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 system for treating a thrombus within a blood vessel of a patient, comprising:
 a guide catheter configured to be positioned within the blood vessel proximal to the thrombus;   a thrombus treatment device configured to be advanced 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, and 
 wherein the thrombus disruption element is configured to be (a) advanced into the thrombus distally from the guide catheter via distal movement of the elongated member and (b) retracted proximally through the thrombus via proximal movement of the elongated member; and 
 
   a vacuum pump fluidly connected to the guide catheter, wherein the vacuum pump is configured to generate a vacuum and automatically apply the vacuum to the guide catheter to at least partially aspirate the thrombus into the guide catheter.   
     
     
         2 . The system of  claim 1  wherein the elongated member is a wire. 
     
     
         3 . The system of  claim 1  wherein the proximal portion of the thrombus disruption element is fixed to the elongated member. 
     
     
         4 . The system of  claim 1  wherein the proximal portion and the distal portion of the thrombus disruption element are fixed to the elongated member. 
     
     
         5 . The system of  claim 1  wherein the elongated member extends distally past the distal portion of the elongated member. 
     
     
         6 . The system of  claim 5  wherein the proximal portion and the distal portion of the thrombus disruption element are fixed to the elongated member. 
     
     
         7 . The system of  claim 1  wherein the thrombus disruption element comprises an expandable mesh. 
     
     
         8 . The system of  claim 1  wherein the blood vessel is a peripheral blood vessel. 
     
     
         9 . The system of  claim 1  wherein the thrombus is a pulmonary embolism. 
     
     
         10 . A system for treating a thrombus within a blood vessel of a patient, comprising:
 a guide catheter configured to be positioned within the blood vessel proximal to the thrombus;   a thrombus treatment device configured to be advanced 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, 
 wherein the distal portion tapers radially inward toward the wire in the distal direction, and 
 wherein the thrombus disruption element is configured to be (a) pushed distally from the guide catheter into the thrombus via pushing of the wire and (b) pulled proximally through the thrombus via pulling of the wire; and 
 
   a vacuum pump fluidly connected to the guide catheter, wherein the vacuum pump is configured to generate a vacuum and automatically apply the vacuum to the guide catheter to at least partially aspirate the thrombus into the guide catheter.   
     
     
         11 . The system of  claim 10  wherein the proximal portion and the distal portion of the thrombus disruption element are fixed to the wire. 
     
     
         12 . The system of  claim 10  wherein the elongated member wire extends distally past the distal portion of the elongated member. 
     
     
         13 . The system of  claim 10  wherein the blood vessel is a peripheral blood vessel. 
     
     
         14 . The system of  claim 10  wherein the thrombus is a pulmonary embolism. 
     
     
         15 . A system for treating a thrombus within a blood vessel of a patient, comprising:
 a guide catheter;   a thrombus treatment device configured to be advanced 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, and 
 wherein the thrombus disruption element is configured to be (a) pushed distally relative to the guide catheter via pushing of the wire and (b) pulled proximally relative to the guide catheter via pulling of the wire; and 
 
   a vacuum pump fluidly connected to the guide catheter, wherein the vacuum pump is configured to generate a vacuum and automatically apply the vacuum to the guide catheter.   
     
     
         16 . The system of  claim 15  wherein the proximal portion and the distal portion of the thrombus disruption element are fixed to the wire. 
     
     
         17 . The system of  claim 15  wherein the elongated member wire extends distally past the distal portion of the elongated member. 
     
     
         18 . The system of  claim 15  wherein the vacuum pump is fluidly connected to a proximal end portion of the guide catheter. 
     
     
         19 . The system of  claim 15  wherein the thrombus disruption element has a maximum diameter of about 4 millimeters or greater. 
     
     
         20 . The system of  claim 15  wherein the thrombus disruption element is configured to self-expand.