Transvascular aspiration catheter and method of use

Abstract

Intravascular catheters are disclosed herein. In accordance with some embodiments, the present technology includes a catheter including an elongate tubular sidewall defining a lumen extending therethrough and having a proximal end, a distal end, and a length between the proximal end and the distal end. The sidewall may include a plurality of filaments, at least some of which are interwoven with other ones of the plurality of filaments. The catheter may be configured to be positioned about a turn in the blood vessel having a radius of curvature of no greater than 24 mm, and wherein, when the distal end of the catheter is distal to the turn, the lumen remains at least 70% unobstructed while torque applied to the sidewall at the proximal end of the catheter is transmitted to the distal end.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims the benefit of priority to U.S. Application No. 18 / 608,651, filed on March 18, 2024, and U.S. Provisional Application No. 63 / 491,260, filed on March 20, 2023, both of which are incorporated herein by reference in their entireties. Technical Field

[0003] The present technology relates to aspiration catheters and methods of use. In particular, the present technology relates to aspiration catheters for removing occlusions. Background Art

[0004] Many interventional procedures, such as mechanical thrombectomy, involve removing all or part of a target occlusion in a blood vessel via aspiration. Aspiration occurs through an elongated catheter shaft that is advanced through the patient's vasculature to the desired treatment location. To achieve optimal performance, the catheter shaft must strike a balance between various performance criteria, including pushability (i.e., column strength), torquability (e.g., the ability to transfer torque from the proximal hub to the distal end), kink resistance, and suction. Existing aspiration catheter designs cannot achieve this balance and are generally unable to effectively access and / or aspirate occluding material. Therefore, there is a need for an aspiration catheter that can access a treatment location in a blood vessel and effectively aspirate occluding material. Summary of the Invention

[0005] The subject technology is, for example, based on the various aspects described below (including reference Figures 1A to 6 ) description. For convenience, various examples of aspects of the subject technology are described as numbered embodiments (1, 2, 3, etc.). These are provided as examples and do not limit the subject technology.

[0006] 1. An intravascular catheter, comprising:

[0007] An elongated tubular sidewall defining a lumen extending therethrough and having a proximal end, a distal end, and a length between the proximal and distal ends, the sidewall comprising a plurality of filaments, at least some of the filaments being interwoven with other filaments of the plurality of filaments, wherein the catheter is configured to be positioned about a bend in a blood vessel having a radius of curvature of no greater than 24 mm, and wherein, when the distal end of the catheter is distal to the bend, a torque applied to the sidewall at the proximal end of the catheter is transmitted to the distal end while the lumen remains at least 70% patent.

[0008] 2. The catheter of embodiment 1, wherein the torque is at least 12 Nm.

[0009] 3. The catheter of Example 1 or Example 2, wherein the sidewall includes a longitudinal axis extending along its length, and wherein the torque applied at the proximal end of the catheter is configured to rotate the sidewall 360 degrees about the longitudinal axis.

[0010] 4. The catheter of any one of embodiments 1 to 3, wherein the insertion length of the catheter is at least 50% when the catheter is positioned around the bend and the torque is applied while the lumen remains at least 70% patency.

[0011] 5. The catheter of any one of embodiments 1 to 4, wherein the sidewall has an outer diameter of at least 8 Fr.

[0012] 6. The catheter of any one of embodiments 1 to 5, wherein the sidewall has an outer diameter of at least 12 Fr.

[0013] 7. The catheter of any one of embodiments 1 to 6, wherein the turn in the blood vessel has a bend angle greater than or equal to 120 degrees.

[0014] 8. A catheter according to any one of embodiments 1 to 7, wherein the side wall defines a lumen extending along the longitudinal axis, and wherein the proximal end of the catheter is configured to be fluidly connected to a negative pressure source to draw occlusive material within the blood vessel into and through the lumen.

[0015] 9. An intravascular catheter, comprising:

[0016] A tubular sidewall having a longitudinal axis, the sidewall comprising a first number of first guidewires and a second number of second guidewires, the second number being greater than the first number, wherein:

[0017] The first guidewire has a first cross-sectional area and is helically wound in a first direction about the longitudinal axis without crossing each other, and

[0018] The second guidewire has a second cross-sectional area smaller than the first cross-sectional area, wherein the second guidewire includes (a) a first group that is wound along the first direction and does not cross the first guidewire, and (b) a second group that is wound along a second direction opposite to the first direction, and wherein the guidewires in the second group are interwoven with the first group of the first and second guidewires.

[0019] 10. The catheter of Example 9, wherein the second number is at least five times the first number.

[0020] 11. The catheter of Example 9 or Example 10, wherein the cross-sectional shape of the first guidewire is different from the cross-sectional shape of the second guidewire.

[0021] 12. The catheter of any one of embodiments 9 to 11, wherein the first guidewire has a rectangular cross-sectional shape and the second guidewire has a circular cross-sectional shape.

[0022] 13. The catheter of any one of Examples 9 to 12, wherein the sidewall defines a lumen, and wherein the proximal end of the catheter is configured to be fluidly coupled to a negative pressure source to draw occlusive material within the vessel into and through the lumen.

[0023] 14. An intravascular catheter, comprising:

[0024] a proximal end, a distal end, and a longitudinal axis extending therebetween;

[0025] a tubular sidewall defining a lumen, the sidewall comprising a plurality of guidewires embedded in the material, the plurality of guidewires comprising a first number of first guidewires and a second number of second guidewires, the second number being greater than the first number, wherein:

[0026] The first guidewire is helically wound around the longitudinal axis in a first direction without crossing each other, the first guidewire being configured to resist radial collapse of the sidewall, and

[0027] The second guidewires include (a) a first group wound in the first direction and not crossing the first guidewire, and (b) a second group wound in a second direction opposite to the first direction, wherein the second guidewires are configured to engage the first guidewire to resist radial expansion of the first guidewire, thereby providing improved torsional ability of the sidewall,

[0028] Wherein the proximal end of the catheter is configured to be fluidly coupled to a source of negative pressure for applying suction through the lumen.

[0029] 15. The catheter of embodiment 14, wherein the material is a first material, and the plurality of guidewires and the first material together comprise a first layer, and wherein the sidewall further comprises a second layer radially inward of the first layer.

[0030] 16. The catheter of embodiment 14, wherein the material is a first material, and the plurality of guidewires and the first material together comprise a first layer, and wherein the sidewall further comprises a second layer radially outward of the first layer.

[0031] 17. The catheter of embodiment 14, wherein the material is a first material, and the plurality of guidewires and the first material together constitute a first layer, and wherein the sidewall further comprises a second layer radially inward of the first layer and a third layer radially outward of the first layer.

[0032] 18. The catheter of any one of Examples 14 to 17, wherein the proximal end of the catheter is configured to be fluidly coupled to a source of negative pressure to draw occlusive material within the vessel into and through the lumen.

[0033] 19. The catheter of any one of embodiments 14 to 18, wherein the tubular sidewall has an outer diameter of at least 8 Fr.

[0034] 20. The catheter of any one of embodiments 14 to 18, wherein the tubular sidewall has an outer diameter of at least 12 Fr. BRIEF DESCRIPTION OF THE DRAWINGS

[0035] Many aspects of the present disclosure may be better understood with reference to the following drawings. The components in the drawings are not necessarily drawn to scale. Instead, emphasis is placed upon clearly illustrating the principles of the present disclosure.

[0036] Figure 1A A side view of a catheter constructed in accordance with several embodiments of the present technology.

[0037] Figure 1B Taken along line 1B-1B Figure 1A Axial cross-sectional view of the catheter shown.

[0038] Figure 2 An axial cross-sectional view of a catheter constructed in accordance with several embodiments of the present technology.

[0039] Figure 3 is a side view of a portion of a catheter constructed in accordance with several embodiments of the present technology.

[0040] Figure 4 、 Figure 5 and Figure 6 Different example use cases for catheters of the present technology are shown. DETAILED DESCRIPTION

[0041] This technology relates to catheters and related methods of use. Figures 1A to 6 Specific details of several embodiments of catheter devices, systems and methods according to the present technology are described. Many embodiments of the present technology are particularly useful in treating targets located in tortuous and / or narrow vessels, such as certain parts of the neurovascular system, the pulmonary system, the peripheral vascular system, or the coronary vascular system. Although the catheter construction disclosed herein is described in the context of mechanical thrombectomy, the present technology can be used for other medical procedures. Similarly, although the catheter construction of the present technology is described in the context of aspiration catheters, the present technology can be used for other types of catheters, including those that are not intended and / or not suitable for aspiration, such as guide catheters, support catheters, etc.

[0042] With respect to the terms "distal" and "proximal" within this specification, unless otherwise indicated, the terms may refer to the relative position of portions of a catheter and / or associated device with respect to the position of an operator and / or the vasculature. Additionally, the term "thickness," as used herein with respect to a particular material or layer, refers to the perpendicular distance between a plane passing through and generally parallel to the radially outermost surface of the particular material or layer and a plane passing through and generally parallel to the radially innermost surface of the particular material or layer.

[0043] Figure 1A is a side view of a catheter 100 constructed in accordance with several embodiments of the present technology, and Figure 1B It is along Figure 1A A cross-sectional axial view taken along line 1B-1B in FIG. Figure 1A and Figure 1B , the catheter 100 includes a handle assembly 102 and an elongated shaft 104 having a proximal portion 104a and a distal portion 104b coupled to the handle assembly 102. The handle assembly 102 includes a hub 106 and a transition portion 108, the hub being configured to facilitate connection to a negative pressure source (not shown) and / or other devices (e.g., a syringe, a Y-adapter, etc.), and the transition portion being configured to provide strain relief at the proximal portion 104a. In other embodiments, the handle assembly 102 can have other suitable configurations based on the desired functions and characteristics of the catheter 100.

[0044] The shaft 104 includes a generally tubular sidewall having an inner surface defining a lumen 110 extending from a proximal portion 104a of the shaft 104 to an opening 112 at a distal end of the distal portion 104b. Figure 1B ). Lumen 110 can be configured to slidably receive and facilitate passage of one or more medical devices, such as guidewires, balloon catheters, implants, intrasaccular occlusion devices (e.g., coils, expandable cages, expandable meshes, etc.), infusion devices, stents and / or stent grafts, intravascular occlusion devices, clot retrievers, implantable heart valves, and other suitable medical devices and / or associated delivery systems. Additionally or alternatively, lumen 110 is configured to receive one or more fluids therethrough, such as radiopaque dyes, saline, medications, etc.

[0045] The size of lumen 110 (or the inner diameter of shaft 104) can vary depending on the desired characteristics of catheter 100. When used for suction, the larger the inner diameter of shaft 104, the greater the suction force that can be applied at the distal end. In those embodiments in which catheter 100 is configured for use in the pulmonary vasculature (e.g., for treating pulmonary embolism), shaft 104 can have an inner diameter of about 0.118 inches (9 French) to about 0.263 inches (20 French), about 0.131 inches (10 French) to about 0.158 inches (12 French), about 0.131 inches (10 French) or greater, about 0.158 inches (12 French) or greater, or about 0.158 inches (12 French). In those embodiments where the catheter 100 is configured for use in the peripheral vasculature (e.g., for tracking an arteriovenous loop graft), the shaft 104 can have an inner diameter of about 0.066 inches (5 French) to about 0.105 inches (8 French), about 0.079 inches (6 French) to about 0.105 inches (8 French), or about 0.105 inches (8 French). Figure 1A The shaft 104 is shown as having a generally circular cross-sectional shape, but it should be understood that the shaft 104 may include other cross-sectional shapes or combinations of shapes. For example, the cross-sectional shape of the shaft 104 may be oval, rectangular, square, triangular, polygonal, and / or any other suitable shape and / or combination of shapes.

[0046] The outer diameter of the shaft 104 may be uniform or vary along its length. Figure 1A and Figure 1BIn the embodiment shown, shaft 104 has an outer diameter that is roughly constant along its length. In some embodiments, the outer diameter of shaft 104 reduces (progressively reduces or continuously reduces) in the proximal to distal direction. In either case, the outer diameter of shaft 104 can be selected to be used for the desired purpose of catheter 100. For example, in those embodiments where catheter 100 is constructed for pulmonary vascular system (for example, for treating pulmonary embolism), shaft 104 can have an outer diameter of approximately 0.131 inch (10 French) to approximately 0.315 inch (24 French), approximately 0.158 inch (12 French) to approximately 0.315 inch (24 French), approximately 0.158 inch (12 French) or larger or approximately 0.158 inch (12 French). In those embodiments where the catheter 100 is configured for use in the peripheral vasculature (e.g., at a forearm ring graft dialysis site via permanent arteriovenous access), the shaft 104 can have an outer diameter of about 0.079 inches (6 French) to about 0.118 inches (9 French), or about 0.105 inches (8 French). In those embodiments where the catheter 100 is configured for use within a patient's small anatomical structures, such as the neurovasculature (e.g., to treat ischemic stroke) or the coronary vasculature, the shaft 104 can have an outer diameter of about 0.053 inches (4 French) to about 0.079 inches (6 French), about 0.017 inches to about 0.079 inches (6 French), about 0.017 inches, about 0.021 inches, or about 0.024 inches.

[0047] like Figure 1A As shown, in some embodiments, the shaft 104 can have a pre-formed bend at the distal portion 104b (e.g., the shape of the shaft 104 can be set to have a desired bend angle), for example, to facilitate navigation through and around various turns in the vascular system. The portion of the shaft 104 that includes the pre-formed bend can be sufficiently rigid and / or elastic so that the bend angle is substantially maintained when the shaft 104 is advanced / withdrawn through the vascular system or otherwise manipulated within the vascular system. In some embodiments, the portion of the shaft 104 that includes the pre-formed bend comprises a composite material that reduces vascular interaction forces (compared to existing commercial catheters). The bend angle can be customized for a specific medical application, such as for navigating the unique curvatures of the pulmonary artery, iliofemoral vein, infrapopliteal artery, and other arteries described herein.

[0048] In some embodiments, the shaft 104 does not have a pre-formed bend.

[0049] The shaft 104 can be formed from a first layer 114, a second layer 116, and a third layer 118. The first layer 114 can be the radially innermost layer (thus surrounding and defining the lumen 110) and surrounded by the second layer 116, and the second layer 116 can be surrounded by the third layer 118. Thus, in some embodiments, the third layer 118 comprises the radially outermost layer of the shaft 104. Figure 1B As shown schematically, second layer 116 can include braid 120 embedded in material 122. In some embodiments, second layer 116 includes only braid 120 (and does not include material 122), which can be positioned between first layer 114 and third layer 118. In some examples where second layer 116 includes only braid 120, the material of third layer 118 can be disposed directly on and around the filaments of braid 120 such that braid 120 is embedded within the material of third layer 118. In some embodiments, shaft 104 includes more or fewer than three layers (e.g., two, four, five, etc.).

[0050] The first layer 114 can extend from the proximal portion 104a of the shaft 104 to a position along the distal portion 104b of the shaft 104. For example, Figure 1A and 1B In the illustrated embodiment, the first layer 114 extends from the proximal portion 104a of the shaft 104 to the opening 112 at the distal end of the distal portion 104b (e.g., the entire length of the shaft 104 or substantially the entire length of the shaft 104). In other embodiments, the first layer 114 extends along only a portion of the length of the shaft 104 and / or has a proximal end and / or a distal end that do not correspond to the proximal end and / or distal end, respectively, of the shaft 104. The length of the first layer 114 can vary depending on, for example, the length of the shaft 104 and the desired properties and functionality of the catheter 100.

[0051] The first layer 114 can be made of any suitable polymer (and / or a combination of multiple polymers) and by any suitable process. In some embodiments, the first layer 114 comprises a lubricating polymer, such as HDPE or polytetrafluoroethylene (PTFE), for example, or platinum, polyetheretherketone (PEEK), polyethylene (PE), polypropylene (PP) or a copolymer of tetrafluoroethylene, such as FEP, a copolymer of tetrafluoroethylene and a perfluoroether, such as perfluoroalkoxyalkane (PFA) (more specifically, perfluoropropyl vinyl ether or perfluoromethyl vinyl ether), etc. Additional suitable polymers include, for example, polyoxymethylene (POM), polybutylene terephthalate (PBT), polyether block esters, polyether block amides (PEBA), fluorinated ethylene propylene (FEP), polyvinyl chloride (PVC), polyurethane, polyimide, polyamide, polyphenylene sulfide (PPS), polyphenylene oxide (PPO), polysulfone, nylon, perfluoro(propyl vinyl ether) (PFA), polyether esters, platinum, polymer / metal composites, Pebax (R)2533、Pebax (R) 3533、Pebax (R) 4533、Pebax (R) 5533、Pebax (R) 6333 or Pebax (R) 7233, etc., or mixtures, blends, or combinations thereof, and may also include or be made of lubricating polymers having a low coefficient of friction. In some embodiments (not shown), the first layer 114 comprises one or more metals or metal alloys and / or combinations thereof. In certain embodiments, the first layer 114 does not comprise any polymeric material and comprises only metals and / or metal alloys.

[0052] like Figure 1B As best shown, the third layer 118 directly contacts at least the outer surface of the second layer 116. The third layer 118 extends distally from the proximal portion 104a of the shaft 104 to a position along the distal portion 104b of the shaft 104 (e.g., the entire length of the shaft 104 or substantially the entire length of the shaft 104). The length of the third layer 118 can vary depending on, for example, the length of the shaft 104 and the desired properties and functions of the catheter 100. In some embodiments, the third layer 118 extends substantially the entire length of the shaft 104. In other embodiments, the third layer 118 extends only along a portion of the length of the shaft 104 and / or has a proximal end and / or distal end that do not correspond to the proximal end and / or distal end, respectively, of the shaft 104.

[0053] The third layer 118 (and / or portions thereof) may be made of any suitable polymer (or composite material or combination thereof) and by any suitable process. Suitable polymers may include, for example, polyoxymethylene (POM), polybutylene terephthalate (PBT), polyether block esters, polyether block amides (PEBA), fluorinated ethylene propylene (FEP), polyethylene (PE), polypropylene (PP), polyvinyl chloride (PVC), polyurethane, polytetrafluoroethylene (PTFE), polyetheretherketone (PEEK), polyimide, polyamide, polyphenylene sulfide (PPS), polyphenylene oxide (PPO), polysulfone, nylon, perfluoro(propyl vinyl ether) (PFA), polyether esters, Pebax, (R) 2533、Pebax (R) 3533、Pebax (R) 4533、Pebax (R) 5533、Pebax (R) 6333 or Pebax (R)7233, platinum, polymer / metal composites, etc., or mixtures, blends, or combinations thereof. In several embodiments, third layer 118 is or at least includes a lubricating polymer and / or a hydrophilic coating to facilitate advancement of shaft 104 through larger vessels and / or vasculature. In some embodiments (not shown), third layer 118 comprises one or more metals or metal alloys (combinations thereof). In certain embodiments, third layer 118 does not comprise any polymeric material and comprises only metals and / or metal alloys.

[0054] In some embodiments, the stiffness of the third layer 118 (and / or shaft 104) varies along its length. In such embodiments, the stiffness variation may be continuous or step-wise by varying the size, shape, thickness, and / or material composition of the third layer 118. For example, Figure 1A and Figure 1B In the illustrated embodiment, the third layer 118 includes at least three distinct portions along its length (labeled, from proximal to distal, as a first portion 123, a second portion 124, and a third portion 126), wherein the respective stiffnesses of the portions 123, 124, and 126 decrease sequentially from the proximal to the distal direction. For example, the first portion 123 has a first stiffness, the second portion 124 has a second stiffness that is less than the first stiffness, and the third portion 126 has a third stiffness that is less than the second stiffness. In other embodiments, the stiffness of the third layer 118 and / or the stiffness of each portion 123, 124, and 126 can increase in the proximal to distal direction (e.g., the second portion 126 can be stiffer than the first portion 124, etc.), or can be substantially uniform in the proximal to distal direction. In other embodiments, the third layer 118 can have more or fewer portions having different stiffnesses (e.g., one continuous portion, three portions, four portions, five portions, etc.).

[0055] The first portion 123, the second portion 124, and the third portion 126 may comprise the same or different materials. In some variations, one or more portions of the third layer 118 may be more transparent than one, some, or all of the other portions of the third layer 118 to enhance visibility of the portion. For example, in some embodiments, the second portion 124 of the third layer 118 may be substantially transparent or translucent, while the first portion 123 and the third portion 126 are substantially opaque. In certain embodiments, the third portion 126 is more transparent than the first portion 123 and the second portion 124. In some variations, the first portion 123, the second portion 124, and the third portion 126 have the same degree of transparency.

[0056] It should be understood that although the portions 123, 124, 126 of the third layer 118 are described herein as separate components with respect to the illustrated embodiment, the portions 123, 124, 126 may be provided as a single layer or structure. For example, the first portion 123 and the second portions 124, 126 may be provided separately but attached or combined together to physically form a single layer (e.g., a single homogeneous material).

[0057] Still refer to Figure 1A and Figure 1B , the third layer 118 can be on and around the second layer 116, and the second layer 116 can be on and around the first layer 114. In some embodiments, some or all of the filaments of the braid 120 of the second layer 116 directly contact at least a portion of the first layer 114, the third layer 118, or both. The second layer 116 can extend distally from the proximal portion 104a of the shaft 104 to a distal end that is aligned with or just proximal to the distal end of the shaft 104. In other embodiments, the second layer 116 extends the entire length of the shaft 104. The length of the second layer 116 can vary depending on, for example, the length of the shaft 104 and the desired properties and functions of the catheter 100. The material 122 of the second layer 116 can be made of any suitable polymer (or composite material or combination thereof) and by any suitable process. Suitable polymers can include, for example, any polymer disclosed herein, including but not limited to Pebax (R) 2533、Pebax (R) 3533、Pebax (R) 4533、Pebax (R) 5533、Pebax (R) 6333 or Pebax (R) 7233. In some embodiments, material 122 flows over the filaments of braid 120 such that material 122 flows over and between the filaments.

[0058] Braid 120 may be formed from a plurality of interwoven filaments (e.g., Figure 1B 、 Figure 2 and Figure 3 104a). The filaments of the braid 120 may include first filaments 130 and second filaments 132 (only a few of the filaments are labeled) interwoven with the first filaments 130. The first filaments 130 may advantageously be configured to resist radial collapse of the sidewall of the shaft 104 (thereby providing improved kink resistance), and the second filaments 132 may be configured to engage the first filaments 130 to resist radial expansion of the first filaments 130 when torque is applied to the proximal end portion 104a of the shaft 104 (thereby providing improved torque transfer along the sidewall with 1:1 torque control). Reference Figure 1B and Figure 3, the first filaments 130 can be helically wound around the longitudinal axis of the sidewall in a clockwise or counterclockwise direction without crossing each other (e.g., thereby forming a coil). Figure 1B 104. As shown, braid 120 may comprise two first long filaments 130 spaced 180 degrees around the circumference of axle 104. In other embodiments, braid 120 may comprise more than two first long filaments 130 (e.g., three first long filaments 130, four first long filaments 130 etc.), as long as the size of first long filament 130 and / or second long filament 132 is reduced to consider the smaller space between the adjacent turns of the first long filament 130 and to make long filament 130, 132 not longitudinally overlap. Compared with braid being placed on coil, making first long filament 130 and second long filament 132 interweaving can advantageously reduce gross thickness and the outer diameter of axle 104, and vice versa. Making first long filament 130 and second long filament 132 interweaving also speeds up manufacturing, because it can be finished in single process, and covering braid and coil requires at least two independent manufacturing steps (e.g., braided tube is woven onto mandrel, then covering coil, or coil is placed on mandrel and braided tube is woven onto coil).

[0059] In some embodiments, the braid 120 may include two first long filaments 130 and 14 second long filaments 132. In some embodiments, the braid 120 may include two first long filaments 130 and 30 second long filaments 132. In some embodiments, the braid 120 may include two first long filaments 130 and 30 second long filaments 132. In some embodiments, the braid 120 may include two first long filaments 130 and 14 second long filaments 132. In some embodiments, the braid 120 may include two first long filaments 130 and 30 second long filaments 132. Other combinations are also possible and within the scope of the present disclosure.

[0060] In some embodiments, the stiffness of an individual first filament 130 can be different from the stiffness of an individual second filament 132. In such embodiments, the stiffness variation can be achieved by varying the size, shape, thickness, and / or material composition of the filaments 130, 132.

[0061] The individual second filaments 132 may have a cross-sectional area that is smaller than the cross-sectional area of ​​the individual first filaments 130. The larger size of the first filaments 130 advantageously provides greater radial strength and column strength to the shaft 104. In some embodiments, the first filaments 130 and the second filaments 132 have the same cross-sectional area. The first filaments 130 and the second filaments 132 may have the same or different cross-sectional shapes (e.g., both are circular, both are elliptical, both are rectangular, etc.). For example, Figure 1B and Figure 3 As shown, in some embodiments, the first filament 130 and the second filament 132 have a rectangular cross-sectional shape. Figure 2 Shown, in some modifications, the first long filament 130 and the second long filament 132 have a circular cross-sectional shape. In some embodiments, the first long filament 130 has a circular cross-sectional shape, and the second long filament 132 has a rectangular cross-sectional shape, or vice versa. In any case, long filament 130,132 can comprise metal, such as stainless steel, platinum, silver, tantalum, superelasticity and / or shape memory material (for example, nitinol, cobalt-chromium alloy, MP35N, 35N LT etc.) or other. In some embodiments, long filament 130,132 can comprise non-metallic material or be made of non-metallic material. The first long filament 130 and the second long filament 132 can be made of identical or different material.

[0062] In some embodiments, the second filaments 132 include a first group 134 that is wound in the same direction (clockwise or counterclockwise) as the first filaments 130 and does not cross the first filaments 130, and a second group 136 that is wound in the opposite direction (clockwise or counterclockwise) to the first group 134 and the first filaments 130 and interwoven with the first group 134 and the first filaments 130. The second filaments 132 of the second group 136 can be interwoven with the first group 134 and the first filaments 130 in a 1-on-1 or 2-on-2 pattern or other pattern. Since the distal ends of the first filaments 130 are fixed at the distal end of the shaft 104, the torque applied to the proximal end portion 104a of the shaft 104 causes the first filaments 130 to expand radially. However, the second filaments 132 act as locking members that resist the radial expansion of the first filaments 130 and prevent kinking.

[0063] In some embodiments, the first group 134 and the second group 136 of the second long filament 132 may be identical or different. In some embodiments, the first group 134 and the second group 136 of the second long filament 132 may be smaller than the second group 132 of the second long filament 132. In some (but not all) embodiments of the shaft 104 with an external diameter of 8Fr, the braid 120 may include two first long filaments 130, six first group of long filaments and eight second group of long filaments. In some (but not all) embodiments of the shaft 104 with an external diameter of 12Fr, the braid 120 may include two first long filaments 130, 14 first group of long filaments 134 and 16 second group of long filaments 136. Other combinations are also possible and within the scope of the present disclosure.

[0064] The catheter 100 of the present technology is configured to be positioned around a bend in a blood vessel (or any tube) having a radius of curvature of 24 mm or less and to withstand at least 360 degrees (e.g., to guide the curved distal end of the catheter in a certain direction) or at least 12 Nm of torque without the sidewalls of the shaft 104 collapsing inward (e.g., kinking) at any point along the length of the shaft 104. In other words, when the distal end of the catheter 100 is located distal to a bend in a blood vessel (or any tube) having a radius of curvature of 24 mm or less, the lumen 110 of the shaft 104 remains at least 70% patency, at least 80% patency, at least 90% patency, or substantially 100% patency while at least 360 degrees or at least 12 Nm of torque is applied to the sidewalls at the proximal end portion 104a of the shaft 104. Therefore, the catheter 100 of the present technology can be positioned around a bend in a blood vessel having a radius of curvature of 24 mm or less and receive a second slender device therethrough (such that the distal end of the second slender device extends distally of the distal end of the shaft 104), wherein the outer diameter of the second slender device is at least 70%, 80% or 90% of the inner diameter of the shaft 104.

[0065] As previously mentioned, the catheter 100 of the present technology can be used in various medical procedures. For example, the catheter 100 of the present technology can be used to remove a clot from the peripheral vasculature. Figure 4 An example portion of the peripheral vasculature of the lower extremity is shown in FIG. As shown, the catheter 100 can be advanced, for example, from a femoral access point I, around a femoral access angle θ1, around an iliac bifurcation C (having a nominal radius of 1.69 inches) and tracked contralaterally toward Hunter's canal. The catheter 100 can extend to a position between A and B (to access a clot), or to the distal end of B. Other locations within the peripheral vasculature are possible. In such embodiments, the elongated shaft 104 can have an outer diameter of about 0.079 inches (6 French) to about 0.118 inches (9 French) or about 0.105 inches (8 French).

[0066] As another example, the catheter 100 may be configured to track around the apex of an arteriovenous graft (AVG) (or "ring graft") (eg, for removal of emboli or other material, or other purposes). Figure 5An example annular graft LG is shown in FIG. The apex A of the annular graft can have a radius of curvature of about 7 mm to about 100 mm, about 7 mm to about 30 mm, about 10 mm or less, about 20 mm or less, or about 30 mm or less, and a bend angle of at least 30 degrees, or about at least 180 degrees, or about 30 degrees to about 180 degrees. The catheter 100 can enter the vessel on one side of the graft and then be tracked around the loop apex A. Other configurations of annular grafts are possible. In such embodiments, the elongated shaft 104 can have an outer diameter of about 0.079 inches (6 French) to about 0.118 inches (9 French) or about 0.105 inches (8 French).

[0067] As yet another example, catheter 100 may be configured to track and navigate from a femoral artery access to the pulmonary artery (for retrieval of a pulmonary embolism), typically through complex and tortuous vascular anatomy. Figure 6 An example path is shown. As shown, catheter 100 can be advanced through heart H and bypass the bifurcation in the main pulmonary artery to enter left pulmonary artery LPA or right pulmonary artery RPA. Other positions in the pulmonary artery are possible. When entering the pulmonary artery, catheter 100 can be positioned around a bend with a radius of curvature of approximately 7mm to approximately 100mm, approximately 7mm to approximately 20mm, approximately 7mm to approximately 10mm, or not more than 30mm. Axle 104 can have an outer diameter of approximately 0.131 inch (10 French) to approximately 0.315 inch (24 French), approximately 0.158 inch (12 French) to approximately 0.315 inch (24 French), approximately 0.158 inch (12 French) or larger, or approximately 0.158 inch (12 French).

[0068] in conclusion

[0069] Although many embodiments are described above with respect to systems, devices, and methods for mechanical thrombectomy, the technology is applicable to other applications and / or other methods, such as removing unwanted material from other body cavities, or using catheter shafts that are not intended and / or suitable for aspiration. Moreover, other embodiments besides those described herein are also within the scope of the present technology. Additionally, several other embodiments of the present technology may have different configurations, components, or procedures than those described herein. Therefore, one of ordinary skill in the art will accordingly understand that the present technology may have other embodiments with additional elements, or the present technology may have other embodiments without the above referenced embodiments. Figures 1A to 6 Other embodiments of several features are shown and described.

[0070] The description of the embodiments of the present technology is not intended to be exhaustive or to limit the technology to the exact form disclosed above. Where the context permits, singular terms or plural terms may also include plural terms or singular terms, respectively. Although the specific embodiments and examples of the present technology are described above for illustrative purposes, it will be appreciated by those skilled in the relevant art that various equivalent modifications may be made within the scope of the present technology. For example, although the steps are presented in a given order, alternative embodiments may perform steps in different orders. The various embodiments described herein may also be combined to provide additional embodiments.

[0071] As used herein, the terms "generally," "substantially," "about," and similar terms are used as terms of approximation rather than terms of degree, and are intended to take into account the inherent variation in measured or calculated values ​​that those skilled in the art will recognize.

[0072] Furthermore, unless the word "or" when referring to a list of two or more items is expressly limited to mean only a single item to the exclusion of other items, the use of "or" in such a list should be interpreted to include (a) any single item in the list, (b) all of the items in the list, or (c) any combination of items in the list. Additionally, the term "comprising" is used throughout to mean including at least the recited features, such that any greater number of the same features and / or other features of additional types are not excluded. It should also be understood that specific embodiments have been described herein for purposes of illustration, but that various modifications may be made without departing from the present technology. Additionally, while advantages associated with certain embodiments of the present technology have been described in the context of those embodiments, other embodiments may also exhibit such advantages, and not all embodiments must exhibit such advantages to fall within the scope of the present technology. Accordingly, the present disclosure and associated technology may encompass other embodiments not expressly shown or described herein.

Claims

1. An intravascular catheter, comprising: An elongated tubular sidewall defining a lumen extending therethrough and having a proximal end, a distal end, and a length between the proximal and distal ends, the sidewall comprising a plurality of filaments, at least some of the filaments being interwoven with other filaments of the plurality of filaments, wherein the catheter is configured to be positioned about a bend in a blood vessel having a radius of curvature of no greater than 24 mm, and wherein, when the distal end of the catheter is distal to the bend, a torque applied to the sidewall at the proximal end of the catheter is transmitted to the distal end while the lumen remains at least 70% patency.

2. The catheter of claim 1, wherein the torque is at least 12 Nm.

3. A catheter according to claim 1 or claim 2, wherein the sidewall includes a longitudinal axis extending along its length, and wherein the torque applied at the proximal end of the catheter is configured to rotate the sidewall 360 degrees about the longitudinal axis.

4. The catheter according to any one of claims 1 to 3, wherein When the catheter is positioned around the bend and the torque is applied while the lumen remains at least 70% patency, the insertion length of the catheter is at least 50%.

5. The catheter of any one of claims 1 to 4, wherein the sidewall has an outer diameter of at least 8 Fr.

6. The catheter of any one of claims 1 to 5, wherein the sidewall has an outer diameter of at least 12 Fr. 7 . The catheter according to claim 1 , wherein the bend in the blood vessel has a bending angle greater than or equal to 120 degrees.

8. A catheter according to any one of claims 1 to 7, wherein the side wall defines a lumen extending along the longitudinal axis, and wherein the proximal end of the catheter is configured to be fluidly connected to a negative pressure source to draw occlusive material within the blood vessel into and through the lumen.

9. An intravascular catheter, comprising: A tubular sidewall having a longitudinal axis, the sidewall comprising a first number of first guidewires and a second number of second guidewires, the second number being greater than the first number, wherein: The first guidewire has a first cross-sectional area and is helically wound in a first direction around the longitudinal axis without crossing each other, and The second guidewire has a second cross-sectional area smaller than the first cross-sectional area, wherein the second guidewire includes (a) a first group wound along the first direction and not crossing the first guidewire, and (b) a second group wound along a second direction opposite to the first direction, and wherein the guidewires in the second group are interwoven with the first group of the first guidewire and the second guidewire.

10. The catheter of claim 9, wherein the second number is at least five times the first number.

11. The catheter of claim 9 or claim 10, wherein the cross-sectional shape of the first guide wire is different from the cross-sectional shape of the second guide wire. 12 . The catheter of claim 9 , wherein the first guidewire has a rectangular cross-sectional shape and the second guidewire has a circular cross-sectional shape.

13. The catheter of any one of claims 9 to 12, wherein the sidewall defines a lumen, and wherein the proximal end of the catheter is configured to be fluidly coupled to a source of negative pressure to draw occlusive material within the blood vessel into and through the lumen.

14. An intravascular catheter, comprising: a proximal end, a distal end, and a longitudinal axis extending therebetween; a tubular sidewall defining a lumen, the sidewall comprising a plurality of guidewires embedded in the material, the plurality of guidewires comprising a first number of first guidewires and a second number of second guidewires, the second number being greater than the first number, wherein: The first guidewires are helically wound around the longitudinal axis in a first direction without crossing each other, the first guidewires being configured to resist radial collapse of the sidewall, and The second guidewires include (a) a first group wound in the first direction and not crossing the first guidewire, and (b) a second group wound in a second direction opposite to the first direction, wherein the second guidewires are configured to engage the first guidewire to resist radial expansion of the first guidewire, thereby providing improved torsional ability of the sidewall, Wherein the proximal end of the catheter is configured to be fluidly coupled to a source of negative pressure for applying suction through the lumen.

15. The catheter of claim 14, wherein the material is a first material and the plurality of guidewires and the first material together comprise a first layer, and wherein the sidewall further comprises a second layer radially inward of the first layer.

16. The catheter of claim 14 or claim 15, wherein the material is a first material and the plurality of guidewires and the first material together comprise a first layer, and wherein the sidewall further comprises a second layer radially outward of the first layer.

17. The catheter of any one of claims 14 to 16, wherein the material is a first material and the plurality of guidewires and the first material together constitute a first layer, and wherein the sidewall further comprises a second layer radially inwardly of the first layer and a third layer radially outwardly of the first layer.

18. The catheter of any one of claims 14 to 17, wherein the proximal end of the catheter is configured to be fluidly coupled to a source of negative pressure to draw occlusive material within the blood vessel into and through the lumen.

19. The catheter of any one of claims 14 to 18, wherein the tubular sidewall has an outer diameter of at least 8 Fr.

20. The catheter of any one of claims 14 to 19, wherein the tubular sidewall has an outer diameter of at least 12 Fr.

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