Axially extended thrombus capture system, tensioning system, and expandable funnel catheter

Abstract

The systems and methods of the present invention can remove target material (including blood clots) from body parts (including but not limited to the circulatory system) for the treatment of pulmonary embolism (PE), deep vein thrombosis (DVT), cerebral vascular embolism, and other vascular obstructions. The capture system may include a tubular body and an end having an opening and a capture guide. In some embodiments, the body or funnel tip of the catheter is expandable.

Description

[0001] Priority claim

[0002] This application claims the benefit of U.S. Provisional Application No. 62 / 930,990, filed on November 5, 2019, and U.S. Provisional Application No. 63 / 064,289, filed on August 11, 2020, as a permanent application under 35 U.S.C. §119(e). The entire contents of the foregoing priority applications are incorporated by reference. This application incorporates by reference U.S. Patent Nos. 9,579,116, 9,744,024, and 9,999,493, the entire contents of each of which are hereby incorporated by reference. Background of the Invention Technical Field

[0004] In some aspects, the present invention relates to systems and methods for removing target material (including blood clots) from a body part (including but not limited to the circulatory system) for the treatment of pulmonary embolism (PE), deep vein thrombosis (DVT), cerebral vascular embolism, and other vascular obstructions. Background Art

[0006] It should be understood that undesirable material such as blood clots (which may be referred to herein as thrombi, thromboemboli, or emboli) in blood vessels may partially or completely block blood vessels in the coronary, cerebral, pulmonary, peripheral venous, and peripheral arterial circulation areas, leading to myocardial infarction, stroke, pulmonary embolism, deep vein thrombosis, and limb infarction, respectively.

[0007] There are a variety of therapies and devices known to dissolve, debulk and / or aspirate emboli. For example, anticoagulants, such as heparin and warfarin, help stabilize blood clots and prevent further clot formation, while thrombolytics, such as urokinase, streptokinase and tPA, help dissolve blood clots. These agents can be delivered to the desired location via systemic infusion or catheter-based infusion. Although thrombolytics can effectively dissolve blood clots, they take a long time to dissolve the clot. Therefore, patients may need to stay in the hospital intensive care unit (ICU) during the thrombolytic infusion. When hospital stays are longer, medical costs increase significantly. The main limitation of these thrombolytics is that they may cause bleeding in areas such as the intracranial, gastrointestinal tract, retroperitoneum and pericardium, which is often life-threatening and leads to a higher risk of morbidity and mortality.

[0008] Mechanical debulking and / or aspiration devices can be used to remove the obstruction. These mechanical techniques can remove the clot by maceration, aspiration, or a combination of both. The advantage of mechanical therapy is that it can remove the clot directly from the obstructed area and eliminate the blockage immediately, so it may be superior to thrombolytics in some cases. However, current mechanical therapies still have some major limitations. During the procedure, there is little or no blood flow, so the patient may become hemodynamically unstable in a very short time. Debris removed during mechanical treatment may migrate distally and cause additional emboli. Small size devices cannot remove large amounts of blood clots in a short time, so the patient may become hemodynamically unstable.

[0009] In some cases, clots can be acute, subacute, and / or chronic and adhere to the vessel wall. Suction devices may be able to remove loose or partially adhered clots, but not organized clots. Furthermore, if the clot is more organized, there is a risk of device clogging at the catheter tip.

[0010] In some cases, the clots to be removed are highly organized and numerous, making them difficult to remove through a small catheter lumen.

[0011] Compared to smaller vessels (such as the coronary arteries), catheter-based thrombus removal from larger vessels (such as the pulmonary artery) has limited success. In catheter-based pulmonary embolectomy, pulmonary emboli are removed percutaneously using a variety of techniques. In fragmentation thrombectomy, the clot is broken into smaller fragments, most of which migrate downstream and cause distal embolization. This technique is sometimes used in conjunction with thrombolytics. In rheological thrombectomy, a high-velocity saline jet creates a Venturi effect and draws clot fragments into the catheter. However, this method carries the risk of hemolysis. Finally, aspiration techniques use suction to draw the clot into the catheter. All of these techniques rely on a catheter to remove the clot from the vessel. Users use small catheters to remove or fragment large clots, a time-consuming and inefficient process. Once the clot is fragmented, the debris can migrate distally and cause unintended embolism. Rheological therapy carries the risk of hemolysis. Furthermore, small catheters have limited aspiration capacity when used to aspirate large emboli, which in some cases can cause unnecessary stress to the user and pose risks to the patient. Large clots require the use of small devices for removal.

[0012] Catheter-based clot removal is also often significantly limited when distal working space within a body lumen is limited. Conventional devices may require full axial and / or radial deployment and expansion to operate. However, the flexibility of using such conventional devices can be very limited in various clinical scenarios, where the size of the clot or other material to be removed varies. Consequently, these conventional devices may be ineffective in situations where distal space within a vessel is limited.

[0013] Clearly, all available treatments have limitations for patients with blood clots or other undesirable material in blood vessels and other body cavities. Anticoagulation only limits the growth of the clot but does not actively remove it. Thrombolytic therapy carries the risk of major bleeding. Catheter-based embolectomy is not effective in removing material from large vessels. Furthermore, these devices require distal space for full deployment and operation, making them ineffective in confined distal spaces. Surgical embolectomy can be very effective, but it is highly invasive and carries a high rate of morbidity and mortality. Therefore, there is a need for a direct mechanical treatment that is as effective or even more effective than surgical embolectomy in removing large clots, while using endovascular techniques, immediately restoring blood flow, and reducing the incidence of complications. Summary of the Invention

[0014] In some embodiments, the present application discloses a capture system for selected materials in vivo. The capture system may include a capture assembly configured to isolate unwanted materials, such as emboli, thrombi, and other foreign matter, from the vascular system. The capture system can be used to remove acute, subacute, and chronic or organized clots. As clots or thrombi form and deposit on blood vessels, acute clots rarely or minimally adhere to the vessel wall. As the clot ages, adhesion to the vessel wall increases, ultimately making the clot difficult to remove. Therefore, a device with high electrical resistance is needed to remove some clot formation.

[0015] The capture system may include a shape memory tubular body comprising a first end, a second end, and an axial length therebetween. The first end of the shape memory tubular body has an opening. The shape memory tubular body is deformable into a first expanded configuration in which the first end is expanded, but the second end and a majority of the shape memory tubular body are compressed. The shape memory tubular body is folded between the first end and the second end. The shape memory tubular body has a first expanded axial length in the first expanded configuration. The shape memory tubular body is deformable into a second expanded configuration in which the shape memory tubular body has a second expanded axial length that is greater than the first expanded axial length.

[0016] Various methods are available for removing emboli, thrombi, and other foreign matter from the vascular system, such as balloon embolectomy, baskets, filters, or collection bags. As clot size increases, clot removal through the catheter lumen becomes more difficult, resulting in the clot becoming lodged within the catheter lumen or the balloon, basket, filter, or collection bag being unable to be removed from the vascular system. Therefore, a device that can remove large clots would be beneficial, particularly if the device were expandable.

[0017] In some embodiments, a capture system is provided. The capture system may include a tubular body comprising a first end, a second end, and an axial length therebetween. The first end may include an opening and a capture guide. The capture system may include one or more tensioners coupled to the capture guide. In some embodiments, the tubular body has a first configuration in which the first end and the capture guide are expanded while the second end and a majority of the tubular body remain compressed, and the tubular body has a first expanded axial length and a first width along the first expanded axial length. In some embodiments, the tubular body is capable of being deformed into a second configuration by applying tension via the tensioner, the tubular body having a second expanded axial length greater than the first expanded axial length, and the tubular body having a second width along the second expanded axial length.

[0018] In some embodiments, the capture system may include a first member comprising a central lumen. In some embodiments, the capture system may include a second member disposed within the central lumen. In some embodiments, the capture guide forms the opening. In some embodiments, the one or more tensioners extend proximally from the capture guide. In some embodiments, the tubular body comprises a shape memory material. In some embodiments, the width of the shape memory material along the second extended axial length is substantially the same as the width of the shape memory material along the first extended axial length. In some embodiments, the one or more tensioners are equally spaced around the circumference of the capture guide. In some embodiments, the one or more tensioners are unequally spaced around the circumference of the capture guide. In some embodiments, the one or more tensioners are configured to apply tension to the capture guide, rendering it rigid. In some embodiments, the one or more tensioners are rigid. In some embodiments, the one or more tensioners are flexible. In some embodiments, the one or more tensioners comprise sutures. In some embodiments, the one or more tensioners are configured to limit or prevent deflection of the capture guide. In some embodiments, the one or more tensioners comprise one or more metal wires. In some embodiments, the one or more tensioners comprise one or more polymer filaments. In some embodiments, the capture guide comprises a shape memory material. In some embodiments, the capture guide comprises a nitinol ring. In some embodiments, the capture guide is configured to conform to different vessel diameters. In some embodiments, the capture guide is configured to conform to different geometric configurations.

[0019] In some embodiments, a method for retrieving a material is provided. The method may include positioning a capture system near the material. In some embodiments, the clot capture system may include a tubular body comprising a first end, a second end, and an axial length therebetween. The first end may include an opening and a capture guide. The clot capture system may include one or more tensioners coupled to the capture guide. The tubular body may have a first configuration in which the first end and the capture guide are expanded while the second end and a majority of the tubular body remain compressed. The method may include deforming the tubular body into a second configuration by applying tension through the tensioner. The tubular body may have a second expanded axial length greater than the first expanded axial length, and the tubular body may have a second width along the second expanded axial length.

[0020] In some embodiments, the material comprises an embolus, thrombus, or other foreign matter. In some embodiments, positioning the capture system comprises positioning the capture system within the patient's vascular system. In some embodiments, the material is a clot adhered to a vessel wall. In some embodiments, the method may comprise capturing the clot by axially extending the tubular body. In some embodiments, the method may comprise removing the clot by retracting the tubular body. In some embodiments, the capture guide withstands high resistance without deflecting. In some embodiments, the capture guide conforms to the inner wall of the vessel. In some embodiments, the capture guide is held in place by the one or more tensioners. In some embodiments, the capture guide is unable to deflect while the material is being removed. In some embodiments, deforming the tubular body into the second configuration further comprises scraping the vessel wall with the capture guide. In some embodiments, the capture guide scores, scrapes, cuts, or shears the material.

[0021] In some embodiments, a catheter system is provided. The catheter system may include an expandable guide catheter comprising an expandable shaft and an expandable funnel tip. The catheter system may include a cap disposed over the expandable shaft and the expandable funnel tip. In some embodiments, the cap is configured to be removed to expand the expandable shaft and the expandable funnel tip.

[0022] In some embodiments, the expandable funnel tip comprises a double-layer structure. In some embodiments, the expandable funnel tip comprises an inner braided layer and an outer braided layer. In some embodiments, the expandable funnel tip comprises at least one coated layer. In some embodiments, the expandable shaft comprises a double-layer structure. In some embodiments, the expandable shaft comprises an inner braided layer and an outer braided layer. In some embodiments, the expandable shaft comprises at least one coated layer. In some embodiments, the catheter may include a dilator. In some embodiments, the catheter may include an obturator.

[0023] In some embodiments, the expandable guide catheter comprises a braid. In some embodiments, the diameter of the braided wire is 0.0003" to 0.030". In some embodiments, the braid pattern can be 1x1, 2x2, paired wires 1x1, paired wires 2x2, or any combination thereof. In some embodiments, the expandable guide catheter comprises an expandable distal end. In some embodiments, the expandable guide catheter comprises a double braid. In some embodiments, the expandable guide catheter comprises a polymer coating. In some embodiments, the expandable guide catheter comprises a coating. In some embodiments, the expandable guide catheter comprises a mesh. In some embodiments, the expandable guide catheter comprises an interior portion that provides reduced surface area, reduced surface contact, and / or reduced friction relative to objects within the lumen of the guide catheter.

[0024] In some embodiments, a method for retrieving a thrombus is provided. The method may include accessing a blood vessel. The method may include passing an expandable guide catheter through the blood vessel. In some embodiments, the expandable guide catheter includes a portion compressed by a cap. The method may include removing the cap to expand the expandable guide catheter.

[0025] In some embodiments, the method may include removing material from the body using a balloon embolectomy. In some embodiments, the method may include removing material from the body using a basket. In some embodiments, the method may include removing material from the body using a filter. In some embodiments, the method may include removing material from the body using a collection bag. In some embodiments, the method may include using a dilator to assist in introducing the expandable guide catheter into the vasculature.

[0026] In some embodiments, a system can include, exclude, consist essentially of, or consist of any number of the features of the present disclosure.

[0027] In some embodiments, a method can include, exclude, consist essentially of, or consist of any number of the features of the present disclosure. BRIEF DESCRIPTION OF THE DRAWINGS

[0028] Figure 1A-1B An embodiment of a catheter system having a tensioner is shown.

[0029] Figure 2A-2B Shown are close-up views of the distal and proximal ends of the catheter system with the tensioner in an inactive state.

[0030] Figure 3A-3B Shown are close-up views of the distal and proximal ends of the catheter system with the tensioner in an activated state.

[0031] Figure 4A-4G Method steps for loading a catheter system into a delivery catheter using a loading tool are shown.

[0032] Figures 5A-5C Method steps for loading a catheter system into a delivery catheter using a loading tool are shown.

[0033] Figure 6A-Figure 6B Shown are close-up views of the distal and proximal ends of the catheter system loaded within a delivery catheter.

[0034] Figure 7 An embodiment of a catheter system is shown.

[0035] Figure 8 A three-lumen shaft is shown.

[0036] Figure 9 An embodiment of an expandable funnel catheter is shown in a loaded configuration.

[0037] Figure 10 An embodiment of an expandable funnel catheter is shown in a deployed configuration.

[0038] Figure 11 An embodiment of a peelable cover for an expandable funnel is shown.

[0039] Figure 12 An embodiment of a dilator for an expandable funnel is shown.

[0040] Figure 13 An embodiment of an expandable funnel catheter is shown in a loaded configuration.

[0041] Figure 14 An exploded view of the expandable funnel catheter is shown.

[0042] Figure 15 Another view of the expandable funnel catheter is shown.

[0043] Figure 16 A view of the expandable funnel is shown.

[0044] Figure 17An embodiment of an expandable funnel catheter is shown in a delivery configuration.

[0045] Figure 18 An embodiment of an expandable funnel catheter is shown without a peelable cover.

[0046] Figures 19A-19E The concept of an expandable funnel is shown.

[0047] Figure 20 The expandable funnel catheter is shown in a loaded configuration.

[0048] Figure 21 Shown in expanded configuration Figure 20 Expandable funnel catheter.

[0049] Figure 22 Shows the funnel starting to fold inwards Figure 20 Expandable funnel catheter.

[0050] Figure 23 Shows the funnel folding inwards Figure 20 Expandable funnel catheter.

[0051] Figure 24 An embodiment of an expandable funnel catheter is shown.

[0052] Figure 25-29 A capture system with a control handle is shown.

[0053] Figure 30A-Figure 30B An embodiment of a capture guide is shown.

[0054] Figure 31 A capture system including an anchor assembly is shown.

[0055] Figures 32A-32C A hemostatic seal assembly is shown.

[0056] Figure 33 A single suture configuration is shown.

[0057] Figures 34A-34C Various non-limiting capture guide configurations are shown.

[0058] Figure 35 Non-limiting different expandable funnel shaft configurations of laser cut patterns are shown. DETAILED DESCRIPTION

[0059] In some embodiments, the present application discloses capture systems and methods for retrieving and removing materials (including emboli, thrombi, blood clots, stones / calculi and / or foreign matter) from a patient's body, including devices, such as luminal devices, that are at least partially located within a patient's body and associated with a vascular system or a non-vascular system. The capture systems and methods can remove materials from the vascular system, including but not limited to devices within or connected to the vascular system, such as stents, filters, and indwelling catheters (including but not limited to dialysis catheters). The capture systems and methods can remove materials from non-vascular areas to treat, for example, gallstones, kidney stones, common bile duct stones, etc. The capture system can be delivered into the patient's body percutaneously or by other techniques.

[0060] The capture system may include a first component. The first component may include a central lumen. The first component may be an outer sheath. The first component may include at least one lumen. The first component may be configured to cover a portion of the capture system, such as a tubular body.

[0061] The capture system may include a second component. The second component may include a central lumen. The second component may be an inner sheath. The second component may include at least one lumen. The second component may be a push rod. The second component may be used to move a portion of the capture system, such as the tubular body.

[0062] The capture system may include the tubular body. The tubular body may include a shape memory material. The tubular body may be a shape memory body. The tubular body may include a first end, a second end, and an axial length therebetween. The first end of the tubular body may have an opening. In some embodiments, the second end of the tubular body may be coupled to the second member.

[0063] During use of the capture system, the tubular body is capable of deforming into a first configuration in which the first end is expanded while the second end and a majority of the tubular body remain compressed within the central lumen of the first member. In some embodiments, the second end is located adjacent the first end. In the first configuration, the tubular body has a first expanded axial length and a first width along the first expanded axial length.

[0064] During use of the capture system, the tubular body is capable of deforming into a second configuration. In some embodiments, the tubular body is deformed by movement between the first member and the second member. In some embodiments, the tubular body is deformed by movement of one or more tensioners. In some embodiments, the tubular body has a second extended axial length that is greater than the first extended axial length and the shape memory body has a second width along the second extended axial length. In some embodiments, the second width of the shape memory body along the second extended axial length is substantially the same as the first width of the shape memory body along the first extended axial length.

[0065] This capture system is used to remove emboli, thrombi, and other foreign matter from the vascular system. It can be used to remove acute, subacute, chronic, or organized clots. When a clot or thrombus forms and settles in a blood vessel, a small amount of the clot or thrombus adheres to the vessel wall. Over time, the clot or thrombus increases its wall adhesion, eventually becoming difficult to remove. Therefore, a capture system with high resistance is required to remove this level of clot formation.

[0066] The capture system includes a capture guide. In some embodiments, the capture guide includes nitinol. In some embodiments, the capture guide includes a ring. In some embodiments, the capture guide includes a nitinol ring. The capture guide may be an annular guide attached to the circumference of the proximal-facing opening of the tubular body. In some embodiments, the capture guide at least partially surrounds the first end opening. In some embodiments, the capture guide completely and partially surrounds the first end opening. In some embodiments, the capture guide forms a continuous ring. In some embodiments, the capture guide forms a discontinuous ring. During use, the capture guide can be radially expanded. During delivery, the capture guide can be compressed.

[0067] The capture system includes a tubular body. The tubular body may be a woven wire mesh. The tubular body may have an extension extending from an opening. The extension may be considered a basket. The tubular body may form a woven wire basket. The tubular body may be porous, semi-permeable, and non-porous. The tubular body may include a nitinol braided mesh, a knitted mesh, or a non-woven mesh, or a nitinol wire. In some embodiments, the tubular body is coated or uncoated with a hydrophilic agent or a hydrophobic agent. In some embodiments, the tubular body includes a shape memory metal or material. In some embodiments, the tubular body does not include a shape memory metal or material.

[0068] The capture guide is located at the first end of the tubular body and forms the opening. The tubular body extends from the first end to the fold. In some embodiments, a portion of the tubular body is compressed and extends from the folded distal end to the second end. The tubular body is designed to extend axially. In some embodiments, the tubular body is configured to expand proximally, reverse, flip and / or variably extend from the first configuration to the second configuration. The second axial length can be different from the first axial length. In some embodiments, the width of the capture assembly can remain substantially unchanged from the first configuration to the second configuration.

[0069] The capture system may include a proximally facing opening of the tubular body. The tubular body may be expanded to a dynamic folding point, which serves as the effective expanded distal end of the tubular body. The compressed retained length portion of the tubular body may be approximately or at least approximately 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, or more of the absolute axial length of the tubular body. In some embodiments, the second end of the tubular body may be maintained inverted, rolled up, and / or otherwise radially compressed. In some embodiments, the second end of the tubular body may be surrounded by the second member. In some embodiments, the second end of the tubular body may be fixed to the second member at an attachment site. The dynamic folding point varies along the length of the tubular body depending on the length of the expanded compressed retained length portion. The dynamic folding point floats and is not directly attached to the first member or the second member, and moves therewith as the expanded portion of the tubular body elongates axially.

[0070] The capture system may include a first component and a second component as described herein. The capture guide and the tubular body may be attached to a series of concentric shafts. The second component may be disposed within the central lumen of the first component. The capture guide and the tubular body may initially be deployed in a short, low profile configuration. This initial configuration may be the first configuration described herein. The capture guide and the tubular body may then be extended to increase the length of the basket, thereby capturing clots or other materials.

[0071] The capture guide is used to open and maintain the basket opening to capture, collect, receive, and remove clots or other materials. The capture guide can conform to various vessel diameters and geometries, such as circular, oval, elliptical, or other vessel cross-sectional shapes. The capture guide can be positioned at various angles or angular orientations relative to the vessel. In some methods of use, the capture guide deflects when encountering resistance during proximal retraction of the loop.

[0072] In some embodiments, the capture system can include one or more features to enable the capture guide (e.g., a nitinol ring) to withstand high resistance without deflection while conforming to the vessel. The capture system can include one or more features to enable the capture guide to scrape clots or other foreign matter from the vessel wall. The capture system can include one or more features that maintain the shape of the capture guide, for example, during proximal retraction to axially extend the tubular body. The capture system can include one or more features to reduce or prevent deflection of the capture guide.

[0073] Figure 1A and Figure 1B An embodiment of a capture system 100 is shown. The capture system 100 can include a first member 102 or outer sheath. The first member 102 can include a central lumen 104. The central lumen 104 can be sized to accommodate one or more components of the capture system 100. The capture system 100 can include a second member 106. The second member 106 can be disposed within the central lumen 104.

[0074] The capture system 100 may include a tubular body 110. The tubular body 110 may include a first end 112 and a second end 114. The attachment point of the second end 114 may be Figure 1A , closer to the interior of the second member 106. The attachment point of the second end 114 can be anywhere along the length of the second member. The tubular body 110 may include an axial length between the first end 112 and the second end 114. The first end 112 may include a capture guide 116. The capture guide 116 may define an opening 118. In some embodiments, the second end 114 can be coupled to the second member 106. In some embodiments, the second end 114 can be disposed within the second member 106. In some embodiments, the second end 114 can be coupled to the nose tip 108. In some embodiments, the second end 114 can be coupled to the third member. In some embodiments, the second end 114 can be coupled to the inner guidewire lumen. In some embodiments, the capture guide 116 can be coupled to the second member 106.

[0075] Capture system 100 may include at least a portion of tubular body 110 compressed in a first configuration. First end 112 of tubular body 110 is expanded. Capture guide 116 is expanded. Tubular body 110 has a first expanded axial length and a first width along the first expanded axial length. Capture system 100 may include nose tip 108 extending beyond the distal end or dynamic fold point of tubular body 110.

[0076] The tubular body 110 is deformable into a second configuration. In some embodiments, the tubular body 110 can be deformed by movement of a tensioner as described herein. In some embodiments, the tubular body 110 can be deformed by movement of the first member 102, movement of the second member 106, and / or movement between the first member 102 and the second member 106. In some embodiments, the tubular body 110 can be deformed by movement of the first member 102, movement of the second member 106, and / or movement of a third member. The tubular body 110 has a second extended axial length that is greater than the first extended axial length, and the shape memory body has a second width along the second extended axial length. In some embodiments, the second width of the shape memory body along the second extended axial length is substantially the same as the first width of the shape memory body along the first extended axial length.

[0077] In some embodiments, the tubular body 110 is configured to invert, flip, or unfold. The compressed retained length portion of the tubular body 110 can be approximately or at least approximately 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, or more, or a range comprising any two of the foregoing values, of the absolute axial length of the tubular body 110. The compressed retained length portion of the tubular body 110 remains inverted, rolled, and / or otherwise radially compressed up to a folding point or inversion point of the tubular body 110. The dynamic folding point varies along the length of the tubular body 110 depending on the length of the compressed retained length portion being expanded. As the expanded portion of the tubular body 110 axially lengthens, the dynamic folding point floats and moves proximally.

[0078] The tubular body 110 may comprise a mesh-like structure having a proximally facing opening at one end. The tubular body 110 may be made of a shape memory metal or polymer, a non-shape memory metal such as stainless steel, or other non-shape memory fabrics, or other materials. In some embodiments, the systems and methods herein may employ conventional mesh structures such as those used in IVC and other embolic filters. In some embodiments, the thrombus capture device may be configured to extend axially throughout its operating range, with or without radially shortening the tubular body 110 throughout its operating range.

[0079] In some embodiments, the proximal end opening of the tubular body 110 may include a capture guide 116. The capture guide 116 may take the form of a radially expandable shape memory portion or a fully annular ring structure. In some embodiments, when the other end of the tubular body 110 and the capture guide 116 are expanded, a substantial portion of the surface area and / or axial length of the mesh of the tubular body 110 remains in a compressed configuration. The tubular body 110 may be a generally tubular mesh structure that is contractible, expandable, and configured to axially lengthen or shorten, such as within a working range, while maintaining or substantially maintaining its diameter within the working range for retraction. The tubular body 110 may capture foreign matter or other unwanted material within the body, including the vascular system, such as blood clots, thrombi, and / or foreign matter.

[0080] Capture system 100 may include one or more features, tensioners, such as a tether or rope 120 . Figure 1A and Figure 1B A feature, a tensioner, such as a tether or rope 120, is shown. The tensioner 120 can include a distal end 122 and a proximal end 124. The distal end 122 of each tensioner 120 is coupled to the capture guide 116. The proximal end 124 of each tensioner 120 extends through the first member 102 or outer sheath. The proximal end 124 of each tensioner 120 extends toward the proximal end of the capture system 100. In some embodiments, the proximal end 124 of each tensioner 120 is coupled to the first member 102. In some embodiments, the proximal end 124 of each tensioner 120 is coupled to the midpoint of the first member 102 or along the length of the first member 102. In some embodiments, the proximal end 124 of each tensioner 120 is coupled to a proximal end control handle. In some embodiments, the proximal end 124 of each tensioner 120 is coupled to the second member 106. In some embodiments, the proximal end 124 of each tensioner 120 is coupled to a third member or sheath. Figure 1A and Figure 1B In some embodiments, the capture guide comprises a ring having only one strut or multiple struts that extend proximally and couple to the first member or inner member. In some embodiments, the struts can extend to the control handle.

[0081] The proximal end 124 of each tensioner 120 can extend through the first member 102 or the outer sheath. The proximal end 124 of each tensioner 120 extends toward the proximal end of the capture system 100. In some embodiments, the proximal end 124 of each tensioner 120 is coupled to the first member 102. In some embodiments, the proximal end 124 of each tensioner 120 is coupled to the midpoint of the first member 102 or along the length of the first member 102. In some embodiments, the proximal end 124 of each tensioner 120 is coupled to the proximal end control handle as described herein.

[0082] The tensioner 120 may be connected to the tubular body 110. The tensioner 120 may be connected to the capture guide 116. The tensioner 120 may be connected to maintain the basket in a tensioned state. The tensioner 120 may be connected to maintain the capture guide 116 rigid. The tensioner 120 may be connected to prevent the opening of the tubular body 110 from deflecting. Figure 1A This is a top view. Figure 1B Although two tensioners 120 are shown, the capture system 100 may include any number of tensioners (e.g., one tensioner, two tensioners, three tensioners, four tensioners, five tensioners, six tensioners, seven tensioners, eight tensioners, nine tensioners, ten tensioners, between two and three tensioners, more than two tensioners, less than five tensioners, or any range of the foregoing values).

[0083] In some embodiments, the tubular body 110 can be moved independently of the tensioner 120. The tubular body 110 can be moved regardless of whether the tensioner 120 is activated or deactivated. When the tubular body 110 is first deployed, the tensioner 120 is activated. Activating the tensioner 120 pulls the tubular body 110 back to capture a clot or other material. Simultaneously, the tubular body 110 also extends. The tubular body 110 has a first configuration in which the first end 112 and the capture guide 116 are expanded and one or more tensioners 120 are activated, while the second end and a majority of the tubular body remain compressed, and the tubular body 110 has a first expanded axial length and a first width along the first expanded axial length. The tubular body 110 is deformable into a second configuration in which the tubular body 110 has a second expanded axial length greater than the first expanded axial length and the tubular body 110 has a second width along the second expanded axial length.

[0084] The capture system 100 can be used in conjunction with a funnel system, such as the expandable funnel catheters 200, 300, and 400 described herein. The funnel system can include an expandable funnel tip. The funnel system can include an expandable shaft. The funnel system can include a housing body. The housing body can be removable to allow the expandable funnel tip and / or expandable shaft to expand. The funnel tip and the funnel shaft are expandable.

[0085] The method of retrieving a material may include any of the steps described herein. In some methods, a funnel system is positioned relative to a target area within a patient's lumen. The funnel tip can be delivered in a collapsed configuration and expanded near the material. The funnel tip can be positioned proximally relative to the material. In some embodiments, a capture system is positioned. The capture system can be positioned distally relative to the material. The capture system can have one or more tensioners coupled to a capture guide that is activated when the capture system is positioned. The capture system 100 can be deformed to extend over the material. The capture system 100 can be retracted into the funnel system. The capture system 100 can be retracted by an expandable funnel catheter 200, 300, 400 as described herein.

[0086] Figure 1A and Figure 1B Two tensioners 120 are shown. The tensioners 120 can be sutures. The tensioners 120 can be any member. The tensioners 120 can connect the capture guide 116 to the first member 102 or the outer sheath. In some embodiments, the tensioners 120 can be connected to the nitinol ring that forms the capture guide 116. In some embodiments, the tensioners 120 can be connected to the distal end of the first member 102. In some embodiments, the tensioners 120 can extend within the lumen of the first member 102. The first member 102 can extend proximally and connect to a coupler insert of the handle of the capture system 100, as described herein. Figure 1A and Figure 1B Two tensioners 120 are shown in an activated state. When activated, the tensioners 120 apply tension to the tubular body 110 and the capture guide 116.

[0087] Figure 2A The two tensioners 120 are shown in an inactive state. When inactive, the tensioners 120 do not apply tension to the tubular body 110 and the capture guide 116. When inactive, the capture guide 116 can deflect in this situation.

[0088] Figure 2B A proximal end of the capture system 100 is shown. The capture system 100 can include at least one handle 130. The first member 102 can extend proximally and connect to a coupling insert 132 of the handle 130 of the capture system 100. Figure 2BThe coupling insert 132 is shown not fully engaged with the coupling body 134. The coupling body 134 and the coupling insert 132 are semi-engaged.

[0089] Figure 3A Two tensioners 120 are shown in an activated state. When activated, the tensioners 120 apply tension to the tubular body 110 and the capture guide 116. When activated, the deflection of the capture guide 116 can be reduced or limited. Figure 3B The coupling insert 132 is shown fully engaged with the coupling body 134. The coupling body 134 is engaged with the coupling insert 132. When the coupling body 134 is engaged with the coupling insert 132, the tensioner 120 applies tension to the capture guide 116.

[0090] The tension applied by the tensioner 120 maintains the rigidity of the capture guide 116. The rigid capture guide 116 is capable of scraping the inner wall of the vessel, thereby removing foreign matter. The rigid capture guide 116 is maintained by tension. When encountering foreign matter adhered to the vessel wall, the capture guide 116 is less susceptible to deflection. In some embodiments, the capture guide 116 can score or cut the foreign matter. In some embodiments, the capture guide 116 scrapes or shears the foreign matter from the vessel wall. The tension applied by the tensioner 120 can be adjusted to various tensions, such as low, medium, or high, depending on the degree of wall-adherent clot or foreign matter. The tensioner can be, for example, a tether, rope, spring, rod, tube, coil, wire, or laser-cut metal element. The tensioner can be any feature configured to apply tension. The tension applied by the tensioner 120 can be adjusted using a control handle as described herein. In some embodiments, the capture guide is circular or oval in shape, with one or more struts extending proximally and coupled to the first member or inner member. In some embodiments, the struts can extend to the control handle. The capture guide with the struts can be laser cut (Figure 34). The struts can be straight, curved, or have features along their length to allow the struts to stretch under high tensile stress.

[0091] The capture guide 116 is held in place by a tensioner 120, which allows it to withstand high resistance without deflecting while conforming to the vessel. In some embodiments, two or more tensioners 120, such as sutures or members, connect the capture guide 116 to the distal end of the first member 102 or outer sheath. In some embodiments, one or more tensioners 120 extend within one or more lumens of the first member 102. The first member 102 can extend proximally and connect to a coupling insert 132. The coupling insert 132 engages the coupling body 134, thereby activating the tensioner 120 to apply tension. Once activated, the capture guide 116 remains stationary and cannot deflect during removal. Maintaining the rigidity of the capture guide 116 during removal facilitates scoring, scraping, cutting, shearing, and capturing material adhered to the vessel wall. The tensioners 120 can be deactivated by separating the coupling insert 132 from the coupling body 134. In some embodiments, the tensioners 120 are activated simultaneously. In some embodiments, the tensioners 120 are activated independently.

[0092] In some embodiments, the tensioner 120 can be rigid. In some embodiments, the tensioner 120 can be a solid member. In some embodiments, the tensioner 120 can be flexible. In some embodiments, the tensioner 120 can be a suture. In some embodiments, the tensioner 120 can be a tether. In some embodiments, the tensioner 120 can be one or more ropes, springs, rods, tubes, coils, wires, or laser-cut metal elements. In some embodiments, the capture guide is circular, such as circular or oval, and has one or more struts extending proximally and coupled to the first member or inner member. In some embodiments, the struts can extend to the control handle. The capture guide with struts can be laser-cut ( FIG. 34 ). The struts can be straight or curved, with features along their length to allow them to stretch under high tensile stress. The tensioner 120 can be one or more tensioners coupled to the capture guide 116. The tensioner 120 can be made of a polymer material, such as a suture filament or metal wire. The tensioner 120 may include a filament material such as PET, PTFE, Kevlar, polyimide, or PEEK. The tensioner 120 may include a metal wire, such as stainless steel or Nitinol. The wire may have features such as a spiral and / or a zigzag shape to allow the wire to stretch or deform under high tensile stress.

[0093] In some embodiments, the capture system can have one or more tensioners 120 coupled to the capture guide 116. In some embodiments, the capture system can have one or more tensioners 120 coupled to the tubular body 110. In some embodiments, the capture system can have one or more tensioners 120 coupled to the opening 118. The tensioners 120 can be positioned around the circumference of the opening 118.

[0094] One or more tensioners 120 can be attached by various methods. In some embodiments, the tensioner 120 is attached to the capture guide 116. The tensioner 120 can be attached by various methods, such as thermal, non-thermal, laser, chemical, and / or mechanical methods, such as suture knots, wraps, or loops. In some embodiments, the one or more tensioners 120 and the capture guide 116 can be continuous or integral. In some embodiments, the one or more tensioners 120 and the capture guide 116 can be integrally formed. In some embodiments, the one or more tensioners 120 and the capture guide 116 can be formed separately. In some embodiments, the one or more tensioners 120 and the capture guide 116 can be integrally formed. In some embodiments, the one or more tensioners 120 and the capture guide 116 can be formed separately. In some embodiments, the one or more tensioners 120 and the tubular body 110 can be integrally formed. In some embodiments, the one or more tensioners 120 and the tubular body 110 can be formed separately. In some embodiments, the capture guide 116 and the tubular body 110 can be integrally formed. In some embodiments, the capture guide 116 and the tubular body 110 can be formed separately.

[0095] The capture system can have one tensioner 120 or multiple tensioners 120. When there are two or more tensioners 120, each tensioner 120 can be positioned equidistant from one another around the circumference of the capture guide 116. For example, two tensioners 120 can be spaced approximately 180 degrees apart. For example, three tensioners 120 can be spaced approximately 120 degrees apart. For example, four tensioners 120 can be spaced approximately 90 degrees apart. When there are two or more tensioners 120, each tensioner 120 can be positioned unequally spaced from one another around the circumference of the capture guide 116. For example, two tensioners 120 can be spaced approximately 120 degrees apart. For example, two tensioners 120 can be spaced approximately 90 degrees apart. When there is one tensioner, the tensioner can be located opposite the second member 106 connected to the capture guide 116.

[0096] In some embodiments, the capture system may have two tensioners 120. The two tensioners 120 may be diametrically opposed. The two tensioners 120 may be equally spaced. The two tensioners 120 may be symmetrical. The two tensioners 120 may be located on opposite sides of the capture guide 116. The two tensioners 120 may be spaced 30 degrees, 45 degrees, 60 degrees, 75 degrees, 90 degrees, 105 degrees, 120 degrees, 135 degrees, 150 degrees, 165 degrees, 180 degrees, or any range of the foregoing values. The two tensioners 120 may apply equal tension to the capture guide 116. The two tensioners 120 may be located lateral to the capture guide 116.

[0097] Return Reference Figure 3A , the capture system may have two tensioners 120. One tensioner 120 may be located to the right of the capture guide 116, while the other tensioner 120 may be located to the left of the capture guide 116. In some embodiments, the capture guide 116 may be coupled to the second member 106. The second member 106 and the two tensioners 120 may be equally spaced apart. The two tensioners 120 and the second member 106 may be spaced 30 degrees, 45 degrees, 60 degrees, 75 degrees, 90 degrees, 105 degrees, 120 degrees, 135 degrees, 150 degrees, 165 degrees, 180 degrees, or any range of the foregoing values. In some embodiments, the two tensioners 120 and the second member 106 may be spaced 120 degrees apart. Other arrangements of the tensioners 120 are also contemplated.

[0098] In some embodiments, the capture system may have three tensioners 120. At least two tensioners 120 may be diametrically opposed. The three tensioners 120 may be equally spaced. The three tensioners 120 may be symmetrical. The at least two tensioners 120 may be located on opposite sides of the capture guide 116. The at least two tensioners 120 may be spaced 30 degrees, 45 degrees, 60 degrees, 75 degrees, 90 degrees, 105 degrees, 120 degrees, 135 degrees, 150 degrees, 165 degrees, 180 degrees, or any range of the foregoing values. The three tensioners 120 may apply equal tension to the capture guide. The three tensioners 120 may form an equilateral triangle on the capture guide. The three tensioners 120 may form an isosceles triangle. At least one tensioner 120 may be located at the top of the capture guide 116. At least one tensioner 120 may be located opposite the second member 106. Two additional tensioners 120 may be located lateral to the capture guide 116. Other arrangements of tensioners 120 are also contemplated.

[0099] In some embodiments, the capture system may include one or more tensioners 120. Tension can be applied to the one or more tensioners 120 to tighten the capture guide 116. The one or more tensioners 120 can maintain the shape of the capture guide 116. The one or more tensioners 120 can maintain the rigidity of the capture guide. The one or more tensioners 120 can enable the capture guide 116 to scrape clots or other foreign material from the vessel wall. The one or more tensioners 120 can be positioned to evenly distribute tension to the capture guide 116. The one or more tensioners 120 can be positioned to increase the rigidity of the capture guide 116 during scraping. The one or more tensioners 120 can facilitate the removal of material from the vessel wall when the capture guide 116 is retracted. The tension applied to the capture guide 116 can be varied by adjusting the one or more tensioners 120. The one or more tensioners 120 can prevent or limit deflection of the capture guide 116 when the capture guide encounters foreign material on the vessel wall.

[0100] One or more tensioners 120 can be configured to prevent the capture guide 116 from rotating. One or more tensioners 120 can maintain the capture guide 116 in a plane. One or more tensioners 120 can move the capture guide 116 while maintaining the capture guide 116 perpendicular to the vessel. One or more tensioners 120 can prevent the capture guide 116 from deflecting when interacting with the deposited material. One or more tensioners 120 can prevent the capture guide 116 from sliding on the material. One or more tensioners 120 can allow the capture guide 116 to scrape along the vessel wall.

[0101] Figure 4A-4G A method of loading the tubular member 110 and tensioner 120 into a delivery catheter is shown. Figure 4A In FIG, the basket loading tool 152 is pre-loaded onto the delivery catheter. The basket loading tool 152 may be located outside the first member 102 or outer sheath. Figure 4B In FIG. 1 , the basket loading tool 152 is slid onto the tubular body 110 or basket. The basket loading tool 152 is slid distally along the length of the first member 102. Figure 4C In the embodiment of the invention, the basket loading tool 152 is slid over the nose tip 108. Figure 4C , the tubular body 110 is positioned within the basket loading tool 152 .

[0102] In some embodiments, the basket loading tool 152 can include a funnel tip. In some embodiments, the basket loading tool 152 can include an expandable end. In some embodiments, the basket loading tool 152 can radially compress the tubular body 110. In some embodiments, the basket loading tool 152 can include two funnel tips. In some embodiments, the basket loading tool 152 can include two expandable ends. In some embodiments, the basket loading tool 152 can be loaded in two directions relative to the first member 102.

[0103] exist Figure 4D In the embodiment, the first member 102 or other sheath slides over the tubular body 110 or basket. The first member 102 slides along the inner wall of the basket loading tool 152. Figure 4E In the embodiment, the first member 102 slides to engage the nose tip 108. Figure 4E , the tubular body 110 is located within the first member 102 .

[0104] exist Figure 4F In the embodiment, the basket loading tool 152 is slid on the first member 102 to remove the basket loading tool 152. The tubular body 110 is located within the first member 102. Figure 4G , the basket loading tool 152 is removed.

[0105] Figures 5A-5C A method of loading the tubular body 110 and tensioner 120 into a delivery catheter is shown. Figure 5A In some embodiments, a basket loading tool 152 is pre-loaded onto a delivery catheter. The basket loading tool can be located outside the first member 102 or outer sheath. A tensioner 120 is coupled to the tubular body 110. In some methods, the tensioner 120 is coupled to the basket to maintain the basket in a tensioned state. In some methods, the tensioner 120 applies tension during loading of the basket with the basket loading tool 152. In other methods, the tensioner 120 does not apply tension during loading of the basket with the basket loading tool 152.

[0106] exist Figure 5B , the basket loading tool 152 slides toward the tubular body 110 or the basket. The basket loading tool 152 slides distally along the length of the first member 102. As the basket loading tool 152 slides to cover the tubular body 110, the tensioner 120 applies tension.

[0107] exist Figure 5CIn some methods, the basket loading tool 152 is slid over the tubular body 110 or basket. The basket loading tool 152 is slid distally toward the nose tip 108. In some embodiments, the tensioner 120 applies tension as the basket loading tool 152 is slid over the tubular body 110. The proximal end 124 of the tensioner 120 is connected to the shaft or outer shaft of the first member 102. In some methods, the basket loading tool 152 is slid over the nose tip 108. In some methods, the first member 102 or other outer sheath is slid over the tubular body 110 or basket. In some methods, the first member 102 is slid along the inner wall of the basket loading tool 152. In some methods, the first member 102 is slid to engage the nose tip 108. In some methods, the basket loading tool 152 is slid over the first member 102 to remove the basket loading tool 152.

[0108] Figure 6A The distal end of the delivery catheter is shown, with the basket and tensioner loaded within the delivery catheter. The basket or tubular body 110 is completely loaded within the first member 102. The first member 102 is engaged with a nose tip 108. Figure 6B The proximal end of the delivery catheter is shown with the handle 130, wherein the coupling insert 132 is separated from the coupling body 134. In some approaches, the tensioner 120 is not in a tensioned state when loaded within the first member 102. In some approaches, the tensioner 120 is in a tensioned state when loaded within the first member 102, and the coupling insert 132 is engaged with the coupling body 134.

[0109] Return Reference Figure 3A , the distal end 122 of each tensioner 120 is coupled to a capture guide 116. In some embodiments, the second member 106 is coupled to the capture guide 116. The capture guide 116 can be configured to retract to scrape the vessel wall. In some embodiments, movement of the tensioner 120 causes movement of the capture guide 116.

[0110] refer to Figure 6BThe proximal end 124 of each tensioner 120 can extend toward the proximal end of the capture system 100. In some embodiments, the proximal end 124 of each tensioner 120 extends along the second member 106. In some embodiments, the proximal end 124 of each tensioner 120 is not coupled to the second member 106. In some embodiments, the proximal end 124 of each tensioner 120 can extend through the first member 102. In some embodiments, the proximal end 124 of each tensioner 120 can extend through the outer sheath. The proximal end 124 of each tensioner 120 can extend to the coupling insert 132. In some methods, the tensioner 120 is separate at the connector 134 and the coupling insert 132. In some methods, the tensioner 120 is joined at the connector 134 and the coupling insert 132. The tensioner 120 can be placed under tension within the lumen of the first member 102.

[0111] In some embodiments, the handle 130 of the capture system 100 is pulled, thereby pulling the one or more tensioners 120. The first member 102 can extend proximally and connect to the coupling insert 132. When the capture system 100 is pulled, the coupling body 134 and the coupling insert 132 can engage. Movement of the handle 130 of the capture system 100 causes the one or more tensioners 120 to apply tension to the capture guide 116. This tension causes the capture guide 116 to move along the vessel wall, thereby contacting, for example, scraping, the vessel wall. Continued movement causes further contact, for example scraping, until unwanted material is removed from the vessel wall.

[0112] Figure 7 A capture system 150 is shown. Capture system 150 can include any of the features of capture system 100 described herein. Capture system 150 can include a tubular body 160. Tubular body 160 can include a first end 162 and a second end (not shown). Tubular body 160 can include an axial length between first end 162 and second end. First end 162 can include a capture guide 166. Capture guide 166 can define an opening 168.

[0113] In some embodiments, capture guide 166 comprises nitinol. In some embodiments, capture guide 166 comprises a ring or a ring-like structure. In some embodiments, capture guide 166 comprises an open shape. In some embodiments, capture guide 166 comprises a closed shape. In some embodiments, capture guide 166 comprises nitinol or other shape memory material. In some embodiments, the capture guide may have a stent-like shape. Capture guide 166 may be attached to the circumference of the proximally facing opening of tubular body 160. In some embodiments, capture guide 166 at least partially surrounds the first end opening. In some embodiments, capture guide 166 completely and partially surrounds the first end opening. In some embodiments, capture guide 166 forms a continuous shape. In some embodiments, capture guide 166 forms a discontinuous shape. Capture guide 166 is expandable. Capture guide 166 may have different geometric configurations so that it can expand when subjected to radial forces. Capture guide 166 may have any shape.

[0114] In some embodiments, one or more tensioners 170 are attached to the capture guide 166. The tensioners 170 can have any of the features of the tensioner 120 described herein. The capture guide 166 can include one or more points or tips. In some embodiments, each tensioner 170 can be coupled to one of the points or tips. In some embodiments, the capture guide 166 includes two points. Other configurations are also contemplated (e.g., one point, two points, three points, four points, five points, six points, or any range of the foregoing values). In some embodiments, the capture guide 166 includes two tensioners. Other configurations are also contemplated (e.g., one tensioner, two tensioners, three tensioners, four tensioners, five tensioners, six tensioners, or any range of the foregoing values).

[0115] A tensioner 170 can be attached to the capture guide 166. In some embodiments, the tensioner 170 can extend within the lumen of the first member or outer sheath. In some embodiments, the tensioner 170 can extend within another inner lumen located at or adjacent to the outer sheath wall as described herein. The outer sheath can have one or more lumens within or adjacent to its wall thickness. In some embodiments, the inner lumen can extend the entire length of the outer sheath. In some embodiments, the inner lumen can extend partially. In some embodiments, the inner lumen can terminate within, distal to, in the middle of, or proximal to the outer sheath.

[0116] The capture guide 166 is capable of expanding to a larger diameter. The tensioner 170 can be attached to the nitinol ring or the apex of the capture guide 166. The capture guide 166 can have different geometric configurations. In some embodiments, the capture guide 166 can be formed into a sawtooth shape, a fish mouth shape, a stent shape, etc. The capture guide 166 can expand when subjected to radial force.

[0117] In some embodiments, a tensioner 170 extends from the capture guide 166 to the proximal end of the delivery catheter. The tensioner 170 can be attached to a handle mechanism. In some embodiments, the tensioner 170 can be attached to the coupling insert 132. When the coupling insert 132 engages the coupling body 134, the tensioner can be activated to apply tension. In some embodiments, the tensioner 170 can be articulated to different tension levels.

[0118] Figure 8 A three-lumen shaft is shown. The shaft includes two inner lumens separated by an angle θ. The shaft includes a central lumen. The first member 102 may have a three-lumen shaft. The second member 106 may be disposed within the central lumen. Tensioners 120, 170 may be disposed within the inner lumens. The inner lumens may guide the tensioners through the first member 102. The inner lumens may prevent entanglement of the tensioners 120, 170. In some embodiments, the tensioners 120, 170 extend within the central lumen. In some embodiments, each tensioner 120, 170 extends within a separate lumen. The inner lumens are within the wall thickness of the first member 102 or the outer sheath.

[0119] In some embodiments, because the radially expanded portion of the tubular body is subjected to minimal or no tension during axial extension or contraction within its axial working range, the tubular body can be axially extended or contracted within its working length / axial range without reducing or significantly reducing its diameter. Without being limited by theory, this can be achieved, at least in part, because the tubular body can be axially extended throughout its working range by unfolding, flipping, or otherwise expanding or deforming the radially compressed, retained portion of the tubular body. The dynamic folding point of the radially expanded portion of the tubular mesh may not be an absolute end of the tubular mesh. Instead, the second end may be located proximally, thereby forming a floating or dynamic folding point. This dynamic folding point is not fixed and, therefore, is not or substantially not under any tension. Thus, the radially compressed, retained portion of the tubular body extends proximally and rearwardly, and in some cases, within the expanded portion of the tubular body. In some embodiments, the second end may be fixed relative to the second member, such that movement of the second member causes movement of the second end, thereby expanding the tubular body.

[0120] In some embodiments, disclosed herein are capture systems and methods for retrieving and removing material (including emboli, thrombi, blood clots, stones / kidney stones, and / or foreign matter) from a patient's body. The capture systems and methods can remove material from the vascular system. The capture systems and methods can remove material from non-vascular areas to treat, for example, gallstones, kidney stones, common bile duct stones, and the like. The capture systems can be delivered percutaneously within a patient's body.

[0121] Figure 9 and Figure 10 An embodiment of an expandable funnel catheter 200 is shown. The expandable funnel catheter 200 can be used in conjunction with the capture system 100 described herein. In some embodiments, the tubular body 110, 160 is retracted through the expandable funnel catheter 200. In some embodiments, unwanted material is retracted through the expandable funnel catheter 200. In some embodiments, tools are retracted through the expandable funnel catheter 200. In some embodiments, a collection basket is retracted through the expandable funnel catheter. In some embodiments, a collection bag is retracted through the expandable funnel catheter. In some embodiments, a collection net is retracted through the expandable funnel catheter. In some embodiments, an expansion device such as a balloon is retracted through the funnel catheter. In some embodiments, an expandable nitinol element such as a disc, ball, and / or bundle is retracted through the expandable funnel catheter. In some embodiments, a polymer plug and / or curved disc, such as a circular disc, is retracted through the expandable funnel catheter. The expandable funnel catheter 200 can be used in conjunction with any of the systems or methods described herein. Figure 9 The expandable funnel catheter 200 is shown in a loaded configuration. The loaded configuration can be a delivery configuration. The loaded configuration can be a sterile packaging configuration. The expandable funnel catheter 200 can include a first hub 202. The expandable funnel catheter 200 can include a second hub 204. The expandable funnel catheter 200 can include a cap 206. The cap 206 can compress the expandable portion of the expandable funnel catheter 200. As described herein, the cap 206 can be removable. The cap can include features such as scores or perforations along its length to facilitate removal. The scores or perforations can be a single line or multiple lines along its length.

[0122] Figure 10 The expandable funnel catheter 200 is shown in a deployed configuration. The cap 206 can be removed to convert the expandable funnel catheter 200 between the loaded configuration and the deployed configuration. The expandable funnel catheter 200 can include an expandable funnel tip 210. The expandable funnel tip 210 can be located near the end of the expandable funnel catheter 200. The expandable funnel catheter 200 can include an expandable shaft 212. The expandable funnel catheter 200 can include a first hub 202. The expandable funnel catheter 200 can include a flushing port 214. The flushing port 214 can extend from the first hub 202.

[0123] The expandable funnel catheter described herein can be used with a clot capture system. The expandable funnel catheter described herein can be used to retrieve material. The expandable funnel catheter described herein can be used in any method requiring the retraction of material through an expandable funnel catheter. The expandable funnel catheter described herein can be used to retract a tubular body. The expandable funnel catheter described herein can be used to retract a catheter. The expandable funnel catheter described herein can be used in any method requiring the retraction of a tool through an expandable funnel catheter. In addition to removing unwanted material, the expandable funnel catheter can also have a wider range of applications. The expandable funnel catheter can be used in any surgical procedure. The expandable funnel catheter can be used in any method.

[0124] The expandable funnel catheter advantageously increases in size within a body cavity. The expandable funnel tip 210 of the expandable funnel catheter is expandable. The expandable funnel tip 210 can expand to accommodate larger materials and tools. The expandable funnel tip 210 can guide the materials and / or tools to the expandable shaft 212. The expandable shaft 212 of the expandable funnel catheter is expandable. The expandable shaft 212 can expand to accommodate materials larger than the diameter of the expandable shaft 212. The expandable shaft 212 can expand to accommodate tools larger than the diameter of the expandable shaft 212. The expandable shaft 212 can expand along the entire length of the shaft. The expandable shaft 212 can expand along a portion of the shaft. The expandable shaft 212 can expand near the expandable funnel tip 210.

[0125] In some embodiments, the funnel tip of the expandable funnel catheter does not expand. In some embodiments, only the funnel tip of the expandable funnel catheter expands. In some embodiments, the shaft of the expandable funnel catheter does not expand. In some embodiments, only the shaft of the expandable funnel catheter expands.

[0126] The expandable funnel catheter advantageously can be partially expanded and still function. Advantageously, the expandable funnel catheter can be expanded only along a portion of its length. Advantageously, the expandable funnel catheter is expanded when it is necessary to remove material larger than the unexpanded diameter of shaft 212 or to receive tools larger than the unexpanded diameter of shaft 212. The expandable funnel catheter facilitates the retrieval of selected materials from the body. By expanding shaft 212, material larger than the unexpanded diameter of shaft 212 can be passed through the expandable funnel catheter. Advantageously, the expandable funnel catheter provides flexibility in removing material based on its size.

[0127] Figure 11A cap 206 is shown. The cap 206 can be a peelable cap. The cap 206 can be used with the expandable funnel catheter 200. The cap 206 can compress the expandable funnel tip 210. The cap 206 can compress the expandable shaft 212. The cap 206 can include a hub 216. In some embodiments, the expandable funnel catheter 200 can be within a constraint. The cap 206 can act as a constraint to minimize the diameter of the expandable funnel catheter 200. In some embodiments, the expandable funnel catheter 200 is constrained by an outer sheath. In some embodiments, the expandable funnel catheter 200 is constrained by the first member 102.

[0128] Figure 12 A dilator 220 is shown. The dilator 220 can extend through the lumen of the expandable funnel catheter 200. The dilator 220 can include a second hub 204. The dilator 220 can extend through the lumen of the expandable funnel catheter 200. In some embodiments, the dilator 220 can facilitate expansion of the expandable funnel catheter 200.

[0129] Figure 13 and Figure 14 An embodiment of an expandable funnel catheter 300 is shown. The expandable funnel catheter 300 can include any of the features of the expandable funnel catheter 200. The expandable funnel catheter 300 can be used in conjunction with any of the systems or methods described herein. Figure 13 The expandable funnel catheter 300 is shown in a loaded configuration. The loaded configuration can be a delivery configuration. The loaded configuration can be a sterile packaging configuration. The expandable funnel catheter 300 can include a first hub 302. The expandable funnel catheter 300 can include a second hub 304. The expandable funnel catheter 300 can include a cap 306. The cap 306 can compress the expandable portion of the expandable funnel catheter 300. As described herein, the cap 306 can be removable. The expandable funnel catheter 300 can include a dilator 320. The dilator 320 can extend through the lumen of the expandable funnel catheter 300. The dilator 320 can include a second hub 304.

[0130] Figure 14The expandable funnel catheter 300 is shown in a deployed configuration. The cap 306 can be removed to convert the expandable funnel catheter 300 between the loaded configuration and the deployed configuration. The expandable funnel catheter 300 may include an expandable funnel tip 310. The expandable funnel tip 310 may be located near the end of the expandable funnel catheter 300. The expandable funnel catheter 300 may include an expandable shaft 312. The expandable funnel catheter 300 may include an expandable body. The expandable funnel catheter 300 may be expandable along the length of the expandable funnel catheter 300. The expandable funnel catheter 300 may be fully expandable. The expandable funnel catheter 300 may be selectively expandable, for example, in some methods only a portion of the expandable funnel catheter 300 is expanded. The expandable funnel catheter 300 may include the first hub 302. The expandable funnel catheter 300 may include a flush port 314.

[0131] Figure 15 Another view is shown. The cover 306 can be a peelable cover. The cover 306 can be removed by pulling a tab. The cover 306 can be removed by breaking along a score line. The cover 306 can be removed by retracting it. The cover 306 can remain intact. The cover 306 can be cut. The cover 306 can be used with the expandable funnel catheter 300. The cover 306 can compress the expandable funnel tip 310. The cover 306 can compress the expandable shaft 312. The cover 306 can include one or more hubs 316.

[0132] Figure 16 Another view is shown. The expandable funnel body may include an expandable funnel tip 310. The expandable funnel body may include an expandable shaft 312. The proximal end is formed with an opening to couple to the housing or first hub 302 and an irrigation / aspiration port 314.

[0133] Figure 17 The expandable funnel catheter 300 is shown in a loaded configuration. The loaded configuration can be a delivery configuration. The expandable funnel catheter 300 can be limited for delivery. The expandable funnel catheter 300 can be expanded within a patient.

[0134] Figure 18 The expandable funnel catheter 300 is shown in a deployed configuration. The expandable funnel catheter 300 is shown without the cap 306. The flush port can be used for flushing or suction to remove foreign matter or thrombus. The expandable funnel catheter 300 is expandable along its entire length. The expandable funnel catheter 300 can accommodate materials and / or tools that are larger than the resting diameter of the expandable shaft 312. The expandable shaft 312 can have a neutral diameter. The expandable shaft 312 can be expanded into the vessel wall to accommodate larger materials and / or tools. In some embodiments, the expandable shaft 312 can be radially expandable. In some embodiments, the expandable shaft 312 can be longitudinally contracted when expanded. In some embodiments, the expandable shaft 312 can be configured to facilitate expansion.

[0135] Figures 19A-19E Other scalable funnel concepts are shown. Figure 19A The location of the funnel braid is shown. The expandable funnel tip 210, 310 may include a funnel braid. The expandable funnel tip 210, 310 may be tapered. The expandable funnel tip 210, 310 may include a braided tapered portion. The expandable funnel tip 210, 310 may include a braided cylindrical portion. The expandable funnel tip 210, 310 may include a mesh. The expandable funnel tip 210, 310 may or may not have a tapered portion.

[0136] Figures 19B-19E A cross-sectional view of another expandable funnel concept is shown. The expandable funnel catheter 200, 300 can include an inner layer. The expandable funnel catheter 200, 300 can include an outer layer. In some embodiments, the expandable funnel tip 210, 310 can include an inner layer and an outer layer. In some embodiments, the expandable shaft 212, 312 can include an inner layer and an outer layer.

[0137] Figure 19B A first embodiment is shown. The inner layer can be expanded by folding. The outer layer can be a polymer material. Figure 19C A second embodiment is shown. The inner layer may have overlapping corrugations. The outer layer may be a polymeric material. Figure 19D A third embodiment is shown. The inner layer may have slits. The inner layer may have one or more slits. The inner layer may provide rigidity. The inner layer may be able to slide and open. The outer layer may allow for expansion. Figure 19E A fourth embodiment is shown. The inner layer may have two, three, or more slits. The inner layer may be made of a polymer material. The outer layer may be made of a polymer material. The polymer materials of the inner and outer layers may be the same or different. The outer layer may be harder. The outer layer may be harder than the inner layer.

[0138] Figure 20 The expandable funnel catheter 400 is shown in a loaded configuration. The expandable funnel catheter 400 can have any of the features described herein. The expandable funnel catheter 400 can include a quick connector 450. The expandable funnel catheter 400 can include a peelable cover 451. The expandable funnel catheter 400 can include an obturator 452. The expandable funnel catheter 400 can include a collapsed funnel catheter 455. The loaded configuration can be a delivery configuration. Figure 20 The loading funnel with peel-away sheath is shown.

[0139] Figure 21 The expandable funnel catheter 400 is shown in an expanded configuration. The expandable funnel catheter 400 can include a funnel shaft 453. The expandable funnel catheter 400 can include an expansion funnel 454. Figure 21A deployment funnel is shown.

[0140] Figure 22 An expandable funnel catheter 400 is shown. The expandable funnel catheter 400 may include a quick connect. The quick connect is disengaged, and one member 460 is proximally retracted from the second member 461, causing the funnel 462 to collapse inward. Figure 22 The funnel is shown folded inwardly. The hub 460 is pulled proximally using the quick release mechanism, folding the funnel 462 inwardly to a smaller profile.

[0141] Figure 23 An expandable funnel catheter 400 is shown. The funnel folds inwardly to a smaller profile. Prior to retraction, the funnel can be folded inwardly to minimize trauma to the entry site. Distal end 463 comprises a low-profile end. Hub 460 is located proximally.

[0142] Figure 24 The funnel is shown in a first configuration and a second configuration. The funnel can be delivered in a low-profile configuration. When delivered to a location within a patient's body, the funnel can expand. Delivery of the expandable funnel and the expandable shaft can be limited. The system can include any features that facilitate delivery. The system can include any features that facilitate expansion.

[0143] Figure 25-29 A capture system 500 is shown that uses a control handle to control the deployment of a tubular body and activate a tensioner. The control handle can be used with any of the systems described herein. The capture system 500 can have any of the features of the capture system 100 or any other system described herein. The capture system can have a nose tip 509. The capture system can have a guidewire lumen 508. The capture system can have a tubular body 507. The capture system can have one or more tensioners 505. The capture system can have a capture guide 506. The capture system can have a control knob 501. The control knob 501 can be moved to different positions. The capture system can have a push lock 502. The capture system can have a push rod 503. The capture system can have a flush port 504.

[0144] When the control knob 501 is in the control handle position 510, this position indicates that the tubular body 507 and the capture guide 506 are in the delivery configuration. When the control knob 501 is in the control handle position 513, this position indicates that the tubular body 507 and the capture guide 506 are extended and one or more tensioners 505 are activated, such as Figure 25. When the control knob 501 is in control handle position 511, this position indicates that the tubular body 507 and capture guide 506 are extended, and the one or more tensioners 505 are deactivated. When the control knob 501 is in control handle position 512, this position indicates that the tubular body 507 and capture guide 506 are extended, and the one or more tensioners 505 have low tension. The deployment of the tubular body 507 and capture guide 506 varies at positions 510, 511, 512, and 513. At position 510, the tubular body 507 and capture guide 506 are in a low-profile configuration. At positions 511, 512, and 513, the tubular body 507 and capture guide 506 are extended. The tension of the one or more tensioners 505 varies at positions 511, 512, and 513. At position 513, the tensioner is tensioned or has high tension. At position 512, the tensioner is in low tension. At position 512, the tensioner has low tension. At position 511, the tensioner is in little or no tension.

[0145] Figure 30A-Figure 30B Embodiments of the capture guide 550 are shown. In some embodiments, the capture guide 550 comprises a pointed shape. In some embodiments, the capture guide 550 comprises a one-point shape. In some embodiments, the capture guide 550 comprises a two-point shape. In some embodiments, the capture guide 550 comprises a three-point shape, see Figure 7 . The number of points may correspond to the number of tensioners. The tensioners may be connected to the capture guide at these points. In some embodiments, the capture guide 550 comprises a non-linear shape. In some embodiments, the capture guide 550 comprises a wavy shape. In some embodiments, the capture guide 550 does not lie on a plane. In some embodiments, the capture guide 550 lies substantially on a plane. Figures 30A-30B As shown, the capture guide can have different geometric configurations and be curved along its circumference. The curved portion can have an eyelet shape. The curved portion can be one or more curved portions along the circumference of the capture guide.

[0146] Figure 31A capture system including an anchor assembly is shown. The anchor assembly 221 may include approximately or at least approximately one, two, three, four, five, or more anchors 241 configured to secure a clot. One or more tensioners may be coupled to the one or more anchors 241. One or more tensioners may be coupled to the capture guide. One or more tensioners may be coupled to the one or more anchors 241 and the capture guide. Additional embodiments of the capture system may be found, for example, in U.S. patent application No. 9,579,116 filed by Nguyen et al. on February 28, 2017, the entire contents of which are incorporated by reference. Additional embodiments of the capture system may be found, for example, in U.S. patent application No. 9,744,024 issued by Nguyen et al. on August 29, 2017, the entire contents of which are incorporated by reference. Other embodiments of the capture system can be found in U.S. Patent Application No. 9,999,493, issued June 19, 2018, by Nguyen et al., the entire contents of which are incorporated by reference. In another embodiment, the distal end of the tensioner can be coupled to an anchor or cutter 241, such as Figure 31 shown.

[0147] Figures 32A-32C A hemostatic seal assembly is shown. In some embodiments, the hemostatic seal assembly can be made of a polymer material, such as polyurethane or silicone. The hemostatic seal assembly can include a tubular body and a twisting feature, such as a helical twisting feature 3200. The twisting feature causes the seal assembly to twist or rotate, thereby reducing the inner diameter and closing the inner lumen. The tubular body of the hemostatic seal assembly can be reinforced with a framework such as a metal or polymer braid or a coil or spiral. The hemostatic seal assembly is positioned or assembled with a housing or hub. The housing or hub can have a port for flushing or suction.

[0148] Figure 33 A single suture 3300 configuration is shown.

[0149] Figures 34A-34C Various forms of capture guide laser cutting elements with struts are illustrated. The capture guide can have one strut or multiple struts. The struts can be equally spaced or unequally spaced. Figure 34B An element is shown, whereby the strut is allowed to stretch under tensile stress. The element may also be in a coil-shaped configuration.

[0150] Figure 35 Non-limiting different expandable funnel shaft configurations of laser cut patterns are shown.

[0151] The expandable funnel catheter 200, 300, 400 may include a dilator 220, 320. The dilator may include an obturator 220, 320. The expandable funnel catheter 200, 300, 400 may include an expandable funnel sheath. The expandable funnel catheter 200, 300, 400 may include an expandable funnel tip 210, 310. The expandable funnel catheter 200, 300, 400 may include an expandable shaft 212, 312. The expandable funnel catheter 200, 300, 400 may include a peelable cap 206, 306.

[0152] The dilator / occluder 220, 320 can be used to help guide the expandable funnel catheter 200, 300, 400 into the vasculature. The expandable funnel catheter 200, 300, 400 can be used to facilitate delivery of the device. In some embodiments, the device is a capture system comprising a tubular body. The tubular body is designed to extend axially. In some embodiments, the tubular body is configured to proximally expand, invert, flip, and / or variably extend from a first configuration to a second configuration.

[0153] The expandable funnel catheter 200, 300, 400 allows for easy passage of a large volume of collected emboli, thrombi, or foreign matter. The collected emboli, thrombi, or foreign matter is retracted into the expandable funnel catheter 200, 300, 400. The expandable funnel catheter 200, 300, 400 can be expanded as needed to allow passage of a large volume of collected emboli, thrombi, or foreign matter. The peelable cap 206, 306 can be used to accommodate the expandable funnel catheter 200, 300, 400.

[0154] In some embodiments, the expandable funnel catheter 200, 300, 400 is constructed from a double braided wire or multiple wires. In some embodiments, both ends terminate at the proximal end of the body of the expandable funnel catheter 200, 300, 400. In some embodiments, one braided end extends distally to the funnel tip and folds back, and a second braided end extends proximally from the fold back to the proximal end of the body. The expandable funnel tip 210, 310 can include two layers of braided mesh. The expandable funnel tip 210, 310 can be folded and coupled to the end of the expandable shaft 212, 312.

[0155] In some embodiments, the funnel catheter body is delivered as a single layer, with the inner layer extending distally to the outer layer. After the obturator is removed, the braided end of the inner layer is proximally inverted into the outer layer to form the inner layer beneath the outer layer. When the inner layer is fully retracted to the proximal end, the funnel portion is expanded.

[0156] In some embodiments, the expandable funnel catheter 200, 300, 400 has an inner portion and an outer portion. The inner portion can slide to expand the funnel tip. The inner portion can slide to contract the funnel tip. The outer portion can slide to expand the funnel tip. The outer portion can slide to contract the funnel tip.

[0157] The distal end forms a funnel-shaped opening. In some embodiments, the distal end may have an opening that is the same as, larger than, or smaller than the main body. The proximal end is formed with an opening for connection to the housing or first hub 202, 302 having the hemostatic seal assembly and the irrigation / suction port 214, 314. In some embodiments, the proximal end opening may be the same as or larger than the main body opening.

[0158] The double braided layer of the expandable funnel catheter 200, 300, 400 can be coated with a polymer material. In some embodiments, the main body, such as the expandable shaft 212, 312 of the expandable funnel catheter 200, 300, 400, can be coated. In some embodiments, the funnel portion, such as the expandable funnel tip 210, 310, can be uncoated. In some embodiments, both the expandable funnel tip 210, 310 and the expandable shaft 212, 312 are coated. In some embodiments, both the outer layer and the inner layer can be coated. In some embodiments, the inner layer is coated. In some embodiments, the outer layer is coated.

[0159] The body of the expandable funnel catheter 200, 300, 400 is coupled to the housing or first hub 202, 302. The first hub 202, 302 may include a hemostatic seal assembly. The first hub 202, 302 may include a port 214, 314 that may be used for irrigation and / or aspiration.

[0160] In some embodiments, the expandable funnel catheter 200, 300, 400 may have a braided shaft extending along its entire length. The expandable funnel portion may extend the entire length of the catheter. The length of the expandable funnel portion may be, for example, approximately 4 cm to 35 cm. The catheter may be extended from the distal end all the way to the percutaneous entry point of the catheter. The outer diameter may range from, for example, 4 French to 30 French. The inner diameter may range from, for example, 3 French to 28 French. The extended length portion may extend the entire length of the catheter. In some embodiments, the length may be approximately 4 cm to 35 cm. The funnel and shaft may be formed as a single component, with the braided configuration being continuous. The shaft may be coupled to or continuous with the funnel tip. The braided shaft may have a funnel at the distal end. The expandable shaft 212, 312 and the expandable funnel tip 210, 310 may be integral. The expandable shaft 212, 312 and the expandable funnel tip 210, 310 may form a monolithic braided structure. The expandable shaft 212, 312 and the expandable funnel tip 210, 310 can be one continuous member. The expandable shaft 212, 312 and the expandable funnel tip 210, 310 can be two separate members. The braided configuration can be a single wire or multiple wires, such as 8, 16, 32, 48, 288, or any range of the foregoing values.

[0161] The expandable shaft 212, 312 and the expandable funnel tip 210, 310 can be expanded from one diameter to a larger diameter. The expandable shaft 212, 312 and the expandable funnel tip 210, 310 can be expanded to receive a device, such as a capture device. The expandable shaft 212, 312 and the expandable funnel tip 210, 310 can be expanded to receive an embolus, foreign matter, clot, and / or thrombus.

[0162] The expandable shaft 212, 312 may include two braided layers. The expandable funnel tip 210, 310 may include two or more braided layers. The braided layers may be made of metal wires such as nitinol or stainless steel, or polymeric wires or filaments such as nylon, polyester, PEEK, polyamide, and / or combinations thereof. The braided layers may be coated with a polymeric material such as polyurethane or silicone. The outer braided layer may be coated. The inner braided layer may be coated. Both the outer braided layer and the inner braided layer may be coated. The diameter of the braided wire may be 0.0003" to 0.015". The braid pattern may be 1x1, 2x2, pairs of wires 1x1, pairs of wires 2x2, or any combination thereof.

[0163] The expandable funnel tips 210, 310 can be composed of metal or polymeric wire or filament. The braided funnel can be divided into two layers: an inner layer and an outer layer. The inner layer and the outer layer can be continuous. The inner layer can extend from the proximal end of the funnel sheath / catheter to the distal end, folding at the distal end to transition to the outer layer and extending overlapping the inner layer. The expandable funnel tips 210, 310 can be coated or uncoated with a polymer material. In some embodiments, the expandable funnel tips 210, 310 are uncoated.

[0164] Expandable funnel catheters 200, 300, and 400 may comprise a braided shaft and a braided funnel extending from a proximal end to a funnel end. When a device, foreign matter, an embolus, or thrombus, clot, or thrombus is present within expandable funnel catheters 200, 300, and 400, the expandable funnel catheters 200, 300, and 400 can be expanded from one configuration and one diameter to another configuration. The braided shaft and funnel may comprise an inner and outer double braided layer extending from the proximal end to the distal end. The braided shaft outer layer may be coated or covered with a material that allows the braided shaft to expand. In some embodiments, the braid may be comprised of a nitinol material. The braided inner and outer layers may be continuous, with a first end beginning at the proximal end of the inner layer and extending distally to the tip of the funnel, where it folds or transitions into the outer layer and extends proximally to the proximal end of the outer layer. The braid wire diameter may range from 0.0003" to 0.015". The wire can be round or flat (1x3, 2x4, 3x5, etc.) The weave pattern can be a 1x1, 2x2, or 1x2 configuration.

[0165] The expandable funnel catheter may include a laser-cut shaft. The laser-cut funnel and shaft may have a geometric pattern that allows the laser-cut shaft to expand. The funnel shaft may be coated with a polymer material, such as polyurethane or silicone.

[0166] In some embodiments, the inner and outer layers of the braided shaft and the funnel may be coated or covered with a polymer material. In some embodiments, the inner layers of the braided shaft and the funnel are coated with a polymer material, and the outer layers of the braided shaft and the funnel are not coated with a polymer material. In some embodiments, the inner and outer layers of the braided shaft and the funnel are not coated, and only the outer layer of the braided shaft is coated. In some embodiments, the inner layers of the braided shaft and the funnel are not coated, while the outer layers of the braided shaft and the funnel are coated. In some embodiments, when the inner layers of the braided shaft and the funnel are uncoated, the outer braided layer is coated, and the outer layer of the funnel is coated or uncoated, the uncoated inner layers of the braided shaft and the funnel can be fixed or move axially and / or radially. When the inner layers of the braided shaft and the funnel move axially and / or radially, the funnel can be contracted. In some embodiments, the expandable funnel tips 210, 310 are fixed. In some embodiments, the expandable funnel tips 210, 310 can move axially. In some embodiments, the expandable shaft 212, 312 is fixed. In some embodiments, the expandable shaft 212, 312 is movable axially or radially.

[0167] The braided shaft is connected to the hub 202 with the hemostatic seal assembly. The braided shaft and the funnel can be assembled with a dilator / occluder 220, 320 and an outer sheath or cap 206, 306. The cap 206, 306 can be used to accommodate the braided shaft and to deflate the funnel during introduction into the blood vessel. Once in the blood vessel, the cap 206, 306 can be peeled off to expand the expandable funnel tip 210, 310 and the expandable shaft 212, 312. The obturator is inserted into the lumen of the funnel catheter to enter the blood vessel. The outer sheath can be composed of a polymer material such as FEP, PTFE, PET, Pebax, polyurethane, or silicone.

[0168] In some embodiments, the expandable funnel catheter 200, 300, or 400 may have a funnel distal end and a shaft. The shaft may have a composite structure, with an inner layer of polymer material, a middle layer of a braided or stent-like metal structure, or a laser-cut geometric pattern (diamond, open-pore structure, connected z-shape), which is radially expandable, and an outer layer of polymer material. The polymer material has sufficient rigidity for introduction into the vascular system and is capable of expanding when encountering large amounts of material, such as emboli, thrombi, or clotted thrombi or foreign matter.

[0169] In some embodiments, the body of the expandable funnel catheter 200, 300, 400 is a composite material, wherein the inner layer is made of a low modulus material, such as PTFE, polyamide, nylon, polyethylene, high-density polyethylene, and the outer layer is made of a low-hardness polymer material so that it can expand when encountering larger materials. The construction of the inner layer allows folding and / or overlapping to make the inner layer easier to slide or open. In some embodiments, the inner layer has a slit along the length of the catheter body. In some embodiments, the inner layer has two slits along the length of the catheter body. In some embodiments, the inner layer has multiple slits, such as three slits, along the catheter body. The outer layer is made of a stretchable polymer material. In some embodiments, the ends of the slits of the inner layer overlap each other. In some embodiments, the inner layer is folded one or more times, such as twice or three times.

[0170] The expandable funnel catheter 200, 300, 400 can be used in conjunction with a thrombectomy system in a variety of ways. In some embodiments, the method may include introducing the assembled expandable funnel catheter 200, 300, 400 into a blood vessel over a guidewire. The peelable cap 206, 306 is then removed to deploy the expandable funnel tip 210, 310 and expandable shaft 212, 312. The occluder is then removed from the expandable funnel tip 210, 310 and expandable shaft 212, 312. The thrombectomy system can be introduced over a guidewire and positioned to a predetermined obstructed treatment area via the expandable funnel tip 210, 310 and expandable shaft 212, 312. Thrombectomy is then performed at the site to remove and collect the clot. When the thrombectomy catheter, balloon, basket, or collection bag is deployed distally toward the clot and then pulled proximally, the expandable funnel tip 210, 310 acts as a barrier, preventing proximal migration of emboli or unwanted material. As clots accumulate in the funnel, a syringe can be attached to the aspiration port 214, 314 of the expandable funnel catheter 200, 300, 400 to aspirate the clot. Larger volumes of clots continue to be collected in the funnel sheath, which allows the expandable shaft 212, 312 to expand as the larger volume of clot passes through it. The expandable funnel catheter 200, 300, 400 can be used with any of the capture systems described herein.

[0171] In some embodiments, the expandable funnel catheter 200, 300, 400 does not include an expandable funnel tip 210, 310 at the distal end. The expandable funnel catheter 200, 300, 400 can be used as a low-profile introducer sheath that can then be expanded to accommodate a larger profile of other therapeutic devices, such as stent delivery, percutaneous valve delivery, or kidney stone removal.

[0172] The expandable funnel catheter 200, 300, 400 may include an expandable distal end configured to be positioned within a patient's body, away from the user. The expandable funnel catheter 200, 300, 400, or at least the distal end, may comprise at least one double braided layer comprising an outer layer and an inner layer. In some embodiments, the expandable funnel catheter 200, 300, 400 may include a double-layer structure. In some embodiments, the expandable funnel catheter 200, 300, 400 may include an outer braided layer. In some embodiments, the outer braided layer is coated with a material, such as one or more polymeric materials. In some embodiments, the expandable funnel catheter 200, 300, 400 may include an inner braided layer. In some embodiments, the inner braided layer is not coated with a polymeric material. In some embodiments, a portion of the inner braided layer is uncoated. In some embodiments, a distal portion of the inner braided layer is uncoated. In some embodiments, the length of the inner braided layer is uncoated. In some embodiments, the entire length of the inner braided layer is uncoated. In some embodiments, a portion of the outer braided layer is coated. In some embodiments, the distal portion of the outer braid is coated. In some embodiments, the length of the outer braid is coated. In some embodiments, the entire length of the outer braid is coated. In some embodiments, the outer braid remains coated or encapsulated with a polymer during the surgical procedure.

[0173] In some embodiments, the outer braided layer is coated with a polymer. The polymer can be any material, including, for example, Pellethane, silicone, Tecoflex, Tecothane, Latex, Pebax, and combinations thereof. The polymer can function similarly to a sliding layer. The polymer can facilitate sliding of the catheter relative to the target vessel. In some embodiments, the inner braided layer is not coated with a polymer, but instead retains the mesh structure shown. This inner braided layer advantageously provides reduced surface area, reduced surface contact, and / or reduced friction relative to objects within the catheter lumen. For example, compared to a solid inner wall, the mesh structure of the inner braided layer provides less surface area in contact with objects within the lumen. This inner braided layer allows for easier axial sliding of the retrieval catheter, one or more tools, materials, or capture system 100, 500 during proximal withdrawal from the lumen. In some methods of use described herein, the capture system 100, 500 can be extended axially over one or more materials and then retracted into the expandable funnel catheter 200, 300, 400. In some methods of use described herein, capture system 100, 500 can be extended axially over an obstruction, such as a clot, and then retracted into expandable funnel catheter 200, 300, 400. In some methods of use described herein, capture system 100, 500 can provide distal protection to prevent material loss when capture system 100, 500 is retracted into expandable funnel catheter 200, 300, 400.

[0174] In some embodiments, the expandable funnel catheter 200, 300, 400 has a funnel shape at its distal end. In some embodiments, the distal end refers to the portion of the expandable funnel catheter 200, 300, 400, or a component thereof, that is farthest from the user during use, while the proximal end refers to the portion of the expandable funnel catheter 200, 300, 400, or a component thereof, that is closest to the user. In some embodiments, the distal end of the expandable funnel catheter 200, 300, 400 is located inside the patient's body, while the proximal end is located outside the patient's body.

[0175] In some embodiments, the expandable funnel catheters 200, 300, 400 can include any of the features of the capture systems 100, 500 described herein. In some embodiments, the mesh can be made of a metallic material, such as a single inelastic wire. In some embodiments, the mesh can be made of an elastic element. In some embodiments, the mesh can be made of a combination of elastic and inelastic wire. In some embodiments, the double braid can be made of a polymeric material or a metallic material. In some embodiments, the metallic material can be nitinol, stainless steel, steel, shape memory alloy, elastomeric alloy, nickel titanium alloy, etc. In some embodiments, the diameter of the braided wire can range from 0.0005" to 0.030", for example, 0.0005", 0.001", 0.0015", 0.002", 0.0025", or 0.003", 0.0005"-0.0015", 0.001"-0.002", 0.0015"-0.0025", 0.002"-0.003", etc. Other configurations of braided wire diameters are also contemplated. The braided wire can be braided in any pattern. In some embodiments, the expandable funnel catheter 200, 300, 400 can include at least one polymer layer. The at least one polymer layer can be applied to any surface of the braided wire. The braided wire can include one or more braid patterns, for example, a first wavy pattern in the first portion of the expandable funnel catheter 200, 300, 400 and a second wavy pattern in the second portion of the expandable funnel catheter 200, 300, 400. The braid pattern can be a typical overlying and underlying pattern, such as two overlying and two underlying; one overlying and one underlying, etc. The braid pattern can be derived from a tubular braid. In some embodiments, the expandable funnel catheter 200, 300, 400 can include multiple layers of braided wire.

[0176] The braided wire can form a mesh. In some embodiments, the cross-section of the wire can be any shape, including circular, polygonal, oval, etc. The shape of the wire can be flat, square, ribbon-shaped, circular, etc. In some embodiments, the total braid angle can be in the range of 10 to 170 degrees. In some embodiments, the total braid angle is 0, 10, 20, 30, 40, 50, 60, 70, 80, 90, 100, 110, 120, 130, 140, 150, 160, 170, 180, between 0 and 45 degrees, between 45 and 90 degrees, between 90 and 135 degrees, between 135 and 180 degrees, etc. In some embodiments, the braid density can be in the range of 5 PPI to 60 PPI. In some embodiments, the braid density is less than 5PPI, 5PPI, 10PPI, 15PPI, 20PPI, 25PPI, 30PPI, 35PPI, 40PPI, 45PPI, 50PPI, 55PPI, 60PPI, 65PPI, 70PPI, 75PPI, 80PPI, between 0PPI-20PPI, between 20PPI-40PPI, between 40PPI-60PPI, between 60PPI-80PPI, etc. In some embodiments, the inner diameter range can be within 1F to 30F. In some embodiments, the inner diameter is less than 1F, 1F, 2F, 3F, 4F, 5F, 6F, 7F, 8F, 9F, 10F, 11F, 12F, 13F, 14F, 15F, 16F, 17F, 18F, 19F, 20F, 21F, 22F, 23F, 24F, 25F, 26F, 27F, 28F, 29F, 30F, 31F, 32F, 33F, 34F, 35F, between 0F and 5F, between 5F and 10F, between 15F and 20F, between 20F and 25F, between 25F and 30F, between 30F and 35F, etc. In some embodiments, the outer diameter can range from 2F to 33F. In some embodiments, the outer diameter is 1F, 1F, 2F, 3F, 4F, 5F, 6F, 7F, 8F, 9F, 10F, 11F, 12F, 13F, 14F, 15F, 16F, 17F, 18F, 19F, 20F, 21F, 22F, 23F, 24F, 25F, 26F, 27F, 28F, 29F, 30F, 31F, 32F, 33F, 34F, 35F, between 0F-5F, between 5F-10F, between 15F-20F, between 20F-25F, between 25F-30F, between 30F-35F, etc.

[0177] In some embodiments, the expandable funnel catheter 200, 300, 400 may include an expandable shaft 212, 312. In some embodiments, the expandable funnel catheter 200, 300, 400 may include a shaft that expands under compression. In some embodiments, the expandable funnel catheter 200, 300, 400 may include a shaft that elongates under compression. In some embodiments, the expandable funnel catheter 200, 300, 400 may include a shaft that expands upon release of a constraint. In some embodiments, the expandable funnel catheter 200, 300, 400 may include a shaft that expands due to temperature. In some embodiments, the expandable funnel catheter 200, 300, 400 may include a shaft that expands to assume a neutral configuration.

[0178] In some embodiments, the expandable funnel catheter 200, 300, 400 may include an inverted structure. In some embodiments, one end of the braid begins at the proximal end and extends to the distal end, at which point it folds inward and extends back to the proximal end. In some embodiments, the double braid extends from the proximal end to the distal end. In some embodiments, the braid at the distal end may be continuous. In some embodiments, the braid at the distal end may be discontinuous. In some embodiments, one end of the braid begins at the proximal end and extends to the distal end, at which point it folds inward and extends back to the proximal end region. In some embodiments, one end of the braid begins at the proximal end and extends to the distal end, at which point it folds outward and extends back to the proximal end region. The outer braid and the inner braid are concentric.

[0179] In some embodiments, the outer braided layer is encapsulated with a polymer material. In some embodiments, the polymer layer may have a uniform wall thickness. In some embodiments, the polymer layer may have a uniform density. In some embodiments, the polymer layer may have a uniform wall thickness over the entire length of the catheter. In some embodiments, the polymer layer may have an uneven wall thickness. In some embodiments, the wall thickness of the proximal end of the catheter is thicker than the wall thickness of the distal end. In some embodiments, the polymer material may have the same softness (durometer) over the entire length of the catheter. In some embodiments, the polymer material may have different or multiple softness (durometer) over the entire length of the catheter. In some embodiments, the polymer material is expandable. In some embodiments, the polymer material is flexible. In some embodiments, the outer layer composite material is expandable. In some embodiments, the polymer material may be any elastomeric material, such as polyurethane, Pellethane, silicone, Tecoflex, Tecothane, Latex, Pebax, and / or a combination thereof. In some embodiments, the polymer can be coupled to the braided material by any method known in the art. In some embodiments, the polymer may be coated, molded, impregnated, or heat fused to the braid.

[0180] In some embodiments, the expandable funnel catheter 200, 300, 400 can have a funnel shape at the distal end. In some embodiments, the guide catheter outer braid is encapsulated from the proximal end to the distal end near the funnel. In some embodiments, the outer and inner braid layers of the funnel are not polymer encapsulated. In some embodiments, the outer braid of the funnel is polymer encapsulated. In some embodiments, the inner braid layer can be polymer encapsulated, while the outer layer is not.

[0181] The expandable funnel catheter 200, 300, 400 can be used as an access system. In some embodiments, the expandable funnel catheter 200, 300, 400 is introduced in a compressed diameter configuration. In some embodiments, after introduction, the expandable funnel catheter 200, 300, 400 can be radially expanded to accommodate passage of a larger diameter surgical instrument, such as a capture system and / or an anchor described herein.

[0182] The expandable funnel catheters 200, 300, 400 can be used to create and expand an access area at a target location within a patient's body. In some embodiments, the expandable funnel catheters 200, 300, 400 are delivered and expanded in a small diameter configuration. In some embodiments, only the distal end, or funnel end, is expanded. In some embodiments, the expandable funnel catheters 200, 300, 400 can change the size of the lumen into which the expandable funnel catheters 200, 300, 400 are inserted, such as by compressing the vessel wall to expand the vessel. The expandable funnel catheters 200, 300, 400 can include a polymeric coating that facilitates sliding contact with the vessel wall.

[0183] In some embodiments, passage of the capture system 100, 500 through the expandable funnel catheter 200, 300, 400 can cause the expandable funnel catheter 200, 300, 400 to expand. In some embodiments, the collapsed capture system 100, 500 can be sized to fit within the expandable funnel catheter 200, 300, 400. In some embodiments, the expanded capture system can be sized to fit within the expandable funnel catheter 200, 300, 400. In some embodiments, the expanded capture system 100, 500 can be retracted through the expandable funnel catheter 200, 300, 400. In some embodiments, the one or more materials can be retracted through the expandable funnel catheter 200, 300, 400. In some embodiments, the one or more tools can be sized to fit within the expandable funnel catheter 200, 300, 400. The uncoated inner braid reduces sliding contact between the expandable funnel catheter 200, 300, 400 and any components passing therethrough.

[0184] In some embodiments, the expandable funnel catheter 200, 300, 400 can function as a resizable cannula. In some embodiments, the expandable funnel catheter 200, 300, 400 can function as a tissue expander. In some embodiments, the expandable funnel catheter 200, 300, 400 can change shape during axial compression of the braid. In some embodiments, axial shortening can cause the expandable funnel catheter 200, 300, 400 to expand radially. In some embodiments, the expandable funnel catheter 200, 300, 400 can expand variably based on the magnitude of the compressive force. In some embodiments, the expandable funnel catheter 200, 300, 400 is self-expanding. In some embodiments, the expandable funnel catheter 200, 300, 400 can be expanded by mechanisms such as a pull wire, release from a constraint, application of a compressive force, application of a tensile force, and the like. In some embodiments, the expandable funnel catheter 200, 300, 400 is formed of a shape memory material.

[0185] In some embodiments, the expandable funnel catheter 200, 300, 400 can facilitate removal of an obstruction within a patient's vasculature. In some embodiments, the expandable funnel catheter 200, 300, 400 can enclose a capture system 100, 500 entangled in a clot. In some embodiments, the surface of the clot can facilitate sliding within the expandable funnel catheter 200, 300, 400 due in part to the inner surface of the expandable funnel catheter 200, 300, 400. In some embodiments, the expandable funnel catheter 200, 300, 400 can facilitate sliding within the target vessel due in part to the outer surface of the expandable funnel catheter 200, 300, 400. In some embodiments, the expandable funnel catheter 200, 300, 400 can be deflated after receiving the capture system 100, 500, material, and / or tool. In some embodiments, the expandable funnel catheter 200, 300, 400 can encapsulate the capture system 100, 500 of the material around itself. In some embodiments, the outer surface of the capture system 100, 500 can slide easily within the expandable funnel conduit 200, 300, 400 due in part to the inner surface of the expandable funnel conduit 200, 300, 400. In some embodiments, the expandable funnel conduit 200, 300, 400 can be collapsed after receiving the capture system 100, 500.

[0186] In some methods of use, the capture system 100, 500 is used in conjunction with a thrombectomy catheter (e.g., a thrombectomy device), or an aspiration catheter may be used to remove embolic debris. In some methods of use, one or more anchors described herein are used in conjunction with a thrombectomy catheter or an aspiration catheter (e.g., a thrombectomy device). The device is a rheological transverse flow thrombectomy catheter that can be used to remove clots larger than the catheter diameter. However, the device's breaking strength decreases with radial distance from the catheter. Therefore, at a certain radial distance, the clot may be larger than The cross-flow pattern produces a stronger destructive force. In the case of organized thrombi, the radial distance from the catheter can be smaller than for softer thrombi.

[0187] In some cases, the capabilities of water jet thrombectomy are often limited. However, by increasing mechanical disruption, for example, through the use of anchors as described herein, water jet ablation can unexpectedly and synergistically improve. By combining mechanical agitation (e.g., the close contact of the flexible and expandable anchoring member and capture system 100, 500 with the thrombus) with a rheological cross-flow thrombectomy catheter, water jet ablation can be improved compared to removal by mechanical agitators or rheological cross-flow thrombectomy catheters alone. Combined, various blood clots can be removed.

[0188] Another aspect and feature of some embodiments of the disclosed devices is a device capable of capturing large and small embolic debris. Another aspect and feature of the disclosed devices is a device capable of temporarily capturing debris that can then be removed by manual aspiration or by using Another aspect and feature of the device disclosed herein is a device that can macerate the debris to a size that is clinically insignificant (depending on the area of ​​the body) or can be pharmacologically treated or removed by another device, such as Thrombectomy Device and Catheter Another aspect and feature of the disclosed device is a device capable of macerating non-embolic debris, such as fixed thrombus, by pulling the device through such an obstruction.

[0189] Intravascular ultrasound (IVUS) transducer can be incorporated into system as described herein.In some embodiments, intravascular ultrasound (IVUS) transducer can be added to or incorporated into transmission system and method.Pressure sensor can be used for measuring the pressure of different positions in vascular system, can be used for determining blood flow, and intravascular ultrasound (IVUS) transducer can be used for measuring fluid flow and / or providing imaging in blood vessel.In some embodiments, described pressure sensor and / or IVUS transducer can be incorporated into guide wire at one or more positions (for example, the distal end or distal part of guide wire), and be incorporated into the middle part and proximal part of guide wire.This guide wire with pressure sensor and / or IVUS transducer can be used like common guide wire, to help guide transmission device through vascular system, and pressure measurement and ultrasonic imaging are provided to help navigation, thereby making device placement location visual, and monitoring and ensuring that device is correctly deployed.In some embodiments, IVUS transducer generates image slices when it advances and retracts, and these image slices can then be assembled together to form the three-dimensional reconstruction of the device in vascular system and / or vascular system. In some embodiments, the guidewire with the pressure sensor and / or IVUS transducer can be secured to a catheter in a manner similar to that described below for a catheter with a pressure sensor and / or IVUS transducer secured to another catheter.

[0190] The use of an ultrasound imaging system can allow the operator to deliver the device without fluoroscopy or with less fluoroscopy, thereby reducing radiation exposure to the patient, while allowing for more accurate assessment of the vasculature, aiding in placement of the device and confirming that the device is correctly placed. Imaging can be used to assist in the deployment of filters or other devices. Imaging can also be used to assist in the retrieval of deployed devices by providing, for example, visualization of retrieval features on a deployed device and retrieval features of a retrieval device (such as a loop on a snare). The vasculature and implant position can be imaged before, after, and / or during deployment. Imaging can be used during the retrieval process. Imaging can be used to help position the filter or device within the vasculature. Imaging can be used to image the deployment location and determine the appropriate size of the filter or other device. Imaging can be used to help estimate processing time.

[0191] Although the imaging systems described above are primarily described as being ultrasound-based, other imaging systems may be used instead or in addition. For example, the imaging system may be based on intravascular ultrasound (IVUS), forward-looking IVUS (FLIVUS), optical coherence tomography (OCT), piezoelectric micromachined ultrasound transducers (PMUT), and / or FACT.

[0192] Other components can also be incorporated into the systems described herein. All or part of the device can be designed to increase its ability to adhere to the obstruction. For example, the wire can be connected to an energy source (e.g., RF, ultrasound, or thermal energy) to "weld" to the obstruction. Applying energy to the device can cause the surrounding portion to deform into the obstruction and "embed" into the obstruction. Alternatively, the device can give the obstruction a positive charge to fully liquefy the obstruction portion, thereby facilitating removal. In another variation, a negative charge can be applied to further form a thrombus and nest the device to obtain better pulling force. The wire can be made stickier by using a hydrophilic material or by a chemical that will produce a chemical bond with the surface of the obstruction. Alternatively, the filament can reduce the temperature of the obstruction to coagulate or adhere to the obstruction.

[0193] Another aspect of the variations that can be applied to the device can be to construct the device (whether it is a traversing filament or a surrounding portion) to better adhere to the obstruction. One such mode includes using a coating that adheres to certain clots (or other materials that cause obstruction). For example, the thread can be coated with a hydrogel or adhesive that adheres to the thrombus. Accordingly, when the device fixes the clot, the combination of additives and the mechanical structure of the device can improve the effectiveness of the device in removing the obstruction. The coating can also be combined with a capture portion or catheter to improve the ability of the device to encapsulate and remove the obstruction, for example, a hydrophilic coating.

[0194] Such improvements may also be mechanical or structural. Any portion of the capturing portion may have hooks, fibers, or barbs that will engage the obstruction as the device surrounds it. The hooks, fibers, or barbs may be incorporated into any portion of the device. However, in some embodiments, it is important that such features do not hinder the practitioner's ability to remove the device from the body.

[0195] In addition to additives, the device may also be connected to an RF, microwave, magnetic, thermal, cryogenic or other power source to allow electrical, current, ultrasonic or RF energy to be transmitted through the device and induce coagulation or other aggregation that causes a clot or other obstruction.

[0196] The methods described herein may also include treating the obstruction before attempting to remove it. Such treatment may include applying chemicals or agents to shrink the obstruction or make it more rigid for easier removal. Such agents include, but are not limited to, chemotherapy drugs or solutions; lytic agents such as tPA, urokinase, or streptokinase; anticoagulants, mild formalin, or aldehyde solutions.

[0197] In view of the above teachings, it is obvious that various other modifications, adaptations and alternative designs are possible. Therefore, it should be understood that the present invention can be implemented in a manner different from that specifically described herein. It is conceivable that various combinations or sub-combinations can be made to the specific features and aspects of the embodiments disclosed above and still fall within one or more of the present invention. In addition, any specific features, aspects, methods, characteristics, properties, qualities, attributes, elements, etc. disclosed herein in relation to the embodiments can be used in all other embodiments described herein. Therefore, it should be understood that the various features and aspects of the disclosed embodiments can be combined with each other or replaced with each other to form different modes of the disclosed invention. Therefore, the scope of the present invention disclosed herein should not be limited by the specific embodiments disclosed above. In addition, although the present invention is susceptible to various modifications and alternative forms, specific examples thereof have been shown in the drawings and described in detail herein. However, it should be understood that the present invention is not limited to the specific forms or methods disclosed. On the contrary, the present invention will cover all modifications, equivalents and alternative forms that fall within the spirit and scope of the various embodiments described. Any method disclosed herein does not have to be performed in the order described. The methods disclosed herein include certain actions taken by the practitioner; however, the methods may also include any third-party descriptions of these actions, whether express or implied. For example, an action such as "inserting a catheter through the femoral artery" includes "instructing the insertion of a catheter through the femoral artery." The ranges disclosed herein also encompass any and all overlaps, sub-ranges, and combinations thereof. Language such as "at most," "at least," "greater than," "less than," "between..." and the like include the numbers listed. Numbers such as "approximately," "about," and "substantially" preceding a term used herein include the numbers listed (e.g., approximately 10% = 10%) and also represent an amount close to the stated amount that can still perform the desired function or achieve the desired result. For example, the terms "approximately," "about," and "substantially" can refer to an amount that is less than 10%, less than 5%, less than 1%, less than 0.1%, and less than 0.01% of the stated amount.

Claims

1. A capture system (100), comprising: a tubular body (110) comprising a first end (112) having an opening (118) and a capture guide (116), a second end (114), and an axial length therebetween; one or more tensioners (120) coupled to the capture guide (116), wherein the tubular body (110) has a first configuration in which the first end (112) and the capture guide (116) are expanded and the one or more tensioners (120) are activated while the second end (114) and a majority of the tubular body (110) remain compressed, and the tubular body (110) has a first expanded axial length and a first width along the first expanded axial length, wherein the tubular body (110) is deformable into a second configuration, the tubular body (110) having a second expanded axial length greater than the first expanded axial length, and the tubular body (110) having a second width along the second expanded axial length, a control handle defining a longitudinal slot and a plurality of transverse slots branching from the longitudinal slot, the control handle comprising a control member (501) configured to move in the longitudinal slot to adjust the tension of the one or more tensioners (120, 505), wherein the control member (501) is configured to be positioned in the plurality of transverse slots, wherein when the control member (501) is positioned in a first transverse slot of the plurality of transverse slots, the one or more tensioners (120, 505) are configured to be deactivated while the capture guide (116, 506) is in a low-profile configuration, and wherein, when the control member (501) is positioned in a second transverse slot of the plurality of transverse slots, the one or more tensioners (120, 505) are configured to remain deactivated while the capture guide (116, 506) is expanded.

2. The capture system (100) according to claim 1, further comprising: A funnel system (200, 300, 400) includes an expandable funnel tip (210), an expandable shaft (212), and a housing body.

3. The capture system (100) of claim 1 or 2, further comprising a first member comprising a central lumen.

4. The capture system (100) of claim 3, further comprising a second member disposed within the central lumen.

5. The capture system (100) of claim 1 or 2, wherein the capture guide (116) forms the opening (118), or wherein the capture guide (116) is configured to conform to different blood vessel diameters, or wherein the capture guide (116) is configured to conform to different geometric configurations.

6. The capture system (100) of claim 1 or 2, wherein the one or more tensioners (120) extend proximally from the capture guide (116), or wherein the one or more tensioners (120) are equally spaced around the circumference of the capture guide (116), or wherein the one or more tensioners (120) are non-equally spaced around the circumference of the capture guide (116).

7. The capture system (100) of claim 1 or 2, wherein the tubular body (110) comprises a shape memory material, or wherein the capture guide (116) comprises a shape memory material, or wherein the capture guide (116) comprises a nitinol ring.

8. The capture system (100) of claim 1 or 2, wherein a width of the shape memory body along the second extended axial length is substantially the same as a width of the shape memory body along the first extended axial length.

9. The capture system (100) of claim 1 or 2, wherein the one or more tensioners (120) are configured to apply tension to the capture guide (116) so that the capture guide (116) is rigid, or wherein the one or more tensioners (120) are configured to limit or prevent deflection of the capture guide (116).

10. The capture system (100) of claim 1 or 2, wherein the one or more tensioners (120) are rigid, or wherein the one or more tensioners (120) are flexible.

11. A capture system (100) according to claim 1 or 2, wherein the one or more tensioners (120) include sutures, or wherein the one or more tensioners (120) include rods, tubes, coils, springs, wires or laser-cut elements, or wherein the one or more tensioners (120) include one or more metal wires, or wherein the one or more tensioners (120) include one or more polymer filaments.

12. The capture system (100) of claim 3, further comprising a third member disposed within the central lumen.

13. The capture system (100) of claim 2, wherein the one or more tensioners (120) are configured to be deactivated and remove tension from the capture guide (116) such that the capture guide (116) is non-rigid.

14. The capture system (100) of claim 2, wherein the funnel tip (210) and funnel shaft are expandable.

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