Bypass catheter

Abstract

An innovative medical device that permits rapid, minimally invasive restoration of blood flow across a vascular blockage. A system allowing for lysis or removal of said blockage. Said device creates a temporary bypass using longitudinal structure configured for insertion into the blood vessel and adapted to deliver a side hole to a target area. The side hole defines a distal first segment and a proximal second segment with a lumen to allow blood flow therethrough to at least one distal end hole. Said device includes at least one semi-permeable membrane which may act as a filter that located circumferentially around outer surface of at least one of said device segments. In an alternate embodiment, a slidable outer sheath can cover the side hole to permit reversal of blood flow from the distal end hole to a proximal end hole located outside a patient's body by means of an aspiration controller. Alternate embodiments include an optional anchoring balloon, a macerating stent or wires, perforations for fluid delivery, and a backflow valve.

1 - 9 . (canceled) 
     
     
         10 . A catheter for bypassing a blocked vessel, comprising:
 (a) an outer wall having a side hole adapted for positioning at a location upstream of a target area;   b) a lumen;   (c) a proximal hole positioned proximally of the side hole;   (d) a distal hole positioned distally of the side hole and in communication with the proximal hole via the lumen, the side hole adapted for passage of blood from upstream of the target area the distal hole,   (e) an expandable semi-permeable filter positioned at a distal region of the catheter and configured to block flow of debris; and   (e) a macerating element extending from the catheter and rotatable to remove clot, the macerating element positioned distal of the side hole and proximal of the distal hole.   
     
     
         11 . The catheter of  claim 10  further comprising a valve positioned in the catheter to prevent blood entering the side hole from flowing proximally, the valve positioned proximally of the side hole. 
     
     
         12 . The catheter of  claim 11 , wherein the valve is closable by a user. 
     
     
         13 . The catheter of  claim 10 , wherein the lumen defines a first diameter in a first segment of the catheter and a second diameter in a more proximal second segment of the catheter, wherein the second diameter is less than the first diameter to restrict backflow of blood into said second segment. 
     
     
         14 . The apparatus of  claim 10 , further comprising at least one perforation disposed in the outer wall of the catheter between the side hole and distal hole for injection of fluid to dissolve or alter the composition of the blockage. 
     
     
         15 . The apparatus of  claim 14 , wherein the catheter further comprises a second lumen communicating with the perforation to deliver the fluid to the clot. 
     
     
         16 . The apparatus of  claim 10 , wherein the macerating element comprises at least one macerating loop. 
     
     
         17 . The apparatus of  claim 10 , wherein a portion of the catheter has a sinusoidal shape. 
     
     
         18 . The apparatus of  claim 10 , further comprising an inflatable balloon to block flow during maceration. 
     
     
         19 . The apparatus of  claim 10 , wherein the lumen is in communication with a source of pressurized fluid to inject pressurized fluid through the lumen to prevent backflow of blood which entered the side hole. 
     
     
         20 . The catheter of  claim 10 , wherein the outer wall has a groove formed therein and the filter is positioned within the groove. 
     
     
         21 . The catheter of  claim 10 , wherein the filter is not affixed to the catheter such that rotation of the catheter does not rotate the filter 
     
     
         22 . The catheter of  claim 10 , wherein the filter is affixed to the catheter such that rotation of the catheter rotates the filter. 
     
     
         23 . The catheter of  claim 10 , further comprising a valve to actively close the side hole to enable aspiration solely through the distal hole. 
     
     
         24 . The catheter of  claim 10 , further comprising a second filter positioned proximal of the side hole. 
     
     
         25 . The apparatus of  claim 10 , further comprising a balloon disposed between the side hole and the proximal hole of the catheter, wherein blood enters the side hole distal of the balloon. 
     
     
         26 . The apparatus of  claim 10 , wherein the catheter is configured such that blow flow into the side hole and distally in the lumen exits exclusively through the distal hole such that the distal hole provides a sole exit opening for blood entering the lumen through the side hole. 
     
     
         27 . The apparatus of  claim 10 , further comprising an outer support sheath for covering the side hole to close the side hole, wherein closing of the side hole redirects blood flow proximally through the distal hole out the proximal hole. 
     
     
         28 . The apparatus of  claim 10 , further comprising a second concentric lumen, wherein the at least one perforation communicates with an area between an internal surface of the second concentric lumen and an outer surface of the lumen for blood flow. 
     
     
         29 . The apparatus of  claim 10 , wherein the lumen in a proximal segment of the catheter is smaller than the distal hole.