Torus balloon with energy emitters for intravascular lithotripsy

Abstract

A catheter for intraluminal lithotripsy including an outer wall, at least one balloon extending from the outer wall, the balloon having a first portion, a second portion proximal of the first portion and an intermediate portion between the first and second portions such that a transverse dimension of the intermediate portion is less than a transverse dimension of the first and second portions. The catheter includes a first lumen, at least one energy emitter mounted on the balloon for emitting energy to break down or soften calcium and a connector connecting the at least one energy emitter to an external energy source, the connector extending through the catheter.

1 - 20 . (canceled) 
     
     
         21 . A bypass catheter comprising:
 a) a side opening formed in a wall of the catheter;   b) a first lumen communicating with the side opening and having a distal opening, the side opening positioned proximal of the distal opening such that blood entering the side opening can flow through the first lumen to bypass the blockage in the blood vessel and exit the distal opening to maintain blood flow;   c) a second lumen extending substantially in the wall of the catheter to infuse lytics out of the catheter into the vessel to treat the vessel blockage, the second lumen communicating with at least one hole positioned between the side opening and the distal opening;   d) at least one energy emitter for emitting energy to break down or soften one or both of calcium and thrombus; and   e) a connector connecting the at least one energy emitter to an external energy source, the connector extending through the catheter.   
     
     
         22 . The catheter of  claim 21 , wherein the at least one energy emitter is positioned at a distal segment of the catheter. 
     
     
         23 . The catheter of  claim 21 , wherein the catheter further comprises a macerating element rotatable for macerating blood clot. 
     
     
         24 . The catheter of  claim 21 , further comprising an axially slidable member slidable relative to the catheter, the slidable member movable to selectively cover and expose the side opening, wherein covering of the side opening restricts flow of blood through the side opening. 
     
     
         25 . The catheter of  claim 21 , further comprising a backflow restricting structure to prevent backflow of blood in the first lumen in a proximal direction. 
     
     
         26 . The catheter of  claim 25 , wherein the backflow restricting member is proximal of the side opening. 
     
     
         27 . The catheter of  claim 21 , wherein the at least one energy emitter is positioned between the side opening and the distal opening. 
     
     
         28 . The catheter of  claim 21 , wherein the connector for the at least one energy emitter extends within the wall of the catheter. 
     
     
         29 . The catheter of  claim 21 , wherein the at least one energy emitter extends at least on a portion of the catheter. 
     
     
         30 . The catheter of  claim 21 , wherein the catheter further comprises a balloon. 
     
     
         31 . The catheter of  claim 30 , wherein at least a portion of the at least one energy emitter is incorporated into the balloon. 
     
     
         32 . The catheter of  claim 30 , wherein the at least one energy emitter is positioned on an outer surface of the balloon. 
     
     
         33 . The catheter of  claim 21 , wherein the first lumen is a largest lumen and the distal opening is aligned with the longitudinal axis of the first lumen. 
     
     
         34 . The catheter of  claim 21 , further comprising a semi-permeable filter positioned distal of the distal opening to capture particles. 
     
     
         35 . The catheter of  claim 21 , wherein aspiration is provided through one or both of the side opening and distal opening. 
     
     
         36 . The catheter of  claim 24 , wherein the catheter is configured such that blood flow is directed exclusively out the distal opening when the side opening is exposed from the slidable member. 
     
     
         37 . The catheter of  claim 24 , wherein when the axially slidable member covers the side opening, blood flows from the distal opening into the first lumen and when the slidable member exposes the side hole blood flows from the side opening through the first lumen to the distal opening. 
     
     
         38 . The catheter of  claim 30 , further comprising a third lumen in the wall of the catheter communicating with the balloon for inflation of the balloon. 
     
     
         39 . The catheter of  claim 21 , further comprising multiple spaced side openings for egress of blood. 
     
     
         40 . The catheter of  claim 21 , further comprising a third lumen substantially within the wall of the catheter and having a spiral course. 
     
     
         41 . The catheter of  claim 30 , wherein the distal opening is positioned distal of the balloon and the side opening is positioned proximal of the balloon, wherein blood flows between the side opening, through the first lumen, and the distal opening while the balloon is inflated and energy is emitted by the at least one energy emitter.