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Abstract

Improved apparatus and methods are described for performing endarterectomy remotely via intraluminal techniques. A flexible blade dissector has a curved, diamond-shaped flexible dissecting blade mounted on a catheter shaft. The distal edge of the flexible dissecting blade is configured to form a dissecting edge for separating an atheromatous plaque from the medial layer of an artery wall. The flexible blade dissector may incorporate a steering mechanism to direct the flexible dissecting blade along a preferred path within the arterial wall. The endarterectomy method is performed by making an incision into an artery wall and initiating a plane of separation between an atherosclerotic plaque and the medial layer of the artery wall, inserting the flexible blade dissector into the plane of separation and advancing the flexible dissecting blade to longitudinally extend the plane of separation. Optionally, a second flexible blade dissector with a wider dissecting blade may be inserted coaxially over the catheter shaft of the first flexible blade dissector and advanced to laterally expand the plane of separation. Once the plaque has been freed from the entire inner circumference of the arterial lumen, the plane of separation is terminated on the distal and proximal ends, and the plaque is removed from the arterial lumen.

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First Claim