Abstract:
A thrombectomy catheter device having an improved hemostasis valve which is self-sealing and which functions as a one-way valve. The self-sealing hemostasis valve can be factory preset to automatically seal with or without the inclusion of a guidewire at a certain desired pressure or allowable leakage. Such sealing is automatic without the need to manually manipulate a hemostasis nut to obtain hemostasis. The thrombectomy catheter device can, without hemostasis nut adjustment, be positioned along and about a guidewire while yet maintaining suitable pressure for sustaining hemostasis at a preferred level. Certain embodiments of the thrombectomy catheter device having a self-sealing hemostasis valve include an adjustable hemostasis nut which can be manually tightened to restrict flow or guidewire movement or loosened to reduce friction on the guidewire and allow fluid to flow out if desired. An introducer facilitates free passage of a guidewire in either direction through the hemostasis nut and hemostasis valving and can also be incorporated to purge internal air or fluids.

Description:
CROSS REFERENCES TO RELATED APPLICATIONS 
     This patent application is a continuation-in-part of Ser. No. 10/198,264 entitled “Rapid Exchange Fluid Jet Thrombectomy Device and Method” filed on Jul. 16, 2002, now U.S. Pat. No. 6,875,193, which is a continuation-in-part of Ser. No. 09/888,455 entitled “Single Operator Exchange Fluid Jet Thrombectomy Device” filed on Jun. 25. 2001, now U.S. Pat. No. 6,755,803, which is a continuation-in-part of Ser. No. 09/356,783 entitled “Rheolytic Thrombectomy Catheter and Method of Using Same” filed on Jul. 16, 1999, now abandoned, which is a divisional of Ser. No. 09/019,728 entitled “Rheolytic Thrombectomy Catheter and Method of Using Same” filed on Feb. 6, 1998, now U.S. Pat. No. 5,989,210. Patent application Serial No. 10/198,264 is also related to Ser. No. 09/417,395 entitled “Thrombectomy Catheter and System” (as amended) filed on Oct. 13, 1999, now U.S. Pat. No. 6,676,627, which is a continuation-in-part of Ser. No. 08/349,665 entitled “Thrombectomy Method” filed on Dec. 5, 1994, now U.S. Pat. No. 6,558,366, which is a divisional of Ser. No. 08/006,076 entitled “Thrombectomy Device” filed on Jan. 15, 1993, now U.S. Pat. No. 5,370,609, which is a continuation of Ser. No. 07/563,313 entitled “Thrombectomy Device and Method” filed on Aug. 6, 1990, abandoned. Patent application Ser. No. 10/198,264 is also related to Ser. No. 08/351,605 entitled “Thrombectomy and Tissue Removal Method and Device” filed on Dec. 8, 1994, now U.S. Pat. No. 6,471,683, which is a divisional of Ser. No. 07/976,367 entitled “Thrombectomy and Tissue Removal Method and Device” filed on Nov. 13, 1992, abandoned, which is a continuation-in-part of Ser. No. 07/563,313 entitled “Thrombectomy Device and Method” filed on Aug. 6, 1990, abandoned. 
    
    
     BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     The present invention relates to a thrombectomy catheter device in general, and more particularly, to a thrombectomy catheter device having a self-sealing hemostasis valve. 
     2. Description of the Prior Art 
     In current interventional thrombotic material removal procedures using thrombosis removal catheter devices, a guidewire is loaded into the tip of a thrombectomy catheter device, through the exhaust tube, through a seal, and out the hemostasis nut where the guidewire was most likely previously positioned within a patient using common interventional means. The hemostasis valve is then manually tightened by way of a hemostasis nut, which normally compresses a silicone ring or seal until it “flattens” to close off the inner diameter of the seal, thereby effecting a seal around and about the guidewire shaft. This seal is activated to keep blood, saline solution, and other fluids carrying debris from leaking out of the device during operation, which fluids carrying debris are normally exhausted out of the device via an exhaust line and collected in an exhaust bag. The seal further keeps blood from leaking out of the patient while the device is not in operation, but still within the patient. During a thrombectomy procedure, it is desirable to move the catheter device over the guidewire without moving the guidewire, while maintaining hemostasis via common interventional practices. The current hemostasis valve on the manifold, although adequate, is not optimized. It is difficult to move the device without moving the guidewire due to the nature of a compressive seal. If movement is improved by loosening the hemostasis nut, then leakage becomes an issue. It is also time-consuming and problematic to have to always manually tighten a hemostasis nut to achieve hemostasis. For example, the physician must remember an extra step to obtain hemostasis, in which the hemostasis nut may be loosened instead of tightened. This loosening then sometimes leads to the hemostasis nut becoming detached from the manifold, which then leads to the inability to obtain hemostasis. The other main issue is “fine tuning” the tightness of the nut to obtain the proper device movement over the guidewire (i.e., no guidewire movement). This often leads to some amount of leakage. 
     SUMMARY OF THE INVENTION 
     The general purpose of the present invention is to provide a thrombectomy catheter device having an improved and self-sealing hemostasis valve which can be preset to automatically seal with or without the inclusion of a guidewire at a certain desired pressure. Such sealing is automatic without the need to manually manipulate a hemostasis nut to obtain hemostasis. The thrombectomy catheter device can, without hemostasis nut adjustment, be positioned along and about a guidewire while yet maintaining suitable pressure or at an allowable leakage rate for sustaining hemostasis at a preferred level. Additionally, the hemostasis nut in several embodiments can be manually tightened to influence the self-sealing hemostasis valve to restrict flow or guidewire movement, or manually loosened to reduce friction on the guidewire and allow fluid to flow out, if desired. The present invention is a mechanical thrombectomy catheter device which uses high velocity saline jets shooting past a gap to entrain and macerate thrombus and other debris located within vessels by way of a low pressure zone and recirculation patterns, as described in previous patents and/or patent applications by the applicants. This basic design is further optimized using cross stream technology that has regions of inflow (low pressure) and outflow (high pressure) that maximize the recirculation pattern, among other things. The thrombectomy catheter device is primarily composed of a manifold and an exhaust line having a maceration tip which associates with and connects to commonly found thrombectomy removal systems such as, but not limited to, a pump, a high pressure supply line, and a drive unit. A cross stream effect occurs at the tip, which is described extensively in previous patents and applications by the applicants along with all of the other components. This particular improvement to this existing technology is concerned with the manifold of the device. The manifold allows for the connection of the high pressure supply line and an exhaust line, and includes structure for exiting of a guidewire which is sealed with a self-sealing hemostasis valve. The new improvement to the manifold is concerned primarily with the self-sealing hemostasis valve, although the current manifold is also improved over the old in such ways as being optimized for size, weight, manufacture, and compatibility with future improvements to the overall thrombectomy catheter system. 
     The preferred design of an improved self-sealing hemostasis valve for cross stream thrombectomy or other catheter devices, and related designs, is one in which the self-sealing hemostasis valve can be factory preset or manufactured to seal at a certain pressure or to maintain an allowable leakage. Presetting the self-sealing hemostasis valve allows the user to use the thrombectomy catheter devices without needing to manipulate a hemostasis nut on a conventional valve to obtain hemostasis. In this way, the seal is automatic or self-sealing. The self-sealing hemostasis valve will also seal at a preset pressure or allowable leakage factor with or without the guidewire in place. Catheters are usually primed where the tip is inserted in a bowl of saline and where the catheter is operated to remove air and fill the effluent line without the guidewire in place. The prior art designs required the hemostasis nut to be manually tightened to eliminate leakage out the manifold. In many instances, it is easy to forget this, and fluid would leak out and the hemostasis nut would need to be tightened to achieve stasis. The new self-sealing hemostasis valve overcomes the inadequacies of the prior art and is automatic and, therefore, more foolproof and easier to use, as fluid may be expelled therefrom by merely taking advantage of the new design in that the valve is also one-way directional flow. Air and fluid can be pushed out the back of the self-sealing hemostasis valve without repositioning the hemostasis nut, but none can be pulled in. This improves safety of the device since air cannot be pulled in under negative pressure circumstances which could lead to air embolization if the user tried to inject fluid, such as contrast fluid, through the manifold. Under normal usage conditions, the guidewire will travel through the self-sealing hemostasis valve without any additional manipulation. If the guidewire will not pass through the self-sealing hemostasis valve easily, as it would be with smaller diameter guidewires, then an introducer can be inserted to fully open the self-sealing hemostasis valve to aid in passage of the guidewire through the manifold, and the introducer can then be pulled out or retracted to create the seal. The introducer can be pushed through the self-sealing hemostasis valve in those embodiments incorporating adjustable hemostasis nuts where the hemostasis nut is fully open to disengage the automatic sealing feature about the guidewire to aid guidewire movement through the self-sealing hemostasis valve or to bleed out air/fluid. Alternatively, in embodiments not having an adjustable hemostasis nut, the introducer can be positioned to engage and open the self-sealing hemostasis valve to disengage the automatic sealing feature about the guidewire to aid guidewire movement through the self-sealing hemostasis valve or to bleed out air/fluid. If hemostasis is not achieved after these operations, then the hemostasis nut where adjustable can be tightened down to effect a seal. The other feature of this design is that the valve can be used as a regular hemostasis valve in that it can be tightened to restrict flow or guidewire movement more, or loosened to reduce friction on the guidewire and allow fluid to flow out, if desired. Another advantage of this design is that it eliminates components from previous similar designs (i.e., it is more manufacturable and has lower cost). 
     Alternate embodiments of the invention also address the issues of guidewire movement, adequate hemostasis, and manual sealing by way of a pliable self-sealing hemostasis valve that is designed much like a biological valve. The entire hemostasis features of the manifolds are composed of components that fit into an appropriately designed cavity in the manifold, a hemostasis nut that screws or otherwise affixes onto the manifold, and an introducer which engages into the hemostasis nut. In a first alternate embodiment, the first component inserted into the manifold is a dual seal, then a washer, then the self-sealing hemostasis valve, then another washer; then the hemostasis nut is snapped on or otherwise affixed and then screwed on as applicable. An introducer is then snapped into or otherwise engaged with the hemostasis nut. For most functions and in all the embodiments, the self-sealing hemostasis valve incorporated in the instant invention is the primary means incorporated for slidable engagement with the guidewire and for sealing engagement with the surrounding cavity in a manner similar to that of the preferred embodiment. In the first alternate embodiment, the dual seal acts as a normal compressive seal when the hemostasis nut is tightened down, as in most hemostasis valves. This secondary dual seal is only used in extreme cases when hemostasis cannot be achieved with the automatic self-sealing hemostasis valve. The washers aid in transferring force evenly and minimize seals or valves binding on each other when the hemostasis nut is tightened. The introducer is only used to aid guidewire movement through the seals or to bleed air out of the manifold. The introducer can be pushed through the self-sealing hemostasis valve while the hemostasis nut is fully open to disengage the automatic sealing feature to aid guidewire movement through this self-sealing hemostasis valve or to bleed out air/fluid. Under normal usage conditions, the guidewire will travel through the self-sealing hemostasis valve and achieve hemostasis without any additional manipulation of the assembly. If the guidewire will not pass through the self-sealing hemostasis valve easily, as it would be the case with smaller diameter guidewires, then the introducer can be pushed to fully open the self-sealing hemostasis valve to aid in passage of the guidewire through the manifold, and can then be pulled out to create the seal. If hemostasis is not achieved with these operations, then the hemostasis nut can be tightened down to engage the secondary seal. 
     According to the first embodiment of the present invention, there is provided a thrombectomy catheter device having a self-sealing hemostasis valve. The thrombectomy catheter device having a self-sealing hemostasis valve includes a centrally located manifold to which a variety of components attach and which are outwardly visible, and also includes features which are seen in exploded and cross sectional views. The manifold includes mutually connected interior passageways, some of which are of configured shape, which are located within a centrally located tubular body of the manifold or in branches of the manifold and which are available for attachment to other components of the instant invention by threaded surfaces located about the manifold. Located at one end of the manifold is a cavity body and a contained cavity for housing of a self-sealing hemostasis valve and an elongated washer. A hemostasis nut having an internal annular ring snappingly engages another annular ring at the proximal region of the manifold cavity body to be loosely connected to the manifold and to be available for threaded engagement thereto. A cylindrical boss is located interiorly of the hemostasis nut to impinge and to apply pressure to the self-sealing hemostasis valve and the elongated washer whereby the shape and other attributes of the self-sealing hemostasis valve may be influenced to achieve various states or stages of hemostasis. Some other items attached to or which are useful to the operation of the instant invention include Luer connectors, a strain relief, a catheter tube, a high pressure tube, a fluid jet emanator, a catheter tube tip, radiopaque markers, inflow and outflow orifices, a ferrule, a threaded high pressure connection port, and an introducer. 
     The first alternate embodiment of the instant invention includes a manifold having an alternately shaped cavity within the cavity body which receives a dual seal, a wide washer, a self-sealing hemostasis valve, and another washer. Sealing to a guidewire is automatic where the self-sealing hemostasis valve is the primary method of sealment to effect hemostasis or, if desired, a hemostasis nut may be incorporated to alternately effect a seal between the dual seal and a guidewire, as well as a seal between the dual seal and the interior of the manifold. An introducer is also provided to aid in alternate accommodation of a guidewire and to provide for venting for the interior of the manifold. 
     A second alternate embodiment of the instant invention includes a manifold having a cavity within the cavity body which receives a self-sealing hemostasis valve, a washer and one end of an introducer. A nonadjustable hemostasis nut threadingly affixes to the proximal region of the manifold where a stop means determines the position of the hemostasis nut along the proximal region of the manifold. Such positioning advances a cylindrical boss residing in the hemostasis nut into contact with a self-sealing hemostasis valve. As in other embodiments, sealing to a guidewire is automatic where the self-sealing hemostasis valve is the primary method of sealment to effect hemostasis. A seal is also effected between the self-sealing hemostasis valve and the interior of the manifold. An introducer is also provided to aid in alternate accommodation of a guidewire and to provide for venting for the interior of the manifold. A cavity extension adjacent to the cavity accommodates the distal end of an affixed introducer when the introducer is optionally positioned distally to accommodate a guidewire or when the introducer is positioned distally to allow the release of air or fluid from the interior of the manifold or other catheter components. 
     A third alternate embodiment of the instant invention embraces the teaching of the second alternate embodiment whereby a cavity insert is included in a reconfigured and expanded length cavity in the manifold where the cavity extension of the second alternative embodiment is removed and a cavity insert is utilized in the expanded length cavity. The cavity insert includes a recess corresponding in size to that of the removed cavity extension to accommodate the distal end of an affixed introducer when the introducer is optionally positioned distally to accommodate a guidewire or when the introducer is positioned distally to allow the release of air or fluid from the interior of the manifold or other catheter components. 
     A fourth alternate embodiment of the instant invention embraces the teaching of the second alternate embodiment whereby the threads at the proximal region of the cavity body are replaced by a smooth cylindrical surface and the internal threads of the hemostasis nut are replaced by a smooth cylindrical surface. The smooth cylindrical surfaces of the proximal region of the cavity body and the smooth cylindrical surfaces of the hemostasis nut mutually accommodate each other and are bonded such as by adhesive or other suitable methods to affix the hemostasis nut to the distal region of the cavity body. 
     A fifth alternate embodiment of the instant invention includes a manifold having a cavity within the cavity body which receives a self-sealing hemostasis valve, a washer and one end of an introducer. A nonadjustable hemostasis nut threadingly affixes to the proximal region of the manifold where a stop means determines the position of the hemostasis nut along the proximal region of the manifold. Such positioning advances a cylindrical boss residing in the hemostasis nut into contact with a self-sealing hemostasis valve. As in other embodiments, sealing to a guidewire is automatic where the self-sealing hemostasis valve is the primary method of sealment to effect hemostasis. A seal is also effected between the self-sealing hemostasis valve and the interior of the manifold. An introducer is also provided to aid in alternate accommodation of a guidewire and to provide for venting for the interior of the manifold. A cavity extension adjacent to the cavity accommodates the distal end of an affixed introducer when the introducer is optionally positioned distally to accommodate a guidewire or when the introducer is positioned distally to allow the release of air or fluid from the interior of the manifold or other catheter components. 
     Structure of the fifth alternate embodiment is simplified and the number of components and complex structures is reduced. A streamlined flexible strain relief is furnished where one end is accommodated by a distally located flangeless tapered manifold region and is secured therein such as by adhesive or other suitable methods. A flangeless high pressure connection branch extending from the manifold accommodates a threaded high pressure connection port which secures therein by adhesive or other suitable methods. 
     Structure of a sixth alternate embodiment is also simplified and the number of components and complex structures is reduced, including the exclusion of a hemostasis nut. A self-sealing hemostasis valve is formed by the interference of a guidewire extending through and transmitting through an elongated hemostasis valve body having a close tolerance fit. The self-sealing hemostasis valve functions in either an active or a passive mode. 
     One significant aspect and feature of the present invention is a thrombectomy catheter device having a self-sealing hemostasis valve. 
     Another significant aspect and feature of the present invention is a thrombectomy catheter device which automatically slidingly engages and seals to a guidewire passing therethrough and does not require adjustment of a hemostasis nut. 
     Yet another significant aspect and feature of the present invention is a thrombectomy catheter device having a self-sealing hemostasis valve which seals to a proximally located manifold cavity wall. 
     A further significant aspect and feature of the present invention is a thrombectomy catheter device having a self-sealing hemostasis valve which includes opposing recessed surfaces whose central portions are radiused and increasingly thinner in a direction towards the center and which include a plurality of slits delineating a plurality of lobes to allow suitable lobe flexing, deforming and reshaping to sealingly and slidingly conform along and about the shape of a guidewire passing therethrough. 
     Yet another significant aspect and feature of the present invention is a thrombectomy catheter device having a self-sealing hemostasis valve which can be factory preset to maintain a desired manifold pressure with or without the inclusion of a guidewire. 
     Still another significant aspect and feature of the present invention is a thrombectomy catheter device having a hemostasis nut which can be utilized in addition to or in lieu of a suitable seal by the self-sealing hemostasis valve. 
     Still another significant aspect and feature of the present invention is a thrombectomy catheter device having a hemostasis nut which snappingly engages and remains engaged over and about the proximal region of the catheter device manifold. 
     Yet another significant aspect and feature of the present invention is a thrombectomy catheter device which can include the use of an introducer inserted through the hemostasis nut to assist in engagement of a guidewire in either direction. 
     Yet another significant aspect and feature of the present invention is a thrombectomy catheter device which can include the use of an introducer to bleed air or fluid from the manifold. 
     Still another significant aspect and feature of the present invention is a self-sealing hemostasis valve which limits flow to an outward direction to prevent the ingestion of foreign matter into the catheter device manifold. 
     Another significant aspect and feature of the present invention is a thrombectomy catheter device having a hemostasis nut which engages a stop to determine the position of the hemostasis nut along the proximal region of the manifold, thereby properly positioning a cylindrical boss against a self-sealing hemostasis valve. 
     Still another significant aspect and feature of the present invention is a thrombectomy catheter device having a cavity extension or cavity insert for accommodation of one end of an actuated introducer. 
     Still another significant aspect and feature of the present invention is a thrombectomy catheter device having a smooth cylindrical surface at the proximal region of a manifold which engages and secures to a smooth cylindrical surface interior to a hemostasis nut. 
     Another significant aspect and feature of the present invention is a thrombectomy catheter device having a self-sealing hemostasis valve of simplified structure including a streamlined flexible strain relief suitably attached, such as by adhesive, to the distal flangeless end of a manifold. 
     Another significant aspect and feature of the present invention is a thrombectomy catheter device having a self-sealing hemostasis valve of simplified structure including a flangeless high pressure connection branch extending from a manifold to accommodate a high pressure connection port secured suitably therein, such as by adhesive. 
     Another significant aspect and feature of the present invention is a thrombectomy catheter device having a self-sealing hemostasis valve where a self-sealing hemostasis valve is formed by the relationship of a guidewire and an elongated hemostasis valve passageway where the guidewire, which actively or passively transmits the elongated hemostasis valve passageway, offers interference within the elongated hemostasis valve passageway to form and act as a self-sealing hemostasis valve. 
     Having thus described embodiments of the present invention and mentioned significant aspects and features thereof, it is the principal object of the present invention to provide a thrombectomy catheter device having a self-sealing hemostasis valve. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Other objects of the present invention and many of the attendant advantages of the present invention will be readily appreciated as the same becomes better understood by reference to the following detailed description when considered in connection with the accompanying drawings, in which like reference numerals designate like parts throughout the figures thereof and wherein: 
         FIG. 1  is a plan view of the visible components of a thrombectomy catheter device having a self-sealing hemostasis valve, the present invention; 
         FIG. 2  is an isometric exploded view of the thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 3  is an exploded view in partial cross section of the components of the thrombectomy catheter device having a self-sealing hemostasis valve excluding the full length of the catheter tube and the included tip, but including a guidewire such as is incorporated in the use of the invention; 
         FIG. 4  is an isometric view of the self-sealing hemostasis valve; 
         FIG. 5  is a proximal end view of the self-sealing hemostasis valve; 
         FIG. 6  is a cross section view of the self-sealing hemostasis valve along line  6 - 6  of  FIG. 5 ; 
         FIG. 7  is an isometric view in cross section of the elongated washer along line  7 - 7  of  FIG. 2 ; 
         FIG. 8  is a proximal end view of the elongated washer; 
         FIG. 9  is a cross section view of the elongated washer along line  9 - 9  of  FIG. 8 ; 
         FIG. 10  is a view in partial cross section of the assembled components of  FIG. 3  shown over and about and with the use of a guidewire and showing the introducer detached; 
         FIG. 11  is a fragmented view in cross section of the proximal region of the manifold showing the compression of the self-sealing hemostasis valve by the action of the hemostasis nut being advanced in a distal direction along the threads at the end of the cavity body of the manifold; 
         FIG. 12  is a view like  FIG. 11  illustrating the use of an introducer, the hollow shaft of which can be inserted through the self-sealing hemostasis valve; 
         FIG. 13  is a view like  FIG. 12  showing the introducer being utilized to load a guidewire through the proximal region of the manifold; 
         FIG. 14 , a first alternate embodiment, is an isometric exploded view of a thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 15  is an exploded view in partial cross section of the components of the first alternate embodiment thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 16  is an isometric view in cross section of the dual seal which aligns in and which is housed distally in a cavity in the manifold; 
         FIG. 17  is a longitudinal cross section view of the dual seal; 
         FIG. 18  is a proximal end view of the dual seal; 
         FIG. 19  is a view in partial cross section of the assembled components of the first alternate embodiment shown over and about and with the use of a guidewire and showing the introducer detached; 
         FIG. 20  is a fragmentary view in cross section of the proximal region of the manifold of the first alternate embodiment illustrating the introducer in engagement with the hemostasis nut and where the hemostasis nut is in loose engagement with the proximal region of the manifold; 
         FIG. 21  is a view like  FIG. 20  showing further advancement of the hemostasis nut distally to impact and utilize the sealing capabilities of the dual seal to effect hemostasis where a thinner guidewire is utilized and a seal between the self-sealing hemostasis valve and the thinner guidewire is not practicable; 
         FIG. 22  is a view like  FIG. 20  illustrating the actuation of the introducer to perform alternate functions as required either to bleed air out of the manifold or to aid guidewire movement through the dual seal and/or self-sealing hemostasis valve when the hemostasis nut is loosely engaging the proximal region of the manifold; 
         FIG. 23 , a second alternate embodiment, is an isometric exploded view of a thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 24  is an exploded view in partial cross section of the components of the second alternate embodiment thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 25  is a view in partial cross section of the assembled components of the second alternate embodiment shown over and about and with the use of a guidewire and showing the introducer detached; 
         FIG. 26  is a fragmentary view in cross section of the proximal region of the manifold of the second alternate embodiment illustrating the introducer in normal engagement with the hemostasis nut and where the hemostasis nut is in fixed nonadjustable engagement with the proximal region of the manifold; 
         FIG. 27  is a view like  FIG. 26  illustrating the function of the introducer to perform alternate functions as required either to bleed air out of the manifold or to aid guidewire movement through the self-sealing hemostasis valve; 
         FIG. 28 , a third alternate embodiment, is an isometric exploded view of a thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 29  is an exploded view in partial cross section of the components of the third alternate embodiment thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 30  is a proximal cross section end view of the cavity insert along line  31 - 31  of  FIG. 28 ; 
         FIG. 31  is a view in partial cross section of the assembled components of the third alternate embodiment shown over and about and with the use of a guidewire and showing the introducer detached; 
         FIG. 32  is a fragmentary view in cross section of the proximal region of the manifold of the third alternate embodiment illustrating the introducer in normal engagement with the hemostasis nut and where the hemostasis nut is in fixed nonadjustable engagement with the proximal region of the manifold; 
         FIG. 33  is a view like  FIG. 32  illustrating the function of the introducer to perform alternate functions as required either to bleed air out of the manifold or to aid guidewire movement through the self-sealing hemostasis valve; 
         FIG. 34 , a fourth alternate embodiment, is an isometric exploded view of a thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 35  is an exploded view in partial cross section of the components of the fourth alternate embodiment thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 36  is a view in partial cross section of the assembled components of the fourth alternate embodiment shown over and about and with the use of a guidewire and showing the introducer detached; 
         FIG. 37  is a fragmentary view in cross section of the proximal region of the manifold of the fourth alternate embodiment illustrating the introducer in normal engagement with the hemostasis nut and where the hemostasis nut is in fixed nonadjustable engagement with the proximal region of the manifold; 
         FIG. 38  is a view like  FIG. 37  illustrating the function of the introducer to perform alternate functions as required either to bleed air out of the manifold or to aid guidewire movement through the self-sealing hemostasis valve; 
         FIG. 39 , a fifth alternative embodiment, is a plan view of the visible components of a thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 40  is an isometric exploded view of the fifth alternate embodiment thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 41  is an exploded view in partial cross section of the components of the fifth alternate embodiment thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 42  is a view in partial cross section of the assembled components of the fifth alternate embodiment shown over and about and with the use of a guidewire and showing the introducer detached; 
         FIG. 43  is a fragmentary view in cross section of the proximal region of the manifold of the fifth alternative embodiment illustrating the introducer in normal engagement with the hemostasis nut and where the hemostasis nut is in fixed nonadjustable engagement with the proximal end of the manifold; 
         FIG. 44  is a view like  FIG. 43  illustrating the function of the introducer to perform alternate functions as required either to bleed air out of the manifold or to aid guidewire movement through the self-sealing hemostasis valve; 
         FIG. 45 , a sixth alternative embodiment, is a plan view of the visible components of a thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 46  is an exploded isometric view of the sixth alternate embodiment thrombectomy catheter device having a self-sealing hemostasis valve; 
         FIG. 47  is an exploded view in partial cross section of the components of the sixth alternate embodiment thrombectomy catheter device having a self-sealing hemostasis valve; and, 
         FIG. 48  is a view in partial cross section of the assembled components of the sixth alternate embodiment shown over and about and with the use of a guidewire. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       FIG. 1  is a plan view of the visible components of a thrombectomy catheter device having a self-sealing hemostasis valve  10 , the present invention, including a one-piece manifold  12  having multiple structures extending therefrom or attached thereto and including a catheter tube  13  and other components as described herein. The visible portion of the one-piece manifold  12  includes a central tubular body  14 , an exhaust branch  16  and a high pressure connection branch  18  extending angularly from the central tubular body  14 , a cavity body  20  extending proximally from the central tubular body  14 , and partially shown and extending distally from the central tubular body  14 , a threaded connection port  22 . The proximal end of the catheter tube  13  secures to the manifold  12  by the use of a Luer fitting  26  accommodated by the threaded connection port  22 . The proximal end of the catheter tube  13  extends through a strain relief  28  and through the Luer fitting  26  to communicate with the manifold  12 . The catheter tube  13  extends distally to a tip  30  which is tapered and which can be flexible in design. The tip  30  of the catheter tube  13  includes a plurality of inflow orifices  32   a - 32   n  and a plurality of outflow orifices  34   a - 34   n , and radiopaque marker bands  36  and  38 , all of which are disclosed and described in detail in previous patent applications and patents by the applicants. Also shown is a hemostasis nut  40  aligned to and snappingly engaged with the proximal region of the cavity body  20 , and a threaded high pressure connection port  42  secured to the high pressure connection branch  18  by a Luer connector  44 . An introducer  46  is also shown. 
       FIG. 2  is an isometric exploded view of the thrombectomy catheter device having a self-sealing hemostasis valve  10 , the present invention, and  FIG. 3  illustrates an exploded view in partial cross section of the components of the thrombectomy catheter device having a self-sealing hemostasis valve  10  excluding the full length of the catheter tube  13  and the included tip  30 , but including a guidewire  48  such as is incorporated in the use of the invention. The catheter tube  13 , which also serves and functions as an exhaust tube, and a high pressure tube  41  distal to the strain relief  28  are foreshortened and shown as partial lengths for the purpose of clarity. 
     With reference to  FIG. 2  and  FIG. 3 , the instant invention is further described. The manifold  12  includes connected and communicating passageways and cavities ( FIG. 3 ) including a high pressure connection branch passageway  50 , an exhaust branch passageway  52 , a tapered central passageway  54  extending from and through the threaded connection port  22  and through the central tubular body  14  to and communicating with a cavity  56 , which preferably is cylindrical, located central to the cavity body  20 . An annular ring  58  having an angled annular surface  60  is located around and about the cavity body  20  at the proximal region of the manifold  12 , as well as threads  62  being proximal to the annular ring  58  and angled annular surface  60 . The annular ring  58  and angled annular surface  60  provide in part for snap engagement of the hemostasis nut  40  to the manifold  12 . 
     Beneficial to the instant invention is the use of a self-sealing hemostasis valve  64  and an elongated washer  66  located proximal to the self-sealing hemostasis valve  64 , the shapes of and the functions of which are described later in detail. The self-sealing hemostasis valve  64  and the elongated washer  66  are aligned in and housed in the cavity  56  at the proximal region of the manifold  12 . The cavity  56  is tubular in shape including a tubular cavity wall  57  and a planar surface  59  which is annular and circular and which intersects the tubular cavity wall  57 . An orifice  61  located central to the planar surface  59  is common to the cavity  56  and the tapered central passageway  54 . The hemostasis nut  40  includes a centrally located cylindrical boss  68 , a beveled passageway  70  extending through and in part forming the cylindrical boss  68 , and internal threads  72  distanced by a proximally located space  71  from the cylindrical boss  68 . A distally located space  77  is located adjacent the proximally located space  71 . The proximally located space  71  and the distally located space  77  accommodate the proximal end  79  of the manifold  12  including the threads  62  and the annular ring  58 , respectively. An annular ring  73  is located distal to the internal threads  72  and the cylindrical boss  68  along and about the distal interior region of the hemostasis nut  40  for the purpose of snap engagement with and beyond the annular ring  58  of the cavity body  20 . The angled annular surface  60  adjacent to the annular ring  58  facilitates snap engagement of the annular ring  58  along, beyond, and proximal to the annular ring  73  of the hemostasis nut  40 . Such snap engagement ( FIG. 12 ) loosely attaches the hemostasis nut  40  to the manifold  12  where the internal threads  72  of the hemostasis nut  40  can subsequently be made to engage the threads  62  of the manifold  12 , whereby the cylindrical boss  68  is brought to bear against the elongated washer  66  to resultingly bring pressure to bear as required against the self-sealing hemostasis valve  64 . Such engagements are shown in  FIG. 10  and  FIG. 11 . The elongated washer  66  and the self-sealing hemostasis valve  64  are captured in the cavity  56  by engagement of the hemostasis nut  40  to the cavity body  20  of the manifold  12 . Also included in the hemostasis nut  40  is an annular lip  112  which can be utilized for snap engagement of particular styles or types of introducers, as required and as later described in detail. 
     Also shown is a ferrule  74  which aligns within a passageway  75  of the threaded high pressure connection port  42  the combination of which aligns partially within the interior passageway  76  of the Luer connector  44 . One end of the high pressure tube  41 , shown in segmented form, is utilized for delivery of high pressure ablation liquids and suitably secures in a center passage of the ferrule  74  to communicate with the passageway  75  of the threaded high pressure connection port  42 . The high pressure tube  41  also extends through the high pressure connection branch passageway  50 , through part of the tapered central passageway  54 , through the strain relief  28  and Luer fitting  26 , and through the catheter tube  13 , through the exhaust tube support rings  78  and  80  to the tip  30  where termination is provided in the form of a fluid jet emanator  82 . The high pressure tube  41  can also be attached to the exhaust tube support ring  78 , such as by welding or other suitable means, and can function as support for the catheter tube  13  in the region beneath the radiopaque marker  36 . Support of the catheter tube  13  in the region beneath the radiopaque marker  38  can be provided by the exhaust tube support ring  80 . The introducer  46  having a centrally located hollow shaft  84  and an actuating handle  86  is also shown. 
       FIG. 4  is an isometric view of the self-sealing hemostasis valve  64  which aligns in and which is housed in the cavity  56  and adjacent to and in contact with the elongated washer  66  in the cavity  56  at the proximal region of the manifold  12 . 
       FIG. 5  is a proximal end view of the self-sealing hemostasis valve  64 , and  FIG. 6  is a cross section view of the self-sealing hemostasis valve  64  along line  6 - 6  of  FIG. 5 . The self-sealing hemostasis valve  64  is made of medical grade silicone material and is symmetrically fashioned to include opposing mirror-like planar and circular-shaped faces  88  and  90  having opposing radiused recessed surfaces  92  and  94  extending therebetween and a circumferential edge  95  between the circular-shaped faces  88  and  90 . The medical grade silicone material between the opposing radiused recessed surfaces  92  and  94  is increasingly thinner in a direction towards the center and is parted or otherwise separated to form a plurality of slits  96   a - 96   n , each slit extending outwardly in radial fashion from the center of the self-sealing hemostasis valve  64  part of the distance along and between the radiused recessed surfaces  92  and  94 , thus creating boundaries beneficial in defining lobes  98   a - 98   n . That is to say, lobe  98   a  is located between slits  96   a  and  96   b , lobe  98   b  is located between slits  96   b  and  96   n , and lobe  98   n  is located between slits  96   n  and  96   a . Adjacent lobes  98   a - 98   n  are in mutual contact along the slits  96   a - 96   n  to effect a seal from side to side of the self-sealing hemostasis valve  64 . Although three lobes  98   a - 98   n  and three slits  96   a - 96   n  are shown, any number of each in correspondence can be utilized as desired and shall not be limiting to the scope of the invention. In the alternative, the silicone material of the self-sealing hemostasis valve  64  could be pierced between the recessed surfaces  92  and  94  to yet maintain a self-sealing quality. The self-sealing hemostasis valve  64  is preferably constructed of medical grade silicone but can be fashioned of other suitable flexible, pliable, and resilient material which can conform to and about existing shapes or forms as required, such as to a guidewire. The degree of flexibility of the lobes  98   a - 98   n  is influenced by the thickness of the lobes  98   a - 98   n , each of which contains a portion of the radiused recessed surfaces  92  and  94 . A guidewire can pass between the inner tips of the lobes  98   a - 98   n  while maintaining a seal between the guidewire and the self-sealing hemostasis valve  64 . Due to the similar geometrical configuration of the opposing faces and associated structure therebetween, the self-sealing hemostasis valve  64  can be inserted into the cavity  56  without regard to orientation of the self-sealing hemostasis valve  64 . The diameter of the self-sealing hemostasis valve  64  is slightly larger than that of the cavity  56  to provide for flexible but snug frictional engagement of the self-sealing hemostasis valve  64  within the cavity  56 , as well as to provide for circumferential sealing of the self-sealing hemostasis valve  64  to the cavity  56 . The self-sealing hemostasis valve  64  is also incorporated into following embodiments and is slightly larger than that cavity into which it is snugly and frictionally engaged to provide for circumferential sealing to the cavity in which it resides. 
       FIG. 7  is an isometric view in cross section of the elongated washer  66  along line  7 - 7  of  FIG. 2 . The elongated washer  66  aligns in and is housed proximally in the cavity  56  adjacent to and in contact with the self-sealing hemostasis valve  64  at the proximal region of the manifold  12 . 
       FIG. 8  is a proximal end view of the elongated washer  66 , and  FIG. 9  is a cross section view of the elongated washer  66  along line  9 - 9  of  FIG. 8 . The elongated washer  66  is symmetrically fashioned and preferably constructed of a suitable polycarbonate but could be fashioned of aluminum or other suitable material, as required. The elongated washer  66  is fashioned to include opposing mirror-like planar and circular-shaped faces  100  and  102  having opposing recessed passages  104  and  106 , respectively, each having a guidance-friendly truncated conical shape, a central passage  108  extending between the inner portions of the opposing recessed passages  104  and  106 , and a circumferential edge  110  between the circular-shaped faces  100  and  102 . Due to the similar geometrical configuration of the opposing faces and associated structure therebetween, the elongated washer  66  can be inserted into the cavity  56  without regard to orientation of the elongated washer  66 . 
     Mode of Operation 
       FIG. 10  is a view in partial cross section of the assembled components of  FIG. 3  shown over and about and with the use of a guidewire  48  and showing the introducer  46  detached. In practice, the thrombectomy catheter device having a self-sealing hemostasis valve  10  is engaged over and about the guidewire  48 , which could have been previously inserted into the vasculature of a patient. Such loading and engagement occurs where the proximal end of the guidewire  48  enters the tip  30  of the catheter tube  13  and where the proximal guidewire tip is negotiated by the fluid jet emanator  82 , the catheter tube  13 , the tapered central passageway  54 , and the orifice  61  which centers the guidewire  48  to the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64 . Loading continues through the first of the recessed passages  106  or  104  depending on orientation of the elongated washer  66 , the central passage  108 , the remaining recessed passage  106  or  104  of the elongated washer  66 , and thence exiting through the beveled passageway  70  of the hemostasis nut  40 . Passage of the guidewire  48  through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  causes the tips and areas immediately surrounding the tips of the lobes  98   a - 98   n  to sealingly and slidingly deform, distend, flex, conform or otherwise comply to and accommodate the profile of the guidewire  48 . The guidewire  48  is shown in sealing and slidable engagement with the self-sealing hemostasis valve  64  where the pressure in the tapered central passageway  54  can be maintained at an undetermined low setting, as little or no influence by the uncompressed self-sealing hemostasis valve  64  takes place as the self-sealing hemostasis valve  64  is not yet under meaningful control of the hemostasis nut  40  which is only loosely coupled to the proximal region of the cavity body  20 . For example, as shown, the cylindrical boss  68  of the hemostasis nut  40  does not yet bring significant pressure against the elongated washer  66  to cause compression of the self-sealing hemostasis valve  64  but still serves to keep the self-sealing hemostasis valve  64  and the elongated washer  66  positioned without movement within the cavity  56 . 
       FIG. 11  is a fragmentary view in cross section of the proximal region of the manifold showing the compression of the self-sealing hemostasis valve  64  by the action of the hemostasis nut  40  being advanced in a distal direction along the threads  62  at the end of the cavity body  20  of the manifold  12 . Such action causes forced impingement of the cylindrical boss  68  with the face  100  (assuming such orientation) of the elongated washer  66  to cause the face  102  of the elongated washer  66  to bear against the self-sealing hemostasis valve  64  to cause the self-sealing hemostasis valve  64  to sealingly and slidingly compress, deform, distend, flex, conform or otherwise comply to and accommodate the profile of the guidewire  48  in a forcible manner. Such tightening of the hemostasis nut  40  in the manner just described increases the tightness and effectiveness of a seal about the guidewire  48  by the self-sealing hemostasis valve  64  where a higher attainable pressure may be maintained within the tapered central passageway  54  of the manifold  12  while still maintaining the ability to slide the thrombectomy catheter device having a self-sealing hemostasis valve  10  along the guidewire  48 . Tightening of the hemostasis nut  40  also causes expansion of the self-sealing hemostasis valve  64  in an outward direction and a distal direction against portions of the surrounding structure of the cavity  56  and in an inward direction against the guidewire  48 , thus influencing the sealing capabilities of the invention. 
     The self-sealing hemostasis valve  64  is self-sealing when not engaging a guidewire and is self-sealing against an inserted guidewire. The hemostasis nut  40  can be adjusted in the manufacturing process to maintain a desired preset pressure in the tapered central passageway  54  for use in the field and can engage the guidewire  48  and maintain suitable pressure during sliding or static engagement thereof. If it is desired to modify the maintained pressure in the tapered central passageway  54  during use, the practitioner can simply rotate the hemostasis nut  40  to increase or decrease maintained pressure in the tapered central passageway  54  as required. 
       FIG. 12  is a view like  FIG. 11  illustrating the use of the introducer  46  the hollow shaft  84  of which can be inserted through the self-sealing hemostasis valve  64  by way of the beveled passageway  70 , the recessed passage  104  which serves as a guide to the central passage  108  which in turn serves as a guide for alignment of the hollow shaft  84  of the introducer  46  with the central portion of the self-sealing hemostasis valve  64 , and through the intersection of inner tips of the lobes  98   a - 98   n  of the self-sealing hemostasis valve  64  and through the orifice  61  and into the tapered central passageway  54  to communicate with the tapered central passageway  54 . Passage of the hollow shaft  84  therethrough can be beneficial for purging of air from the manifold  12  (or can be incorporated to assist in flexing of the lobes  98   a - 98   n  of the self-sealing hemostasis valve  64  to assist in passage of the guidewire  48  when the invention is loaded over a guidewire beginning at the tip  30 ). In the alternative, the introducer  46  can be utilized to load a guidewire through the proximal region of the manifold  12 , as shown in  FIG. 13 . 
     The self-sealing hemostasis valve  64  can also serve as a one-way flow valve where the lobes  98   a - 98   n  are restricted to one-way movement. With the inclusion of a guidewire or in the absence of a guidewire and under higher than normal or required internal pressures significantly above those normally required, the lobes  98   a - 98   n  can flex in a proximal direction and inwardly and accommodatingly into the recessed passage  106  of the elongated washer  66  to break the seal offered by the lobes  98   a - 98   n . However, negative pressure within the manifold  12  or other unforseen external influences cannot flex the lobes  98   a - 98   n  significantly in a distal direction as the planar surface  59  of the cavity  56  offers resistance to such movement and stems any flow in a distal direction. Due to this one-way flow, feature, ingestion of foreign or undesirable substances such as air or particles is denied the self-sealing hemostasis valve  64 . 
       FIG. 13  is a view like  FIG. 12  showing the introducer  46  being utilized to load a guidewire  48  through the proximal region of the manifold  12 . This feature is useful if difficulty in negotiating the self-sealing hemostasis valve  64  by the guidewire  48  is encountered. 
       FIG. 14 , a first alternate embodiment, is an isometric exploded view of a thrombectomy catheter device having a self-sealing hemostasis valve  10   a , and  FIG. 15  is an exploded view in partial cross section of the components of the thrombectomy catheter device having a self-sealing hemostasis valve  10   a . The thrombectomy catheter device having a self-sealing hemostasis valve  10   a  utilizes the majority of the components, structures, and features of the previously described thrombectomy catheter device having a self-sealing hemostasis valve  10 , and also operates similarly, but includes a different arrangement and/or type of components that align within and which are accommodated internally by an alternately configured cavity  120  located in a cavity body  122  of a manifold  12   a . The cavity  120  is for the most part tubular in shape including a tubular cavity wall  124  and a truncated conical surface  126  which intersects the tubular cavity wall  124 . An orifice  128  located central to the truncated conical surface  126  is common to the cavity  120  and the tapered central passageway  54 . The cavity  120  accommodates, amongst other components, a dual seal  130  fashioned and preferably constructed of medical grade silicone or of other suitable flexible, pliable, and resilient material which can conform to and about existing shapes or forms as required, such as to a guidewire. The diameter of the dual seal  130  is slightly larger than that of the cavity  120  to provide for flexible but snug frictional engagement of the dual seal  130  within the cavity  120 , as well as providing for circumferential sealing of the dual seal  130  to the cavity  120 . The cavity  120  also accommodates, in order adjacent to the dual seal  130 , a wide washer  132  of TEFLON® or other suitable flexible material having a central passage  133 , the self-sealing hemostasis valve  64 , previously described, and a washer  134 , preferably similar in composition to the wide washer  132 , having a central passage  135 . 
     The washer  134  and the wide washer  132  may also be incorporated into other embodiments and function as low friction spacers to reduce rotational frictional binding to maintain the proper shape of the self-sealing hemostasis valve  64  and the dual seal  130  when the hemostasis nut  40  is tightened. Due to the similar geometrical configurations of the opposing faces and associated structure therebetween of the wide washer  132 , the self-sealing hemostasis valve  64 , and the washer  134 , these three components can be inserted into the cavity  120  without regard to the orientation of each. Also provided as part of the invention is an introducer  136  having a hollow shaft  138 , annular rings  140  and  142  about the hollow shaft  138 , and an actuating handle  144 . The washer  134  provides for accommodated communication with the introducer  136 . 
       FIGS. 16 ,  17  and  18  illustrate the dual seal  130  which seals in dual, i.e., in different, directions along and about different regions. One such seal involving the dual seal  130  is effected in an outward direction against and in intimate contact with the surrounding structure of the cavity  120 , and the other seal involving the dual seal  130  is effected in an inward direction against and in intimate contact with the guidewire  48  in the compressed stage, as later described in detail.  FIG. 16  is an isometric view in cross section of the dual seal  130  which aligns in and is housed distally in the cavity  120  and adjacent to and in contact with the wide washer  132  in the manifold  12   a .  FIG. 17  is a longitudinal cross section view of the dual seal  130 .  FIG. 18  is a proximal end view of the dual seal  130 . The dual seal  130  of medical grade silicone material is fashioned to include a distally located truncated conical surface  146  which is complementary to and which comes into intimate contact with the truncated conical surface  126  of the cavity  120 , an opposing proximally located planar and circular-shaped face  148 , an outer circumferential edge  150  extending between the truncated conical surface  146  and the face  148 , a rounded recess  152  juxtaposing face  148 , and a multi-radiused passageway  154  extending along the centerline between the rounded recess  152  and the truncated conical surface  146 . 
     Mode of Operation 
       FIG. 19  is a view in partial cross section of the assembled components of the alternate embodiment shown in  FIG. 15  shown over and about and with the use of a guidewire  48  and showing the introducer  136  detached. Such loading and engagement occurs much in the same fashion as previously described with reference to  FIG. 10  where the proximal end of the guidewire  48  enters the tip  30  of the catheter tube  13  and where the proximal guidewire tip is negotiated by the fluid jet emanator  82 , the catheter tube  13 , the tapered central passageway  54 , and the orifice  61  which centers the guidewire  48  to the components contained in the cavity  120 . Such loading continues through the multi-radiused passageway  154  of the dual seal  130 , the central passage  133  of the wide washer  132 , and thence through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  which, as previously described, can be oriented in either direction. Loading continues through the central passage  135  of the washer  134  and exiting through the beveled passageway  70  of the hemostasis nut  40 . Passage of the guidewire through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  causes the tips and areas immediately surrounding the tips of the lobes  98   a - 98   n  to sealingly and slidingly deform, distend, flex, conform or otherwise comply to and accommodate the profile of the guidewire  48 . The guidewire  48  is shown in sealing and slidable engagement with the self-sealing hemostasis valve  64  where the pressure in the tapered central passageway  54  can be maintained at a low undetermined setting, as little or no influence by the uncompressed self-sealing hemostasis valve  64  takes place as the self-sealing hemostasis valve  64  is not yet under control of the hemostasis nut  40  which is only loosely coupled to the proximal region of the cavity body  122 . For example, as shown, the cylindrical boss  68  of the hemostasis nut  40  does not yet bring significant pressure against the components residing in the cavity  120  including the dual seal  130 , the wide washer  132 , the self-sealing hemostasis valve  64 , and the washer  134 , but still serves to keep the dual seal  130 , the wide washer  132 , the self-sealing hemostasis valve  64 , and the washer  134  positioned without movement within the cavity  120 . As previously described, the hemostasis nut  40  can made to threadingly engage the proximal region of the manifold  12   a  and to be advanced to compress the components residing in the cavity  120 . As shown in the following  FIG. 20 , the introducer  136  snappingly engages the hemostasis nut  40 . 
       FIG. 20  is a fragmentary view in cross section of the proximal region of the manifold  12   a  illustrating the introducer  136  in engagement with the hemostasis nut  40  and where the hemostasis nut  40  is in loose engagement with the proximal region of the manifold  12   a . Engagement of the introducer  136  with the hemostasis nut  40  is accomplished by snap engagement of the annular ring  142  with and in a distal direction beyond the annular lip  112  of the hemostasis nut  40 . The distal end of the hollow shaft  138  of the introducer  136  slidingly engages and is in intimate contact with the wall of the central passage  135  of the washer  134  to firm up the relationship of the introducer  136  with the hemostasis nut  40  so that the introducer  136  does not exhibit a tendency to appear in floppy or unsuitable connection to the hemostasis nut  40 , thereby providing stabilization between the introducer and the hemostasis nut  40 . The self-sealing hemostasis valve  64  provides for sealing about guidewire  48  in a manner as previously described dependent on the degree of compression applied to the self-sealing hemostasis valve  64  by advancement of the hemostasis nut  40  distally. The inclusion of the wide washer  132  and the washer  134  aids in transferring force evenly and minimizes binding of the self-sealing hemostasis valve  64  and the dual seal  130  when the hemostasis nut  40  is advanced to the desired setting. The hemostasis nut  40  can be factory adjusted to maintain a desired manifold pressure, as previously described. Adjustments other than those made in the factory setting affect both the self-sealing hemostasis valve  64  and the dual valve  130  simultaneously but to different degrees and in different stages where advancement of the hemostasis nut  40  distally firstly and significantly impacts and utilizes the sealing capabilities of the self-sealing hemostasis valve  64  to control pressure at and about the self-sealing hemostasis valve  64  where the relationship of the self-sealing hemostasis valve  64  to the guidewire  48  and to the surrounding cavity  120  is predominately the same as described for the preferred embodiment ( FIG. 11 ). As shown in  FIG. 21 , further advancement of the hemostasis nut  40  distally utilizes the sealing capabilities of the self-sealing hemostasis valve  64  to whatever extent possible, and additionally impacts and utilizes the sealing capabilities of the dual seal  130  to effect hemostasis in special cases, one case being such as where a thinner guidewire is utilized and a seal between the self-sealing hemostasis valve  64  and the thinner guidewire is less than satisfactory. Such movement longitudinally compresses the dual seal  130  to cause the material of the dual seal  130  to expand in an outward direction against the cavity wall  124  to increase intimate contact pressure therebetween and to increase intimate contact pressure in a distal direction against the truncated conical surface  126  of the surrounding structure of the cavity  120  and to expand the structure of the dual seal  130  in an inward direction to force and form portions of the multi-radiused passageway  154  around, about and against a guidewire the preceding of which seals the dual seal  130  both against the walls of the cavity  120  and to the guidewire  48 . Depending on the degree of compression about the guidewire  48  as caused by advancement of the hemostasis nut  40 , the manifold  12   a  can be moved in either direction with a slight amount of lateral force; or in the case where friction along the guidewire  48  cannot be readily overcome, the hemostasis nut  40  can be adjusted a small amount to allow positioning of the manifold  12   a  along the guidewire  48  and then retightened while still effecting suitable hemostasis. Advancing the hemostasis nut  40  distally with respect to the cavity  120  during such engagement compresses the dual seal  130  increasingly to increase the allowable pressure which may be maintained within the manifold  12   a  to obtain suitable hemostasis. The hemostasis nut may be retarded proximally from an advanced distal position to controllingly decrease compression of the dual seal  130  about the guidewire and against the cavity  120  to maintain hemostasis at a lesser pressure if able. 
       FIG. 22  is a view like  FIG. 20  illustrating the function of the introducer  136  to perform alternate functions as required either to bleed air or fluids out of the manifold  12   a  or to aid guidewire movement through the dual seal  130  and/or self-sealing hemostasis valve  64  when the hemostasis nut  20  is loosely engaging the proximal region of the manifold  12   a  and having little or no significant effect upon the components residing in the cavity  120 . To achieve usefulness, the actuating handle  144  of the introducer  136  is manually pushed in a distal direction to force the distal end of the hollow shaft  138  towards and through the slits  96   a - 96   n  of the self-sealing hemostasis valve  64 . Such entry into and through the self-sealing hemostasis valve  64  flexes, deforms and distends the lobes  98   a - 98   n  apart and in a distal direction to render the sealing capability against a guidewire, such as guidewire  48 , ineffective. The ability to spread or open the tips of the lobes  98   a - 98   n  is useful for use with an alternate guidewire, such as guidewire  48   a , of a thinner or more flexible nature where the reduced thickness or increased flexibility thereof decreases or hinders the ability of the alternate guidewire  48   a  to successfully navigate, negotiate or pass through the lobes  98   a - 98   n  in their normal sealed position. In such state, any air of a pressure higher than ambient in the tapered central passageway  54  and connecting passages or tubes or other pertinent pressure carrying structures is vented to ambient through the hollow shaft  138  of the introducer  136 . As readily seen in the illustration, the introducer  136  provides a relatively large passageway through the hollow shaft  138  for introduction of the proximal end of an alternate guidewire  48   a , or the guidewire  48 , for passage therethrough. The proximal end of the alternate guidewire  48   a  is aligned to the hollow shaft  138  by a taper  54   a  at the proximal end of the tapered central passageway  54  adjacent to the orifice  128  and by the orifice  128  common to both the tapered central passageway  54  and the cavity  120 . Subsequent to passage of the proximal end of the guidewire  48   a  to a position proximal to the flexed, distended and deformed self-sealing hemostasis valve  64 , the introducer can be retarded proximally to disengage from intimate contact with the self-sealing hemostasis valve  64 , whereupon a seal is established with the guidewire  48   a  (or guidewire  48 ) and the self-sealing hemostasis valve  64  regains sealing qualities relating to the guidewire  48   a  (or guidewire  48 ) and cavity  120 , such as previously described. 
       FIG. 23 , a second alternate embodiment, is an isometric exploded view of a thrombectomy catheter device having a self-sealing hemostasis valve  10   b , and  FIG. 24  is an exploded view in partial cross section of the components of the second alternate embodiment thrombectomy catheter device having a self-sealing hemostasis valve  10   b . The second alternate embodiment provides a thrombectomy catheter device having a self-sealing hemostasis valve  10   b  which features a nonadjustable hemostasis nut  168  fixed over and about the proximal region of a manifold  12   b . The thrombectomy catheter device having a self-sealing hemostasis valve  10   b  utilizes a large number of the components, structures, and features of the previously described thrombectomy catheter devices having a self-sealing hemostasis valve  10  and  10   a  and also operates in a somewhat similar fashion, but includes a different arrangement and/or type of components that align within and/or which can be associated with and which can be accommodated internally by an alternately configured cavity  156  located in a cavity body  158  of the manifold  12   b . The cavity  156  is for the most part tubular in shape including a tubular cavity wall  160  and a planar surface  162  which is annular and circular and which intersects the tubular cavity wall  160 . A cavity extension  164 , being for the most part tubular, extends distally from the cavity  156  beginning at the planar surface  162  to intersect and connect with an orifice  166 . The orifice  166  is common to the cavity extension  164 , the cavity  156  and to the tapered central passageway  54  located central to the central tubular body  14 . The cavity  156  accommodates, in order adjacent to planar surface  162 , the flexible washer  134  of TEFLON® or other suitable flexible material having the central passage  135  and the self-sealing hemostasis valve  64 , previously described. The washer  134  functions as a low friction spacer to reduce rotational frictional binding to maintain the proper shape of the self-sealing hemostasis valve  64  when the hemostasis nut  168  is tightened. The washer  134  provides for stabilization introducer  136 . 
     Also provided as part of the second alternate embodiment is the introducer  136 , previously described, having a hollow shaft  138 , annular rings  140  and  142  about the hollow shaft  138 , and an actuating handle  144  which aligns in hemostasis nut  168 . The hemostasis nut  168  includes a centrally located cylindrical boss  170 , a beveled passageway  172  extending through and in part forming the cylindrical boss  170 , and internal threads  174  distanced from the cylindrical boss  170  by a distally located space  178  extending along the internal threads  174  and along the distal portion of the cylindrical boss  170 . A proximally located space  176  is located adjacent to the distally located space  178 , and an annular stop surface  180  is located between the proximal region of the internal threads  174  and the distal region of the proximally located space  176 . The distally located space  178  accommodates the proximal end  186  of the manifold  12   b  including threads  182  located along and about the proximal portion of the cavity body  158  of the manifold  12   b . Also included in the hemostasis nut  168  is an annular lip  184  which can be utilized for snap engagement of the introducer  136  or other particular styles or types of introducers as required, as later described in detail. The hemostasis nut  168  threadingly engages the manifold  12   b  where the internal threads  174  of the hemostasis nut  168  engage and are advanced along the threads  182  of the manifold  12   b  until advancement of the hemostasis nut  168  is predeterminately stopped by impingement of the annular stop surface  180  against the proximal end  186  of the manifold  12   b , whereby and whereupon the cylindrical boss  170  is brought to bear directly against the self-sealing hemostasis valve  64  which is in direct communication with the washer  134  to resultingly bring pressure to bear as required against the self-sealing hemostasis valve  64  and the washer  134  to foster and promote sealing of the hemostasis valve  64  with the cavity wall  160  of the cavity  156 . A suitable adhesive can be applied to the internal threads  174  of the hemostasis nut  168  and to the threads  182  of the manifold  12   b  to ensure permanent fixation of the hemostasis nut  168  to the manifold  12   b . Such engagement also ensures sealing of the self-sealing hemostasis valve  64  to a guidewire, such as previously described. Such engagements are shown in  FIG. 25  and  FIG. 26 . The washer  134  and the self-sealing hemostasis valve  64  are captured in the cavity  156  by engagement of the hemostasis nut  168  to the cavity body  158  of the manifold  12   b . Due to the similar geometrical configurations of the opposing faces and associated structure therebetween of the self-sealing hemostasis valve  64  and the washer  134 , these components can be inserted into the cavity  156  without regard to the orientation of each. 
     Mode of Operation 
       FIG. 25  is a view in partial cross section of the assembled components of  FIG. 24  shown loaded and engaged over and about and with the use of a guidewire  48 . The introducer  136  is shown disengaged from its normal engaged position in the beveled passageway  172  for clarity. Such loading and engagement occurs much in the same fashion as previously described with reference to  FIG. 10  or  FIG. 19  where the proximal end of the guidewire  48  enters the tip  30  of the catheter tube  13  and where the proximal guidewire tip is negotiated by the fluid jet emanator  82 , the catheter tube  13 , the tapered central passageway  54 , and the orifice  166  which centers the guidewire  48  with the cavity extension  164  and with the components contained in the cavity  156 . Such loading continues through the cavity extension  164 , through the central passage  135  of the washer  134 , and thence through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  which, as previously described, can be oriented in either direction. Loading continues with the guidewire  48  exiting through the beveled passageway  172  of the hemostasis nut  168  and concentrically and co-located hollow shaft  138  of the introducer  136 , as best shown in  FIG. 26 . Passage of the guidewire  48  through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  causes the tips and areas immediately surrounding the tips of the lobes  98   a - 98   n  to sealingly and slidingly deform, distend, flex, conform or otherwise comply to and accommodate the profile of the guidewire  48 . The guidewire  48  is shown in sealing and slidable engagement with the self-sealing hemostasis valve  64  where the pressure in the tapered central passageway  54  can be maintained at a setting which allows minimal leakage of fluids, such as blood or saline solution, proximally through the seal created between the self-sealing hemostasis valve  64  and the guidewire  48 . Such pressure setting is determined by the position of the cylindrical boss  170  of the hemostasis nut  168  in relation to the self-sealing hemostasis valve  64 , as described later in detail. The hemostasis nut  168  serves to keep the self-sealing hemostasis valve  64  and the washer  134  positioned without movement within the cavity  156  and to compress the components residing in the cavity  156  at a suitable level. 
       FIG. 26  is a fragmentary view in cross section of the proximal region of the manifold  12   b  illustrating the introducer  136  in normal engagement with the hemostasis nut  168  and where the hemostasis nut  168  is in fixed nonadjustable engagement with the proximal end  186  located at the proximal region of the manifold  12   b . The self-sealing hemostasis valve  64  provides for sealing which is nonadjustable about guidewire  48  in a manner as previously described dependent on the degree of compression applied to the self-sealing hemostasis valve  64  by the fixed position of the hemostasis nut  168 . Compression of the self-sealing hemostasis valve  64  and of the washer  134  is influenced by the pressure applied thereto by the cylindrical boss  170  extending from the interior of the hemostasis nut  168 . Such pressure is determined by the relationship of the longitudinal position of the hemostasis nut  168  with respect to the proximal end  186  of the manifold  12   b  where the proximal end  186  impinges the annular stop surface  180  to influence such a relationship. If during fabrication the proximal end  186  is of a lengthened dimension proximally, the hemostasis nut  168  would correspondingly be located in a position more proximal, thereby applying less compressive force applied by the cylindrical boss  170  upon the self-sealing hemostasis valve  64  and the washer  134 , thereby decreasing the sealing capabilities against the guidewire  48  and against the cavity wall  160  of the cavity  156 . Conversely, if during fabrication the proximal end  186  is of a shortened dimension distally, the hemostasis nut  168  would correspondingly be located in a position more distal, thereby applying more compressive force by the cylindrical boss  170  upon the self-sealing hemostasis valve  64  and the washer  134 , thereby increasing the sealing capabilities against the guidewire  48  and against the cavity wall  160  of the cavity  156 . The annular ring  142  around and about the hollow shaft  138  of the introducer  136  snappingly engages the annular lip  184  of the beveled passageway  172  to capture hollow shaft  138  of the introducer  136  within the beveled passageway  172 , whereby the introducer  136  is positioned as shown for normal use where the distal end of the introducer  136  is in close proximity to the self-sealing hemostasis valve  64 . 
       FIG. 27  is a view like  FIG. 26  illustrating the function of the introducer  136  to perform alternate functions as required either to bleed air or fluids out of the manifold  12   b  or to aid guidewire movement through the self-sealing hemostasis valve  64 . To achieve such usefulness, the actuating handle  144  of the introducer  136  is manually pushed in a distal direction to force the distal end of the hollow shaft  138  towards and through the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  and through the central passage  135  of the washer  134 . Such entry into and through the self-sealing hemostasis valve  64  flexes, deforms and distends the lobes  98   a - 98   n  apart and in a distal direction to render the sealing capability against a guidewire, such as guidewire  48 , ineffective, as well as slightly deforming the washer  134 . The distal portion of the introducer  136  is accommodated by the cavity extension  164  during actuation of the introducer  136  in a distal direction. The ability to spread or open the tips of the lobes  98   a - 98   n  is useful for use with an alternate guidewire, such as guidewire  48   a , of a thinner or more flexible nature where the reduced thickness or increased flexibility thereof decreases or hinders the ability of the alternate guidewire  48   a  to successfully navigate, negotiate or pass through the lobes  98   a - 98   n  in their normal sealed position. In such state, any air of a pressure higher than ambient in the tapered central passageway  54  and connecting passages or tubes or other pertinent pressure carrying structures is vented to ambient through the hollow shaft  138  of the introducer  136 . As readily seen in the illustration, the introducer  136  provides a relatively large passageway through the hollow shaft  138  for introduction of the proximal end of an alternate guidewire  48   a , or the guidewire  48 , for passage therethrough. The proximal end of the alternate guidewire  48   a  is aligned to the hollow shaft  138  by a taper  54   a  ( FIG. 25 ) at the proximal end of the tapered central passageway  54  adjacent to the orifice  166 . The introducer  136 , having been manually positioned as shown, remains held in that position by the engagement to the flexed, deformed and distended lobes  98   a - 98   n  of the self-sealing hemostasis valve  64 . Subsequent to passage of the proximal end of the guidewire  48   a  to a position proximal to the flexed, distended and deformed self-sealing hemostasis valve  64 , the introducer  136  can be manually retarded proximally to the position shown in  FIG. 26  to disengage from intimate contact with the self-sealing hemostasis valve  64 , whereupon a seal is established with the guidewire  48   a  (or guidewire  48 ) and the self-sealing hemostasis valve  64  regains sealing qualities relating to the guidewire  48   a  (or guidewire  48 ) and cavity  156 , such as previously described. 
       FIG. 28 , a third alternate embodiment, is an isometric exploded view of a thrombectomy catheter device having a self-sealing hemostasis valve  10   c , and  FIG. 29  is an exploded view in partial cross section of the components of the third alternative embodiment thrombectomy catheter device having a self-sealing hemostasis valve  10   c . The third alternate embodiment provides a thrombectomy catheter device having a self-sealing hemostasis valve  10   c  which features a cavity insert  187  in addition to a nonadjustable hemostasis nut  188  fixed over and about the proximal region of a manifold  12   c . The thrombectomy catheter device having a self-sealing hemostasis valve  10   c  utilizes a large number of the components, structures, and features of the previously described thrombectomy catheter devices having a self-sealing hemostasis valve  10 ,  10   a  and  10   b , and also operates in a somewhat similar fashion, but includes a different arrangement and/or type of components that align within and/or which can be associated with and which can be accommodated internally by an alternately configured cavity  190  located in a cavity body  192  of the manifold  12   c . The cavity  190  is, for the most part, tubular in shape, including a tubular cavity wall  194  and a planar surface  196  which is annular and circular and which intersects the tubular cavity wall  194 . The cavity insert  181 , which aligns in the cavity  190 , includes a centrally located recess  200  which is cylindrical in shape and a passage  202  aligned with and common to the recess  200 . An orifice  198  is common to the cavity  190  and to the tapered central passageway  54  located central to the central tubular body  14 . The cavity  190  accommodates, in order adjacent to planar surface  196 , the cavity insert  187 , the flexible washer  134  of TEFLON® or other suitable flexible material having the central passage  135  and the self-sealing hemostasis valve  64 , previously described. The washer  134  functions as a low friction spacer to reduce rotational frictional binding to maintain the proper shape of the self-sealing hemostasis valve  64  when the hemostasis nut  168  is tightened. The washer  134  provides for stabilization with the introducer  136 . 
     Also provided as part of the third alternate embodiment is the introducer  136 , previously described, having a hollow shaft  138 , annular rings  140  and  142  about the hollow shaft  138 , and an actuating handle  144  which aligns in hemostasis nut  188 . The hemostasis nut  188  includes a centrally located cylindrical boss  204 , a beveled passageway  206  extending through and in part forming the cylindrical boss  204 , and internal threads  208  distanced from the cylindrical boss  204  by a distally located space  210  extending along the internal threads  208  and along the distal portion of the cylindrical boss  204 . A proximally located space  212  is located adjacent to the distally located space  210 , and an annular stop surface  214  is located between the proximal region of the internal threads  208  and the distal region of the proximally located space  212 . The distally located space  210  accommodates the proximal end  216  of the manifold  12   c  including threads  218  located along and about the proximal portion of the cavity body  192  of the manifold  12   c . Also included in the hemostasis nut  188  is an annular lip  220  which can be utilized for snap engagement of the introducer  136  or other particular styles or types of introducers as required, as later described in detail. The hemostasis nut  188  threadingly engages the manifold  12   c  where the internal threads  208  of the hemostasis nut  188  engage and are advanced along the threads  218  of the manifold  12   c  until advancement of the hemostasis nut  188  is predeterminately stopped by the annular stop surface  214 , whereby and whereupon the cylindrical boss  204  is brought to bear directly against the self-sealing hemostasis valve  64  which is in direct communication with the washer  134  to resultingly bring pressure to bear as required against the self-sealing hemostasis valve  64  and the washer  134  to foster and promote sealing of the hemostasis valve  64  with the cavity wall  194  of the cavity  190 . A suitable adhesive can be applied to the internal threads  208  of the hemostasis nut  188  and to the threads  218  of the manifold  12   c  to ensure permanent fixation of the hemostasis nut  188  to the manifold  12   c . Such engagement also ensures sealing of the self-sealing hemostasis valve  64  to a guidewire, such as previously described. Such engagements are shown in  FIG. 31  and  FIG. 32 . The cavity insert  187 , the washer  134 , and the self-sealing hemostasis valve  64  are captured in the cavity  190  by engagement of the hemostasis nut  188  to the cavity body  192  of the manifold  12   c . Due to the similar geometrical configurations of the opposing faces and associated structure therebetween of the self-sealing hemostasis valve  64  and the washer  134 , these components can be inserted into the cavity  190  without regard to the orientation of each; however, the cavity insert  187  must be oriented as shown. 
       FIG. 30  is a proximal cross section end view of the cavity insert  187  along line  31 - 31  of  FIG. 28 . The cavity insert  187 , which aligns in the cavity  190  of the cavity body  192 , is fashioned and preferably constructed of a suitable polycarbonate but could be fashioned of aluminum or other suitable material, as required. The cavity insert  187  includes the centrally located recess  200  which is cylindrical in shape juxtaposing the passage  202 . Also included are opposing circular-shaped faces  222  and  224  where face  224  is interrupted by the recess  200 . A circumferential edge  226  aligns between the circular-shaped faces  222  and  224 . 
     Mode of Operation 
       FIG. 31  is a view in partial cross section of the assembled components of  FIG. 29  shown loaded and engaged over and about and with the use of a guidewire  48 . The introducer  136  is shown disengaged from its normal engaged position in the beveled passageway  206  for the purpose of clarity. Such loading and engagement occurs much in the same fashion as previously described with reference to  FIG. 10 ,  FIG. 19  or  FIG. 25  where the proximal end of the guidewire  48  enters the tip  30  of the catheter tube  13  and where the proximal guidewire tip is negotiated by the fluid jet emanator  82 , the catheter tube  13 , the tapered central passageway  54 , and the orifice  198  which centers the guidewire  48  with the passage  202  and the recess  200  of the cavity insert  187  and with the components contained in the cavity  190 . Such loading continues through the cavity insert  187 , through the central passage  135  of the washer  134 , and thence through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  which, as previously described, can be oriented in either direction. Loading continues with the guidewire  48  exiting through the beveled passageway  206  of the hemostasis nut  188  and concentrically and co-located hollow shaft  138  of the introducer  136 , as best shown in  FIG. 32 . Passage of the guidewire  48  through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  causes the tips and areas immediately surrounding the tips of the lobes  98   a - 98   n  to sealingly and slidingly deform, distend, flex, conform or otherwise comply to and accommodate the profile of the guidewire  48 . The guidewire  48  is shown in sealing and slidable engagement with the self-sealing hemostasis valve  64  where the pressure in the tapered central passageway  54  can be maintained at a setting which allows minimal leakage of fluids, such as blood or saline solution, proximally through the seal created between the self-sealing hemostasis valve  64  and the guidewire  48 . Such pressure setting is determined by the position of the cylindrical boss  204  of the hemostasis nut  188  in relation to the self-sealing hemostasis valve  64 , as described later in detail. The hemostasis nut  188  serves to keep the self-sealing hemostasis valve  64 , the washer  134  and the cavity insert  187  positioned without movement within the cavity  190  and to compress the components residing in the cavity  190  at a suitable level. 
       FIG. 32  is a fragmentary view in cross section of the proximal region of the manifold  12   c  illustrating the introducer  136  in normal engagement with the hemostasis nut  188  and where the hemostasis nut  188  is in fixed nonadjustable engagement with the proximal end  216  located at the proximal region of the manifold  12   c . The self-sealing hemostasis valve  64  provides for sealing which is nonadjustable about guidewire  48  in a manner as previously described dependent on the degree of compression applied to the self-sealing hemostasis valve  64  by the fixed position of the hemostasis nut  188 . Compression of the self-sealing hemostasis valve  64  and of the washer  134  is influenced by the pressure applied thereto by the cylindrical boss  204  extending from the interior of the hemostasis nut  188 . Such pressure is determined by the relationship of the longitudinal position of the hemostasis nut  188  with respect to the proximal end  216  of the manifold  12   c  where the proximal end  216  impinges the annular stop surface  214  to influence such a relationship. If during fabrication the proximal end  216  is of a lengthened dimension proximally, the hemostasis nut  188  would correspondingly be located in a position more proximal, thereby applying less compressive force applied by the cylindrical boss  204  upon the self-sealing hemostasis valve  64  and the washer  134 , thereby decreasing the sealing capabilities against the guidewire  48  and against the cavity wall  194  of the cavity  190 . Conversely, if during fabrication the proximal end  216  is of a shortened dimension distally, the hemostasis nut  188  would correspondingly be located in a position more distal, thereby applying more compressive force by the cylindrical boss  204  upon the self-sealing hemostasis valve  64  and the washer  134 , thereby increasing the sealing capabilities against the guidewire  48  and against the cavity wall  194  of the cavity  190 . The annular ring  142  around and about the hollow shaft  138  of the introducer  136  snappingly engages the annular lip  220  of the beveled passageway  206  to capture the hollow shaft  138  of the introducer  136  within the beveled passageway  206 , whereby the introducer  136  is positioned as shown for normal use where the distal end of the introducer  136  is in close proximity to the self-sealing hemostasis valve  64 . 
       FIG. 33  is a view like  FIG. 32  illustrating the function of the introducer  136  to perform alternate functions as required either to bleed air or fluids out of the manifold  12   c  or to aid guidewire movement through the self-sealing hemostasis valve  64 . To achieve such usefulness, the actuating handle  144  of the introducer  136  is manually pushed in a distal direction to force the distal end of the hollow shaft  138  towards and through the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  and through the central passage  135  of the washer  134 . Such entry into and through the self-sealing hemostasis valve  64  flexes, deforms and distends the lobes  98   a - 98   n  apart and in a distal direction to render the sealing capability against a guidewire, such as guidewire  48 , ineffective, as well as slightly deforming the washer  134 . The distal portion of the introducer  136  is accommodated by the recess  200  of the cavity insert  187  during actuation of the introducer  136  in a distal direction. The ability to spread or open the tips of the lobes  98   a - 98   n  is useful for use with an alternate guidewire, such as guidewire  48   a , of a thinner or more flexible nature where the reduced thickness or increased flexibility thereof decreases or hinders the ability of the alternate guidewire  48   a  to successfully navigate, negotiate or pass through the lobes  98   a - 98   n  in their normal sealed position. In such state, any air of a pressure higher than ambient in the tapered central passageway  54  and connecting passages or tubes or other pertinent pressure carrying structures is vented to ambient through the hollow shaft  138  of the introducer  136 . As readily seen in the illustration, the introducer  136  provides a relatively large passageway through the hollow shaft  138  for introduction of the proximal end of an alternate guidewire  48   a , or the guidewire  48 , for passage therethrough. The proximal end of the alternate guidewire  48   a  is aligned to the hollow shaft  138  by the taper  54   a  at the proximal end of the tapered central passageway  54  adjacent to the orifice  198 . The introducer  136 , having been manually positioned as shown, remains held in that position by the engagement to the flexed, deformed and distended lobes  98   a - 98   n  of the self-sealing hemostasis valve  64 . Subsequent to passage of the proximal end of the guidewire  48   a  to a position proximal to the flexed, distended and deformed self-sealing hemostasis valve  64 , the introducer  136  can be manually retarded proximally to the position shown in  FIG. 32  to disengage from intimate contact with the self-sealing hemostasis valve  64 , whereupon a seal is established with the guidewire  48   a  (or guidewire  48 ) and the self-sealing hemostasis valve  64  regains sealing qualities relating to the guidewire  48   a  (or guidewire  48 ) and cavity  190 , such as previously described. 
       FIG. 34 , a fourth alternate embodiment, is an isometric exploded view of a thrombectomy catheter device having a self-sealing hemostasis valve  10   d , and  FIG. 35  is an exploded view in partial cross section of the components of the thrombectomy catheter device having a self-sealing hemostasis valve  10   d . The fourth alternate embodiment provides a thrombectomy catheter device having a self-sealing hemostasis valve  10   d  which replaces the threads, such as threads  218 , shown on the proximal region of a manifold  12   c , as shown in  FIG. 29 , by a smooth cylindrical surface  228  in addition to a nonadjustable hemostasis nut  230  where the internal threads, such as internal threads  208  as shown in  FIG. 29 , are replaced by a smooth cylindrical surface  232 . In this embodiment, the nonadjustable hemostasis nut  230  is adhesively fixed to the smooth cylindrical surface  228  at a predetermined position to cause a desired longitudinal force to maintain a leak-proof seal in the range of 25 to 50 psi or at other desired pressure values. The thrombectomy catheter device having a self-sealing hemostasis valve  10   d  utilizes a large number of the components, structures, and features of the previously described thrombectomy catheter devices having a self-sealing hemostasis valve  10 ,  10   a ,  10   b  and  10   c  and also operates in a somewhat similar fashion, but includes a different arrangement and/or type of components that align within and/or which can be associated with and which can be accommodated internally by a cavity  234  located in a cavity body  236  of a manifold  12   d . The cavity  234  is, for the most part, tubular in shape, including a tubular cavity wall  238  and a planar surface  240  which is annular and circular and which intersects the tubular cavity wall  238 . A cavity extension  242 , for the most part being tubular, extends distally from the cavity  234  beginning at the planar surface  240  to intersect and connect with an orifice  244  which is common to the cavity  234  and to the tapered central passageway  54  located central to the central tubular body  14 . The cavity  234  accommodates, in order adjacent to planar surface  240 , the flexible washer  134  of TEFLON® or other suitable flexible material having the central passage  135  and the self-sealing hemostasis valve  64 , previously described. The washer  134  functions as a low friction spacer to reduce rotational frictional binding to maintain the proper shape of the self-sealing hemostasis valve  64  when the hemostasis nut  230  is tightened. The washer  134  provides for stabilization with the introducer  136 . 
     Also provided as part of the fourth alternate embodiment is the introducer  136 , previously described, having a hollow shaft  138 , annular rings  140  and  142  about the hollow shaft  138 , and an actuating handle  144  which aligns in hemostasis nut  230 . The hemostasis nut  230  includes a centrally located cylindrical boss  248 , a beveled passageway  250  extending through and in part forming the cylindrical boss  248 , and a smooth cylindrical surface  232  distanced from the cylindrical boss  248  by a proximally located space  252  extending between the smooth cylindrical surface  232  and the cylindrical boss  248 . A distally located space  253  is located adjacent to the proximally located space  252  and an annular stop surface  254  is located at the proximal region of the proximally located space  252 . The proximally located space  252  accommodates the proximal end  256  of the manifold  12   d  including the smooth cylindrical surface  228  located along and about the proximal region of the cavity body  236  of the manifold  12   d . Also included in the hemostasis nut  230  is an annular lip  255  which can be utilized for snap engagement of the introducer  136  or other particular styles or types of introducers as required, as later described in detail. The hemostasis nut  230  engages the manifold  12   d  where the smooth cylindrical surface  232  of the hemostasis nut  230  engages the smooth cylindrical surface  228  of the manifold  12   d  until advancement of the hemostasis nut  230  is predeterminately stopped by impingement of the proximal end  256  of the manifold  12   d  by the annular stop surface  254  of the hemostasis nut  230 , whereby and whereupon the cylindrical boss  248  is brought to bear directly against the self-sealing hemostasis valve  64  which is in direct communication with the washer  134  to resultingly bring pressure to bear as required against the self-sealing hemostasis valve  64  and the washer  134  to foster and promote sealing of the hemostasis valve  64  with the cavity wall  238  of the cavity  234  optionally, and with suitable dimensioning, additional engagement of the hemostasis nut  230  to the manifold  12   d  can be obtained by engagement of the walls or other surfaces of the distally located space  253  of the hemostasis nut  230  with an annular shoulder  258  located midway along the cavity body  236  at the distal end of the smooth cylindrical surface  228  which can also act as a stop. A suitable adhesive can be applied to the smooth cylindrical surface  232  of the hemostasis nut  230  and to the smooth cylindrical surface  228  of the manifold  12   d  to ensure permanent fixation of the hemostasis nut  230  to the manifold  12   d . Such engagements also ensure sealing of the self-sealing hemostasis valve  64  to a guidewire, such as previously described. Such engagements are shown in  FIG. 36  and  FIG. 37 . The washer  134  and the self-sealing hemostasis valve  64  are captured in the cavity  234  by engagement of the hemostasis nut  230  to the cavity body  236  of the manifold  12   d . Due to the similar geometrical configurations of the opposing faces and associated structure therebetween of the self-sealing hemostasis valve  64  and the washer  134 , these components can be inserted into the cavity  234  without regard to the orientation of each. 
     Mode of Operation 
       FIG. 36  is a view in partial cross section of the assembled components of  FIG. 35  shown loaded and engaged over and about and with the use of a guidewire  48 . The introducer  136  is shown disengaged from its normal engaged position in the beveled passageway  250  for the purpose of clarity. Such loading and engagement occurs much in the same fashion as previously described with reference to  FIG. 10 ,  FIG. 19 ,  FIG. 25  or  FIG. 31  where the proximal end of the guidewire  48  enters the tip  30  of the catheter tube  13  and where the proximal guidewire tip is negotiated by the fluid jet emanator  82 , the catheter tube  13 , the tapered central passageway  54 , and the orifice  244  which centers the guidewire  48  with the cavity extension  242  and with the components contained in the cavity  234 . Such loading continues through the cavity extension  242 , through the central passage  135  of the washer  134 , and thence through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  which, as previously described, can be oriented in either direction. Loading continues with the guidewire  48  exiting through the beveled passageway  250  of the hemostasis nut  230  and concentrically and co-located hollow shaft  138  of the introducer  136 , as best shown in  FIG. 37 . Passage of the guidewire  48  through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  causes the tips and areas immediately surrounding the tips of the lobes  98   a - 98   n  to sealingly and slidingly deform, distend, flex, conform or otherwise comply to and accommodate the profile of the guidewire  48 . The guidewire  48  is shown in sealing and slidable engagement with the self-sealing hemostasis valve  64  where the pressure in the tapered central passageway  54  can be maintained at a setting which allows minimal leakage of fluids, such as blood or saline solution, proximally through the seal created between the self-sealing hemostasis valve  64  and the guidewire  48 . Such a pressure setting is determined by the position of the cylindrical boss  248  of the hemostasis nut  230  in relation to the self-sealing hemostasis valve  64 , as described later in detail. The hemostasis nut  230  serves to keep the self-sealing hemostasis valve  64  and the washer  134  positioned without movement within the cavity  234  and to compress the components residing in the cavity  234  at a suitable level. 
       FIG. 37  is a fragmentary view in cross section of the proximal region of the manifold  12   d  illustrating the introducer  136  in normal engagement with the hemostasis nut  230  and where the hemostasis nut  230  is in fixed nonadjustable engagement with the proximal end  256  located at the proximal region of the manifold  12   d . The self-sealing hemostasis valve  64  provides for sealing which is nonadjustable about guidewire  48  in a manner as previously described dependent on the degree of compression applied to the self-sealing hemostasis valve  64  by the fixed position of the hemostasis nut  230 . Compression of the self-sealing hemostasis valve  64  and of the washer  134  is influenced by the pressure applied thereto by the cylindrical boss  248  extending from the interior of the hemostasis nut  230 . Such pressure is determined by the relationship of the longitudinal position of the hemostasis nut  230  with respect to the proximal end  256  of the manifold  12   d  where the proximal end  256  impinges the annular stop surface  254  to influence such a relationship. If during fabrication the proximal end  256  is of a lengthened dimension proximally, the hemostasis nut  230  would correspondingly be located in a position more proximal, thereby applying less compressive force applied by the cylindrical boss  248  upon the self-sealing hemostasis valve  64  and the washer  134 , thereby decreasing the sealing capabilities against the guidewire  48  and against the cavity wall  238  of the cavity  234 . Conversely, if during fabrication the proximal end  256  is of a shortened dimension distally, the hemostasis nut  230  would correspondingly be located in a position more distal, thereby applying more compressive force by the cylindrical boss  248  upon the self-sealing hemostasis valve  64  and the washer  134 , thereby increasing the sealing capabilities against the guidewire  48  and against the cavity wall  238  of the cavity  234 . The annular ring  142  around and about the hollow shaft  138  of the introducer  136  snappingly engages the annular lip  255  of the beveled passageway  250  to capture the hollow shaft  138  of the introducer  136  within the beveled passageway  250 , whereby the introducer  136  is positioned as shown for normal use where the distal end of the introducer  136  is in close proximity to the self-sealing hemostasis valve  64 . 
       FIG. 38  is a view like  FIG. 37  illustrating the function of the introducer  136  to perform alternate functions as required either to bleed air or fluids out of the manifold  12   d  or to aid guidewire movement through the self-sealing hemostasis valve  64 . To achieve such usefulness, the actuating handle  144  of the introducer  136  is manually pushed in a distal direction to force the distal end of the hollow shaft  138  towards and through the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  and through the central passage  135  of the washer  134 . Such entry into and through the self-sealing hemostasis valve  64  flexes, deforms and distends the lobes  98   a - 98   n  apart and in a distal direction to render the sealing capability against a guidewire, such as guidewire  48 , ineffective, as well as slightly deforming the washer  134 . The distal portion of the introducer  136  is accommodated by the cavity extension  242  during actuation of the introducer  136  in a distal direction. The ability to spread or open the tips of the lobes  98   a - 98   n  is useful for use with an alternate guidewire, such as guidewire  48   a , of a thinner or more flexible nature where the reduced thickness or increased flexibility thereof decreases or hinders the ability of the alternate guidewire  48   a  to successfully navigate, negotiate or pass through the lobes  98   a - 98   n  in their normal sealed position. In such state, any air of a pressure higher than ambient in the tapered central passageway  54  and connecting passages or tubes or other pertinent pressure carrying structures is vented to ambient through the hollow shaft  138  of the introducer  136 . As readily seen in the illustration, the introducer  136  provides a relatively large passageway through the hollow shaft  138  for introduction of the proximal end of an alternate guidewire  48   a , or the guidewire  48 , for passage therethrough. The proximal end of the alternate guidewire  48   a  is aligned to the hollow shaft  138  by the taper  54   a  at the proximal end of the tapered central passageway  54  adjacent to the orifice  244 . The introducer  136 , having been manually positioned as shown, remains held in that position by the engagement to the flexed, deformed and distended lobes  98   a - 98   n  of the self-sealing hemostasis valve  64 . Subsequent to passage of the proximal end of the guidewire  48   a  to a position proximal to the flexed, distended and deformed self-sealing hemostasis valve  64 , the introducer  136  can be manually retarded proximally to the position shown in  FIG. 37  to disengage from intimate contact with the self-sealing hemostasis valve  64 , whereupon a seal is established with the guidewire  48   a  (or guidewire  48 ) and the self-sealing hemostasis valve  64  regains sealing qualities relating to the guidewire  48   a  (or guidewire  48 ) and cavity  234 , such as previously described. 
       FIG. 39 , a fifth alternate embodiment, is a plan view of th visible components of a thrombectomy catheter device having a self-sealing hemostasis valve  300 , including a one-piece manifold  302  having multiple structures extending therefrom or attached thereto and including a catheter tube  304  and other components as described herein. The visible portion of the one-piece manifold  302  includes a central tubular body  306 , an exhaust branch  308  and a flangeless high pressure connection branch  310  extending angularly from the central tubular body  306 , and a partially shown cavity body  312  extending proximally from the central tubular body  306 . The proximal end of the catheter tube  304  secures to the manifold  302  by an interceding streamlined flexible strain relief  314 . The proximal end of the catheter tube  304  extends through streamlined flexible strain relief  314  to communicate with the manifold  302 . The catheter tube  304  extends distally to a tip  316  which is tapered and which can be flexible in design. The tip  316  of the catheter tube  304  includes a plurality of inflow orifices  318   a - 318   n  and a plurality of outflow orifices  320   a - 320   n , and radiopaque marker bands  322  and  324 , all of which are disclosed and described in detail in previous patent applications and patents by the applicants. Also shown is a hemostasis nut  326  aligned to and snappingly engaged with the proximal region of the cavity body  312 , and a threaded high pressure connection port  328  having threads  329  which is secured such as by, but not limited to, adhesive, to the high pressure connection branch  310 . Also provided as part of the fifth alternate embodiment is an introducer  330  having a hollow shaft  332 , annular rings  334  and  336  about the hollow shaft  332 , and an actuating handle  338 . The structure of introducer  330  is similar to the structure of introducer  136  which has been previously described with reference to  FIG. 15  and the function of which also has been previously described. 
       FIG. 40  is an isometric exploded view of the thrombectomy catheter device having a self-sealing hemostasis valve  300 , and  FIG. 41  is an exploded view in partial cross section of the components of the fifth alternate embodiment thrombectomy catheter device having a self-sealing hemostasis valve  300 . The fifth alternate embodiment provides a thrombectomy catheter device having a self-sealing hemostasis valve  300  having fewer components and simplified structure where the use of complex threaded surfaces and structures is minimized. Such simplification is provided by the inclusion of the streamlined flexible strain relief  314  which is fitted and adhesively or otherwise suitably affixed to the distal interior portion of the manifold  302 , and by the inclusion of a threaded high pressure connection port  328  which is fitted and adhesively or otherwise suitably affixed to the interior of the high pressure connection branch passageway  337  of the high pressure connection branch  310 . 
     The fifth alternate embodiment provides a thrombectomy catheter device having a self-sealing hemostasis valve  300  which features the hemostasis nut  326  which aligns over and about threads  344  at the proximal region of the manifold  302 . The thrombectomy catheter device having a self-sealing hemostasis valve  300  utilizes a number of the components, structures, and features of the previously described thrombectomy catheter devices having a self-sealing hemostasis valve  10 ,  10   a ,  10   b ,  10   c  and  10   d  and also operates in similar fashions according to the teachings of the invention, but includes a different arrangement and/or type of components that align within and/or which can be associated with and which can be accommodated internally by an alternately configured cavity  346  located in the cavity body  312  of the manifold  302 . The cavity  346  is for the most part tubular in shape including a tubular cavity wall  350  and a planar surface  352  which is annular and circular and which intersects the tubular cavity wall  350 . A cavity extension  354 , being for the most part tubular, extends distally from the cavity  346  beginning at the planar surface  352  to intersect and connect with an orifice  356 . The orifice  356  is common to the cavity extension  354 , the cavity  346 , and a tapered central passageway  357  located central to the central tubular body  306 . The cavity  346  accommodates the self-sealing hemostasis valve  64 , previously described in detail with reference to  FIGS. 4 ,  5  and  6 , which aligns to planar surface  352 . 
     Also provided as part of the fifth alternate embodiment is the introducer  330 , previously described as introducer  136  and having like components and functions, having a hollow shaft  332 , annular rings  334  and  336  about the hollow shaft  332 , and an actuating handle  338 . The hollow shaft  332  accommodatingly aligns in the hemostasis nut  326 . The hemostasis nut  326  includes a centrally located cylindrical boss  358 , a beveled passageway  360  extending through and in part forming the cylindrical boss  358 , and internal threads  362  distanced from the cylindrical boss  358  by a distally located space  364  extending along the internal threads  362  and along the distal portion of the cylindrical boss  358 . A proximally located space  366  is located adjacent to the distally located space  364 . An annular stop surface  368  is located at the proximal region of the proximally located space  366 . The distally located space  364  accommodates the proximal end  370  of the manifold  302  including threads  344  located along and about the outer proximal portion of the cavity body  312  of the manifold  302 . Also included in the hemostasis nut  326  is an annular lip  372  which can be utilized for snap engagement of the introducer  330  or other particular styles or types of introducers as required. The hemostasis nut  326  threadingly engages the manifold  302  where the internal threads  362  of the hemostasis nut  326  engage and are advanced along the threads  344  of the manifold  302  until advancement of the hemostasis nut  326  is predeterminately stopped by impingement of the annular stop surface  368  against the proximal end  370  of the manifold  302 , whereby and whereupon the cylindrical boss  358  is brought to bear directly against the self-sealing hemostasis valve  64  resultingly bringing pressure to bear as required against the self-sealing hemostasis valve  64  to effect sealing with the cavity wall  350  of the cavity  346 , to seal the self-sealing hemostasis valve  64  to the guidewire  48  and to seal the self-sealing hemostasis valve  64  to the planar surface  352 . In the alternative, a suitable adhesive can be applied to the internal threads  362  of the hemostasis nut  326  and/or to the threads  344  of the manifold  302  to ensure permanent fixation of the hemostasis nut  326  to the manifold  302 . Such engagement also ensures fixed and nonadjustable sealing of the self-sealing hemostasis valve  64  to a guidewire, such as previously described. The self-sealing hemostasis valve  64  is captured in the cavity  346  by engagement of the hemostasis nut  326  to the cavity body  312  of the manifold  302 , as shown in  FIG. 42 . Due to the similar geometrical configurations of the opposing faces and associated structure therebetween of the self-sealing hemostasis valve  64 , the self-sealing hemostasis valve  64  can be inserted into the cavity  346  without regard to the orientation of the opposing sides. 
     The streamlined flexible strain relief  314  can be fashioned of flexible plastic, rubber or the like and includes a constant radius region  374  adjoined by a short tapered region  376 , each region fitting to and being accommodated respectively by the tapered central passageway  357  and an included short tapered region  378  of the tapered central passageway  357  of the manifold  302 , as shown in  FIG. 42 . Adjoining the short tapered region  376  of the streamlined flexible strain relief  314  is a tapered region  380  being located distally thereto. A passageway  382  extends along the length of the streamlined flexible strain relief  314  for accommodation and passage of the guidewire  48  and a high pressure tube  383 . An adhesive injection port  384  can be located at a suitable location extending through a tapered exterior region  386  of the manifold  302 , which is flangeless, to introduce adhesive  388  to the distal interior region of the manifold  302  including the distal end of the tapered central passageway  357  and the included short tapered region  378  of the tapered central passageway  357 . Such adhesive injection can be accomplished when the streamlined flexible strain relief  314  is mated to the distal end of the manifold  302 , as shown in  FIG. 42 , or, adhesive may be applied to the mated surfaces separately, or electronic welding or bonding can be incorporated, or adhesive may be otherwise suitably applied as applicable to the art. 
     The threaded high pressure connection port  328  has a passageway  396  and is fitted to and adhesively affixed to the interior of the flangeless high pressure connection branch  310  of the manifold  302  opposing flats  390  are located at the distal portion of the threaded high pressure connection port  328  to adequately receive adhesive  392  in close communication to ensure proper physical fixation and adhering of the threaded high pressure connection port  328  within the high pressure connection branch passageway  337  of the high pressure connection branch  310 . An adhesive injection port  394  ( FIGS. 39 and 40 ) can be located at a suitable location to extend through the high pressure connection branch  310  of the manifold  302  to introduce adhesive  392  to the interior region of the high pressure connection branch  310 . The adhesive  392 , in addition to adhering the flats  390  of the threaded high pressure connection port  328  to the high pressure connection branch passageway  337 , also bonds the appropriate portions of the threads  329  of the threaded high pressure connection port  328  to the high pressure connection branch passageway  337 . Adhesive injection can be accomplished when the threaded high pressure connection port  328  is mated to the high pressure connection branch  310  of the manifold  302 , as shown in  FIG. 42 . Adhesive could also be applied to the mated surfaces separately, or electronic welding or bonding can be incorporated, or adhesive may be otherwise suitably applied as applicable to the art. Also shown is a ferrule  398  which aligns and suitably secures within the passageway  396  of the threaded high pressure connection port  328 , the combination of which aligns partially within the high pressure connection branch passageway  337  of the high pressure connection branch  310 . 
     One end of the high pressure tube  383 , shown in segmented form, is utilized for delivery of high pressure ablation liquids and suitably secures in a center passage of the ferrule  398  to communicate with the passageway  396  of the threaded high pressure connection port  328 . The high pressure tube  383  also extends through the high pressure connection branch passageway  337 , through part of the tapered central passageway  357 , through the streamlined flexible strain relief  314 , through the catheter tube  304 , and through exhaust tube support rings  400  and  402  to the tip  316  where termination is provided in the form of a fluid jet emanator  404 . The high pressure tube  383  can also be attached to the exhaust tube support ring  400 , such as by welding or other suitable means, and can function as support for the catheter tube  304  in the region beneath the radiopaque marker  322 . Support of the catheter tube  304  in the region beneath the radiopaque marker  324  can be provided by the exhaust tube support ring  402 . 
     Mode of Operation 
       FIG. 42  is a view in partial cross section of the assembled components of  FIG. 41  shown loaded and engaged over and about and with the use of a guidewire  48 . The introducer  330  is shown disengaged from its normal engaged position in the beveled passageway  360  for clarity. Such loading and engagement occurs much in the same fashion as previously described with reference to  FIGS. 10 ,  19  and  25  where the proximal end of the guidewire  48  enters the tip  316  of the catheter tube  304  and where the proximal guidewire tip is negotiated by the fluid jet emanator  404 , the catheter tube  304 , the tapered central passageway  357 , and the orifice  356  which centers the guidewire  48  with the cavity extension  354  and with the components contained in the cavity  346 . Such loading continues through the cavity extension  354 , through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  which, as previously described, can be oriented in either direction. Loading continues with the guidewire  48  exiting through the beveled passageway  360  of the hemostasis nut  326  and concentrically and co-located hollow shaft  332  of the introducer  330 , as best shown in  FIG. 43 . Passage of the guidewire  48  through the junction of the tips of the lobes  98   a - 98   n  which concurrently locate with the inboard portion of the slits  96   a - 96   n  of the self-sealing hemostasis valve  64  causes the tips and areas immediately surrounding the tips of the lobes  98   a - 98   n  to sealingly and slidingly deform, distend, flex, conform or otherwise comply to and accommodate the profile of the guidewire  48 . The guidewire  48  is shown in sealing and slidable engagement with the self-sealing hemostasis valve  64  where the pressure in the tapered central passageway  357  can be maintained at a setting which allows minimal leakage of fluids, such as blood or saline solution, proximally through the seal created between the self-sealing hemostasis valve  64  and the guidewire  48 . Such pressure setting is determined by the fixed position of the cylindrical boss  358  of the hemostasis nut  326  in relation to the self-sealing hemostasis valve  64 , as described later in detail. The hemostasis nut  326  serves to keep the self-sealing hemostasis valve  64  positioned without movement within the cavity  346  and to compress the self-sealing hemostasis valve  64  residing in the cavity  346  at a suitable level. 
       FIG. 43  is a fragmentary view in cross section of the proximal region of the manifold  302  illustrating the introducer  330  in normal engagement with the hemostasis nut  326  and where the hemostasis nut  326  is in fixed nonadjustable engagement with the proximal end  370  located at the proximal region of the manifold  302 . The self-sealing hemostasis valve  64  provides for sealing which is nonadjustable about the guidewire  48  in a manner as previously described dependent on the degree of compression applied to the self-sealing hemostasis valve  64  by the fixed position of the hemostasis nut  326 . Compression of the self-sealing hemostasis valve  64  is influenced by the pressure applied thereto by the cylindrical boss  358  extending from the interior of the hemostasis nut  326 . Such pressure is determined by the relationship of the longitudinal position of the hemostasis nut  326  with respect to the proximal end  370  of the manifold  302  where the proximal end  370  impinges the annular stop surface  368  to influence such a relationship. If during fabrication the proximal end  370  is of a lengthened dimension proximally, the hemostasis nut  326  would correspondingly be located in a position more proximal, thereby applying less compressive force applied by the cylindrical boss  358  upon the self-sealing hemostasis valve  64 , thereby decreasing the sealing capabilities against the guidewire  48  and against the cavity wall  350  of the cavity  346 . Conversely, if during fabrication the proximal end  370  is of a shortened dimension distally, the hemostasis nut  326  would correspondingly be located in a position more distal, thereby applying more compressive force by the cylindrical boss  358  upon the self-sealing hemostasis valve  64 , thereby increasing the sealing capabilities against the guidewire  48  and against the cavity wall  350  of the cavity  346 . The annular ring  336  around and about the hollow shaft  332  of the introducer  330  snappingly engages the annular lip  372  of the beveled passageway  360  to capture the hollow shaft  332  of the introducer  330  within the beveled passageway  360 , whereby the introducer  330  is positioned as shown for normal use where the distal end of the introducer  330  is in close proximity to the self-sealing hemostasis valve  64 . 
       FIG. 44  is a view like  FIG. 43  illustrating the function of the introducer  330  to perform alternate functions as required either to bleed air or fluids out of the manifold  302  or to aid guidewire movement through the self-sealing hemostasis valve  64 . To achieve such usefulness, the actuating handle  338  of the introducer  330  is manually pushed in a distal direction to force the distal end of the hollow shaft  332  towards and through the slits  96   a - 96   n  of the self-sealing hemostasis valve  64 . Such entry into and through the self-sealing hemostasis valve  64  flexes, deforms and distends the lobes  98   a - 98   n  apart and in a distal direction to render the sealing capability against a guidewire, such as guidewire  48 , ineffective. The distal portion of the introducer  330  is accommodated by the cavity extension  354  during actuation of the introducer  330  in a distal direction. The ability to spread or open the tips of the lobes  98   a - 98   n  is useful for use with an alternate guidewire, such as guidewire  48   a , of a thinner or more flexible nature where the reduced thickness or increased flexibility thereof decreases or hinders the ability of the alternate guidewire  48   a  to successfully navigate, negotiate or pass through the lobes  98   a - 98   n  in their normal sealed position. In such state, any air of a pressure higher than ambient in the tapered central passageway  357  and connecting passages or tubes or other pertinent pressure carrying structures is vented to ambient through the hollow shaft  332  of the introducer  330 . As readily seen in the illustration, the introducer  330  provides a relatively large passageway through the hollow shaft  332  for introduction of the proximal end of an alternate guidewire  48   a , or the guidewire  48 , for passage therethrough. The proximal end of the alternate guidewire  48   a  is aligned to the hollow shaft  332  by a taper  357   a  ( FIGS. 41 and 42 ) at the proximal end of the tapered central passageway  357  adjacent to the orifice  356 . The introducer  330 , having been manually positioned as shown, remains held in that position by the engagement to the flexed, deformed and distended lobes  98   a - 98   n  of the self-sealing hemostasis valve  64 . Subsequent to passage of the proximal end of the guidewire  48   a  to a position proximal to the flexed, distended and deformed self-sealing hemostasis valve  64 , the introducer  330  can be manually retarded proximally to the position shown in  FIG. 43  to disengage from intimate contact with the self-sealing hemostasis valve  64 , whereupon a seal is established with the guidewire  48   a  (or guidewire  48 ) and the self-sealing hemostasis valve  64  regains sealing qualities relating to the guidewire  48   a  (or guidewire  48 ) and cavity  346 , such as previously described. 
       FIG. 45 , a sixth alternate embodiment, is a plan view of the visible components of a thrombectomy catheter device having a self-sealing hemostasis valve  410 , and  FIG. 46  is an isometric exploded view of the thrombectomy catheter device having a self-sealing hemostasis valve  410  including a one-piece manifold  412  having multiple structures extending therefrom or attached thereto and including a catheter tube  414  and other components as described herein. The thrombectomy catheter device having a self-sealing hemostasis valve  410  utilizes a number of the components, structures, and features of the previously described thrombectomy catheter devices having a self-sealing hemostasis valve  10 ,  10   a ,  10   b ,  10   c ,  10   d  and  300 , and also operates in a somewhat similar fashion according to the teachings of the invention, but includes a different arrangement and/or type of components that align within and/or which can be associated with and which are located adjacent to a central tubular body  416  of the manifold  412 . The one-piece manifold  412  includes the central tubular body  416 , an exhaust branch  418  and a high pressure connection branch  420  extending angularly from the central tubular body  416 , an elongated hemostasis valve body  422  extending proximally from the central tubular body  416 , and extending distally from the central tubular body  416 , a threaded connection port  424 . The proximal end of the catheter tube  414  secures to the manifold  412  by the use of a Luer fitting  426  accommodated by the threaded connection port  424 . The proximal end of the catheter tube  414  extends through a strain relief  428  and through the Luer fitting  426  to communicate with the manifold  412 . The catheter tube  414  extends distally to a tip  430  which is tapered and which can be flexible in design. The tip  430  of the catheter tube  414  includes a plurality of inflow orifices  432   a - 432   n  and a plurality of outflow orifices  434   a - 434   n , and radiopaque marker bands  436  and  438 , all of which are disclosed and described in detail in previous patent applications and patents by the applicants. Also shown is a threaded high pressure connection port  440  secured to the high pressure connection branch  420  by a Luer connector  442 . 
       FIG. 47  is an exploded view in cross section of the components of the thrombectomy catheter device having a self-sealing hemostasis valve  410 , and  FIG. 48  is a view in partial cross section of the assembled components of the thrombectomy catheter device having a self-sealing hemostasis valve  410  each excluding the full length of the catheter tube  414  and the included tip  430 , but including the guidewire  454  such as is incorporated in the use of the invention. The catheter tube  414 , which also serves and functions as an exhaust tube, and a high pressure tube  444  distal to the strain relief  428  are foreshortened and shown as partial lengths for the purpose of clarity. 
     With reference to  FIG. 47  and  FIG. 48 , the sixth alternate embodiment is further described. The manifold  412  includes connected and communicating passageways ( FIG. 47 ) including a high pressure connection branch passageway  446 , an exhaust branch passageway  448 , a tapered central passageway  450  extending from and through the threaded connection port  424  and through the central tubular body  416  to and communicating with an elongated hemostasis valve passageway  452  of defined dimensions, which preferably is cylindrical, co-located with the elongated hemostasis valve body  422 , and being located proximal to the central tubular body  416 . 
     Also shown is a ferrule  456  which aligns within a passageway  458  of the threaded high pressure connection port  440 , the combination of which aligns partially within the interior passageway  460  of the Luer connector  442 . One end of the high pressure tube  444  is utilized for delivery of high pressure ablation liquids and suitably secures in a center passage of the ferrule  456  to communicate with the passageway  458  of the threaded high pressure connection port  440 . The high pressure tube  444  also extends through the high pressure connection branch passageway  446 , through part of the tapered central passageway  450 , through the strain relief  428  and Luer fitting  426 , through the catheter tube  414 , and through exhaust tube support rings  462  and  464  to the tip  430  where termination is provided in the form of a fluid jet emanator  466 . The high pressure tube  444  can also be attached to the exhaust tube support ring  462 , such as by welding or other suitable means, and can function as support for the catheter tube  414  in the region beneath the radiopaque marker  436 . Support of the catheter tube  414  in the region beneath the radiopaque marker  438  can be provided by the exhaust tube support ring  464 . 
     Mode of Operation 
     Stationary components and static components are incorporated to form a self-sealing hemostasis valve  468  where the relationship of the elongated hemostasis valve passageway  452  to the portion of a guidewire  454  which actively or passively transits the elongated hemostasis valve passageway  452  located central to the elongated hemostasis valve body  422  forms the self-sealing hemostasis valve  468 . For purposes of demonstration and illustration, the length of the elongated hemostasis valve passageway  452  could range from 0.25 inch to 0.50 inch and could have a diameter of 0.015 inch. The guidewire  454  could have a diameter of 0.014 inch thereby having a total clearance of 0.001 inch between the guidewire  454  and the elongated hemostasis valve passageway  452 . The interference of the guidewire  454  along and within the interior of the elongated hemostasis valve passageway  452  achieves hemostasis with an acceptable amount of leakage through the self-sealing hemostasis valve  468 . Various sizes of guidewires  454  could be used where a matched thrombectomy catheter device having a self-sealing hemostasis valve  410  has an appropriately dimensioned elongated hemostasis valve passageway  452 . As in other self-sealing hemostasis valves, the self-sealing hemostasis valve  468  provides for hemostasis when the components are static or when the components are positioned along a guidewire. 
     Any self-sealing hemostasis seal valve, passageway or other style of seal, such as previously described herein, can exhibit frictional resistance when passed over a guidewire. Such frictional resistance can be reduced by hydrophilically coating the self-sealing hemostasis seal valve, seal or interior of a passageway through which a guidewire passes. The interior of the passageway through which a guidewire passes could also be coated with a hydrogel which expands when hydrated to offer a better seal and where the passageway is kept closed even when a guidewire is not present. The use of hydrogel allows for smooth passage over a guidewire due to its slippery nature. 
     Various modifications can made to the present invention without departing from the apparent scope thereof. 
     
       
         
               
             
               
               
               
             
           
               
                   
               
               
                 THROMBECTOMY CATHETER DEVICE HAVING 
               
               
                 A SELF-SEALING HEMOSTASIS VALVE 
               
               
                 PARTS LIST 
               
               
                   
               
             
             
               
                   
               
             
          
           
               
                   
                  10 
                 thrombectomy 
               
               
                   
                   
                 catheter device 
               
               
                   
                   
                 having a 
               
               
                   
                   
                 self-sealing 
               
               
                   
                   
                 hemostasis valve 
               
               
                   
                  10a–d 
                 alternative 
               
               
                   
                   
                 embodiment of 
               
               
                   
                   
                 thrombectomy 
               
               
                   
                   
                 catheter device 
               
               
                   
                   
                 having a 
               
               
                   
                   
                 self-sealing 
               
               
                   
                   
                 hemostasis valve 
               
               
                   
                  12 
                 manifold 
               
               
                   
                  12a–d 
                 manifold 
               
               
                   
                  13 
                 catheter tube 
               
               
                   
                  14 
                 central tubular 
               
               
                   
                   
                 body 
               
               
                   
                  16 
                 exhaust branch 
               
               
                   
                  18 
                 high pressure 
               
               
                   
                   
                 connection branch 
               
               
                   
                  20 
                 cavity body 
               
               
                   
                  22 
                 threaded 
               
               
                   
                   
                 connection port 
               
               
                   
                  26 
                 Luer fitting 
               
               
                   
                  28 
                 strain relief 
               
               
                   
                  30 
                 tip 
               
               
                   
                  32a–n 
                 inflow orifices 
               
               
                   
                  34a–n 
                 outflow orifices 
               
               
                   
                  36 
                 radiopaque marker 
               
               
                   
                   
                 band 
               
               
                   
                  38 
                 radiopaque marker 
               
               
                   
                   
                 band 
               
               
                   
                  40 
                 hemostasis nut 
               
               
                   
                  41 
                 high pressure tube 
               
               
                   
                  42 
                 threaded high 
               
               
                   
                   
                 pressure connection 
               
               
                   
                   
                 port 
               
               
                   
                  44 
                 Luer connector 
               
               
                   
                  46 
                 introducer 
               
               
                   
                  48 
                 guidewire 
               
               
                   
                  48a 
                 guidewire 
               
               
                   
                  50 
                 high pressure 
               
               
                   
                   
                 connection branch 
               
               
                   
                   
                 passageway 
               
               
                   
                  52 
                 exhaust branch 
               
               
                   
                   
                 passageway 
               
               
                   
                  54 
                 tapered central 
               
               
                   
                   
                 passageway 
               
               
                   
                  54a 
                 taper 
               
               
                   
                  56 
                 cavity 
               
               
                   
                  57 
                 tubular cavity 
               
               
                   
                   
                 wall 
               
               
                   
                  58 
                 annular ring 
               
               
                   
                  59 
                 planar surface 
               
               
                   
                  60 
                 angled annular 
               
               
                   
                   
                 surface 
               
               
                   
                  61 
                 orifice 
               
               
                   
                  62 
                 threads 
               
               
                   
                  64 
                 self-sealing 
               
               
                   
                   
                 hemostasis valve 
               
               
                   
                  66 
                 elongated washer 
               
               
                   
                  68 
                 cylindrical boss 
               
               
                   
                  70 
                 beveled 
               
               
                   
                   
                 passageway 
               
               
                   
                  71 
                 proximally 
               
               
                   
                   
                 located space 
               
               
                   
                  72 
                 internal threads 
               
               
                   
                  73 
                 annular ring 
               
               
                   
                  74 
                 ferrule 
               
               
                   
                  75 
                 passageway 
               
               
                   
                  76 
                 interior 
               
               
                   
                   
                 passageway 
               
               
                   
                  77 
                 distally located 
               
               
                   
                   
                 space 
               
               
                   
                  78 
                 exhaust tube 
               
               
                   
                   
                 support ring 
               
               
                   
                  79 
                 proximal end 
               
               
                   
                  80 
                 exhaust tube support 
               
               
                   
                   
                 ring 
               
               
                   
                  82 
                 fluid jet emanator 
               
               
                   
                  84 
                 hollow shaft 
               
               
                   
                  86 
                 actuating handle 
               
               
                   
                  88 
                 face 
               
               
                   
                  90 
                 face 
               
               
                   
                  92 
                 recessed surface 
               
               
                   
                  94 
                 recessed surface 
               
               
                   
                  95 
                 edge 
               
               
                   
                  96a–n 
                 slits 
               
               
                   
                  98a–n 
                 lobes 
               
               
                   
                 100 
                 face 
               
               
                   
                 102 
                 face 
               
               
                   
                 104 
                 recessed passage 
               
               
                   
                 106 
                 recessed passage 
               
               
                   
                 108 
                 central passage 
               
               
                   
                 110 
                 edge 
               
               
                   
                 112 
                 annular lip 
               
               
                   
                 120 
                 cavity 
               
               
                   
                 122 
                 cavity body 
               
               
                   
                 124 
                 cavity wall 
               
               
                   
                 126 
                 truncated conical 
               
               
                   
                   
                 surface 
               
               
                   
                 128 
                 orifice 
               
               
                   
                 130 
                 dual seal 
               
               
                   
                 132 
                 wide washer 
               
               
                   
                 133 
                 central passage 
               
               
                   
                 134 
                 washer 
               
               
                   
                 135 
                 central passage 
               
               
                   
                 136 
                 introducer 
               
               
                   
                 138 
                 hollow shaft 
               
               
                   
                 140 
                 annular ring 
               
               
                   
                 142 
                 annular ring 
               
               
                   
                 144 
                 actuating handle 
               
               
                   
                 146 
                 truncated conical 
               
               
                   
                   
                 surface 
               
               
                   
                 148 
                 face 
               
               
                   
                 150 
                 edge 
               
               
                   
                 152 
                 rounded recess 
               
               
                   
                 154 
                 multi-radiused 
               
               
                   
                   
                 passageway 
               
               
                   
                 156 
                 cavity 
               
               
                   
                 158 
                 cavity body 
               
               
                   
                 160 
                 cavity wall 
               
               
                   
                 162 
                 planar surface 
               
               
                   
                 164 
                 cavity extension 
               
               
                   
                 166 
                 orifice 
               
               
                   
                 168 
                 hemostasis nut 
               
               
                   
                 170 
                 cylindrical boss 
               
               
                   
                 172 
                 beveled passageway 
               
               
                   
                 174 
                 internal threads 
               
               
                   
                 176 
                 proximally located 
               
               
                   
                   
                 space 
               
               
                   
                 178 
                 distally located 
               
               
                   
                   
                 space 
               
               
                   
                 180 
                 annular stop surface 
               
               
                   
                 182 
                 threads 
               
               
                   
                 184 
                 annular lip 
               
               
                   
                 186 
                 proximal end 
               
               
                   
                 187 
                 cavity insert 
               
               
                   
                 188 
                 hemostasis nut 
               
               
                   
                 190 
                 cavity 
               
               
                   
                 192 
                 cavity body 
               
               
                   
                 194 
                 cavity wall 
               
               
                   
                 196 
                 planar surface 
               
               
                   
                 198 
                 orifice 
               
               
                   
                 200 
                 recess 
               
               
                   
                 202 
                 passage 
               
               
                   
                 204 
                 cylindrical boss 
               
               
                   
                 206 
                 beveled passageway 
               
               
                   
                 208 
                 internal threads 
               
               
                   
                 210 
                 distally located 
               
               
                   
                   
                 space 
               
               
                   
                 212 
                 proximally 
               
               
                   
                   
                 located space 
               
               
                   
                 214 
                 annular stop 
               
               
                   
                   
                 surface 
               
               
                   
                 216 
                 proximal end 
               
               
                   
                 218 
                 threads 
               
               
                   
                 220 
                 annular lip 
               
               
                   
                 222 
                 face 
               
               
                   
                 224 
                 face 
               
               
                   
                 226 
                 edge 
               
               
                   
                 228 
                 smooth 
               
               
                   
                   
                 cylindrical 
               
               
                   
                   
                 surface 
               
               
                   
                 230 
                 hemostasis nut 
               
               
                   
                 232 
                 smooth 
               
               
                   
                   
                 cylindrical 
               
               
                   
                   
                 surface 
               
               
                   
                 234 
                 cavity 
               
               
                   
                 236 
                 cavity body 
               
               
                   
                 238 
                 cavity wall 
               
               
                   
                 240 
                 planar surface 
               
               
                   
                 242 
                 cavity extension 
               
               
                   
                 244 
                 orifice 
               
               
                   
                 248 
                 cylindrical boss 
               
               
                   
                 250 
                 beveled passageway 
               
               
                   
                 252 
                 proximally located 
               
               
                   
                   
                 space 
               
               
                   
                 253 
                 distally located 
               
               
                   
                   
                 space 
               
               
                   
                 254 
                 annular stop surface 
               
               
                   
                 255 
                 annular lip 
               
               
                   
                 256 
                 proximal end 
               
               
                   
                 258 
                 annular shoulder 
               
               
                   
                 300 
                 thrombectomy 
               
               
                   
                   
                 catheter device 
               
               
                   
                   
                 having a 
               
               
                   
                   
                 self-sealing 
               
               
                   
                   
                 hemostasis valve 
               
               
                   
                 302 
                 manifold 
               
               
                   
                 304 
                 catheter tube 
               
               
                   
                 306 
                 central tubular body 
               
               
                   
                 308 
                 exhaust branch 
               
               
                   
                 310 
                 high pressure 
               
               
                   
                   
                 connection branch 
               
               
                   
                 312 
                 cavity body 
               
               
                   
                 314 
                 streamlined flexible 
               
               
                   
                   
                 strain relief 
               
               
                   
                 316 
                 tip 
               
               
                   
                 318a–n 
                 inflow orifices 
               
               
                   
                 320a–n 
                 outflow orifices 
               
               
                   
                 322 
                 radiopaque marker 
               
               
                   
                   
                 band 
               
               
                   
                 324 
                 radiopague marker 
               
               
                   
                   
                 band 
               
               
                   
                 326 
                 hemostasis nut 
               
               
                   
                 328 
                 threaded high 
               
               
                   
                   
                 pressure 
               
               
                   
                   
                 connection port 
               
               
                   
                 329 
                 threads 
               
               
                   
                 330 
                 introducer 
               
               
                   
                 332 
                 hollow shaft 
               
               
                   
                 334 
                 annular ring 
               
               
                   
                 336 
                 annular ring 
               
               
                   
                 337 
                 high pressure 
               
               
                   
                   
                 connection branch 
               
               
                   
                   
                 passageway 
               
               
                   
                 338 
                 actuating handle 
               
               
                   
                 344 
                 threads 
               
               
                   
                 346 
                 cavity 
               
               
                   
                 350 
                 cavity wall 
               
               
                   
                 352 
                 planar surface 
               
               
                   
                 354 
                 cavity extension 
               
               
                   
                 356 
                 orifice 
               
               
                   
                 357 
                 tapered central 
               
               
                   
                   
                 passageway 
               
               
                   
                 357a 
                 taper 
               
               
                   
                 358 
                 cylindrical boss 
               
               
                   
                 360 
                 beveled passageway 
               
               
                   
                 362 
                 internal threads 
               
               
                   
                 364 
                 distally located 
               
               
                   
                   
                 space 
               
               
                   
                 366 
                 proximally located 
               
               
                   
                   
                 space 
               
               
                   
                 368 
                 annular stop surface 
               
               
                   
                 370 
                 proximal end 
               
               
                   
                 372 
                 annular lip 
               
               
                   
                 374 
                 constant radius 
               
               
                   
                   
                 region 
               
               
                   
                 376 
                 short tapered region 
               
               
                   
                 378 
                 short tapered region 
               
               
                   
                 380 
                 tapered region 
               
               
                   
                 382 
                 passageway 
               
               
                   
                 383 
                 high pressure tube 
               
               
                   
                 384 
                 adhesive injection 
               
               
                   
                   
                 port 
               
               
                   
                 386 
                 tapered exterior 
               
               
                   
                   
                 region 
               
               
                   
                 388 
                 adhesive 
               
               
                   
                 390 
                 flat 
               
               
                   
                 392 
                 adhesive 
               
               
                   
                 394 
                 adhesive injection 
               
               
                   
                   
                 port 
               
               
                   
                 396 
                 passageway 
               
               
                   
                 398 
                 ferrule 
               
               
                   
                 400 
                 exhaust tube 
               
               
                   
                   
                 support ring 
               
               
                   
                 402 
                 exhaust tube 
               
               
                   
                   
                 support ring 
               
               
                   
                 404 
                 fluid jet 
               
               
                   
                   
                 emanator 
               
               
                   
                 410 
                 thrombectomy 
               
               
                   
                   
                 catheter device 
               
               
                   
                   
                 having a 
               
               
                   
                   
                 self-sealing 
               
               
                   
                   
                 hemostasis valve 
               
               
                   
                 412 
                 manifold 
               
               
                   
                 414 
                 catheter tube 
               
               
                   
                 416 
                 central tubular 
               
               
                   
                   
                 body 
               
               
                   
                 418 
                 exhaust branch 
               
               
                   
                 420 
                 high pressure 
               
               
                   
                   
                 connection branch 
               
               
                   
                 422 
                 elongated 
               
               
                   
                   
                 hemostasis valve 
               
               
                   
                   
                 body 
               
               
                   
                 424 
                 threaded 
               
               
                   
                   
                 connection port 
               
               
                   
                 426 
                 Luer fitting 
               
               
                   
                 428 
                 strain relief 
               
               
                   
                 430 
                 tip 
               
               
                   
                 432a–n 
                 inflow orifices 
               
               
                   
                 434a–n 
                 outflow orifices 
               
               
                   
                 436 
                 radiopaque marker 
               
               
                   
                   
                 band 
               
               
                   
                 438 
                 radiopaque marker 
               
               
                   
                   
                 band 
               
               
                   
                 440 
                 threaded high 
               
               
                   
                   
                 pressure connection 
               
               
                   
                   
                 port 
               
               
                   
                 442 
                 Luer connector 
               
               
                   
                 444 
                 high pressure tube 
               
               
                   
                 446 
                 high pressure 
               
               
                   
                   
                 connection branch 
               
               
                   
                   
                 passageway 
               
               
                   
                 448 
                 exhaust branch 
               
               
                   
                   
                 passageway 
               
               
                   
                 450 
                 tapered central 
               
               
                   
                   
                 passageway 
               
               
                   
                 452 
                 elongated hemostasis 
               
               
                   
                   
                 valve passageway 
               
               
                   
                 454 
                 guidewire 
               
               
                   
                 456 
                 ferrule 
               
               
                   
                 458 
                 passageway 
               
               
                   
                 460 
                 interior passageway 
               
               
                   
                 462 
                 exhaust tube support 
               
               
                   
                   
                 ring 
               
               
                   
                 464 
                 exhaust tube support 
               
               
                   
                   
                 ring 
               
               
                   
                 466 
                 fluid jet emanator 
               
               
                   
                 468 
                 self-sealing 
               
               
                   
                   
                 hemostasis valve