         9 . A system for percutaneous retrograde endovascular filtering and embolectomy/thrombectomy according to  claim 10 , wherein:
 the curved mid-portion of each strut expands to a first diameter greater than that of the constraining sleeve when the filter device is in the deployed position; and   the curved mid-portion of each strut is contracted a second diameter approximate that of the constraining sleeve when the filter device is in the partially withdrawn position.   
     
     
         10 . A system for percutaneous retrograde endovascular filtering and embolectomy/thrombectomy according to  claim 9 , further comprising an aspiration port positioned at a second end of the lumen. 
     
     
         11 . A system for percutaneous retrograde endovascular filtering and embolectomy/thrombectomy according to  claim 9 , wherein the filter comprises a nitinol mesh. 
     
     
         12 . A system for percutaneous retrograde endovascular filtering and embolectomy/thrombectomy according to  claim 9 , wherein the filter comprises a porous polymer matrix. 
     
     
         13 . A system for percutaneous retrograde endovascular filtering and embolectomy/thrombectomy according to  claim 8 , wherein the filter comprises synthetic or metallic mesh.