Importance

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Abstract

An abrasive drive shaft atherectomy device for removing stenotic tissue from an artery. The device includes a rotational atherectomy apparatus having a flexible, elongated drive shaft having a central lumen and a segment, near its distal end, coated with an abrasive material to define an abrasive segment. In one embodiment the device includes a special guide wire having a generally straight proximal portion, a distal end portion, and a flexible intermediate positioning segment. The positioning segment has a predetermined curved shape such that when the abrasive segment of the drive shaft is advanced over the guide wire to a position along the curved positioning segment, such curved segment positions the abrasive segment laterally away from the longitudinal axis of the proximal portion of the drive shaft. In another embodiment a conventional, generally straight guide wire is utilized, along with a separate positioning wire. The positioning wire is slidably secured, at its distal end to the guide wire so that the positioning wire can be moved proximally and distally with respect to the guide wire. The positioning wire includes a distal positioning segment having a predetermined shape. Rather than being advanced over the guide wire, the drive shaft is advanced over the positioning wire. When the drive shaft's abrasive segment is positioned along the predetermined curved shape of positioning wire's positioning segment, the positioning segment positions the abrasive segment laterally away from the guide wire, thus giving control over the lateral position of the burr within the artery. In either embodiment, the device therefore allows selective removal of tissue from one side of an artery, permitting selective treatment of eccentric stenotic lesions without damaging the artery wall, and permitting treatment of lesions generally without blocking blood flow through the artery during use of the device.

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First Claim