Methods and apparatus for treating embolism

Abstract

A method and apparatus for treating a clot in the blood vessel of a patient, and particularly the treatment of a pulmonary embolism is disclosed. The treatment includes restoring flow through the clot followed by clot removal, either partially or substantially completely. The clot treatment device is expandable into the blood vessel and may contain radial extensions that assist in restoring flow as well as in removing clot material.

I/We claim: 
     
         1 . A method of treating a thrombus within a blood vessel of a patient, the method comprising:
 advancing a guide catheter to a location within the blood vessel proximal to the thrombus;   advancing a thrombus treatment device through the guide catheter, wherein the thrombus treatment device comprises—
 an elongated member; and 
 a thrombus disruption element positioned over the elongated member, wherein the thrombus disruption element has a proximal portion, a distal portion, and a central portion extending between the proximal portion and the distal portion, 
   wherein the thrombus disruption element has an outer surface that tapers (a) radially outward away from the elongated member in a distal direction at least partially between the proximal portion and the central portion and (b) radially inward toward the elongated member in the distal direction at least partially between the central portion and the distal portion;   deploying the thrombus disruption element from the guide catheter and at least partially into the thrombus such that the thrombus disruption element at least partially penetrates the thrombus, wherein deploying the thrombus disruption element from the guide catheter includes applying a distal force to the elongated member;   retracting the thrombus disruption element proximally to at least partially disrupt the thrombus;   generating a vacuum with a vacuum pump; and   automatically applying the vacuum to the guide catheter to at least partially aspirate the thrombus into the guide catheter.   
     
     
         2 . The method of  claim 1  wherein the elongated member is a wire. 
     
     
         3 . The method of  claim 1  wherein the proximal portion of the thrombus disruption element is fixed to the elongated member. 
     
     
         4 . The method of  claim 1  wherein the proximal portion and the distal portion of the thrombus disruption element are fixed to the elongated member. 
     
     
         5 . The method of  claim 1  wherein the elongated member extends distally past the distal portion of the elongated member. 
     
     
         6 . The method of  claim 5  wherein the proximal portion and the distal portion of the thrombus disruption element are fixed to the elongated member. 
     
     
         7 . The method of  claim 1  wherein deploying the thrombus disruption element from the guide catheter includes pushing the elongated member to push the thrombus disruption element distally to penetrate the thrombus. 
     
     
         8 . The method of  claim 1  wherein the thrombus disruption element comprises an expandable mesh. 
     
     
         9 . The method of  claim 1  wherein the method further comprises repeatedly (a) deploying the thrombus disruption element from the guide catheter and at least partially into the thrombus such that the thrombus disruption element at least partially penetrates the thrombus and (b) retracting the thrombus disruption element proximally to at least partially disrupt the thrombus. 
     
     
         10 . The method of  claim 1  wherein automatically applying the vacuum to the guide catheter to at least partially aspirate the thrombus into the guide catheter comprises automatically applying the vacuum to the guide catheter while (a) deploying the thrombus disruption element from the guide catheter and at least partially into the thrombus such that the thrombus disruption element at least partially penetrates the thrombus and (b) retracting the thrombus disruption element proximally to at least partially disrupt the thrombus. 
     
     
         11 . The method of  claim 1  wherein the blood vessel is a peripheral blood vessel. 
     
     
         12 . The method of  claim 1  wherein the thrombus is a pulmonary embolism. 
     
     
         13 . A method of treating a thrombus within a blood vessel of a patient, the method comprising:
 advancing a guide catheter to a location within the blood vessel proximal to the thrombus;   advancing a thrombus treatment device through the guide catheter, wherein the thrombus treatment device comprises—
 a wire; and 
 a thrombus disruption element positioned over the wire, wherein the thrombus disruption element has a proximal portion and a distal portion, wherein the proximal portion tapers radially outward away from the wire in a distal direction, and wherein the distal portion tapers radially inward toward the wire in the distal direction; 
   pushing the wire of the thrombus treatment device distally to push the thrombus disruption element distally out of the guide catheter into the thrombus;   pulling the wire of the thrombus treatment device proximally to pull the thrombus disruption element proximally through the thrombus;   generating a vacuum with a vacuum pump; and   automatically applying the vacuum to the guide catheter to at least partially aspirate the thrombus into the guide catheter.   
     
     
         14 . The method of  claim 13  wherein the proximal portion and the distal portion of the thrombus disruption element are fixed to the wire. 
     
     
         15 . The method of  claim 13  wherein the method further comprises repeatedly (a) pushing the wire of the thrombus treatment device distally to push the thrombus disruption element distally into the thrombus and (b) pulling the wire of the thrombus treatment device proximally to pull the thrombus disruption element proximally through the thrombus. 
     
     
         16 . The method of  claim 13  wherein automatically applying the vacuum to the guide catheter to at least partially aspirate the thrombus into the guide catheter comprises automatically applying the vacuum to the guide catheter while (a) pushing the wire of the thrombus treatment device distally to push the thrombus disruption element distally out of the guide catheter into the thrombus and (b) pulling the wire of the thrombus treatment device proximally to pull the thrombus disruption element proximally through the thrombus. 
     
     
         17 . The method of  claim 13  wherein automatically applying the vacuum to the guide catheter to at least partially aspirate the thrombus into the guide catheter comprises automatically applying the vacuum to the guide catheter while repeatedly (a) pushing the wire of the thrombus treatment device distally to push the thrombus disruption element distally into the thrombus and (b) pulling the wire of the thrombus treatment device proximally to pull the thrombus disruption element proximally through the thrombus. 
     
     
         18 . The method of  claim 13  wherein the elongated member wire extends distally past the distal portion of the elongated member. 
     
     
         19 . The method of  claim 13  wherein the blood vessel is a peripheral blood vessel. 
     
     
         20 . The method of  claim 13  wherein the thrombus is a pulmonary embolism.