Importance

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Abstract

A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being's vascular system. The system comprises an instrument having a working head, e.g., a rotary impacting impeller located within an apertured shroud, and a debris extraction sub-system. The instrument is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced by the operation of the working head on the occlusive material. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head, e.g., through a opening in the shroud, and withdraws that liquid and some blood at a second and higher flow rate, e.g., through the guide catheter. This action creates a differential flow adjacent the working head, whereupon debris produced by the operation of the working head is withdrawn in the infusate liquid and blood by the differential flow for collection outside the being's body. The introduction of the infusate liquid establishes an unbalanced flow adjacent the working head to enable the catheter to be steered hydrodynamically.

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First Claim