Embolus extraction device

Abstract

A device (100) for removing emboli from a cerebral artery, comprising (i) a catheter (150), (ii) a funnel (130) biased to assume an expanded state in which a mouth (133) of the funnel is wider than a proximal end (1311) of the funnel, (iii) a stem (132) attached to the proximal end of the funnel and extending proximally through the catheter, and (iv) a handle (120) at a proximal portion of the catheter, the handle comprising: (a) a deployment knob (122) configured to deploy an embolus from the catheter; the device includes (a) a catheter (126) operably coupled to the rod so as to be manually operable to transition the funnel toward a deployed expanded state in which the funnel is in sealing engagement with the catheter such that suction applied by the catheter draws the emboli into the mouth, and (b) a stabilizer (126) configured to stabilize the device in the deployed state by applying tension to the rod.

Description

Cross-reference to related applications

[0001] This application claims priority to Provisional U.S. Patent Application 63 / 470,906, filed June 4, 2023, by Mustafa et al., which is incorporated herein by reference. Invention Field

[0002] Some applications of this invention generally relate to devices for removing emboli from blood vessels. More specifically, some applications of this invention relate to removing emboli from cerebral blood vessels in a subject. background

[0003] Vascular diseases caused by blood vessel blockage are a major cause of mortality and morbidity.

[0004] A cerebral embolism is a blockage in a blood vessel within the brain or in an artery that supplies blood to the brain. The blockage can be caused by a blood clot, fat globule, or air pocket within the artery. Cerebral embolism can lead to embolic stroke, which accounts for a large proportion of vascular disease-related deaths.

[0005] Interventional procedures are routinely used to treat vascular diseases. However, treating vascular occlusions, such as those in small blood vessels located in the brain and in remote vessels, can be challenging due to the small diameter of the navigation and / or the tools required.

[0006] Minimally invasive retrieval of cerebral embolism is typically performed using a retrieval catheter designed to capture and remove the embolus using a mechanical trap and / or aspiration.

[0007] While such removal devices may be effective in removing small clots, using suction to remove large clots can cause the collector to collapse due to clot material clogging the collector opening. This collapse often results in incomplete clot removal and clot fragmentation.

[0008] To overcome these limitations of traverse aspiration-assisted clot removal, operators often disconnect the aspiration source (syringe or pump) to reverse the collapse and then reapply aspiration to attempt to remove the clot, or completely withdraw the system from the vascular system to unplug the trap and repeat the procedure.

[0009] Therefore, there is still room for improvement in clot removal systems, especially in the complete removal capability of systems that utilize suction. Invention Overview

[0010] This invention is intended to provide examples and is not intended to limit the scope of the invention in any way. For example, any features included in the examples summarized in this invention are not claimed by the claims unless those features are expressly recited by the claims. Furthermore, the examples summarized in this invention and the features, components, steps, concepts, etc., described elsewhere in this disclosure can be combined in various ways. The examples summarized in this invention may include various features and steps as described elsewhere in this disclosure.

[0011] Any techniques, methods, operations, steps, etc. described or suggested herein may be performed on living animals (e.g., humans, other mammals, etc.) or on non-living simulations, such as corpses, corpse hearts, anthropomorphic ghosts, and / or simulator devices (which may include computerized and / or physical representations of body parts, tissues, etc.).

[0012] Therefore, according to some embodiments, an apparatus is provided for removing an obstruction (e.g., embolus, clot, plaque, or any other obstruction) from a subject's blood vessels (e.g., from an artery, such as from a cerebral artery, or from a vein, such as from a cerebral vein), the apparatus comprising (i) a flexible catheter, (ii) a funnel attached to the proximal end of the funnel, (iii) a flexible rod, and / or (iv) a handle located at the proximal portion of the catheter.

[0013] In some embodiments, the catheter has (a) a proximal portion, (b) a distal portion configured for transluminal advancement into a blood vessel (e.g., a cerebral artery), the distal portion having an edge, and / or (c) a lumen extending from the proximal portion to the edge.

[0014] In some embodiments, the funnel has (a) a spout located at the distal end of the funnel, and (b) an opening located at the proximal end of the funnel. In some embodiments, the funnel is biased to present an expanded state, wherein the spout is wider than the opening and the edges. In some embodiments, the funnel is elastically compressible into a compressed state, in which the spout is narrower than in the expanded state.

[0015] In some implementations, the rod is attached to the proximal end of the funnel and extends proximally through the conduit.

[0016] In some embodiments, the handle is located at the proximal portion of the catheter and includes an unfolding knob operably coupled to a flexible rod for manual operation to gradually transition the device between: (a) a delivery state in which the funnel is compressed within the catheter, and / or (b) an unfolding state in which the funnel is expanded, wherein the outer surface of the funnel is sealed to the edge, and the nozzle (i) is exposed from the distal portion of the catheter, and (ii) is fluidly connected to the lumen such that suction applied through the lumen draws obstructions (e.g., emboli) into the funnel via the nozzle. In some embodiments, the handle includes a stabilizer separate from the unfolding knob and configured to stabilize the device in the unfolded state by applying tension to the rod.

[0017] In some embodiments, the handle is configured to limit the distal advance of the rod in a manner that provides a predetermined restriction on the distal advance of the funnel from the distal portion of the conduit.

[0018] In some implementations, the unfolding knob is a finger wheel.

[0019] In some implementations, the unfolding knob is a slider, which can be operated by sliding the slider.

[0020] In some implementations, the stabilizer is configured to suppress further operation of the unfolding knob when actuated.

[0021] In some embodiments, the conduit includes a hypotube and a polymeric cover coated with the hypotube, and the polymeric cover extends beyond the hypotube to define an edge.

[0022] In some implementations, the flexibility of the catheter gradually increases distally along the catheter.

[0023] In some implementations, the flexibility of the rod gradually increases towards the distal end of the rod.

[0024] In some implementations, the distal portion of the catheter has a curvature that can be adjusted by applying an axial force to the rod.

[0025] In some implementations, the distal portion of the catheter is more flexible than the proximal portion.

[0026] In some implementations, the distal portion of the catheter has a length of 10-30 cm.

[0027] In some implementations, the distal portion of the catheter is biased toward a bent position.

[0028] In some embodiments, the device is configured such that the curvature of the distal portion can be reduced by positioning the funnel, which is in its compressed state, within the distal portion of the conduit.

[0029] In some implementations, the rod is eccentrically connected to the funnel within the lumen, such that distal pushing of the rod applies an eccentric thrust to the funnel, which is responsively hinged relative to the rod, thereby increasing the curvature of the conduit.

[0030] In some embodiments, the rod is eccentrically connected to the funnel within the lumen, such that a distal push of the rod applies an eccentric thrust to the funnel, which responsively deflects to deflect the distal portion of the catheter.

[0031] In some implementations: (i) the funnel has a flared surface away from the opening in its expanded state, and / or (ii) the stabilizer is configured to stabilize the device by retracting the funnel back into a sealed engagement with the conduit by sealing the flared surface against the edge.

[0032] In some implementations, the edges open outwards.

[0033] In some implementations, the catheter is fixedly attached to the handle.

[0034] In some implementations, the conduit is welded to the handle.

[0035] In some embodiments, the rod includes an external stop that provides predetermined limitation on distal advancement of the funnel from the distal portion of the conduit by limiting distal advancement of the rod via the handle to a predetermined distance.

[0036] In some implementations, the stabilizer is configured such that actuation of the stabilizer pulls the rod proximally a predetermined distance.

[0037] In some implementations, the stabilizer can be manually actuated independently of the unfolding knob.

[0038] In some implementations, the stabilizer includes a button and can be manually actuated by pushing the button.

[0039] In some embodiments, the handle also includes a port fluidly connected to the conduit, the port being adapted to receive a suction applicator adapted to apply suction.

[0040] In some embodiments, the apparatus also includes a suction applicator.

[0041] In some implementations, the suction applicator includes a syringe.

[0042] In some implementations, the suction applicator includes a foot pedal such that pressing the foot pedal applies suction.

[0043] In some implementations, the funnel is made of braided thread.

[0044] In some implementations, the braided yarns are gathered into an elliptical loop at the proximal end, which defines the opening as an elliptical opening.

[0045] In some implementations, the elliptical ring is covered with a polymer coating that enhances the opening.

[0046] In some embodiments, in a sealing connection, the polymer coating fits snugly within the distal portion of the conduit.

[0047] In some implementations: (i) the funnel has a central longitudinal axis passing through the mouth and the opening, and / or (ii) the elliptical opening has a long axis inclined relative to the longitudinal axis.

[0048] In some embodiments: (i) the elliptical opening has: (a) a distal vertex located on the long axis, on a first side of the longitudinal axis, and / or (b) a proximal vertex located on the long axis, and disposed on the side of the longitudinal axis opposite to the distal vertex, on the proximal side of the distal vertex, and / or (ii) a rod attached to the proximal end of the funnel by attaching it to the elliptical opening at the proximal vertex.

[0049] In some embodiments, the stabilizer includes a manually actuable mechanism adapted to stabilize the device in an deployed state by applying tension to the rod when manually actuated.

[0050] In some embodiments, the stabilizer includes a spring-loaded mechanism adapted to stabilize the device in the deployed state by applying tension to the rod.

[0051] In some implementations, the spring-loaded mechanism is adapted to automatically apply tension to the rod when the manual operation of the unfolding knob is stopped.

[0052] In some implementations, the unfolding knob can be operated by rotation.

[0053] In some embodiments, the handle includes a drive wheel that engages with a lever and is operably coupled to a knob, such that rotating the knob in a first knob direction causes the drive wheel to rotate in a forward drive wheel direction, thereby pushing the lever distally to gradually change the device from a delivery state to an unfolded state.

[0054] In some implementations, the drive wheel defines the roller, and the rod passes tangentially over the roller.

[0055] In some implementations, the drive wheel defines the spool, and the rod is wound around the spool.

[0056] In some implementations, the drive wheel defines the winch, and the rod bends around the winch.

[0057] In some implementations, the stabilizer is configured such that actuation of the stabilizer causes the drive wheel to rotate in the opposite drive wheel direction, thereby pulling the rod proximally.

[0058] In some embodiments, the stabilizer is configured with a first position and a second position, and is configured to be actuated by moving the stabilizer from the first position to the second position, such that the actuation of the stabilizer causes the drive wheel to rotate a predetermined discrete amount in the opposite drive wheel direction, thereby pulling the rod proximally a predetermined discrete distance.

[0059] In some implementations: (i) the drive wheel has drive wheel teeth, (ii) the stabilizer has seal teeth, and / or (iii) the actuation stabilizer engages the seal teeth with the drive wheel teeth and moves the drive wheel in the opposite drive wheel direction.

[0060] In some embodiments, the drive wheel teeth are circumferentially distributed, the seal teeth are linearly distributed, and the actuation of the stabilizer causes the seal teeth and drive wheel teeth to form a rack and pinion arrangement.

[0061] In some embodiments, the engagement between the sealer teeth and the drive wheel teeth is stabilized by the distal movement of the damping rod and the funnel relative to the conduit.

[0062] According to some embodiments, an apparatus for removing obstructions (e.g., emboli, clots, plaques, or any other obstructions) from a subject's blood vessels (e.g., from arteries, such as from cerebral arteries, or from veins, such as from cerebral veins) is also provided, the apparatus comprising a flexible catheter, a funnel, a flexible rod, and / or a handle, wherein the flexible rod is attached to the proximal end of the funnel, and the handle is located at the proximal portion of the catheter.

[0063] In some embodiments, the catheter has (i) a proximal portion, (ii) a distal portion configured for transluminal advancement into a blood vessel (e.g., a cerebral artery), the distal portion having an edge, and / or (iii) a lumen extending from the proximal portion to the edge.

[0064] In some embodiments, the funnel has (i) a mouth located at the distal end of the funnel and (ii) an opening located at the proximal end of the funnel.

[0065] In some implementations, the funnel is biased to present an expanded state, wherein the spout is wider than the opening and the edges.

[0066] In some implementations, the funnel can be elastically compressed into a compressed state, in which the spout is narrower than in the expanded state.

[0067] In some implementations, the rod is attached to the proximal end of the funnel and extends proximally through the conduit.

[0068] In some embodiments, the handle includes an unfolding knob operably coupled to a flexible rod so that the device can be manually operated to gradually transition between: (a) a delivery state in which the funnel is compressed within the conduit, and / or (b) an unfolding state in which the funnel is expanded, wherein the outer surface of the funnel is sealed to the edge, and the mouth (i) is exposed from the distal portion of the conduit, and (ii) is fluidly connected to the lumen such that suction applied through the lumen draws obstructions (e.g., plugs) into the funnel via the mouth.

[0069] In some implementations, the handle includes a stabilizer separate from the deployment knob and configured to stabilize the device in the deployed state by slack on the tension bar.

[0070] According to some embodiments, an apparatus for removing obstructions (e.g., emboli, clots, plaques, or any other obstructions) from a subject's blood vessels (e.g., from arteries, such as from cerebral arteries, or from veins, such as from cerebral veins) is also provided, the apparatus comprising a flexible catheter, a funnel, a flexible rod, and / or a handle, wherein the flexible rod is attached to the proximal end of the funnel, and the handle is located at the proximal portion of the catheter.

[0071] In some embodiments, the catheter has (i) a proximal portion, (ii) a distal portion configured for transluminal advancement into a blood vessel (e.g., a cerebral artery), the distal portion having an edge, and / or (iii) a lumen extending from the proximal portion to the edge.

[0072] In some embodiments, the funnel has (i) a mouth located at the distal end of the funnel and (ii) an opening located at the proximal end of the funnel.

[0073] In some implementations, the funnel is biased to present an expanded state, wherein the spout is wider than the opening and the edges.

[0074] In some implementations, the funnel can be elastically compressed into a compressed state, in which the spout is narrower than in the expanded state.

[0075] In some implementations, the rod is attached to the proximal end of the funnel and extends proximally through the conduit.

[0076] In some implementations, the handle is defined as a flat base for resting on a surface.

[0077] In some embodiments, the handle includes a finger wheel operably coupled to a flexible rod, such that manual operation of the finger wheel causes the device to gradually transition between (i) a delivery state (in which the funnel is compressed within the conduit) and (ii) an unfolding state (in which the funnel is expanded and the mouth is exposed from the distal portion of the conduit).

[0078] In some embodiments, the handle includes a fluid port facing proximally and fluidly connected to the mouth of the funnel and adapted to receive a suction source, such that suction applied to the fluid port is transmitted via a lumen to draw obstructions (e.g., plugs) into the funnel via the mouth.

[0079] In some embodiments, the handle has a foot that extends to define an extension of the flat base.

[0080] In some implementations, the fluid port faces the proximal side.

[0081] In some implementations, the toggle faces outwards.

[0082] In some implementations, the proximal portion of the catheter is fixedly attached to the handle.

[0083] In some implementations, the handle is shaped to be gripped by the user's hand, with conduits extending between the fingers of the hand and away from the handle.

[0084] In some implementations, the proximal portion of the catheter is attached to the handle at the distal portion of the handle.

[0085] In some embodiments, the handle further includes a sealer configured to convert the device into a sealed state by retracting the funnel back into engagement with an edge seal, such that in the sealed state: (i) the funnel remains in an expanded state, and / or (ii) the mouth of the funnel is fluidly connected to the lumen, such that suction applied through the lumen draws an obstruction (e.g., a plug) into the funnel via the mouth.

[0086] In some implementations, the seal faces the distal side.

[0087] According to some embodiments, an apparatus for removing obstructions (e.g., emboli, clots, plaques, or any other obstructions) from a subject's blood vessels (e.g., from arteries, such as from cerebral arteries, or from veins, such as from cerebral veins) is also provided, the apparatus comprising a flexible catheter, a funnel, a flexible rod, and / or a handle, wherein the flexible rod is attached to the proximal end of the funnel, and the handle is located at the proximal portion of the catheter.

[0088] In some embodiments, the catheter has (i) a proximal portion, (ii) a distal portion configured for transluminal advancement into a blood vessel (e.g., a cerebral artery), the distal portion having an edge, and / or (iii) a lumen extending from the proximal portion to the edge.

[0089] In some embodiments, the funnel has (i) a mouth located at the distal end of the funnel and (ii) an opening located at the proximal end of the funnel.

[0090] In some implementations, the funnel is biased to present an expanded state, wherein the spout is wider than the opening and the edges.

[0091] In some implementations, the funnel can be elastically compressed into a compressed state, in which the spout is narrower than in the expanded state.

[0092] In some implementations, the rod is attached to the proximal end of the funnel and extends proximally through the conduit.

[0093] In some embodiments, the handle includes an unfolding knob operably coupled to a flexible rod so that the device can be manually operated to gradually transition between (i) a delivery state (in which the funnel is compressed within the catheter) and (ii) an unfolding state (in which the funnel is expanded and the nozzle is exposed from the distal portion of the catheter).

[0094] In some embodiments, the handle includes a sealer separate from the unfolding knob and configured to switch the device to a sealed state by retracting the funnel back to engage with the edge seal, such that in the sealed state: (a) the funnel remains in the expanded state, and / or (b) the mouth of the funnel is fluidly connected to the lumen, such that suction applied through the lumen draws obstructions (e.g., plugs) into the funnel via the mouth.

[0095] In some implementations, the sealer can be manually actuated independently of the unfolding knob.

[0096] In some implementations, the sealer is a separate component relative to the unfolding knob.

[0097] In some implementations, the seal is a button, and pressing the button switches the device to a sealed state.

[0098] In some implementations, the unfolding knob is a finger wheel.

[0099] In some embodiments, the conduit includes a thiocyanate tube and a polymer coating that coats the thiocyanate tube, and the polymer coating extends beyond the thiocyanate tube to define an edge.

[0100] In some embodiments, the handle is configured to limit the distal advance of the rod in a manner that provides a predetermined restriction on the distal advance of the funnel from the distal portion of the conduit.

[0101] In some implementations, the unfolding knob is a slider, which can be operated by sliding the slider.

[0102] In some implementations, the seal is configured to inhibit further operation of the unfolding knob upon actuation.

[0103] In some implementations, the flexibility of the catheter gradually increases distally along the catheter.

[0104] In some implementations, the flexibility of the rod gradually increases towards the distal end of the rod.

[0105] In some implementations, the distal portion of the catheter has a curvature that can be adjusted by applying an axial force to the rod.

[0106] In some implementations, the distal portion of the catheter is more flexible than the proximal portion.

[0107] In some implementations, the distal portion of the catheter has a length of 10-30 cm.

[0108] In some implementations, the distal portion of the catheter is biased toward a bent position.

[0109] In some embodiments, the device is configured such that the curvature of the distal portion can be reduced by positioning the funnel, which is in its compressed state, within the distal portion of the conduit.

[0110] In some implementations, the rod is eccentrically connected to the funnel within the lumen, such that distal pushing of the rod applies an eccentric thrust to the funnel, which is responsively hinged relative to the rod, thereby increasing the curvature of the conduit.

[0111] In some embodiments, the rod is eccentrically connected to the funnel within the lumen, such that a distal push of the rod applies an eccentric thrust to the funnel, which responsively deflects to deflect the distal portion of the catheter.

[0112] In some implementations: (i) the funnel has an open surface away from the opening in its expanded state, and / or (ii) the sealer is configured to retract the funnel back into a sealing engagement with the conduit by sealing the open surface against the edge.

[0113] In some implementations, the edges open outwards.

[0114] In some implementations, the catheter is fixedly attached to the handle.

[0115] In some implementations, the conduit is welded to the handle.

[0116] In some embodiments, the rod includes an external stop that provides predetermined limitation on distal advancement of the funnel from the distal portion of the conduit by limiting distal advancement of the rod via the handle to a predetermined distance.

[0117] In some embodiments, the sealer is configured such that actuation of the sealer pulls the rod proximally a predetermined distance.

[0118] In some embodiments, the handle also includes a port fluidly connected to the conduit, the port being adapted to receive a suction applicator adapted to apply suction.

[0119] In some embodiments, the apparatus also includes a suction applicator.

[0120] In some implementations, the suction applicator includes a syringe.

[0121] In some implementations, the funnel is made of braided thread.

[0122] In some implementations, the braided yarns are gathered into an elliptical loop at the proximal end, which defines the opening as an elliptical opening.

[0123] In some implementations, the elliptical ring is covered with a polymer coating that enhances the opening.

[0124] In some embodiments, the polymer coating fits snugly within the distal portion of the conduit in a sealed state.

[0125] In some implementations: (i) the funnel has a central longitudinal axis passing through the mouth and the opening, and / or (ii) the elliptical opening has a long axis inclined relative to the longitudinal axis.

[0126] In some embodiments: (i) the elliptical opening has: (a) a distal vertex located on the long axis, on a first side of the longitudinal axis, and / or (b) a proximal vertex located on the long axis and disposed on the side of the longitudinal axis opposite to the distal vertex, proximal to the distal vertex, and / or (ii) a rod attached to the proximal end of the funnel by attaching it to the elliptical opening at the proximal vertex.

[0127] In some embodiments, the sealer includes a spring-loaded mechanism adapted to convert the device into a sealed state by applying tension to a rod.

[0128] In some implementations, the spring-loaded mechanism is adapted to automatically apply tension to the rod when the manual operation of the unfolding knob is stopped.

[0129] In some embodiments, the sealer includes a manually actuated mechanism adapted to stabilize the device in the deployed state by applying tension to the rod when manually actuated.

[0130] In some implementations, the unfolding knob can be operated by rotation.

[0131] In some embodiments, the handle includes a drive wheel that engages with a lever and is operably coupled to a knob, such that rotating the knob in a first knob direction causes the drive wheel to rotate in a forward drive wheel direction, thereby pushing the lever distally to gradually change the device from a delivery state to an unfolded state.

[0132] In some implementations, the drive wheel defines the roller, and the rod passes tangentially over the roller.

[0133] In some implementations, the drive wheel defines the spool, and the rod is wound around the spool.

[0134] In some implementations, the drive wheel defines the winch, and the rod bends around the winch.

[0135] In some embodiments, the sealer is configured such that actuation of the sealer causes the drive wheel to rotate in the opposite drive wheel direction, thereby retracting the funnel back into the sealing engagement by pulling the rod proximally.

[0136] In some embodiments, the seal is configured with a first position and a second position, and is configured to be actuated by moving the seal from the first position to the second position, such that the actuation of the seal causes the drive wheel to rotate by a predetermined discrete amount in the opposite drive wheel direction, thereby pulling the rod proximally by a predetermined discrete distance.

[0137] In some implementations: (i) the drive wheel has drive wheel teeth, (ii) the seal has seal teeth, and / or (iii) the actuation seal engages the seal teeth with the drive wheel teeth and moves the drive wheel in the opposite drive wheel direction.

[0138] In some embodiments, the drive wheel teeth are circumferentially distributed, the seal teeth are linearly distributed, and the actuation of the seal causes the seal teeth and the drive wheel teeth to form a rack and pinion arrangement.

[0139] In some embodiments, the engagement between the sealer teeth and the drive wheel teeth stabilizes the device in a sealed state by holding the funnel in a sealing engagement with the edge through the distal movement of the inhibition rod and the funnel relative to the conduit.

[0140] According to some embodiments, an apparatus for removing obstructions (e.g., emboli, clots, plaques, or any other obstructions) from a subject's blood vessels (e.g., from arteries, such as from cerebral arteries, or from veins, such as from cerebral veins) is also provided, the apparatus comprising a flexible catheter and / or funnel.

[0141] In some embodiments, the catheter has (a) a proximal portion, (b) a distal portion configured for transluminal advancement into a blood vessel (e.g., a cerebral artery), the distal portion having an edge, and / or (c) a lumen extending from the proximal portion to the edge.

[0142] In some embodiments, the funnel is formed of a set of braided threads covered with a covering. In some embodiments, the funnel has (i) a mouth portion located at the distal end of the funnel, (ii) a scoop portion located at the mouth portion and projecting distally, the scoop portion being defined by: (a) a first outer lobe formed by a bend in a first thread of the set of threads, (b) a second outer lobe formed by a bend in a second thread of the set of threads, (c) an inner lobe disposed between and overlapping the first and second outer lobes, the inner lobe being formed by a bend in a third thread of the set of threads, the third thread being more flexible than the first thread and more flexible than the second thread, and / or (d) an opening located at the proximal end of the funnel.

[0143] In some embodiments, the funnel is biased to present an expanded state and / or resiliently compressible into a compressed state, wherein in the expanded state the spout is wider than the opening and edges, and in the compressed state the spout is narrower than in the expanded state.

[0144] In some implementations, for each of the first, second, and third lobes, the corresponding wire defines two tails that are diverging from each other away from the bend, extending along the funnel toward the opening with opposite helical handedness.

[0145] In some implementations: (i) the funnel has a central longitudinal axis passing through the mouth and the opening, and / or (ii) in the expanded state, the spoon-shaped portion opens radially outward from the central longitudinal axis.

[0146] In some embodiments: (i) each of the first outer lobe and the second outer lobe defines an outer tail and an inner tail, the outer tail extending spirally away from the bend and the inner lobe and along the funnel toward the opening, and the inner tail extending spirally away from the bend to overlap with the inner lobe and along the funnel toward the mouth; and / or (ii) a set of wires includes at least one corresponding lobe support wire for each of the outer lobes, each lobe support wire defining a loop that surrounds the outer tail of the corresponding outer lobe at the mouth to support the corresponding outer lobe.

[0147] In some implementations, the set of wires includes exactly two corresponding lobe support wires for each of the outer lobes.

[0148] In some implementations, each of the petal support wires defines a pair of tails that extend proximally away from the circumference and spirally along the funnel toward the opening.

[0149] In some implementations, for each of the petal support lines, the tails of the pair extend parallel to each other along the funnel toward the opening and have the same helical chirality.

[0150] In some embodiments, for each of the outer lobes, a set of wires includes a first lobe support wire and a second lobe support wire, the tail of the first lobe support wire extending parallel to the opening along the funnel and having the same helical chirality as the tail of the second lobe support wire.

[0151] In some implementations, the loop of the first support wire is located distal to the loop of the second support wire, and the first support wire is stiffer than the second support wire.

[0152] In some implementations: (i) the spoon-shaped portion is a first spoon-shaped portion, (ii) the funnel has opposing spoon-shaped portions at the mouth, the opposing spoon-shaped portions being defined by at least two arcuate wires in a set of wires, each arcuate wire forming a partial arcuate portion around the mouth, the arcuate portions overlapping each other, and / or (iii) the opposing spoon-shaped portions are opposite to the first spoon-shaped portion.

[0153] In some embodiments, in response to the compressive force applied to the funnel, the opposing spoon-shaped portion is configured to extend distally by deformation into an arcuate portion having a reduced radius of curvature.

[0154] In some implementations, the opposing spoon-shaped portions are defined by exactly two curved wires that form exactly two curved portions.

[0155] In some embodiments, the first spoon-shaped portion is not defined by other wires in the group of wires, except for the first wire defining the first outer lobe, the second wire defining the second outer lobe, and the third wire defining the inner lobe.

[0156] In some embodiments, the first spoon-shaped portion protrudes distally beyond the opposing spoon-shaped portion.

[0157] In some implementations, the first spoon-shaped portion is longer than the opposite spoon-shaped portion.

[0158] In some implementations, each arcuate wire is an arcuate wire in a pair of parallel extending arcuate wires, with each pair of arcuate wires facing the distal side.

[0159] In some embodiments, the opposing spoon-shaped portion further includes a single arcuate wire between the two arcuate wires and forming the arcuate portion proximally from the two arcuate wires.

[0160] According to some embodiments, a method for advancing an embolus removal device into a real or simulated blood vessel (e.g., an artery, such as a cerebral artery, or a vein, such as a cerebral vein) of a real or simulated object is also provided, the method comprising: (i) advancing a distal portion of a flexible catheter through a lumen into the blood vessel (e.g., a cerebral artery) while: (a) a funnel is compressed within the lumen of the catheter, and / or (b) a flexible rod attached to the proximal end of the funnel extends proximally through the catheter; (ii) adjusting the curvature of the distal portion by applying an axial force to the rod extending proximally through the lumen from the proximal end of the funnel; and / or (iii) subsequently advancing the funnel from the distal portion such that the funnel expands within the blood vessel (e.g., a cerebral artery).

[0161] In some embodiments, advancing the distal portion of the catheter into a blood vessel (e.g., a cerebral artery) via the lumen includes advancing the distal portion of the catheter into the blood vessel (e.g., a cerebral artery) via the lumen while the funnel is positioned within the lumen from the distal portion toward the proximal side.

[0162] In some implementations, the method also includes applying suction to draw real or simulated blockages (e.g., emboli, clots, plaques, or any other blockages) into the funnel.

[0163] In some embodiments, the distal portion of the catheter is biased toward a curved state, and adjusting the curvature of the distal portion by applying an axial force to the rod includes reducing the curvature of the distal portion by pushing a funnel in its compressed state distally within the distal portion of the catheter.

[0164] In some embodiments, the distal portion of the catheter is biased toward a curved state, and adjusting the curvature of the distal portion by applying an axial force to the rod includes increasing the curvature of the distal portion by pulling the funnel in its compressed state proximally within the distal portion of the catheter.

[0165] In some embodiments, the rod extends eccentrically within the lumen, and adjusting the curvature of the distal portion by applying an axial force to the rod includes advancing the rod and funnel distally within the lumen to increase the curvature by applying an eccentric compressive force to the conduit through the funnel and rod.

[0166] In some implementations, the method further includes rotating the catheter within the subject before adjusting the curvature of the distal portion.

[0167] In some embodiments, the rod extends eccentrically within the lumen, and adjusting the curvature of the distal portion by applying an axial force to the rod includes reducing the curvature by pulling the rod and funnel proximally within the lumen.

[0168] According to some embodiments, a method is also provided for removing a real or simulated obstruction (e.g., embolus, clot, plaque, or any other obstruction) from a real or simulated blood vessel (e.g., from an artery, such as from a cerebral artery, or from a vein, such as from a cerebral vein) of a real or simulated object, the method comprising: (i) advancing a distal portion of a flexible catheter through a lumen into the blood vessel (e.g., a cerebral artery) while: (a) the funnel is compressed within the lumen of the catheter, and / or (b) a rod extends proximally from the proximal end of the funnel through the lumen to a handle; (ii) (iii) Using an unfolding knob operably coupled to a handle, advance the funnel from the distal portion of the conduit such that the funnel self-expands with the mouth at the distal end of the funnel being wider than the opening at the distal end of the funnel and the proximal end of the funnel; (iv) actuate the sealer on the handle to retract the funnel back into a sealing engagement with the distal portion such that, in the sealing engagement, the funnel remains expanded and the mouth of the funnel is fluidly connected to the lumen; and / or (iv) subsequently apply suction through the lumen such that the suction draws the obstruction (e.g., a plug) into the funnel via the mouth.

[0169] According to some embodiments, a method for removing a real or simulated obstruction (e.g., an embolus) from a real or simulated blood vessel (e.g., a cerebral artery) of a real or simulated subject is also provided, the method comprising: (a) advancing a distal portion of a flexible catheter through a lumen into the cerebral artery while: (i) a funnel is compressed within the lumen of the catheter, and / or (ii) a rod extends from the proximal end of the funnel proximally through the lumen to a handle; (b) using an unfolding knob operably coupled to the handle of the rod, unfolding the funnel from the distal portion of the catheter such that the funnel self-expands with the mouth at the distal end of the funnel being wider than the opening at the distal end of the funnel and the proximal end of the funnel; (c) subsequently actuating a stabilizer on the handle to stabilize the funnel in a sealed engagement with the catheter; and / or (d) while the funnel remains stable in a sealed engagement with the distal portion: (i) aspirating the embolus into the funnel via the mouth through the lumen, and / or (ii) retracting the funnel and the catheter from the cerebral artery and the subject while continuing to apply aspiration through the lumen.

[0170] In some embodiments, step (b) of the method includes the following steps: (i) expanding the funnel from the distal portion of the catheter until the mouth is exposed: (I) applying suction to the mouth via the lumen, (II) determining the degree of resistance to the suction, and / or (III) in response to the determined value, identifying whether there is contact with an embolus.

[0171] In some embodiments, step (b) of the method further includes, after identification, (I) retracting the funnel into the distal portion such that the funnel becomes compressed within the lumen, (II) advancing the catheter distally within the artery, and / or (III) repeating step (b) until contact with the embolus is identified.

[0172] In some embodiments, advancing the distal portion of the catheter into the cerebral artery via the lumen includes advancing the distal portion of the catheter into the cerebral artery via the lumen while the funnel is positioned from the distal portion toward the proximal portion within the lumen.

[0173] According to some embodiments, a method for removing a real or simulated embolus from a real or simulated cerebral artery of a real or simulated object is also provided, the method comprising: (a) advancing a distal portion of a flexible catheter through a lumen into the cerebral artery while a funnel is compressed within the lumen of the catheter, the funnel being formed of a set of braided threads covered with a covering and having: (i) a mouth portion located at the distal end of the funnel, (ii) a spoon-shaped portion located at the mouth portion and projecting distally, the spoon-shaped portion being defined by: (I) a first lateral flap formed by a bend in a first thread of the set of threads, (II) a second lateral flap formed by the set of threads The bending portion of the second wire in the wire is formed, (III) an inner flap disposed between and overlapping the first and second outer flaps, the inner flap being formed by the bending portion of the third wire in the group of wires, the third wire being more flexible than the first wire and more flexible than the second wire, and / or (IV) an opening located at the proximal end of the funnel; (b) gradually advancing the funnel from the distal portion of the conduit such that the funnel self-expands with the mouth wider than the distal portion and the opening; and / or (c) applying suction through the lumen such that the suction draws the plug into the funnel through the mouth.

[0174] According to some embodiments, an apparatus for removing emboli from a subject's cerebral artery is also provided, the apparatus comprising a flexible catheter and / or funnel.

[0175] In some embodiments, the catheter has (i) a proximal portion, (ii) a distal portion configured for transluminal advancement into a cerebral artery, the distal portion having an edge, and / or (iii) a lumen extending from the proximal portion to the edge.

[0176] In some embodiments, the funnel has a central longitudinal axis passing through the mouth and the opening, and has (i) a mouth at the distal end of the funnel and (ii) an opening at the proximal end of the funnel.

[0177] In some implementations, the funnel can be elastically compressed into a compressed state.

[0178] In some embodiments, the funnel is biased to present an expanded state, wherein the mouth is wider than (i) the opening and edge and (ii) the mouth in a compressed state, and wherein the funnel defines: (a) a distal section that includes the mouth and is generally cylindrical, (b) a proximal section that includes the opening and is generally cylindrical, (c) an intermediate section that tapers gradually from the distal section to the proximal section to fluidly connect the distal section to the proximal section, and / or (d) a first scoop-shaped portion and an opposing scoop-shaped portion located at the mouth, extending distally from the distal section and opening away from the other scoop-shaped portion and away from the longitudinal axis.

[0179] According to some embodiments, an apparatus for removing emboli from a subject's cerebral artery is also provided, the apparatus comprising a flexible catheter, a funnel, a flexible rod attached to the proximal end of the funnel, and / or a handle at the proximal portion of the catheter.

[0180] In some embodiments, the catheter has (i) a proximal portion, (ii) a distal portion configured for transluminal advancement into a cerebral artery, the distal portion having an edge, and / or (iii) a lumen extending from the proximal portion to the edge.

[0181] In some embodiments, the funnel has (i) a mouth located at the distal end of the funnel and (ii) an opening located at the proximal end of the funnel.

[0182] In some implementations, the funnel is biased to present an expanded state, in which the spout is wider than the opening and edges.

[0183] In some implementations, the funnel can be elastically compressed into a compressed state, in which the spout is narrower than in the expanded state.

[0184] In some implementations, the rod is attached to the proximal end of the funnel and extends proximally through the conduit.

[0185] In some embodiments, the handle includes an unfolding knob operably coupled to a flexible rod so that the device can be manually operated to gradually transition between (i) a delivery state (in which the funnel is compressed within the catheter) and (ii) an unfolding state (in which the funnel is expanded and the nozzle is exposed from the distal portion of the catheter).

[0186] In some embodiments, the handle includes a sealer separate from the unfolding knob and configured to convert the device into a sealed state by retracting the funnel back into engagement with the edge seal, such that in the sealed state: (a) the funnel remains in the expanded state, and / or (b) the mouth of the funnel is fluidly connected to the lumen, such that suction applied through the lumen draws fluid into the funnel via the mouth.

[0187] According to some embodiments, a method for removing a real or simulated embolus from a real or simulated cerebral artery of a real or simulated object is also provided, the method comprising: (a) advancing a distal portion of a flexible catheter through a lumen into the cerebral artery while a funnel is compressed within the lumen of the catheter, the funnel being formed of a set of braided threads covered with a covering and having: (i) a mouth portion located at the distal end of the funnel, and (ii) a spoon-shaped portion located at the mouth portion and projecting distally, the spoon-shaped portion being defined by: (I) a first lateral flap formed by a bend in a first thread of the set of threads, and (II) a second lateral flap formed by a bend in a second thread of the set of threads. (III) An inner flap disposed between and overlapping the first and second outer flaps, the inner flap being formed by a bend in a third wire of the set of wires, the third wire being more flexible than the first wire and more flexible than the second wire, and / or (IV) an opening located at the proximal end of the funnel; (b) advancing the funnel from the distal portion of the catheter such that: (i) the funnel self-expands with the mouth wider than the distal portion and the opening, and (ii) the scoop portion dilates the artery in such a way that the scoop portion removes the embolus from the arterial wall; and / or (c) suction is applied through the lumen such that the suction draws the embolus into the funnel via the mouth portion.

[0188] A fuller understanding of the invention will be obtained from the following detailed description of its application, taken in conjunction with the accompanying drawings, in which: Brief description of the attached diagram

[0189] Figure 1 , Figures 2A-2F , Figures 3A-3C , Figures 4A-4B , Figures 5A-5B , Figures 6A-6B , Figures 7A-7B and Figures 8A-8B An apparatus for removing emboli from a subject's blood vessel using a funnel that can be advanced distally from a catheter of the device is shown; Figures 9A-9C and Figures 10A-10D Various mechanisms for maintaining a seal between the funnel and the conduit, according to some embodiments, are shown; and Figures 11A-11B and Figures 12A-12C Various methods and systems for adjusting the curvature of the distal portion of a conduit by applying an axial force to a rod attached to a funnel are shown for some applications. Detailed Implementation

[0190] Now for reference Figure 1 , Figures 2A-2F , Figures 3A-3C , Figures 4A-4B , Figures 5A-5B , Figures 6A-6B , Figures 7A-7B , Figures 8A-8B and Figures 9A-9C The document illustrates a device (e.g., system or apparatus) 100 for removing an obstruction 15 (e.g., embolus, thrombus, mass, clot, plaque, or any other obstruction) from a subject's blood vessels (e.g., from arteries, such as cerebral arteries, or from veins, such as cerebral veins). In some embodiments, the device 100 may be used to remove an embolus from a blood vessel (e.g., from an artery, such as cerebral arteries, peripheral arteries, and / or pulmonary arteries) or from a vein, such as cerebral veins, peripheral veins, and / or pulmonary veins). In other embodiments, the device 100 may be used to remove an embolus from any other blood vessel of the subject (e.g., from a blood vessel in the lungs, kidneys, or limbs of the subject). It should be understood that although reference numeral 15 is referred to as an embolus throughout the application, reference numeral 15 may similarly refer to another type of obstruction, such as a thrombus, mass, clot, plaque, or any other obstruction.

[0191] In some embodiments, device 100 can be used to remove masses, lumps, and / or obstructions from an organ. For example, device 100 can be used to remove kidney stones from a subject's kidney. In such embodiments, reference numeral 20 can therefore be understood to indicate any body cavity, not limited to blood vessels.

[0192] Device 100 includes a funnel 130, a flexible conduit 150, and a handle 120. The funnel 130 is used to receive (e.g., collect) an obstruction (e.g., an embolus) into the device. The funnel is advanceable from the flexible conduit 150. The handle 120 is used to control the advancement of the funnel distal to the conduit. The handle 120 also includes a fluid port 124 fluidly connected to the funnel 130 and adapted to receive a suction source 160 (e.g., a syringe or vacuum source) such that suction applied to the fluid port is delivered via the conduit 150 into the funnel to aspirate the embolus 15 into the funnel. In some embodiments, the suction source 160 may be operated via a foot pedal (e.g., by a user manually pressing a pedal to apply suction). In some embodiments, the suction source 160 is electrically operable, for example, including an electric pump.

[0193] The distal portion 152 of the catheter 150 is configured for placement within the funnel 130 in a delivery state (e.g., a compressed state) within the catheter (e.g., within its distal portion 152, such as...). Figure 2A As shown in the diagram, the fluid is propelled into the subject's blood vessel 20 via the cavity.

[0194] A flexible rod 132 is attached to the proximal end 1311 of the funnel and extends proximally through the conduit (e.g., through its lumen 156) to a handle 120, at which an unfolding knob 122 is operatively coupled to the rod. Operation (e.g., rotation) of the unfolding knob 122 pushes the rod 132 distally, thereby gradually changing the funnel 130 from a delivery state within the conduit 150 to an expanded state.

[0195] In some implementations, once the distal portion 152 has been advanced into the vessel 20 suspected of containing the embolus 15, the funnel 130 is partially extended from the catheter (e.g., to...). Figure 2B The state shown in the diagram allows the funnel's spout 133 to extend from the catheter, and suction is applied to the funnel via the lumen 156. Based on the resistance to suction experienced by the spout 133, it can be determined whether the funnel is close to the embolus 15, or whether further distal advancement of the catheter 150 is needed to achieve closer proximity to the embolus before the funnel 130 is fully extended and / or further suction is applied. If further distal advancement is determined to be needed, to prevent the funnel from contacting the vessel wall and thus interfering with distal advancement of the device through the vessel, the funnel 130 can first retract proximally back into the distal portion 152—for example, via an actuation (e.g., rotation) of the deployment knob in the opposite direction.

[0196] Once it has been determined that the mouth part 133 has contacted or is adjacent to the plug 15 ( Figure 2C As the funnel 130 expands from its distal portion 152, it transitions to its expanded state within the blood vessel. Therefore, the embolus 15 may be gradually trapped or captured within the funnel. In some embodiments, suction is applied via the fluid port 124 as the funnel 130 expands, so that the embolus 15 is aspirated into the funnel via the mouthpiece. Figures 2C-2F In this stage, in some cases, suction applied via suction source 160 may be sufficient to aspirate the plug 15 through lumen 156 into funnel 130, and along the catheter proximally until it reaches handle 120 (e.g., and optionally aspirated into suction source 160). Alternatively, in other cases, and as... Figures 2D-2FAs shown, the embolus 15 may be captured within the funnel 130 or at the mouth of the funnel 130 during or after the funnel unfolds, and the device 100 retracts from the blood vessel and the subject while the funnel remains unfolded from the distal portion and is sealed against the edge 158 of the catheter, thereby bringing the embolus back along the blood vessel. In this case, suction may be applied during the withdrawal of the device from the body (e.g., to ensure that the embolus remains captured by the funnel 130 and does not migrate elsewhere). The mouth 133 may advantageously be elliptical and / or circular, thus having an increased surface area, for example to increase the patency of the funnel and / or allow the embolus 15 to pass through it uninterruptedly. In some embodiments, and as will be explained in more detail below, the mouth 133 may maintain its elliptical shape when the funnel 130 unfolds from the distal portion 152.

[0197] In some embodiments, suction can be continuously applied through the lumen 156 as the funnel 130 unfolds from the distal portion 152. For example, once the mouthpiece 133 is connected to the plug 15 ( Figure 2C Upon contact, suction can be continuously applied through lumen 156 until catheter 150 is withdrawn from the subject. In some embodiments, suction is applied iteratively as the funnel unfolds. In some embodiments, suction is applied in a pulsed manner.

[0198] In some embodiments, the funnel 130 is configured to expand the wall of the blood vessel 20 by applying a radial expansion force to the wall of the blood vessel 20 (e.g., as shown in the figure). Figures 2D-2F (As shown in the diagram). In some such embodiments, the mouth 133 or the body of the funnel can be shaped to achieve this (e.g., as will be explained in more detail below). In some such embodiments, applying a radial expansion force to the vessel wall using the funnel can advantageously remove (e.g., release) the embolus from its lodged position within the vessel, thereby allowing the funnel to more easily capture the embolus therein.

[0199] In some embodiments, once the funnel 130 has at least partially deployed at the proximal edge of the embolus 15, to aid in embolus removal, a filament (e.g., a guide filament and / or microcatheter for guiding the advancement of the catheter 150) can be advanced distally from the catheter 150 and the funnel 130 and through the embolus, such that the filament passes through the embolus and reaches the distal side (e.g., distally) of the embolus. In some such embodiments, the filament can deploy a stent retriever distal to the embolus. In some embodiments, the stent retriever can be used to pull the embolus toward or into the mouth 133 of the funnel.

[0200] In some embodiments, the funnel 130 advantageously provides a seal (e.g., a plug) to the blood vessel 20 proximal to the embolus 15 (e.g., when the embolus is drawn into the funnel 130), thereby preventing small fragments of the embolus from migrating downstream (e.g., proximal).

[0201] In some embodiments, to aid in the removal of the embolus 15 from the wall of the vessel 20, an embolus-breaking device passes through the working channel of device 100 (e.g., through lumen 156 and funnel 130) and enters the embolus through nozzle 133. The embolus-breaking device may be a vibrating element, an ultrasonic device, a heating element, and / or a laser applicator. The embolus-breaking device may be adapted to apply energy to break the embolus into smaller fragments, thereby removing the embolus from the vessel wall and allowing it to be aspirated into funnel 130. In some embodiments, the embolus-breaking device may apply an energy pulse to the embolus to break it up. In some embodiments, funnel 130 advantageously provides a seal (e.g., a plug) to the vessel 20 proximal to the embolus 15 (e.g., when the embolus is broken into fragments by the clot-breaking device), thereby preventing small fragments of the embolus from migrating during embolus breaking. Funnel 130 may provide a complete or partial seal (e.g., thereby allowing some blood to flow around the funnel).

[0202] Figures 3A-3C Various views of the funnel 130 are shown, with particular emphasis on the braided arrangement of the funnel and its spout 133. In some embodiments, the funnel 130 is formed of a set of braided threads 136 biased to present an expanded state in which the spout 133 is wider than the opening 131 at the proximal end 1311 of the funnel, and resiliently compressible to a compressed state in which the spout is narrower than in the expanded state. The threads 136 may comprise hyperelastic or shape-memory materials, such as polymers or metal alloys, such as nitinol. In some embodiments, the threads 136 may comprise other materials, such as fabrics (e.g., laser-perforated fabrics), threads, and / or polymers. The funnel 130 (e.g., its threads 136) may be covered by a cover (e.g., a sheath) 1300, such as... Figure 1 As shown in the diagram. The cover 1300 may be a polymer cover. In some embodiments, the cover 1300 defines a plurality of holes therein, for example, such that the cover does not completely seal the wire 136. This can prevent the funnel from losing its patency during suction, for example, by preventing radial inward kinking and / or collapse of the funnel. In some embodiments, the cover 1300 does not define a plurality of holes therein, for example, such that the cover completely seals the wire 136.

[0203] In some embodiments, to achieve the required flexibility of the funnel 130 while ensuring it has the strength required for removal from the blood vessel 20 and scooping out the embolus 15, wires of varying stiffness are used to provide rigidity and flexibility to the funnel. For example, in some embodiments, the wire near the mouth 133 is more rigid than the wire proximal to provide a flexible funnel with a rigid and therefore stronger mouth. In some embodiments, an alternating pattern of rigid / less rigid wires can be used to provide both the required strength and flexibility.

[0204] In some embodiments, the mouth portion 133 can be specifically designed to grasp or remove the embolus. For example, the funnel 130 (e.g., its braided thread 136) defines a distally projecting spoon-shaped portion 137 at the mouth portion 133 to aid in removing the embolus from the wall of the blood vessel and scooping it into the funnel 130. Figure 3C As shown, the spoon-shaped portion 138 may define a first outer lobe 1372 formed by a bend in a first wire 1376 of a set of wires 136, a second outer lobe 1374 formed by a bend in a second wire 1378 of the same set of wires, and an inner lobe 1373 disposed between and overlapping the first and second outer lobes. In some embodiments, the inner lobe 1373 is formed by a bend in a third wire 1377 of the same set of wires, the third wire being more flexible than the first wire 1376 and more flexible than the second wire 1378. In some embodiments, the spoon-shaped portion 137 is formed by exactly three lobes, for example, as described above and as shown in the figure, for example, the spoon-shaped portion does not include other lobes.

[0205] In some embodiments, for each of the first lobe 1372, the second lobe 1374, and the inner lobe 1373, the corresponding thread defines two tails that diverge from each other away from the bend, extending along the funnel toward the opening 131 in opposite helical chirality. For example, the thread 1378 of the second lobe 1374 defines two tails—an inner tail 1378a extending away from the bend to overlap with the inner lobe 1373 and spirally extending along the funnel toward the mouth, and an outer tail 1378b extending away from the bend and the inner lobe and spirally extending along the braid toward the opening and the inner tail. The thread 1376 of the first lobe 1372 defines similar outer and inner tails.

[0206] In some embodiments, the set of wires 136 includes at least one corresponding lobe support wire (e.g., exactly two lobe support wires 1371, 1379) for each of the outer lobes 1372, 1374, each lobe support wire defining a loop that surrounds the outer tail of the corresponding outer lobe 1372, 1374 at the mouth to support the corresponding outer lobe. In some embodiments, and as... Figure 3BAs shown, for each of the petal support wires 1371, each petal support wire defines a pair of tails 1371a, 1371b that extend proximally away from the ring and spirally along the funnel toward the opening. In some embodiments, and as shown, for each of the petal support wires, the tails in the pair extend parallel along the funnel toward the opening and have the same spiral chirality as each other. In some embodiments, and as shown, the tails in each pair extend parallel and have the same spiral chirality as the tails in the other pair. In some embodiments, for each of the outer petals 1372 and 1374, the ring of the more distal petal support wire 1371 is stiffer than the ring of the more proximal petal support wire 1379. The spoon-shaped portions 137 (e.g., petals 1372, 1373, and 1374) generally flare outward and away from the central longitudinal axis ax1 of the funnel.

[0207] In some embodiments, lobes 1372, 1373 and 1374, as well as additional lobe support wires 1371 and 1379, extend spirally from the mouth portion 133 toward the proximal end 1311. Figure 3A The funnel 130 is shown with Figure 3C The side opposite to the side shown in the diagram illustrates the relationship between the funnel and... Figure 3C The aforementioned lobes / wires of a septet (e.g., a group of seven wires) 1365 are formed on opposite sides of the diagram. These lobes / wires extend spirally along the funnel towards the proximal end 1311, while remaining parallel to each other. The septet 1365 can be composed sequentially of wires 1378b, 1377, 1376, and two pairs of supporting wires 1371 and 1379, respectively. That is, the septet 1365 is formed by a single rigid wire 1378b, which is separated from the group of three rigid (e.g., more rigid or thicker) wires 1376, 1371a, 1371b by a single intervening flexible wire 1377. A pair of more flexible wires 1379 extend parallel to the group of three rigid wires from the proximal side of the group. In some embodiments, there is more than one intervening flexible wire. In some embodiments, no other rigid wires are used besides the rigid wires described above. In some embodiments, other rigid wires are incorporated within the braided arrangement to provide stiffness and / or strength to the funnel 130.

[0208] In some implementations, and as such Figure 3AAs shown, the funnel 130 has opposing spoon-shaped portions 138, which are opposite to spoon-shaped portions 137 at the mouth portion 133. The opposing spoon-shaped portions 138 may protrude distally, but are generally shorter than the spoon-shaped portions 137 (so that the spoon-shaped portions 137 protrude distally beyond the opposing spoon-shaped portions), for example, so that the mouth portion 133 has an oval shape.

[0209] In some embodiments, the opposing spoon-shaped portions 138 are defined by at least two arcuate wires 1381 and 1382 from a set of wires 136, each arcuate wire forming a partial arcuate portion around the mouth, as shown, these arcuate portions overlapping each other. In some embodiments, the opposing spoon-shaped portions 138 are formed by two pairs of parallel arcuate portions (or herringbone portions): 1382 and 1384 and 1381 and 1383, these arcuate portions pointing distally, respectively positioned on either side of the symmetry line s1 of the funnel (e.g., on opposite sides of the symmetry line s1) – for example, as Figure 3A As shown. In some embodiments, the opposing spoon-shaped portions 138 further include a central arcuate portion (or herringbone portion) 1389 disposed on and / or centered on the wire s1. The central arcuate portion 1389 may be proximal to the arcuate portions 1381, 1383, 1382, and 1384. This arrangement of the wire within the opposing spoon-shaped portions 138 can provide advantageous characteristics and / or behavior to the opposing spoon-shaped portions. For example, compared to other arrangements of the wire, this arrangement of the wire can cause the opposing spoon-shaped portions 138 to protrude further distally when the funnel 130 expands only partially (e.g., see...). Figures 2B-2C This can provide the mouthpiece 133 with a shape that, when the funnel 130 partially expands, is more rounded and / or otherwise better suited to engaging (e.g., sealing against) the plug 15, thereby providing improved suction—for example, compared to the angled (and potentially narrow) oval shape the mouthpiece might present without such an opposing spoon-shaped portion. (See reference...) Figures 2C-2E During the described steps, this optimal engagement and / or sealing of the abutment 15 may be particularly advantageous.

[0210] In some embodiments, at least one of the spoon-shaped portions 137 and / or the opposing spoon-shaped portions 138 opens away from the other spoon-shaped portion and away from the longitudinal axis ax1. In some embodiments, and as... Figures 2D-2F As shown, the spoon-shaped portions 137 and 138 facilitate the removal of the embolus 15, for example, by keeping the embolus away from the wall of the blood vessel 20, and / or by extending around the embolus so that the mouth portion 133 can enclose the embolus therein. In some embodiments, only the spoon-shaped portion 137 opens outward at the mouth portion (e.g., other wires at the outer periphery of the spoon-shaped portion 138 and the mouth portion 133 do not open outward). In some embodiments, only the spoon-shaped portions 137 and 138 open outward at the mouth portion (e.g., the portion of the mouth portion 133 between the two spoon-shaped portions does not open outward).

[0211] In some implementations, and as such Figure 1 As shown, at least one imaging marker 1337 is disposed at the mouth 133, for example, to provide an indication of the expansion of the mouth from the distal portion 152 and / or near the embolus 15. In some embodiments, the imaging marker 1337, or a pair of imaging markers, is mounted on at least one of the lateral flaps 1372, 1374. In some such embodiments, expanding the funnel 130 from the distal portion 152 allows the imaging markers 1337 to separate from each other, thereby providing an indication of the position of the funnel 130 (e.g., and specifically its mouth 133) within the blood vessel 20. For example, determining the distance between two imaging markers 1337 can provide the user with an indication of the degree of expansion of the funnel 130 (e.g., its mouth 133) within the blood vessel.

[0212] Figures 4A-4B The funnel 130 is shown in its expanded state. Figure 4B A view of funnel 130 is shown, which is already relative to... Figure 4A The view shown is rotated 90 degrees, with catheter 150 partially removed. In some embodiments, and as... Figure 4A As shown, the funnel 130 defines (i) a distal section 1301 including a spout 133 and generally cylindrical, (ii) a proximal section 1303 including an opening 131 and generally cylindrical, and (iii) an intermediate section 1302 that tapers gradually from the distal to the proximal section to fluidly connect the distal section to the proximal section. In some embodiments, a spoon-shaped portion 137 (and optionally an opposing spoon-shaped portion 138) extends distally from the distal section to open away from each other and away from the longitudinal axis ax1. In some embodiments, this particular shape of the funnel 130 (e.g., cylindrical-conical-cylindrical-opening shape) advantageously helps to maintain the patency of the funnel during aspiration. In some embodiments, this shape advantageously allows the funnel to exert a radial expansion force on the wall of the vessel during expansion within the arm of the vessel, thereby facilitating the removal of clots.

[0213] In some embodiments, the braided wire 136 converges at the proximal end 1311 of the funnel 130 into an elliptical ring 1312 that defines the opening 131 as an elliptical opening. In some embodiments, and similar to that described with reference to the mouthpiece 133, having an elliptical opening at the proximal end increases the cross-sectional area of ​​the opening, thereby allowing for better funnel patency and less obstruction when the plug 15 passes through. In some embodiments, the elliptical ring 1312 is reinforced with wire near the outer proximal end 1311; for example, reference numeral 1312 can be understood as pointing to the reinforcing wire. In some embodiments, the elliptical ring 1312 (e.g., the reinforcing wire 1312) is covered with a polymer coating 135 that reinforces the opening. The polymer coating 135 may be separate from the polymer covering 1300 of the funnel 130 (e.g., composed of a different material and / or having an increased thickness).

[0214] The polymer coating and / or filament 1312 can help maintain the patency of the proximal end 1311 and / or prevent slippage between the braided filaments 136 at the proximal end during aspiration and unfolding of the funnel from the catheter. In some embodiments, the polymer coating 135 and / or filament 1312 facilitate the ejection of the funnel 130 from the distal portion 152 by inhibiting radial expansion of the funnel against the inner surface of the catheter 150 (which can occur during the ejection of the funnel from the catheter) and / or by inhibiting buckling (e.g., collapse) of the proximal portion of the proximal end 1311 during pushing and / or aspiration.

[0215] In some embodiments, the elliptical opening 131 has a major axis ax2 inclined relative to the longitudinal axis ax1. The elliptical opening 131 has a distal vertex 1316 on the major axis ax2 located on a first side of the longitudinal axis ax1 and a proximal vertex 1315 located on the major axis, and the elliptical opening 131 is positioned on the side of the longitudinal axis opposite to the distal vertex, close to the distal vertex. The rod 132 can be attached to the proximal end 1311 of the funnel by attaching it to the elliptical opening 131 at the proximal vertex 1315.

[0216] In some implementations, and as such Figure 2E and Figure 2F As shown, when the funnel is sealed to the distal portion 152 (e.g., within the edge 158), the polymer coating 135 fits snugly within the distal portion of the conduit, thereby providing a seal between the two components, the funnel and the distal portion 152.

[0217] In some embodiments, the conduit 150 includes a thiocyanate tube and a polymer coating on the thiocyanate tube. In some embodiments, the polymer coating of the conduit extends beyond the thiocyanate tube to define an edge 158. In some embodiments, the edge 158 flares outward away from the thiocyanate tube such that the opening section of the funnel (e.g., the middle section 1302 or coating 135) can be located close to the edge.

[0218] Now for reference Figures 5A-5B , Figures 6A-6B , Figures 7A-7B , Figures 8A-8B and Figures 9A-9C They show the handle 120 in more detail.

[0219] like Figure 1 As shown, the rod 132 is flexible and can move freely within the lumen 156 (e.g., not within the side lumen of the catheter 150). Therefore, the distal push of the rod 132 via the actuation of the release knob 122 can introduce relaxation into the rod—for example, within the lumen 156, the rod can take on a serpentine or sinusoidal shape.

[0220] In some embodiments, the handle 120 includes a component or mechanism 126 that pulls the funnel 130 into and / or retains it in a sealing engagement with the distal portion 152 by moving the lever 132 proximally, tightening slack on the lever, and / or by applying tension to the lever. Thus, the component / mechanism 126 may be referred to as a sealer 126 (i.e., pulling the funnel 130 into the sealing engagement) or a stabilizer 126 (i.e., stabilizing the device 100 in its unfolded state with the funnel in the sealing engagement). Nevertheless, for simplicity, the name "sealer" is generally used for this component throughout the specification.

[0221] In some embodiments, the seal 126 passively holds the device in a sealed engagement, for example, by applying and / or maintaining tension on the rod 132. In some such embodiments, the seal 126 may be a spring-loaded mechanism. In some embodiments, the seal 126 may apply a predetermined amount of tension or proximal movement to the rod 132 whenever the rod is advanced distally, or may tighten the rod 132 by a predetermined amount of slack, for example, as referenced. Figures 10A-10D As described.

[0222] Figures 9A-9C An embodiment in which the sealer 126 is a component on the handle 120 is shown, and the sealer 126 can be actuated independently of the unfolding knob 122. Figure 9A The device 100 is schematically shown in its delivery state, for example, as if the distal portion 152 of the catheter 150 has just reached the blood vessel. Figure 9BThe diagram schematically shows the device 100 after the funnel 130 has been deployed by the push rod 132, thereby introducing relaxation into the rod.

[0223] In some embodiments, the sealer 126 includes a button, slider, knob, or any other actuator that can be manually operated to apply tension to the rod 132. In some such embodiments, once the user pushes the funnel 130 from the distal portion 152 ( Figure 9B ), and optionally, before applying suction, the seal 126 is actuated (e.g., pressed, rotated, and / or slid) to tighten the slack in the rod 132 and / or apply tension to the rod 132. Figure 9C This can advantageously maintain a sealed engagement between the proximal end 1311 and the distal portion 152 (e.g., within its edge 158), even if the device 100 is later retracted from the subject. In the event that the funnel 130 has lost its sealed engagement with the catheter 150 (e.g., during its advancement from the catheter), the actuating sealer 126 can draw the proximal end 1311 of the funnel 130 proximally to form a sealed engagement with the catheter.

[0224] In some embodiments, the seal 126 is operatively coupled to the release knob 122 such that actuation of the seal locks or inhibits further operation of the release knob (e.g., thereby inhibiting further distal pushing of the lever 132). This can advantageously prevent the funnel 130 from disengaging from the sealed engagement with the conduit 150, for example, due to accidental movement of the knob 122 during plug retraction. In some embodiments, further operation of the release knob 122 is possible once the seal 126 has been actuated, but can be accomplished simply by applying a predetermined amount of force and / or actuation to the release knob, for example, to overcome the locking mechanism between the seal and the knob.

[0225] In some embodiments, the handle 120 includes a drive wheel 129 that engages with the lever 132, the drive wheel being operably coupled to the knob 122 (e.g., via a gear mechanism), such that rotating the knob in a first knob direction causes the drive wheel to move in a forward drive wheel direction. Figure 9B The device 100 is rotated on the surface, thereby pushing the lever to the distal end to gradually change the device 100 from the delivery state to the unfolded state (e.g., as the funnel 130 is in the middle of the delivery state). Figure 9A and Figure 9B (As shown in the transitions between). In some embodiments, and as illustrated, the drive wheel 129 defines or serves as a roller through which the rod passes tangentially. Alternatively, the drive wheel 129 may serve as or define a spool (e.g., around which the rod is wound) or a winch (e.g., around which the rod is bent).

[0226] In some embodiments, the complementary roller 1291 is positioned on the side of the rod 132 opposite to the drive wheel 129 to maintain contact / clamping between the drive wheel and the rod. The complementary roller 1291 may be spring-loaded, for example, as shown. The complementary roller 1291 may be a passive roller that rotates in response to axial movement of the rod 132.

[0227] In some embodiments, the drive wheel 129 includes drive wheel teeth 1271 or is rotatably fixed to drive wheel teeth 1271, which may be circumferentially distributed around the cogwheel 127. The seal 126 may have seal teeth 1261 (e.g., linearly distributed on the inner portion 125 of the seal), such that actuating the seal (i) engages the seal teeth with the drive wheel teeth 1271 and (ii) causes the cogwheel and drive wheel to move in opposite directions ( Figure 9C The seal 126 moves along the gear 1271. In some embodiments, and as shown, actuation of the seal 126 (i) causes the seal teeth 1261 to engage with the drive wheel teeth 1271 in a rack and pinion arrangement, and (ii) via operation of this rack and pinion arrangement, moves the gear and the drive wheel in opposite directions. For example, and as shown, actuation of the seal 126 can cause the seal teeth 1261 to move along the tangent of the gear 127.

[0228] Spring 1267 can push seal 126 outward ( Figure 8B This prevents the seal from accidentally engaging with the drive wheel 129 (e.g., its gear 127). In such an embodiment, actuating the seal causes the spring 1267 to strain (e.g., compress).

[0229] In some embodiments, and as described above, once there is engagement between the sealer tooth 1261 and the drive wheel tooth 1271 (e.g., once the sealer 126 has been activated), further advance of the rod and funnel via the deployment knob 122 can be prevented. Figure 9C That is, the engagement between the sealer tooth 1261 and the drive wheel tooth 1271 can be stabilized by the movement of the inhibition rod and the funnel relative to the distal side of the conduit to ensure a secure seal between the funnel 130 and the distal portion 152.

[0230] Additionally or alternatively, actuating the seal 126 may engage a stop 1255 disposed on the seal 126 with a tab 1269 or recess disposed within the handle, thereby stabilizing the device in a sealed state by preventing the stop and thus the seal from returning to its unactuated state, thereby inhibiting distal movement of the rod 132.

[0231] In some embodiments, the funnel 130 can be re-advanced by reversing or overcoming the seal after the seal 126 has been actuated. In the example shown, this is achieved simply by operating the unfolding knob 122 in the first knob direction, thereby rotating the drive wheel 129 (and gear 127) in the forward drive wheel direction. This thereby pushes the seal tooth 1261 out of engagement with the drive wheel tooth 1271. In embodiments where the handle 120 includes a spring 1267, this disengagement trigger spring responsively pushes the seal tooth 1261 away from the drive wheel tooth 1271, thereby pushing the seal 126 outward from the housing. In embodiments where the handle 120 includes a stop 1255, this rotation of the drive wheel 129 also overcomes the stop. A predetermined amount of force and / or rotation of the knob may be required to achieve this disengagement.

[0232] It should be understood that although the seal 126 is a separate component of the unfolding knob 122, the two components are interconnected. For example, as shown, actuation of the seal 126 reverses the drive wheel 129 (to which the unfolding knob 122 is rotatably coupled), and may even cause rotation of the unfolding knob itself. Therefore, this independence (e.g., separation) between the two components means that the seal is a separate component that can be actuated without contacting the unfolding knob.

[0233] In some embodiments, the handle 120 is configured to limit the distal advancement of the rod 132 in a manner that provides a predetermined limitation on the distal advancement of the funnel from the distal portion 152 of the conduit 150. For example, as Figures 9A-9C and Figure 6B As shown, the handle 120 may include a stop 123 to prevent excessive distal advancement of the rod 132. The rod 132 may have a stop 139 at its proximal portion, such that excessive distal advancement of the rod, and thus the funnel 130, causes the stop to abut the stop 123. This advantageously prevents the funnel from losing its sealing engagement with the conduit by preventing the funnel from dislodging from the conduit due to excessive advancement of the rod and / or by preventing the rod from becoming excessively loose and thus allowing the funnel to slide distally within the conduit. In some embodiments, a predetermined limit to the distal advancement of the rod 132 forced by the stop 123 is associated with the degree to which the seal 126 moves the rod 132 proximally. For example, in the case where the conduit and / or the rod 132 is compressed and thus shortened, the stop 123 may allow the proximal end 1311 of the funnel 130 to displace the conduit by a predetermined amount, and the seal 126 may move the rod proximally to a similar or the same degree as that predetermined amount.

[0234] Now for reference Figures 10A-10D The illustration shows a sealer / stabilizer 126a according to some embodiments, which can be considered a variation of sealer 126. Sealer 126a is typically housed within or located near handle 120.

[0235] The seal 126a includes a pair of grippers 1262, which are optionally slidably housed within a housing 1268. The housing 1268 is adapted to limit the amount of movement of the grippers proximally and distally. The grippers 1262 grip a rod 132 (e.g., by clamping the rod between the grippers). A pair of springs 1266 can be positioned on opposite sides of each end of the grippers 1262 to push (e.g., push) the grippers toward the rod 132. Figure 10B As shown, moving the lever distally (e.g., pushing) (e.g., by rotating the unfolding knob 122, which then rotates the drive wheel 129 to push the lever distally) causes the gripper 1262 to slide distally (e.g., roll) within the housing 1268 while gripping the lever. As shown, a pair of springs 1264 connect the distal wall of the housing 1268 to the gripper 1262, such that this distal movement of the gripper 1262 toward the distal wall causes the springs to become compressed. Figure 10C As shown, once the spring 1264 is fully compressed, further distal movement is impossible, and further distal movement of the lever 132 (e.g., via rotation of the unfolding knob, which in turn rotates the drive wheel 129) only causes the lever 132 to roll (e.g., slide) through the clamp 1262 without causing further distal movement of the clamp. The drive wheel 129 (e.g., together with the opposing passive drive wheel on the opposite side of the lever) can apply a stronger force on the lever 132 than the clamp 1262, thereby allowing the lever to roll or slide through the clamp. As described above, distal movement of the lever 132 advances the funnel 130 distally from the distal portion 1152, thereby unfolding the funnel within the blood vessel.

[0236] like Figure 10D As shown, once the user stops applying a distal force to lever 132 (i.e., when manual operation of the unfolding knob ceases), spring 1264 expands freely, thereby pushing gripper 1262 proximally (e.g., until the gripper contacts the proximal wall of housing 1268 and / or until the spring is fully expanded). This proximal movement of gripper 1262 pulls (e.g., drags) lever 132 proximally. In some cases, and as with lever 132 in... Figure 9B and Figure 9C As shown in the transition, this proximal movement of rod 132 can simply tension the rod, thereby increasing the stability of the device by ensuring that the rod does not become excessively slack, which could cause the funnel to slide distally out of the distal portion 152. In some embodiments, this proximal movement of rod 132 can cause the funnel 130 to move proximally within the conduit 150, which can return the proximal end 1311 of the funnel to a sealing engagement with the distal portion 152 if the funnel inadvertently leaves the conduit and loses its seal with the distal portion 152.

[0237] Therefore, the sealer / stabilizer 126 is manually operated, while the sealer / stabilizer 126a is automatically operated when the manual operation is stopped and / or when the unfolding knob is released.

[0238] The handle 120 can be designed to provide optimal accessibility to the user (e.g., the physician) during embolus removal surgery. For example, as... Figures 5A-7B As shown, in some embodiments, the handle 120 has a flat base 128 for resting on a surface such as a bed or patient during surgery. In some embodiments, the handle 120 has a foot 1281 that protrudes to define at least a portion of the flat base 128 to further increase the stability of the handle. That is, the foot 1281 extends to define an extension of the flat base.

[0239] In some embodiments, the base of the catheter 150 (e.g., proximal end 159) is attached (e.g., welded or connected) to the handle 120, for example, as... Figure 6B As shown in the figure. The proximal end 159 can be attached to the handle at the distal portion of the handle 120, for example, as shown.

[0240] In some embodiments, the sealer 126 is a button on the handle facing the distal side, for example, it may be parallel to the conduit 150, as shown.

[0241] The knob 122 can be a finger wheel mounted on a handle (e.g., on the side of the handle opposite to the base 128, or laterally mounted on the handle), allowing the user to easily position their thumb or finger on the finger wheel when the base rests on a surface (e.g., the proximal end 159 of the conduit extends between the user's fingers). That is, the handle 120 can be shaped to be gripped by the user's hand, with the conduit extending between the user's fingers and away from the handle. In some embodiments, the knob 122 is a knob, slider, button, and / or actuator. In some embodiments, the knob may not be manually actuated via the knob 122; instead, it can be replaced by an electrically (e.g., via a motor) driven drive wheel actuator (e.g., a button) that drives the drive wheel 129. That is, the drive wheel 129 can be actuated via a motor to push the lever 132 distally. In some such embodiments, the drive wheel actuator can be robotically actuated; for example, a funnel can be advanced from the conduit 150 via a robotic controller. In some embodiments, the seal 126 may not be manually actuated; instead, it can be replaced by a seal actuator (e.g., separate from the drive wheel actuator) that drives the aforementioned motor to apply tension to the rod 132 and / or drives the drive wheel 129 to move the rod proximally. In some such embodiments, the seal-actuator applies tension until any excess slack within the rod is consumed (e.g., until the rod 132 is tensioned). In some embodiments, actuating the seal actuator locks the motor. In some embodiments, the seal actuator and / or drive wheel actuator may be robot-actuated, voice-operated, actuated by pressing a button on a user interface, and / or operable via a foot pedal.

[0242] In some such embodiments, the connection between the unfolding knob 122 and the lever 132 ensures that the funnel 130 is stable during the movement of the catheter 150 and / or the handle 120 during the procedure (e.g., unintentionally or intentionally), i.e., the funnel does not move distally or proximally relative to the catheter without intentional rotation of the finger wheel.

[0243] In some implementations, and as such Figure 6B As shown, a rod 132 extends proximally from the lumen 156 through the handle, where it engages with the release knob 122 (e.g., via drive wheel 129) and further proximally through the handle, with the rod 132 extending beyond the proximal end of the handle, for example parallel to the fluid port 124. In some such embodiments, the rod is housed in a housing 121 on the side of the handle opposite the conduit. In some embodiments, a stop 123 may be housed within the housing 121, for example, such that the stop 139 does not extend through the body of the handle 120. In some such embodiments, the stop 123 is positioned proximally to the body of the handle 120, for example, the stop is sized not to extend through the body of the handle.

[0244] In some embodiments, the fluid port 124 is positioned proximally on the handle, for example, beside and parallel to the housing 121, and fluidly connected to the lumen 156 via a fluid lumen 1242 extending inwardly toward the conduit 150 from the inside of the handle, for example, as... Figure 6B As shown in the image.

[0245] Refer again Figures 1 to 10D In some embodiments, catheter 150 (e.g., its distal portion 152) is actively steerable (e.g., via a pull cord embedded in the catheter wall). In some embodiments, catheter 150 (e.g., its distal portion 152) is passively steerable (e.g., not actively steerable). In some embodiments, before advancing catheter 150 into the subject, a guide cord is first advanced through handle 120 (e.g., through fluid port 124 and lumen 1242) into the lumen 156 of the catheter and into the subject's vascular system (e.g., into the femoral artery or vein, or the carotid artery or vein). In this way, the guide cord can be used to guide catheter 150 along the vascular system. In some embodiments, a microcatheter is additionally passed through a lead and through the catheter, such that the microcatheter further assists in guiding catheter 150 toward blood vessel 20. In some embodiments, the lead and / or microcatheter guides catheter 150 10-20 cm.

[0246] In some embodiments, the stiffness and / or width of the catheter 150 gradually decreases distally. That is, the catheter may be more flexible and / or thinner toward the distal portion 152 or at the distal portion 152 to increase the flexibility and maneuverability of the distal portion of the catheter into increasingly narrow blood vessels. In some embodiments, the distal portion 152 is more flexible than the stiffer proximal portion 151 of the catheter. In some such embodiments, the distal portion 152 may be approximately 20 cm, and the proximal portion 151 may be approximately 100 cm.

[0247] In some embodiments, the stiffness and / or width of the rod 132 decreases distally along its length, making the rod more rigid toward the handle 120 and more flexible toward the funnel 130. In some embodiments, this increased stiffness proximal is provided by the rod 132, which has an increasingly larger cross-sectional area along its length. In some embodiments, the rod 132 has a generally circular cross-section (e.g., as shown in the image). Figure 1(As shown in the diagram). In some embodiments, this increased proximal stiffness of rod 132 is provided by rods that define various geometric cross-sectional shapes along their length. For example, different cross-sectional shapes can provide different stiffnesses for the rod. In some such embodiments, rod 132 may have triangular, square, oval, or any combination thereof cross-sections along different segments of its length to provide these varying (e.g., gradually increasing) stiffnesses. In some such embodiments, the cross-sectional area of ​​the rod does not necessarily vary significantly along its length. In some such embodiments, the cross-sectional area of ​​the rod does indeed vary proximally (e.g., increase) along the length of the rod. In some such embodiments, the stiffness of the rod increases proximally in association with the stiffness of the conduit; for example, as the conduit becomes more rigid and / or has a diameter that expands toward the proximal end 159, the stiffness and / or diameter of the rod increases accordingly.

[0248] In some embodiments, to provide optimal flexibility to the distal portion 152 during catheter advancement through the vascular system, the funnel 130 is initially positioned proximally from the distal portion 152, for example, constrained within the lumen 156 20-50 cm proximally from the edge 158. This allows the distal portion 152 to navigate more easily through the tortuous vascular system, for example, by allowing greater control over the curvature of the vascular system.

[0249] Now for reference Figures 11A-11B and Figures 12A-12C This illustrates various methods and systems for adjusting the curvature of the distal portion according to some applications. During catheter advancement toward the embolus 15, it may be necessary to deflect or bend the distal portion to steer the catheter toward the vessel 20 in which the embolus 15 is located. For example, if the distal portion is proximal to a fork in the vascular system, it may be desirable to bend or deflect the distal portion toward the specific vessel in which the fork is suspected to be in which the embolus 15 is located. In some embodiments, and as described above, the catheter 150 may be manufactured such that the distal portion 152 is more flexible than the more proximal portion of the catheter, for example, to facilitate such steer. The distal portions 152a and 152b may be variations of the distal portion 152 or substantially identical to it. It should be understood that the catheter 150 may be modified to have distal portions 152a and / or 152b.

[0250] In some implementations, and as such Figures 11A-11B As shown, rod 132 extends eccentrically within lumen 156, such that pushing the rod distally within the lumen and the funnel through the rod (e.g., and the funnel together with it) applies an eccentric compressive force (e.g., as in...) to the conduit. Figure 11A and Figure 11B(as shown in the transition between) thus increasing curvature. In some embodiments, the rod 132 extends eccentrically within the lumen 156 because the rod is connected at a proximal apex 1315 to a proximal end 1311, for example, eccentrically connected to the funnel 130 (e.g., as shown in the transition between). Figure 4B (As shown in the diagram). Retracting the rod 132 and funnel 130 proximally within the lumen 156 can straighten the distal portion 152a, for example, thereby reducing the curvature of the distal portion.

[0251] The user can choose to rotate the distal portion to achieve a desired angle of the distal portion 152a relative to the vascular system. In some embodiments, this is done before advancing the funnel distally within the distal portion (e.g., before increasing the curvature of the device). In some embodiments, this is done after advancing the funnel distally within the distal portion.

[0252] Figures 12A-12C An embodiment in which the distal portion 152b is biased toward a bent state is shown. For example, the distal portion 152b can be shaped (e.g., thermally set) to have a pre-bent form. In some such embodiments, pushing the funnel in its compressed state distally within the distal portion of the catheter reduces the curvature of the catheter (e.g., straightens the catheter, as the distal portion 152b is in...). Figure 12B and Figure 12A As shown in the transition between them), and pulling the funnel proximally increases the curvature of the catheter (as shown in the distal portion 152b). Figure 12A and Figure 12B (As shown in the transition between). That is, the funnel 130 can function like a spine, hardening the distal portion when the funnel is positioned within it. For example, as a larger extent of the funnel 130 is positioned within the distal portion 152, the distal portion becomes harder and / or has a reduced curvature.

[0253] like Figure 12C As shown, the user can select to rotate the distal portion to achieve a desired angle of the distal portion 152b relative to the vascular system. In some embodiments, this is done before advancing the funnel distally within the distal portion. In some embodiments, this is done after advancing the funnel distally within the distal portion.

[0254] Refer again Figures 1 to 12CIn some embodiments, device 100 can be used as a flow restriction and / or stabilization device during treatment of a subject. For example, the device can be used as part of a delivery system during medical procedures, rather than for removing an obstruction from a blood vessel. As described above, funnel 130 can be designed such that expanding the funnel within a blood vessel obstructs (e.g., partially and / or completely obstructs) blood flow through it. Similarly, funnel 130 can be designed such that expanding the funnel within a blood vessel stabilizes catheter 150, for example, by pressing the funnel 130 against the vessel wall and preventing the device from sliding distally and / or proximally. In some embodiments, device 100 can be used during procedures involving the implantation of an occluder (e.g., a coil and / or bead) into a blood vessel (e.g., during treatment of an aneurysm, arteriovenous malformation, and / or hemorrhagic stroke). In some such embodiments, the occluder delivery device is directed through the working channel of device 100 (e.g., through lumen 156 and funnel 130, and exiting through mouth 133) and toward the treatment site. In some such embodiments, the device 100 can be positioned proximally from the treatment site, for example, such that the mouth 133 faces the treatment site but is positioned proximally. During treatment (e.g., during implantation of an occluder within the treatment site), the occluder delivery device can, for example, rebound proximally in response to a distal force exerted by the delivery of the occluder. The funnel 130 can prevent this rebound effect, for example, due to the stable presence of its abutment against the wall of the blood vessel. Similarly, if the occluder migrates downstream (e.g., proximally) during treatment, the funnel 130 will advantageously hold the occluder and prevent it from becoming lodged within the blood vessel. This can be particularly advantageous if the occluder is a drug delivery device (e.g., for delivering radioactive and / or chemical drugs to the treatment site). In some embodiments, the funnel 130 only partially obstructs the blood vessel; for example, it allows some blood to flow through the funnel.

[0255] This disclosure includes different variations of some elements. Variations of a given element generally have the same structure and / or function as each other, except for any differences described. For any given element for which different variations are disclosed, the same name is used for each variation in order to indicate that they are actually variations of the same given element. Unless otherwise stated, application of the devices, systems and techniques described herein may include any arrangement in which one variation of an element is replaced by another variation of that element with the same name. Furthermore, throughout the figures, suffixes are used to denote different variations of the same element. Unless otherwise stated, these variations may be substituted for each other with necessary modifications. That is, unless otherwise stated, any element with a given figure reference numeral may be replaced by any other element with the same figure reference numeral (i.e., any other variation of that element), regardless of any suffix.

[0256] To avoid unnecessary confusion caused by too many reference numerals and leaders in a particular figure, some elements are introduced through one or more figures without being explicitly identified in every other figure containing that element.

[0257] The systems, apparatuses, devices, methods, etc., described herein should not be construed as limiting in any way. Rather, this disclosure refers individually, and in various combinations and sub-combinations of each other, to all novel and non-obvious features and aspects of various implementations and applications of the disclosure. The disclosed systems, apparatuses, devices, methods, etc., are not limited to any particular aspect, feature, or combination thereof, nor are they required to possess any one or more particular advantages or solve any one or more particular problems.

[0258] The various systems, devices, and apparatuses described in this disclosure can be sterilized (e.g., with heat, radiation, ethylene oxide, hydrogen peroxide, etc.) to ensure their safety for use with patients, and the methods described herein may include such sterilization of associated systems, devices, and apparatuses. Furthermore, for some applications, the scope of this disclosure includes sterilizing any one or more of the various systems, devices, and apparatuses described in this disclosure.

[0259] Any techniques, methods, operations, steps, etc. described or suggested herein may be performed on living animals (e.g., humans, other mammals, etc.) or on non-living simulations, such as corpses, corpse hearts, anthropomorphic blood shadows, and / or simulator devices (which may include computerized and / or physical representations of body parts, tissues, etc.).

[0260] This document discloses various implementations of systems, devices, methods, etc., and allows for any combination of their features, components, and options, unless explicitly excluded.

[0261] Although some of the operations of the disclosed methods are described in a specific order for ease of presentation, it should be understood that this descriptive approach includes rearrangement unless the specific language used herein requires a particular order. For example, operations described in sequence may be rearranged or performed simultaneously in certain circumstances. Furthermore, for simplicity, the accompanying drawings may not show the various ways in which the disclosed systems, apparatuses, devices, methods, etc., can be used in conjunction with other systems, apparatuses, devices, methods, etc.

[0262] Example Implementation (The following are some non-limiting examples of the concepts in this article): Example 1. An apparatus for removing an obstruction (e.g., embolus, clot, plaque, or any other obstruction) from a blood vessel (e.g., from an artery, such as from a cerebral artery, or from a vein, such as from a cerebral vein) of a subject, the apparatus comprising: (A) a flexible catheter having: (a) a proximal portion, (b) a distal portion configured for transluminal advancement into a blood vessel (e.g., a cerebral artery) having an edge, and / or (c) a lumen extending from the proximal portion to the edge; (B) a funnel having: (a) an opening (i) at a distal end of the funnel, and / or (ii) an opening at a proximal end of the funnel, (b) the funnel being biased to present an expanded state in which the opening is wider than the opening and the edge, and / or (c) the funnel being resiliently compressible into a compressed state in which the opening is narrower than in the expanded state; (C) a flexible rod attached to... The funnel extends proximally through the catheter; and (D) a handle located at the proximal portion of the catheter, the handle comprising: (a) an unfolding knob operably coupled to a flexible rod for manual operation to gradually transition the device between: (I) a delivery state in which the funnel is compressed within the catheter, and / or (II) an unfolding state in which the funnel is expanded, wherein the outer surface of the funnel is sealed against an edge, and / or a mouthpiece (i) is exposed from the distal portion of the catheter, and / or (ii) is fluidly connected to the lumen such that suction applied through the lumen draws obstructions (e.g., emboli) into the funnel via the mouthpiece, and / or (b) a stabilizer separate from the unfolding knob, and / or configured to stabilize the device in the unfolded state by applying tension to the rod.

[0263] Example 2. The apparatus according to Example 1, wherein the handle is configured to limit the distal advance of the rod in a manner that provides a predetermined limit to the distal advance of the funnel from the distal portion of the conduit.

[0264] Example 3. The device according to any one of Examples 1-2, wherein the unfolding knob is a finger wheel.

[0265] Example 4. The apparatus according to any one of Examples 1-3, wherein the unfolding knob is a slider, and the unfolding knob can be operated by sliding the slider.

[0266] Example 5. The apparatus according to any one of Examples 1-4, wherein the stabilizer is configured to suppress further operation of the unfolding knob upon actuation.

[0267] Example 6. The device according to any one of Examples 1-5, wherein the conduit comprises a thiocyanate tube and / or a polymer coating on the thiocyanate tube, and / or wherein the polymer coating extends beyond the thiocyanate tube to define an edge.

[0268] Example 7. The device according to any one of Examples 1-6, wherein the flexibility of the catheter gradually increases distally along the catheter.

[0269] Example 8. The apparatus according to Example 7, wherein the flexibility of the rod gradually increases distally along the rod.

[0270] Example 9. The device according to any one of Examples 1-8, wherein the distal portion of the conduit has a curvature that can be adjusted by applying an axial force to the rod.

[0271] Example 10. The device according to Example 9, wherein the distal portion of the catheter is more flexible than the proximal portion of the catheter.

[0272] Example 11. The device according to Example 9, wherein the distal portion of the catheter has a length of 10-30 cm.

[0273] Example 12. The device according to Example 9, wherein the distal portion of the conduit is biased toward a bent state.

[0274] Example 13. The apparatus according to Example 12, wherein the apparatus is configured such that the curvature of the distal portion can be reduced by positioning the funnel in a compressed state within the distal portion of the conduit.

[0275] Example 14. The apparatus according to Example 9, wherein a rod is eccentrically connected to a funnel within a lumen such that a distal push of the rod applies an eccentric thrust to the funnel, the funnel being responsively hinged relative to the rod, thereby increasing the curvature of the conduit.

[0276] Example 15. The apparatus according to Example 9, wherein a rod is eccentrically connected to a funnel within a lumen, such that a distal push of the rod applies an eccentric thrust to the funnel, and the funnel responsively rotates to deflect the distal portion of the conduit.

[0277] Example 16. The device according to any one of Examples 1-15, wherein: (i) the funnel has an open surface away from the opening in its expanded state, and / or (ii) the stabilizer is configured to stabilize the device by retracting the funnel back into a sealing engagement with the conduit by sealing the open surface against the edge.

[0278] Example 17. The apparatus according to Example 16, wherein the edge opens to the distal side.

[0279] Example 18. The device according to any one of Examples 1-17, wherein the conduit is fixedly attached to the handle.

[0280] Example 19. The apparatus according to Example 18, wherein the conduit is welded to the handle.

[0281] Example 20. The device according to any one of Examples 1-19, wherein the rod includes an external stop that provides predetermined restriction on distal advance of the funnel from the distal portion of the conduit by limiting distal advance of the rod via the handle to a predetermined distance.

[0282] Example 21. The apparatus according to Example 20, wherein the stabilizer is configured such that actuation of the stabilizer pulls the rod proximally a predetermined distance.

[0283] Example 22. The device according to any one of Examples 1-21, wherein the stabilizer can be manually actuated independently of the unfolding knob.

[0284] Example 23. The device according to Example 22, wherein the stabilizer includes a button and / or can be manually actuated by pushing the button.

[0285] Example 24. The apparatus according to any one of Examples 1-23, wherein the handle further includes a port fluidly connected to the conduit, the port being adapted to receive a suction applicator adapted to apply suction.

[0286] Example 25. The apparatus according to Example 24 further includes a suction applicator.

[0287] Example 26. The apparatus according to Example 25, wherein the suction applicator comprises a syringe.

[0288] Example 27. The apparatus according to any one of Examples 1-26, wherein the funnel is made of braided thread.

[0289] Example 28. The apparatus according to Example 27, wherein the braided yarns converge into an elliptical loop at the proximal end, the elliptical loop defining the opening as an elliptical opening.

[0290] Example 29. The apparatus according to Example 28, wherein the elliptical ring is covered with a polymer coating that reinforces the opening.

[0291] Example 30. The device according to Example 29, wherein, in the sealing engagement, the polymer coating fits tightly within the distal portion of the conduit.

[0292] Example 31. The apparatus according to Example 28, wherein: (i) the funnel has a central longitudinal axis passing through the mouth and the opening, and / or (ii) the elliptical opening has a long axis inclined relative to the longitudinal axis.

[0293] Example 32. The apparatus according to Example 31, wherein: (i) the elliptical opening has: (a) a distal vertex located on the long axis, on a first side of the longitudinal axis, and / or (b) a proximal vertex located on the long axis, and / or disposed on the side of the longitudinal axis opposite to the distal vertex, proximal to the distal vertex, and / or (ii) a rod attached to the proximal end of the funnel by attaching it to the elliptical opening at the proximal vertex.

[0294] Example 33. The device according to any one of Examples 1-32, wherein the stabilizer includes a manually actuable mechanism adapted to stabilize the device in an deployed state by applying tension to the rod upon manual actuation.

[0295] Example 34. The device according to any one of Examples 1-33, wherein the stabilizer includes a spring-loaded mechanism adapted to stabilize the device in the deployed state by applying tension to the rod.

[0296] Example 35. The apparatus according to Example 34, wherein the spring-loaded mechanism is adapted to automatically apply tension to the lever when the manual operation of the unfolding knob is stopped.

[0297] Example 36. The device according to any one of Examples 1-35, wherein the unfolding knob is operable by rotation.

[0298] Example 37. The device according to Example 36, wherein the handle includes a drive wheel that engages with a rod and is operably coupled to a knob such that rotating the knob in a first knob direction causes the drive wheel to rotate in a forward drive wheel direction, thereby pushing the rod distally to gradually change the device from a delivery state to an unfolded state.

[0299] Example 38. The apparatus according to Example 37, wherein a drive wheel defines a roller, and a rod passes tangentially through the roller.

[0300] Example 39. The apparatus according to Example 38, wherein a drive wheel defines a spool, and a rod is wound around the spool.

[0301] Example 40. The apparatus according to Example 38, wherein a drive wheel defines a winch and a rod bends about the winch.

[0302] Example 41. The apparatus according to Example 37, wherein the stabilizer is configured such that actuation of the stabilizer causes the drive wheel to rotate in the opposite drive wheel direction, thereby pulling the rod proximally.

[0303] Example 42. The apparatus according to Example 41, wherein the stabilizer is configured with a first position and a second position, and / or is configured to be actuated by moving the stabilizer from the first position to the second position, such that the actuation of the stabilizer causes the drive wheel to rotate by a predetermined discrete amount in the opposite drive wheel direction, thereby pulling the rod proximally by a predetermined discrete distance.

[0304] Example 43. The apparatus according to Example 41, wherein: (i) the drive wheel has drive wheel teeth, (ii) the stabilizer has seal teeth, and / or (iii) the actuation stabilizer engages the seal teeth with the drive wheel teeth and moves the drive wheel in the opposite drive wheel direction.

[0305] Example 44. The apparatus according to Example 43, wherein the drive wheel teeth are circumferentially distributed, the seal teeth are linearly distributed, and / or the actuation of the stabilizer causes the seal teeth to form a rack and pinion arrangement with the drive wheel teeth.

[0306] Example 45. The device according to Example 43, wherein the engagement between the sealer teeth and the drive wheel teeth is stabilized by the distal movement of the inhibition rod and the funnel relative to the conduit.

[0307] Example 46. An apparatus for removing an obstruction (e.g., embolus, clot, plaque, or any other obstruction) from a blood vessel (e.g., from an artery, such as from a cerebral artery, or from a vein, such as from a cerebral vein) of a subject, the apparatus comprising: (A) a flexible catheter having: (a) a proximal portion, (b) a distal portion configured for transluminal advancement into a blood vessel (e.g., a cerebral artery) having an edge, and / or (c) a lumen extending from the proximal portion to the edge; (B) a funnel having: (a) (i) a mouth at a distal end of the funnel, and / or (ii) an opening at a proximal end of the funnel, (b) biased to present an expanded state in which the mouth is wider than the opening and the edge, and / or (c) resiliently compressible into a compressed state in which the mouth is narrower than in the expanded state; (C) a flexible rod having attached (i) A funnel is attached to the proximal end and / or extends proximally through the catheter; and (D) a handle located at the proximal portion of the catheter, the handle comprising: (a) an unfolding knob operably coupled to a flexible rod for manual operation to gradually transition the device between: (i) a delivery state in which the funnel is compressed within the catheter, and / or (ii) an unfolding state in which the funnel is expanded, wherein the outer surface of the funnel is sealed against an edge, and / or a mouthpiece (i) is exposed from the distal portion of the catheter, and / or (ii) is fluidly connected to the lumen such that suction applied through the lumen draws obstructions (e.g., emboli) into the funnel via the mouthpiece, and / or (b) a stabilizer separate from the unfolding knob, and / or configured to stabilize the device in the unfolded state by slackening of a tightening rod.

[0308] Example 47. An apparatus for removing an obstruction (e.g., embolus, clot, plaque, or any other obstruction) from a blood vessel (e.g., from an artery, such as from a cerebral artery, or from a vein, such as from a cerebral vein) of a subject, the apparatus comprising: (A) a flexible catheter having: (a) a proximal portion, (b) a distal portion configured for transluminal advancement into a blood vessel (e.g., a cerebral artery) having an edge, and / or (c) a lumen extending from the proximal portion to the edge; (B) a funnel having: (a) (i) a mouth at a distal end of the funnel, and / or (ii) an opening at a proximal end of the funnel, (b) being biased to present an expanded state in which the mouth is wider than the opening and the edge, and / or (c) being elastically compressible into a compressed state in which the mouth is wider than in the expanded state. (c) a narrower opening in the extended state; (d) a flexible rod attached to the proximal end of the funnel and / or extending proximally through the conduit; and (e) a handle located at the proximal portion of the conduit, the handle defining a flat base for resting on a surface, the handle comprising: (a) a finger wheel operably coupled to the flexible rod such that manual operation of the finger wheel causes the device to gradually transition between (i) a delivery state and / or (ii) an unfolded state, in which the funnel is compressed within the conduit, and in the unfolded state, the funnel is expanded and the mouth is exposed from the distal portion of the conduit; and / or (b) a fluid port facing proximally and / or fluidly connected to the mouth of the funnel and adapted to receive a suction source such that suction applied to the fluid port is transmitted via the lumen to draw obstruction (plug) into the funnel via the mouth.

[0309] Example 48. The device according to Example 47, wherein the handle has a foot that extends to define an extension portion of a flat base.

[0310] Example 49. The apparatus according to any one of Examples 47-48, wherein the fluid port is oriented proximal to the side.

[0311] Example 50. The device according to any one of Examples 47-49, wherein the finger wheel faces outward.

[0312] Example 51. The device according to any one of Examples 47-50, wherein the proximal portion of the catheter is fixedly attached to the handle.

[0313] Example 52. The device according to Example 51, wherein the handle is shaped to be gripped by a user's hand, wherein the conduit extends between the fingers of the hand and away from the handle.

[0314] Example 53. The device according to Example 51, wherein the proximal portion of the catheter is attached to the handle at the distal portion of the handle.

[0315] Example 54. The device according to Example 53, wherein the handle further includes a sealer configured to convert the device into a sealed state by retracting the funnel back to engage with an edge seal, such that in the sealed state: (i) the funnel remains in an expanded state, and / or (ii) the mouth of the funnel is fluidly connected to the lumen, such that suction applied through the lumen draws a plug into the funnel via the mouth.

[0316] Example 55. The apparatus according to Example 54, wherein the seal faces the distal side.

[0317] Example 56. An apparatus for removing an obstruction (e.g., embolus, clot, plaque, or any other obstruction) from a blood vessel (e.g., from an artery, such as from a cerebral artery, or from a vein, such as from a cerebral vein) of a subject, the apparatus comprising: (A) a flexible catheter having: (a) a proximal portion, (b) a distal portion configured for transluminal advancement into a blood vessel (e.g., a cerebral artery) having an edge, and / or (c) a lumen extending from the proximal portion to the edge; (B) a funnel having: (a) an opening (i) at a distal end of the funnel, and / or (ii) an opening at a proximal end of the funnel, (b) the funnel being biased to present an expanded state in which the opening is wider than the opening and the edge, and / or (c) the funnel being resiliently compressible into a compressed state in which the opening is narrower than in the expanded state; (C) a flexible rod, It is attached to the proximal end of the funnel and / or extends proximally through the catheter; and (D) a handle located at the proximal portion of the catheter, the handle comprising: (a) an unfolding knob operably coupled to a flexible rod so as to be manually operated to gradually change the device between (i) a delivery state and / or (ii) an unfolded state, in which the funnel is in a compressed state within the catheter, and in the unfolded state, the funnel is in an expanded state and the nozzle is exposed from the distal portion of the catheter, and / or (b) a sealer, separate from the unfolding knob, and / or configured to change the device to a sealed state by retracting the funnel back to engage with an edge seal, such that in the sealed state: (I) the funnel remains in the expanded state, and / or (II) the nozzle of the funnel is fluidly connected to the lumen, such that suction applied through the lumen draws obstructions (e.g., emboli) into the funnel via the nozzle.

[0318] Example 57. The device according to Example 56, wherein the sealer can be manually actuated independently of the unfolding knob.

[0319] Example 58. The apparatus according to any one of Examples 56-57, wherein the sealer is a separate component relative to the unfolding knob.

[0320] Example 59. The device according to any one of Examples 56-58, wherein the sealer is a button, and / or wherein pressing the button changes the device to a sealed state.

[0321] Example 60. The device according to any one of Examples 56-59, wherein the unfolding knob is a finger wheel.

[0322] Example 61. The device according to any one of Examples 56-60, wherein the conduit comprises a thiocyanate tube and / or a polymer coating coated on the thiocyanate tube, and / or wherein the polymer coating extends beyond the thiocyanate tube to define an edge.

[0323] Example 62. The device according to any one of Examples 56-61, wherein the handle is configured to limit the distal advance of the rod in a manner that provides a predetermined limit to the distal advance of the funnel from the distal portion of the conduit.

[0324] Example 63. The apparatus according to any one of Examples 56-62, wherein the unfolding knob is a slider, and the unfolding knob can be operated by sliding the slider.

[0325] Example 64. The apparatus according to any one of Examples 56-63, wherein the sealer is configured to inhibit further operation of the unfolding knob upon actuation.

[0326] Example 65. The device according to any one of Examples 56-64, wherein the flexibility of the catheter gradually increases distally along the catheter.

[0327] Example 66. The apparatus according to Example 65, wherein the flexibility of the rod gradually increases distally along the rod.

[0328] Example 67. The device according to any one of Examples 56-66, wherein the distal portion of the conduit has a curvature that can be adjusted by applying an axial force to the rod.

[0329] Example 68. The device according to Example 67, wherein the distal portion of the catheter is more flexible than the proximal portion of the catheter.

[0330] Example 69. The device according to Example 67, wherein the distal portion of the catheter has a length of 10-30 cm.

[0331] Example 70. The apparatus according to Example 67, wherein the distal portion of the conduit is biased toward a bent state.

[0332] Example 71. The apparatus according to Example 70, wherein the apparatus is configured such that the curvature of the distal portion can be reduced by positioning the funnel in a compressed state within the distal portion of the conduit.

[0333] Example 72. The apparatus according to Example 67, wherein a rod is eccentrically connected to a funnel within a lumen such that distal pushing of the rod applies an eccentric thrust to the funnel, the funnel being responsively hinged relative to the rod, thereby increasing the curvature of the conduit.

[0334] Example 73. The apparatus according to Example 67, wherein a rod is eccentrically connected to a funnel within a lumen, such that a distal push of the rod applies an eccentric thrust to the funnel, and the funnel responsively rotates to deflect the distal portion of the conduit.

[0335] Example 74. The apparatus according to any one of Examples 56-73, wherein: (i) the funnel has an open surface away from the opening in its expanded state, and / or (ii) the sealer is configured to retract the funnel back into a sealing engagement with the conduit by sealing the open surface against the edge.

[0336] Example 75. The apparatus according to Example 74, wherein the edge opens to the distal side.

[0337] Example 76. The device according to any one of Examples 56-75, wherein the conduit is fixedly attached to the handle.

[0338] Example 77. The apparatus according to Example 76, wherein the conduit is welded to the handle.

[0339] Example 78. The device according to any one of Examples 56-77, wherein the rod includes an external stop that provides predetermined restriction on distal advance of the funnel from the distal portion of the conduit by limiting distal advance of the rod via the handle to a predetermined distance.

[0340] Example 79. The apparatus according to Example 78, wherein the sealer is configured such that actuation of the sealer pulls the rod proximally a predetermined distance.

[0341] Example 80. The apparatus according to any one of Examples 56-79, wherein the handle further includes a port fluidly connected to the conduit, the port being adapted to receive a suction applicator adapted to apply suction.

[0342] Example 81. The apparatus according to Example 80 further includes a suction applicator.

[0343] Example 82. The apparatus according to Example 81, wherein the suction applicator comprises a syringe.

[0344] Example 83. The apparatus according to any one of Examples 56-82, wherein the funnel is made of braided thread.

[0345] Example 84. The apparatus according to Example 83, wherein the braided yarns converge into an elliptical loop at the proximal end, the elliptical loop defining the opening as an elliptical opening.

[0346] Example 85. The apparatus according to Example 84, wherein the elliptical ring is covered with a polymer coating to enhance the opening.

[0347] Example 86. The apparatus according to Example 85, wherein, in a sealed state, the polymer coating fits tightly within the distal portion of the conduit.

[0348] Example 87. The apparatus according to Example 84, wherein: (i) the funnel has a central longitudinal axis passing through the mouth and the opening, and / or (ii) the elliptical opening has a long axis inclined relative to the longitudinal axis.

[0349] Example 88. The apparatus according to Example 87, wherein: (i) the elliptical opening has: (a) a distal vertex located on the long axis, on a first side of the longitudinal axis, and / or (b) a proximal vertex located on the long axis, and / or disposed on the side of the longitudinal axis opposite to the distal vertex, proximal to the distal vertex, and / or (ii) a rod attached to the proximal end of the funnel by attaching it to the elliptical opening at the proximal vertex.

[0350] Example 89. The device according to any one of Examples 56-88, wherein the sealer includes a spring-loaded mechanism adapted to convert the device into a sealed state by applying tension to a rod.

[0351] Example 90. The apparatus according to Example 89, wherein the spring-loaded mechanism is adapted to automatically apply tension to the lever when the manual operation of the unfolding knob stops.

[0352] Example 91. The device according to any one of Examples 56-90, wherein the sealer includes a manually actuable mechanism adapted to stabilize the device in an deployed state by applying tension to the rod during manual actuation.

[0353] Example 92. The device according to any one of Examples 56-91, wherein the unfolding knob is operable by rotation.

[0354] Example 93. The device according to Example 92, wherein the handle includes a drive wheel that engages with a rod and is operably coupled to a knob such that rotating the knob in a first knob direction causes the drive wheel to rotate in a forward drive wheel direction, thereby pushing the rod distally to gradually change the device from a delivery state to an unfolded state.

[0355] Example 94. The apparatus according to Example 93, wherein a drive wheel defines a roller, and a rod passes tangentially through the roller.

[0356] Example 95. The apparatus according to Example 94, wherein a drive wheel defines a spool, and a rod is wound around the spool.

[0357] Example 96. The apparatus according to Example 94, wherein a drive wheel defines a winch and a rod bends about the winch.

[0358] Example 97. The apparatus according to Example 93, wherein the sealer is configured such that actuation of the sealer causes the drive wheel to rotate in the opposite drive wheel direction, thereby retracting the funnel back into the sealing engagement by pulling the rod proximally.

[0359] Example 98. The apparatus according to Example 97, wherein the seal is configured with a first position and a second position, and / or is configured to be actuated by moving the seal from the first position to the second position, such that actuation of the seal causes the drive wheel to rotate a predetermined discrete amount in the opposite drive wheel direction, thereby pulling the rod proximally a predetermined discrete distance.

[0360] Example 99. The apparatus according to Example 97, wherein: (i) the drive wheel has drive wheel teeth, (ii) the seal has seal teeth, and / or (iii) the actuating seal engages the seal teeth with the drive wheel teeth and moves the drive wheel in the opposite drive wheel direction.

[0361] Example 100. The apparatus according to Example 99, wherein the drive wheel teeth are circumferentially distributed, the seal teeth are linearly distributed, and / or the actuation of the seal causes the seal teeth to form a rack and pinion arrangement with the drive wheel teeth.

[0362] Example 101. The device according to Example 99, wherein the engagement between the sealer teeth and the drive wheel teeth is maintained in a sealing engagement with the edge by the distal movement of the inhibition rod and the funnel relative to the conduit, thereby stabilizing the device in a sealed state.

[0363] Example 102. A device for removing an obstruction (e.g., embolus, clot, plaque, or any other obstruction) from a blood vessel (e.g., from an artery, such as from a cerebral artery, or from a vein, such as from a cerebral vein) of a subject, the device comprising: (A) a flexible catheter having: (a) a proximal portion, (b) a distal portion configured for transluminal advancement into a blood vessel (e.g., a cerebral artery) having an edge, and / or (c) a lumen extending from the proximal portion to the edge; (B) a funnel: (a) formed of a set of braided threads covered with a covering, (b) having: (i) a mouth portion located at the distal end of the funnel, (ii) a spoon-shaped portion located at the mouth portion and projecting distally, the spoon-shaped portion being defined by: (I) a first (i) an outer lobe formed by a bend in the first wire of the group of wires, (ii) a second outer lobe formed by a bend in the second wire of the group of wires, (iii) an inner lobe disposed between the first and second outer lobes and / or overlapping the first and second outer lobes, the inner lobe being formed by a bend in the third wire of the group of wires, the third wire being more flexible than the first wire and more flexible than the second wire, and / or (iv) an opening located at the proximal end of the funnel, (c) the funnel being biased to present an expanded state, in which the mouth is wider than the opening and the edge, and / or (d) the funnel being elastically compressible to a compressed state, the mouth being narrower in the compressed state than in the expanded state.

[0364] Example 103. The apparatus according to Example 102, wherein for each of the first, second and / or third lobes, the corresponding wire defines two tails that are diverging from each other away from the bend to extend along the funnel toward the opening in opposite helical chirality.

[0365] Example 104. The apparatus according to any one of Examples 102-103, wherein: (i) the funnel has a central longitudinal axis passing through the mouth and the opening, and / or (ii) in the expanded state, the spoon-shaped portion opens radially outward from the central longitudinal axis.

[0366] Example 105. The apparatus according to any one of Examples 102-104, wherein: (i) each of the first outer lobe and the second outer lobe defines an outer tail and an inner tail, the outer tail extending spirally away from the bend and the inner lobe, and / or along the funnel toward the opening, and / or the inner tail extending away from the bend to overlap with the inner lobe and spirally extending along the funnel toward the mouth, and / or (ii) a set of wires including at least one corresponding lobe support wire for each of the outer lobes, each lobe support wire defining a loop that surrounds the outer tail of the corresponding outer lobe at the mouth to support the corresponding outer lobe.

[0367] Example 106. The apparatus according to Example 105, wherein a set of wires includes exactly two corresponding lobe support wires for each of the outer lobes.

[0368] Example 107. The apparatus according to Example 105, wherein each of the petal support wires defines a pair of tails that extend proximally away from the circumference and spirally along the funnel toward the opening.

[0369] Example 108. The apparatus according to Example 107, wherein, for each of the lobe support wires, the tails of the pair of tails extend parallel to and / or with the same helical chirality toward the opening along the funnel.

[0370] Example 109. The apparatus according to Example 108, wherein, for each of the outer lobes, the set of wires includes a first lobe support wire and a second lobe support wire, the tail of the first lobe support wire extending parallel to the opening along the funnel, and / or having the same helical chirality as the tail of the second lobe support wire.

[0371] Example 110. The apparatus according to Example 109, wherein the loop of the first support wire is distal to the loop of the second support wire, and / or the first support wire is stiffer than the second support wire.

[0372] Example 111. The apparatus according to any one of Examples 102-110, wherein: (i) the spoon-shaped portion is a first spoon-shaped portion, (ii) the funnel has opposing spoon-shaped portions at the mouth, the opposing spoon-shaped portions being defined by at least two arcuate wires from a set of wires, each arcuate wire forming a partial arcuate portion around the mouth, the arcuate portions overlapping each other, and / or (iii) the opposing spoon-shaped portions are opposite to the first spoon-shaped portion.

[0373] Example 112. The apparatus according to Example 111, wherein, in response to a compressive force applied to the funnel, the opposing spoon-shaped portion is configured to extend distally by deformation into an arcuate portion having a reduced radius of curvature.

[0374] Example 113. The apparatus according to Example 111, wherein the opposing spoon-shaped portions are defined by two arc-shaped wires that exactly form two arc-shaped portions.

[0375] Example 114. The apparatus according to Example 113, wherein the first spoon-shaped portion is not defined by any other wire in the group of wires, except for the first wire defining the first outer lobe, the second wire defining the second outer lobe, and / or the third wire defining the inner lobe.

[0376] Example 115. The apparatus according to Example 111, wherein the first spoon-shaped portion protrudes distally beyond the opposing spoon-shaped portion.

[0377] Example 116. The apparatus according to Example 111, wherein the first spoon-shaped portion is longer than the opposing spoon-shaped portion.

[0378] Example 117. The apparatus according to Example 111, wherein each of the arcuate wires is one of a pair of parallel extending arcuate wires, each pair of arcuate wires facing the distal side.

[0379] Example 118. The apparatus according to Example 111, wherein the opposing spoon-shaped portion further includes a single arcuate wire forming the arcuate portion between and / or from the two arcuate wires toward the proximal side.

[0380] Example 119. A method for advancing an embolus removal device into a real or simulated blood vessel (e.g., an artery, such as a cerebral artery, or a vein, such as a cerebral vein) of a real or simulated object, the method comprising: (i) advancing a distal portion of a flexible catheter through a lumen into the blood vessel (e.g., a cerebral artery) while: (a) a funnel is compressed within the lumen of the catheter, and / or (b) a flexible rod attached to the proximal end of the funnel extends proximally through the catheter; (ii) adjusting the curvature of the distal portion by applying an axial force to the rod extending proximally through the lumen from the proximal end of the funnel; and (iii) subsequently advancing the funnel from the distal portion such that the funnel expands within the blood vessel (e.g., a cerebral artery).

[0381] Example 120. The method according to Example 119, wherein advancing the distal portion of the catheter into the cerebral artery via the lumen includes advancing the distal portion of the catheter into the cerebral artery via the lumen while the funnel is positioned within the lumen from the distal portion toward the proximal side.

[0382] Example 121. The method according to Example 119, wherein the method further includes applying suction to draw a real or simulated embolus into the funnel.

[0383] Example 122. The method according to Example 119, wherein the distal portion of the catheter is biased toward a curved state, and / or wherein adjusting the curvature of the distal portion by applying an axial force to the rod includes reducing the curvature of the distal portion by pushing the funnel in its compressed state distally within the distal portion of the catheter.

[0384] Example 123. The method according to Example 119, wherein the distal portion of the catheter is biased toward a curved state, and / or wherein adjusting the curvature of the distal portion by applying an axial force to the rod includes increasing the curvature of the distal portion by pulling the funnel in its compressed state proximally within the distal portion of the catheter.

[0385] Example 124. The method according to Example 119, wherein the rod extends eccentrically within the lumen, and / or wherein adjusting the curvature of the distal portion by applying an axial force to the rod includes advancing the rod and funnel distally within the lumen to increase the curvature by applying an eccentric compressive force to the conduit through the funnel and rod.

[0386] Example 125. The method according to Example 119, wherein the method further includes rotating the catheter within the subject before adjusting the curvature of the distal portion.

[0387] Example 126. The method according to Example 119, wherein the rod extends eccentrically within the lumen, and / or wherein adjusting the curvature of the distal portion by applying an axial force to the rod includes pulling the rod and funnel proximally within the lumen to reduce the curvature.

[0388] Example 127. A method for removing a real or simulated obstruction (e.g., embolus, clot, plaque, or any other obstruction) from a real or simulated blood vessel (e.g., from an artery, such as from a cerebral artery, or from a vein, such as from a cerebral vein) of a real or simulated object, the method comprising: (i) advancing a distal portion of a flexible catheter through a lumen into the blood vessel (e.g., a cerebral artery) while: (a) a funnel is compressed within the lumen of the catheter, and / or (b) a rod extends proximally from the proximal end of the funnel through the lumen to a handle; (ii) using an operably (iii) An unfolding knob connected to the handle of the rod advances the funnel from the distal portion of the conduit, causing the funnel to self-expand in such a way that the mouth at the distal end of the funnel is wider than the opening at the proximal end of the distal portion and the proximal end of the funnel; (iv) an actuation of the seal on the handle retracts the funnel back into a sealing engagement with the distal portion, such that in the sealing engagement the funnel remains expanded and / or the mouth of the funnel is fluidly connected to the lumen; and (iv) aspiration is then applied through the lumen, such that the aspiration draws the obstruction (e.g., a plug) into the funnel via the mouth.

[0389] Example 128. A method for removing a real or simulated obstruction (e.g., embolus, clot, plaque, or any other obstruction) from a real or simulated blood vessel (e.g., from an artery, such as from a cerebral artery, or from a vein, such as from a cerebral vein) of a real or simulated object, the method comprising: (a) advancing a distal portion of a flexible catheter through a lumen into the blood vessel (e.g., a cerebral artery) while: (i) a funnel is compressed within the lumen of the catheter, and / or (ii) a rod extends proximally from the proximal end of the funnel through the lumen to a handle; (B) using an unfolding mechanism operably coupled to a handle of the rod. (c) Turn the knob to unfold the funnel from the distal portion of the catheter, such that the funnel self-expands with the mouth at the distal end of the funnel being wider than the opening at the proximal end of the distal portion; and (d) subsequently, actuate the stabilizer on the handle to stabilize the funnel in a sealed engagement with the catheter; and (d) while the funnel remains stable in a sealed engagement with the distal portion: (i) aspirate the obstruction (e.g., embolus) into the funnel via the mouth through the lumen, and / or (ii) retract the funnel and catheter from the blood vessel (e.g., cerebral artery) and the subject while continuing to apply aspiration through the lumen.

[0390] Example 129. The method according to Example 128, wherein step (b) of the method includes the following steps: (i) expanding the funnel from the distal portion of the catheter until the mouth is exposed, (ii) applying suction to the mouth via the lumen, (iii) determining the degree of resistance to the suction, and / or (iv) in response to the determined value, identifying whether there is contact with an embolus.

[0391] Example 130. The method according to Example 129, wherein step (b) of the method further comprises, after identification: (i) retracting the funnel into the distal portion such that the funnel becomes compressed within the lumen, (ii) advancing the catheter distally within the artery, and / or (iii) repeating step (b) until contact with the embolus is identified.

[0392] Example 131. The method according to any one of Examples 128-130, wherein advancing the distal portion of the catheter into the cerebral artery via the lumen comprises advancing the distal portion of the catheter into the cerebral artery via the lumen while the funnel is positioned from the distal portion toward the proximal side within the lumen.

[0393] Example 132. A method for removing a real or simulated embolus from a real or simulated cerebral artery of a real or simulated object, the method comprising: (a) advancing a distal portion of a flexible catheter through a lumen into the cerebral artery while a funnel is compressed within the lumen of the catheter, the funnel being formed of a set of braided threads covered with a covering, and / or having: (i) a mouth portion located at the distal end of the funnel, (ii) a spoon-shaped portion located at the mouth portion and projecting distally, the spoon-shaped portion being defined by: (I) a first lateral flap formed by a bend in a first thread of the set of threads, (II) a second lateral flap formed by a bend in a second thread of the set of threads. (iii) An inner flap is formed by the bending portion of a second wire, which is disposed between and / or overlaps with the first and second outer flaps, the inner flap being formed by the bending portion of a third wire in the group of wires, the third wire being more flexible than the first wire and more flexible than the second wire, and / or (iv) an opening located at the proximal end of the funnel; (b) the funnel is gradually advanced from the distal portion of the conduit such that the funnel self-expands in such a way that the mouth is wider than the distal portion and the opening; and (c) suction is applied through the lumen such that the suction draws the plug into the funnel through the mouth.

[0394] Example 133. An apparatus for removing an embolus from a subject's cerebral artery, the apparatus comprising: (a) a flexible catheter having: (i) a proximal portion, (ii) a distal portion configured for transluminal advancement into the cerebral artery having an edge, and / or (iii) a lumen extending from the proximal portion to the edge; (B) a funnel having a central longitudinal axis passing through a mouth and an opening, and / or (I) having (i) a mouth located at the distal end of the funnel, and / or (ii) an opening located at the proximal end of the funnel, (II) being resiliently compressible into a compressed state, and / or (III) biased to present an expanded state, wherein in the expanded state the mouth is wider than (i) the opening and the edge and / or (ii) the mouth in the compressed state, and / or wherein the funnel... The definition includes: (a) a distal segment comprising a mouth and / or generally cylindrical; (b) a proximal segment comprising an opening and / or generally cylindrical; (c) an intermediate segment tapering from the distal segment to the proximal segment to fluidly connect the distal segment to the proximal segment; and / or (d) a first spoon-shaped portion and an opposing spoon-shaped portion located at the mouth, extending distally from the distal segment, and / or opening away from the other spoon-shaped portion and away from the longitudinal axis.

[0395] Example 134. A device for treating a subject, the device comprising: (A) a flexible catheter having: (i) a proximal portion, (ii) a distal portion configured for transluminal advancement into a cerebral artery of the subject, the distal portion having an edge, and / or (iii) a lumen extending from the proximal portion to the edge; (B) a funnel having: (i) a mouth at a distal end of the funnel, and / or (ii) an opening at a proximal end of the funnel, (II) being biased to present an expanded state in which the mouth is wider than the opening and the edge, and / or (III) being resiliently compressible into a compressed state in which the mouth is narrower than in the expanded state; (C) a flexible rod attached to the proximal end of the funnel and / or extending proximally through the catheter; and ( D) A handle located at the proximal portion of the catheter, the handle comprising: (a) an unfolding knob operably coupled to a flexible rod for manual operation to gradually transition the device between (i) a delivery state and / or (ii) an unfolded state, in which the funnel is compressed within the catheter and in the unfolded state the funnel is expanded and the nozzle is exposed from the distal portion of the catheter; and / or (b) a sealer separate from the unfolding knob and / or configured to transition the device to a sealed state by retracting the funnel back to engage with an edge seal, such that in the sealed state: (i) the funnel remains in the expanded state, and / or (ii) the nozzle of the funnel is fluidly connected to the lumen, such that suction applied through the lumen draws fluid into the funnel via the nozzle.

[0396] Example 135. A method for removing a real or simulated embolus from a real or simulated cerebral artery of a real or simulated object, the method comprising: (A) advancing a distal portion of a flexible catheter through a lumen into the cerebral artery while a funnel is compressed within the lumen of the catheter, the funnel being formed of a set of braided threads covered with a covering, and / or having: (i) a mouth portion located at the distal end of the funnel, (ii) a spoon-shaped portion located at the mouth portion and projecting distally, the spoon-shaped portion being defined by: (a) a first lateral flap formed by a bend in a first thread of the set of threads, (b) a second lateral flap formed by a bend in a second thread of the set of threads, (c) a medial flap. (a) a valve, disposed between and / or overlapping the first and second lateral valves, the medial valve being formed by a bend in a third wire of the set of wires, the third wire being more flexible than the first wire and more flexible than the second wire, and / or (d) an opening located at the proximal end of the funnel; (B) advancing the funnel from the distal portion of the catheter such that: (i) the funnel self-expands with the mouth wider than the distal portion and the opening, and / or (ii) the scoop portion dilates the artery in such a way that the scoop portion removes the embolus from the arterial wall; and (C) suction is applied through the lumen such that the suction draws the embolus into the funnel via the mouth portion.

[0397] It should be understood that throughout this application, the term "proximal" refers to the side closest to the operator (with less entry into the body), while the term "distal" refers to the side furthest from the operator (with more entry into the body).

[0398] This invention is not limited to the examples specifically shown and described above. Rather, the scope of protection of this invention includes combinations and sub-combinations of the various features described above, as well as variations and modifications of these features that would occur to those skilled in the art upon reading the foregoing description and that are not in the prior art.

Claims

1. A device for removing an embolus from a subject's cerebral artery, the device comprising: - Flexible catheters, which have: -- Proximal part, -- A distal portion, configured for transluminal advancement into the cerebral artery, the distal portion having an edge, and / or -- A lumen that extends from the proximal portion to the edge; - Funnel: -- The funnel has (i) a mouth located at the distal end of the funnel, and / or (ii) an opening located at the proximal end of the funnel. -- The funnel is biased to present an expanded state, in which the spout is wider than the opening and the edge, and / or -- The funnel can be elastically compressed into a compressed state, and the spout is narrower in the compressed state than in the expanded state; A flexible rod, which is attached to the proximal end of the funnel and / or extends proximally through the conduit; and A handle, located at the proximal portion of the catheter, the handle comprising: -- An unfolding knob, operably connected to the flexible rod, allows for manual operation to gradually change the device between the following states: --- Delivery state, in which the funnel is in the compressed state within the conduit, and / or --- In the expanded state, the funnel is in the extended state, the outer surface of the funnel is sealed to the edge, and / or the nozzle (i) is exposed from the distal portion of the conduit, and / or (ii) is fluidly connected to the lumen, such that suction applied through the lumen draws the plug into the funnel via the nozzle, and / or -- A stabilizer, separate from the deployment knob, and / or configured to stabilize the device in the deployed state by applying tension to the rod.

2. The apparatus according to claim 1, wherein, The catheter is fixedly attached to the handle.

3. The apparatus according to any one of claims 1-2, wherein, The handle also includes a port fluidly connected to the conduit, the port being adapted to receive a suction applicator adapted to apply the suction.

4. The apparatus according to any one of claims 1-3, wherein, The stabilizer includes a manually actuated mechanism adapted to stabilize the device in the deployed state by applying tension to the rod during manual actuation.

5. The apparatus according to any one of claims 1-4, wherein, The handle is configured to limit the distal advance of the rod in a manner that provides a predetermined restriction on the distal advance of the funnel from the distal portion of the conduit.

6. The apparatus according to any one of claims 1-5, wherein, The stabilizer is configured to suppress further operation of the unfolding knob when actuated.

7. The apparatus according to any one of claims 1-6, wherein, The conduit includes a thiourea tube and / or a polymer coating on the thiourea tube, and / or the polymer coating extends beyond the thiourea tube to define the edge.

8. The apparatus according to any one of claims 1-7, wherein, The flexibility of the catheter gradually increases distally along the catheter.

9. The apparatus according to claim 8, wherein, The flexibility of the rod gradually increases towards the distal end of the rod.

10. The apparatus according to any one of claims 1-9, wherein, The distal portion of the catheter has a curvature that can be adjusted by applying an axial force to the rod.

11. The apparatus according to claim 10, wherein, The distal portion of the catheter is biased toward a bent state.

12. The apparatus according to claim 11, wherein, The device is configured such that the curvature of the distal portion can be gradually reduced by gradually moving the funnel, which is in a compressed state, distally within the distal portion of the conduit.

13. The apparatus according to claim 10, wherein, The rod is eccentrically connected to the funnel within the lumen, such that distal pushing of the rod applies an eccentric thrust to the funnel, which is responsively hinged relative to the rod, thereby increasing the curvature of the conduit.

14. The apparatus according to claim 10, wherein, The rod is eccentrically connected to the funnel within the lumen, such that a distal push of the rod applies an eccentric thrust to the funnel, which responsively rotates to deflect the distal portion of the catheter.

15. The apparatus according to any one of claims 1-14, wherein: The funnel, in its expanded state, has an opening surface away from the opening, and / or The stabilizer is configured to stabilize the device by retracting the funnel back into the sealed engagement with the conduit by sealing the open surface against the edge.

16. The apparatus according to claim 15, wherein, The edge opens outwards.

17. The apparatus according to any one of claims 1-16, wherein, The rod includes an external stop that provides a predetermined restriction on distal advancement of the funnel from the distal portion of the conduit by limiting distal advancement of the rod via the handle to a predetermined distance.

18. The apparatus according to claim 17, wherein, The stabilizer is configured such that actuation of the stabilizer pulls the rod proximally by the predetermined distance.

19. The apparatus according to any one of claims 1-18, wherein, The stabilizer can be manually actuated independently of the unfolding knob.

20. The apparatus according to claim 19, wherein, The stabilizer includes a button, and / or can be manually actuated by pushing the button.

21. The apparatus according to any one of claims 1-20, wherein, The funnel is made of braided yarn.

22. The apparatus according to claim 21, wherein, The braided yarns converge into an elliptical loop at the proximal end, the elliptical loop defining the opening as an elliptical opening.

23. The apparatus according to claim 22, wherein, The elliptical ring is covered with a polymer coating that enhances the opening.

24. The apparatus according to claim 23, wherein, In the sealing engagement, the polymer coating fits snugly within the distal portion of the conduit.

25. The apparatus according to claim 22, wherein: The funnel has a central longitudinal axis passing through the mouth and the opening, and / or The elliptical opening has a long axis that is inclined relative to the longitudinal axis.

26. The apparatus according to claim 25, wherein: The elliptical opening has: The distal vertex, which is located on the long axis, on the first side of the longitudinal axis, and / or The proximal vertex, which is located on the long axis, and / or disposed on the side of the longitudinal axis opposite to the distal vertex, proximal to the distal vertex, and / or The rod is attached to the proximal end of the funnel by attaching it to the elliptical opening at the proximal apex.

27. The apparatus according to any one of claims 1-26, wherein, The stabilizer includes a spring-loaded mechanism adapted to stabilize the device in the deployed state by applying tension to the rod.

28. The apparatus according to claim 27, wherein, The spring loading mechanism is adapted to automatically apply the tension to the rod when the manual operation of the unfolding knob is stopped.

29. The apparatus according to any one of claims 1-28, wherein, The unfolding knob can be operated by rotation.

30. The apparatus according to claim 29, wherein, The handle includes a drive wheel that engages with the rod and is operably coupled to the knob, such that rotating the knob in a first knob direction causes the drive wheel to rotate in a forward drive wheel direction, thereby pushing the rod distally to gradually change the device from the delivery state to the unfolded state.

31. The apparatus according to claim 30, wherein, The drive wheel defines the roller, and the rod passes tangentially through the roller.

32. The apparatus according to claim 30, wherein, The stabilizer is configured such that actuation of the stabilizer causes the drive wheel to rotate in the opposite drive wheel direction, thereby pulling the rod proximally.

33. The apparatus according to claim 32, wherein, The stabilizer is configured with a first position and a second position, and / or is configured to be actuated by moving the stabilizer from the first position to the second position, such that the actuation of the stabilizer causes the drive wheel to rotate by a predetermined discrete amount in the direction of the reverse drive wheel, thereby pulling the rod proximally by a predetermined discrete distance.

34. The apparatus according to claim 32, wherein: The drive wheel has drive wheel teeth. The stabilizer has sealing teeth, and / or Actuating the stabilizer causes the seal teeth to engage with the drive wheel teeth, and moves the drive wheel in the opposite drive wheel direction.

35. The apparatus according to claim 34, wherein, The drive wheel teeth are circumferentially distributed, the seal teeth are linearly distributed, and / or the actuation of the stabilizer causes the seal teeth and the drive wheel teeth to form a rack and pinion arrangement.

36. The apparatus according to claim 34, wherein, The engagement between the sealer teeth and the drive wheel teeth stabilizes the device by inhibiting distal movement of the rod and the funnel relative to the conduit.

37. An apparatus for removing an obstruction from a blood vessel of a subject, the apparatus comprising: - Flexible catheters, which have: -- Proximal part, -- A distal portion, configured for transluminal insertion into the blood vessel, the distal portion having an edge, and / or -- A lumen that extends from the proximal portion to the edge; - Funnel: -- The funnel has (i) a mouth located at the distal end of the funnel, and / or (ii) an opening located at the proximal end of the funnel. -- The funnel is biased to present an expanded state, in which the spout is wider than the opening and the edge, and / or -- The funnel can be elastically compressed into a compressed state, and the spout is narrower in the compressed state than in the expanded state; - A flexible rod that is attached to the proximal end of the funnel and / or extends proximally through the conduit; and - A handle located at the proximal portion of the catheter, the handle defining a flat base for resting on a surface, the handle comprising: -- A finger wheel operably coupled to the flexible rod, such that manual operation of the finger wheel causes the device to gradually transition between (i) a delivery state and / or (ii) an unfolding state, in which the funnel is in the compressed state within the conduit, and in the unfolding state, the funnel is in the expanded state and the nozzle is exposed from the distal portion of the conduit, and / or -- A fluid port facing proximal and / or fluidly connected to the mouth of the funnel, and adapted to receive a suction source such that suction applied to the fluid port is transmitted via the lumen to draw the obstruction into the funnel via the mouth.

38. The apparatus according to claim 37, wherein, The handle has a foot that extends to define an extension of the flat base.

39. The apparatus according to any one of claims 37-38, wherein, The finger wheel faces outwards.

40. The apparatus according to any one of claims 37-39, wherein, The proximal portion of the catheter is fixedly attached to the handle.

41. The apparatus according to claim 40, wherein, The handle is shaped to be gripped by the user's hand, wherein the conduit extends between the fingers of the hand and away from the handle.

42. The apparatus according to claim 40, wherein, The proximal portion of the catheter is attached to the handle at the distal portion of the handle.

43. The apparatus according to claim 42, wherein, The handle also includes a sealer configured to convert the device into a sealed state by retracting the funnel back to engage with the edge seal, such that in the sealed state: The funnel remains in the expanded state, and / or The spout of the funnel is fluidly connected to the lumen, such that suction applied through the lumen draws the obstruction into the funnel via the spout.

44. The apparatus according to claim 43, wherein, The seal faces the distal side.

45. An apparatus for removing an obstruction from a blood vessel of a subject, the apparatus comprising: - Flexible catheters, which have: -- Proximal part, -- A distal portion, configured for transluminal insertion into the blood vessel, the distal portion having an edge, and / or -- A lumen that extends from the proximal portion to the edge; - Funnel: -- The funnel is formed from a set of braided threads covering a covering. -- The funnel has: --- Mouth, which is located at the distal end of the funnel. --- A spoon-shaped portion, located at the mouth portion and protruding distally, the spoon-shaped portion being defined by the following: ---- The first outer lobe is formed by the bend of the first wire in the group of wires. ---- The second outer lobe is formed by the bend of the second wire in the group of wires. ---- An inner lobe, the inner lobe being disposed between and / or overlapping the first and second outer lobes, the inner lobe being formed by a bent portion of a third wire in the set of wires, the third wire being more flexible than the first wire and more flexible than the second wire, and / or --- An opening located near the proximal end of the funnel. -- The funnel is biased to present an expanded state, in which the spout is wider than the opening and the edge, and / or -- The funnel can be elastically compressed into a compressed state, and the mouth is narrower in the compressed state than in the expanded state.

46. ​​The apparatus according to claim 45, wherein, For each of the first lobe, the second lobe, and / or the third lobe, the corresponding wire defines two tails that are diverging from each other away from the bend, extending along the funnel toward the opening in opposite helical chirality.

47. The apparatus according to any one of claims 45-46, wherein: The funnel has a central longitudinal axis passing through the mouth and the opening, and / or In the expanded state, the spoon-shaped portion opens radially outward from the central longitudinal axis.

48. The apparatus according to any one of claims 45-47, wherein: Each of the first lateral lobe and the second lateral lobe defines an lateral tail and an inner tail, the lateral tail extending spirally away from the bend and the inner lobe, and / or along the funnel toward the opening, and / or the inner tail extending away from the bend to overlap with the inner lobe and spirally along the funnel toward the mouth, and / or The set of wires includes at least one corresponding lobe support wire for each of the outer lobes, each lobe support wire defining a loop that surrounds the outer tail of the corresponding outer lobe at the mouth to support the corresponding outer lobe.

49. The apparatus according to claim 48, wherein, The set of wires includes exactly two corresponding lobe support wires for each of the outer lobes.

50. The apparatus according to claim 48, wherein, Each of the petal support wires defines a pair of tails that extend proximally away from the circumference and spirally extend along the funnel toward the opening.

51. The apparatus according to claim 50, wherein, For each of the lobe support wires, the tails of the pair of tails extend parallel to each other and / or with the same helical chirality along the funnel toward the opening.

52. The apparatus according to claim 51, wherein, For each of the outer lobes, the set of wires includes a first lobe support wire and a second lobe support wire, the tail of the first lobe support wire extending parallel to the opening along the funnel, and / or having the same helical chirality as the tail of the second lobe support wire.

53. The apparatus according to claim 52, wherein, The loop of the first lobe support wire is distal to the loop of the second lobe support wire, and / or the first lobe support wire is stiffer than the second lobe support wire.

54. The apparatus according to any one of claims 45-53, wherein: The spoon-shaped portion is the first spoon-shaped portion. The funnel has opposing spoon-shaped portions at its opening, each spoon-shaped portion being defined by at least two curved wires from the set of wires. Each curved wire forms a partial curved portion around the opening, and these curved portions overlap each other. The opposing spoon-shaped portion is opposite to the first spoon-shaped portion.

55. The apparatus according to claim 54, wherein, In response to the compressive force applied to the funnel, the opposing spoon-shaped portion is configured to extend distally by deformation to the arcuate portion having a reduced radius of curvature.

56. The apparatus according to claim 54, wherein, The opposing spoon-shaped portions are defined by two arc-shaped wires that form the two arc-shaped portions.

57. The apparatus according to claim 56, wherein, Apart from the first wire defining the first outer lobe, the second wire defining the second outer lobe, and / or the third wire defining the inner lobe, the first spoon-shaped portion is not defined by any other wire in the group of wires.

58. The apparatus according to claim 54, wherein, The first spoon-shaped portion protrudes distally beyond the opposing spoon-shaped portion.

59. The apparatus according to claim 54, wherein, The first spoon-shaped portion is longer than the opposite spoon-shaped portion.

60. The apparatus according to claim 54, wherein, Each of the arc-shaped wires is one of a pair of parallel arc-shaped wires, with each pair of arc-shaped wires facing the far side.

61. The apparatus according to claim 54, wherein, The opposing spoon-shaped portion also includes a single arc-shaped wire, which forms an arc-shaped portion between the two arc-shaped wires and / or from the two arc-shaped wires toward the proximal side.

62. An apparatus for removing an obstruction from a blood vessel of a subject, the apparatus comprising: - Flexible catheters, which have: -- Proximal part, -- A distal portion, configured for transluminal insertion into the blood vessel, the distal portion having an edge, and / or -- A lumen that extends from the proximal portion to the edge; - A funnel having a central longitudinal axis passing through the spout and the opening, and / or -- The funnel has (i) a mouth located at the distal end of the funnel, and / or (ii) an opening located at the proximal end of the funnel. -- The funnel can be elastically compressed into a compressed state, and / or -- The funnel is biased to present an expanded state, in which the mouth is wider than (i) the opening and the edge and / or (ii) the mouth in a compressed state, and / or wherein the funnel defines: -- The distal segment, which includes the mouth portion and / or is generally cylindrical. -- Proximal segment, the proximal segment including the opening and / or generally cylindrical. -- An intermediate segment, which tapers gradually from the distal segment to the proximal segment to fluidly connect the distal segment to the proximal segment, and / or -- A first spoon-shaped portion and an opposing spoon-shaped portion, the first spoon-shaped portion and the opposing spoon-shaped portion being located at the mouth portion, extending distally from the distal segment, and / or opening away from the other spoon-shaped portion and away from the longitudinal axis.

63. An apparatus for treating a subject, the apparatus comprising: - Flexible catheters, which have: -- Proximal part, -- A distal portion, configured for transluminal insertion into the subject's blood vessel, the distal portion having an edge, and / or -- A lumen that extends from the proximal portion to the edge; - Funnel: -- The funnel has (i) a mouth located at the distal end of the funnel, and / or (ii) an opening located at the proximal end of the funnel. -- The funnel is biased to present an expanded state, in which the spout is wider than the opening and the edge, and / or -- The funnel can be elastically compressed into a compressed state, in which the spout is narrower than in the expanded state; - A flexible rod that is attached to the proximal end of the funnel and / or extends proximally through the conduit; and - A handle located at the proximal portion of the catheter, the handle comprising: -- An unfolding knob, operably coupled to the flexible rod, allows for manual operation to gradually switch the device between (i) a delivery state and / or (ii) an unfolding state, in which the funnel is in the compressed state within the catheter, and in the unfolding state, the funnel is in the expanded state and the nozzle is exposed from the distal portion of the catheter, and / or -- A sealing device, separate from the unfolding knob, and / or configured to convert the device into a sealed state by retracting the funnel back to engage with the edge seal, such that in the sealed state: --- The funnel remains in the expanded state, and / or --- The mouth of the funnel is fluidly connected to the lumen, such that suction applied through the lumen draws fluid into the funnel via the mouth.

64. An apparatus for removing an obstruction from a blood vessel of a subject, the apparatus comprising: - Flexible catheters, which have: -- Proximal part, -- A distal portion, configured for transluminal insertion into the blood vessel, the distal portion having an edge, and / or -- A lumen that extends from the proximal portion to the edge; - Funnel: -- The funnel has (i) a mouth located at the distal end of the funnel, and / or (ii) an opening located at the proximal end of the funnel. -- The funnel is biased to present an expanded state, in which the spout is wider than the opening and the edge, and / or -- The funnel can be elastically compressed into a compressed state, in which the spout is narrower than in the expanded state; - A flexible rod that is attached to the proximal end of the funnel and / or extends proximally through the conduit; and - A handle located at the proximal portion of the catheter, the handle comprising: -- An unfolding knob, operably coupled to the flexible rod, allows for manual operation to gradually switch the device between (i) a delivery state and / or (ii) an unfolding state, in which the funnel is in the compressed state within the catheter, and in the unfolding state, the funnel is in the expanded state and the nozzle is exposed from the distal portion of the catheter, and / or -- A sealing device, separate from the unfolding knob, and / or configured to convert the device into a sealed state by retracting the funnel back to engage with the edge seal, such that in the sealed state: --- The funnel remains in the expanded state, and / or --- The mouth of the funnel is fluidly connected to the lumen, such that suction applied through the lumen draws the obstruction into the funnel via the mouth.

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