Patent Publication Number: US-2009240278-A1

Title: Device for placing an occlusion removing structure in a tubular structure with a substantially closed distal end

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     The present Application claims the benefit of U.S. Provisional Patent Application 60/774,705 titled “Device for Placing an Occlusion Removing Structure in a Tubular Structure with a Substantially Closed Distal End,” filed Feb. 17, 2006, the contents of which are incorporated in this disclosure by reference in their entirety. 
    
    
     BACKGROUND 
     There are a large variety of tubular structures comprising a central axial lumen and a substantially closed distal end used in medical applications and in non-medical commercial and industrial applications. Examples of such tubular structures used in medical applications include catheters and drains, such as, for example, Foley catheters. In many such applications, the tubular structure is prone to collecting occlusive debris within the central lumen of the tubular structure that occludes the tubular structure, causing a decrease or cessation of function of the tubular structure, and necessitating that the occlusion be removed or that the tubular structure be replaced. 
     In medical applications in particular, replacing a tubular structure can be very costly, and can put a patient at increased risk of infection. Therefore, it is often preferable to remove the occlusion from within the central lumen of the tubular structure while maintaining the tubular structure in position. In some applications, the occlusion can be removed by flushing the central lumen of the tubular structure with a liquid, thereby moving the occlusion out of the tubular structure through drainage holes in the side of the tubular structure. In many applications, however, flushing the occlusion out of the tubular structure is not appropriate, such as, for example, when using a tubular structure to drain a cavity or space within the human body. 
     Therefore, there is needed a device for placing an occlusion removing structure within a tubular structure with a substantially closed distal end, such that when the tubular structure becomes occluded, the occlusion removing structure can be withdrawn from the tubular structure proximally, thereby removing the occlusion proximally rather than distally while maintaining the tubular structure in position. Further, there is needed a method for unoccluding a tubular structure with a substantially closed distal end. 
     SUMMARY 
     According to one embodiment of the present invention, there is provided a device for placing an occlusion removing structure into a tubular structure with a substantially closed distal end. The device comprises a) a proximal end, a distal end, and an intermediate portion between the proximal end and the distal end; b) an occlusion removing structure comprising a proximal end, and a distal end with a tip, and further comprising an elongated tubular mesh comprising a proximal end, a distal end, an axial length between the proximal end and the distal end, an outer surface, an inner surface and a central lumen cross-sectional area defined by the inner surface; where the tubular mesh exists in two states: i) a radially expanded and axially contracted first state, where the central lumen cross-sectional area is a first central lumen cross-sectional area, and the axial length is a first axial length; and ii) a radially contracted and axially expanded second state, where the central lumen cross-sectional area is a second central lumen cross-sectional area, and the axial length is a second axial length; and where the first central lumen cross-sectional area is greater than the second central lumen cross-sectional area, and the first axial length is less than the second axial length; c) a distracting structure for distracting the occlusion removing structure from the radially expanded and axially contracted first state to the radially contracted and axially expanded second state; and d) an attaching and locking structure for attaching and locking the occlusion removing structure to the distracting structure non-integrally, and for reversibly locking the occlusion removing structure in the radially contracted and axially expanded second state; and where the occlusion removing structure, distracting structure, and attaching and locking structure are all non-integral with respect to each other. 
     In one embodiment, the occlusion removing structure further comprises a proximal end piece at the proximal end of the occlusion removing structure, and a cap comprising the tip at the distal end of the occlusion removing structure. In another embodiment, the occlusion removing structure further comprises a proximal end piece at the proximal end of the occlusion removing structure; and the attaching and locking structure mates with the proximal end piece of the occlusion removing structure to allow the occlusion removing structure to be removed from a tubular structure while keeping the tubular structure in position. 
     In another embodiment, the distracting structure comprises: a) a proximal end comprising a first connector; and b) a distal end comprising an elongated tube or rod comprising a proximal end, a distal end, an axial length defined by the distance between the proximal end and the distal end, and an outer surface defining an outer circumference; and the elongated tube or rod further comprises a material suitable for forcing the tubular mesh into the radially contracted and axially expanded first state by increasing the axial length of the tubular mesh from the first axial length to the second axial length; and the proximal end of the elongated tube is joined to the first connector. In a preferred embodiment, the tube or rod further comprises two segments, a proximal segment and a distal segment; and the distal segment is relatively more laterally flexible than the proximal segment. 
     In another embodiment, the attaching and locking structure comprises two non-integral sections, a first section and a second section; and the first section comprises: i) a proximal end comprising a second connector for mating with the first connector of the distracting structure; and ii) a distal end. In a preferred embodiment, the distal end of the first section of the attaching and locking structure comprises a rigid tube comprising a proximal end, a distal end, an axial length between the proximal end and the distal end, an outer surface, an inner surface, and a central lumen defined by the inner surface. In another preferred embodiment, the second section of the attaching and locking structure comprises a proximal end and a distal end; and the proximal end of the second section comprises a third connector for mating with the distal end of the second connector of the first section. In a preferred embodiment, the occlusion removing structure further comprises a proximal end piece at the proximal end of the occlusion removing structure; the second section of the attaching and locking structure comprises a proximal end and a distal end; the distal end of the second section comprises two legs that are split axially from near the proximal end, through the distal end of the second section; and the legs form a fourth connector configured to mate with the proximal end piece of the occlusion removing structure. 
     According to another embodiment of the present invention, there is provided a method for placing an occlusion removing structure into a tubular structure with a proximal end, a substantially closed distal end and a central lumen. The method comprises: a) providing a device according to the present invention in the radially contracted and axially expanded second state; b) placing the occlusion removing structure of the device in the tubular structure; and c) allowing the occlusion removing structure to assume the radially expanded and axially contracted first state. 
     In one embodiment, placing the occlusion removing structure of the device comprises inserting the distal end of the device into the proximal end of the tubular structure, and advancing the distal end of the device through the central lumen of the tubular structure until the occlusion removing structure is entirely within the tubular structure, or until the distal end of the tubular structure contacts the substantially closed distal end of the tubular structure. In another embodiment, the distracting structure comprises, a proximal end comprising a first connector and a distal end; the attaching and locking structure comprises two non-integral sections, a first section and a second section; the first section comprises, i) a proximal end comprising a second connector for mating with the first connector of the distracting structure; and ii) a distal end; and the method further comprises disconnecting the first connector from the second connector, and withdrawing the distracting structure from the device while maintaining at least a portion of the tubular mesh within the tubular structure, thereby converting the tubular mesh from the radially contracted and axially expanded second state to the radially expanded and axially contracted first state. In another embodiment, the occlusion removing structure further comprises a proximal end piece at the proximal end of the occlusion removing structure; the distracting structure comprises, a proximal end comprising a first connector and a distal end; the attaching and locking structure comprises two non-integral sections, a first section and a second section; the first section comprises, i) a proximal end comprising a second connector for mating with the first connector of the distracting structure; and ii) a distal end; the second section of the attaching and locking structure comprises a proximal end comprising a third connector for mating with the distal end of the second connector of the first section and a distal end; the distal end of the second section comprises two legs that are split axially from near the proximal end, through the distal end of the second section; and the legs form a fourth connector configured to mate with the proximal end piece of the occlusion removing structure; where the method further comprises disconnecting the second connector from the third connector and withdrawing the first section of the attaching and locking structure from the second section of the attaching and locking structure, thereby allowing the legs of the second section to contract radially and unlock the fourth connector from the proximal end piece of the occlusion removing structure; and where the method further comprises removing the second section of the attaching and locking structure from the occlusion removing structure, thereby leaving the occlusion removing structure in the tubular structure. In another embodiment, the occlusion removing structure further comprises a proximal end piece at the proximal end of the occlusion removing structure; and the method further comprises separating the tubular mesh from the proximal end piece. 
     In another embodiment, the method further comprises allowing the tubular structure to become occluded with occluding material, and then withdrawing the occlusion removing structure from the tubular structure after the tubular structure becomes occluded with occluding material. In a preferred embodiment, the occlusion removing structure further comprises a proximal end piece at the proximal end of the occlusion removing structure; the attaching and locking structure comprises two non-integral sections, a first section and a second section; the first section comprises, i) a proximal end comprising a second connector; and ii) a distal end; the second section of the attaching and locking structure comprises a proximal end comprising a third connector for mating with the distal end of the second connector of the first section and a distal end; the distal end of the second section comprises two legs that are split axially from near the proximal end, through the distal end of the second section; and the legs form a fourth connector configured to mate with the proximal end piece of the occlusion removing structure; and; withdrawing the occlusion removing structure from the tubular structure after the tubular structure becomes occluded with occluding material comprises: d) inserting the fourth connector of the second section of the attaching and locking structure into the proximal end piece of the occlusion removing structure; e) then advancing the distal end of the first section of the attaching and locking structure though the proximal end of the second section, thereby radially expanding the legs of the second section and locking the fourth connector to the proximal end piece of the occlusion removing structure; f) connecting the second connector of the first section to the third connector of the second section; and g) retracting the occlusion removing structure, along with the attaching and locking structure, proximally, thereby, holding the occluding material within the tubular mesh as the occlusion removing structure is withdrawn from the tubular structure. 
     In one embodiment, the tubular structure is within a space or cavity within a human or within a non-human animal. In another embodiment, the space or cavity is created by a surgical procedure. In another embodiment, the space or cavity is selected from the group consisting of the abdominal cavity, the bladder, the intestines, the intracranial cavity, the mediastinum, the nasal passages, the stomach, the renal pelvis and the ureter. In another embodiment, the space or cavity is created during a surgical procedure on the back, breast, chest, head, hip or vertebral column. In another embodiment, the tubular structure is selected from the group consisting of an abscess drainage catheter, a biliary tube, a biliary stents, a chest tube, a decompression catheter, a feeding tube, a gastrointestinal decompression catheter, a gastrostomy tube, a jejunostomy tube, a mediastinal tube, a nasogastric tube, a nephrostomy catheter, a percutaneous drainage catheter, a peritoneal dialysis catheter, a vascular catheter, a venous hemodialysis catheter, a post-surgical drain and a ventriculostomy tube. 
     According to another embodiment of the present invention, there is provided a kit for placing an occlusion removing structure in a tubular structure with a substantially closed distal end. In one embodiment, the kit comprises a device according to the present invention, and instructions on how to use the device. In another embodiment, the kit comprises a device for placing an occlusion removing structure into a tubular structure with a substantially closed distal end, and instructions on how to use the device, where the instructions disclose the steps in a method according to the present invention 
    
    
     
       FIGURES 
       These and other features, aspects and advantages of the present invention will become better understood with regard to the following description, appended claims, and accompanying figures where: 
         FIG. 1  is a top perspective view of one embodiment of a device according to the present invention for placing an occlusion removing structure into a tubular structure with a substantially closed distal end; 
         FIG. 2  is an exploded, top perspective view of the proximal end of the device shown in  FIG. 1 ; 
         FIG. 3  is a partial, top perspective view of one embodiment of an occlusion removing structure (first component) of the device shown in  FIG. 1  and  FIG. 2 ; 
         FIG. 4  is a close-up, top perspective view of one embodiment of the proximal end of the occlusion removing structure; 
         FIG. 5  is a partial, top perspective view of one embodiment of a distracting structure (second component) of the device shown in  FIG. 1  and  FIG. 2 ; and 
         FIG. 6  is a partial, cross-sectional, top perspective view of one embodiment of an attaching and locking structure (third component) of the device shown in  FIG. 1  and  FIG. 2 . 
     
    
    
     DESCRIPTION 
     According to one embodiment of the present invention, there is provided a device for placing the distal end of an occlusion removing structure at or near the distal end of a tubular structure with a substantially closed distal end. According to another embodiment of the present invention, there is provided a method for placing the distal end of an occlusion removing structure into a tubular structure with a substantially closed distal end, where placing results in the distal end of the occlusion removing structure being positioned at or near the distal end of the tubular structure. In a preferred embodiment, the method comprises providing a device according to the present invention. The device and method prolong the useful life of a tubular structure, such as a medical drain, and obviate the need for replacing the tubular structure when it becomes occluded, thereby decreasing the cost associated with drain replacement, and the risk of patient morbidity associated with drain replacement. Though the device of the present invention is presented primarily in the context of use with a medical tubular structure in this disclosure, the device can also be used for other purposes, as will be understood by those with skill in the art with reference to this disclosure. Further, though the device and method are disclosed primarily in the context of use with a tubular structure with a substantially closed distal end, the device and method can also be used with a tubular structure with a substantially open distal end as will be understood by those with skill in the art with reference to this disclosure. The device and method will now be presented in detail. 
     As used in this disclosure, the term “comprise” and variations of the term, such as “comprising” and “comprises,” are not intended to exclude other additives, components, integers or steps. 
     As used in this disclosure, two elements of a device are “integral” if they are joined together in a manner that does not allow separation of the two elements from one another by the user of the device without cutting through or destroying the function of one or both of the two elements. 
     As used in this disclosure, two elements of a device are “non-integral” if they are joined together in a manner to allow separation of the two elements from one another by the user of the device without cutting through or destroying the function of one or both of the two elements. 
     As used in this disclosure, the term “occlusion” means a mass or clog of occluding material within the central lumen of a tubular structure, which either partially or completely decreases the function of a tubular structure, and the term “occlude” and variations of the term, such as “occluded,” and “occluding,” refer to a process where an occlusion within the central lumen of a tubular structure either partially or completely decreases the function of a tubular structure. As will be understood by those with skill in the art with reference to this disclosure, debris being aspirated from inside a blood vessel left after removal of an embolus or plaque from the blood vessel wall by a therapy catheter does not decrease the function of an aspiration catheter aspirating the debris and, therefore, the debris within the aspiration catheter is not an occlusion within the aspiration catheter. 
     As used in this disclosure, the term “at or near the distal end of the tubular structure” and corresponding phrases means that the tip of the distal end of the occlusion removing structure is positioned within the distal most 10% of the axial length of the tubular structure. For example, if the axial length of the tubular structure that resides within the space or cavity being tubular structured is 10 cm, then after placing the occlusion removing structure, the tip of the distal end of the occlusion removing structure is positioned between 9 cm and 10 cm from the proximal end of the tubular structure, that is, the tip of the distal end of the occlusion removing structure is positioned within 1 cm of the distal end of the tubular structure. 
     As used in this disclosure, the term “substantially closed distal end” means that the distal end of the tubular structure is either completely closed or comprises an opening of a cross-sectional area that is suitable only for passing a guide wire through, such as comprising a hole at the distal end comprising a cross-sectional area of between 1 mm and 3 mm, or comprises an opening of a cross-sectional area that is 20% or less of the average cross-sectional area of the central lumen of the tubular structure. 
     All dimensions specified in this disclosure are by way of example only and are not intended to be limiting. Further, the proportions shown in these Figures are not necessarily to scale. As will be understood by those with skill in the art with reference to this disclosure, the actual dimensions of any device or part of a device disclosed in this disclosure will be determined by its intended use. 
     As depicted in the figures, the proximal direction of the components is shown to the left of the figure, and the distal direction of the components is shown to the right of the figure. All dimensions specified in this disclosure are by way of example only and are not intended to be limiting. Further, the proportions shown in these Figures are not necessarily to scale. As will be understood by those with skill in the art with reference to this disclosure, the actual dimensions of any device or part of a device disclosed in this disclosure will be determined by its intended use. 
     The devices of the present invention and their component parts comprise any suitable material for the intended purpose of the device, as will be understood by those with skill in the art with reference to this disclosure. For example, when used with a medical drain, the device will usually comprise one or more than one biocompatible material capable of being sterilized. 
     The devices of the present invention and their component parts can be constructed according to standard techniques, as will be understood by those with skill in the art with reference to this disclosure. 
     As will be understood by those with skill in the art with reference to this disclosure, the device and method for the present invention can be used for a variety of both medical and non-medical uses. In one example, with respect to medical uses, the device and method of the present invention can be used to place an occlusion removing structure within a tubular structure selected from the group consisting of an abscess drainage catheter, a biliary tube, a biliary stent, a chest tube, a decompression catheter, a feeding tube, a gastrointestinal decompression catheter, a gastrostomy tube, a jejunostomy tube, a mediastinal tube, a nasogastric tube, a nephrostomy catheter, a percutaneous drainage catheter, a peritoneal dialysis catheter, a vascular catheter, a venous hemodialysis catheter, a post-surgical drain and a ventriculostomy tube. In another example, with respect to non-medical uses, the device and method of the present invention can be used to place an occlusion removing structure within a tubular structure selected from the group consisting of a household drain, a sewer pipe and a fuel line, as well as other tubular structures used throughout the automotive and petrochemical industries, as will be understood by those with skill in the art with reference to this disclosure. 
     According to one embodiment of the present invention, there is provided a device for placing an occlusion removing structure into a tubular structure with a substantially closed distal end, where the occlusion removing structure comprises a distal end with a tip, where the tubular structure comprises a distal end, and where placing the occlusion removing structure results in placing the tip of the distal end of the occlusion removing structure at or near the distal end of the tubular structure. The device comprises means for removing an occlusion, means for distracting the means for removing an occlusion from a radially expanded and axially contracted first state to a radially contracted and axially expanded second state, and means for attaching and locking the means for removing an occlusion in a radially contracted and axially expanded second state to the means for distracting. The structures disclosed in this disclosure that correspond to the means for removing an occlusion, the means for distracting the means for removing an occlusion, and the means for attaching and locking the means for removing an occlusion will be understood by those with skill in the art with reference to this disclosure. In general, as disclosed in this disclosure, the means for removing an occlusion corresponds to the occlusion removing structure (first component) of the device, the means for distracting the means for removing an occlusion corresponds to the distracting structure (second component) of the device, and the means for attaching and locking the means for removing an occlusion corresponds to the attaching and locking structure (third component) of the device. 
     Referring now to  FIG. 1 ,  FIG. 2 ,  FIG. 3 ,  FIG. 4 ,  FIG. 5  and  FIG. 6 , there are shown, respectively, a top perspective view of one embodiment of a device according to the present invention for placing an occlusion removing structure into a tubular structure with a substantially closed distal end ( FIG. 1 ); an exploded, top perspective view of the proximal end of the device shown in  FIG. 1  ( FIG. 2 ); a partial, top perspective view of one embodiment of an occlusion removing structure (first component) of the device shown in  FIG. 1  and  FIG. 2  ( FIG. 3 ); a close-up, top perspective view of one embodiment of the proximal end of the occlusion removing structure ( FIG. 4 ); a partial, top perspective view of one embodiment of a distracting structure (second component) of the device shown in  FIG. 1  and  FIG. 2  ( FIG. 5 ); a partial, cross-sectional, top perspective view of one embodiment of an attaching and locking structure (third component) of the device shown in  FIG. 1  and  FIG. 2  ( FIG. 6 ). As can be seen, in one embodiment of the present invention, the device  10  comprises a proximal end  12 , a distal end  14 , and an intermediate portion  16  between the proximal end  12  and the distal end  14 . The device  10  further comprises three components, an occlusion removing structure  18  (first component), a distracting structure  20  (second component) for distracting the occlusion removing structure  18  from a radially expanded and axially contracted first state to a radially contracted and axially expanded second state, and an attaching and locking structure  22  (third component) for attaching the occlusion removing structure  18  to the distracting structure  20  non-integrally, and for reversibly, locking the occlusion removing structure  18  in a radially contracted and axially expanded second state. The occlusion removing structure  18 , distracting structure  20 , and attaching and locking structure  22  are all non-integral with respect to each other. 
     Referring now to  FIG. 1 ,  FIG. 2 ,  FIG. 3  and  FIG. 4 , the occlusion removing structure  18  comprises a proximal end comprising a proximal end piece  24 , a distal end comprising a cap  26  with a tip  28  at the distal-most portion of the distal end, and an elongated tubular mesh  30  between the proximal end piece  24  and the cap  26 . In one embodiment, as shown in  FIG. 1 ,  FIG. 2 ,  FIG. 3  and particularly in  FIG. 4 , the proximal end piece  24  comprises a tube comprising a proximal end  32 , a distal end  34 , an axial length between the proximal end  32  and the distal end  34 , an outer surface  36 , an inner surface  38  and a cross-sectional area defined by the inner surface  38 . 
     In a preferred embodiment, the tubular mesh  30  comprises a plurality of wires  40  forming a mesh, where each of the wires  40  crisscross a plurality of other wires  40 , rather than comprising a plurality of wires that are merely spaced apart from one another or parallel to one another. In one embodiment, the tubular mesh  30  comprises between 5 and 50 wires  40 . In another embodiment, the tubular mesh  30  comprises between 10 and 20 wires  40 . In another embodiment, the tubular mesh  30  comprises between 12 and 15 wires  40 . 
     In one embodiment, particularly as shown in  FIG. 3  and  FIG. 4 , the tubular mesh  30  comprises a proximal end  42 , a distal end  44 , an axial length between the proximal end  42  and the distal end  44 , an outer surface  46 , an inner surface  48  and a central lumen cross-sectional area defined by the inner surface  48 . The tubular mesh  30  exists in two states: 1) a radially expanded and axially contracted first state, where the central lumen cross-sectional area is a first central lumen cross-sectional area, and the axial length is a first axial length; and 2) a radially contracted and axially expanded second state, where the central lumen cross-sectional area is a second central lumen cross-sectional area, and the axial length is a second axial length. The first central lumen cross-sectional area is greater than the second central lumen cross-sectional area, and the first axial length is less than the second axial length. 
     As will be understood by those with skill in the art with reference to this disclosure, both the central lumen cross-sectional area and the axial length of the tubular mesh  30  will depend on the intended purpose of the device  10 . By way of example only, in one embodiment, the first central lumen cross-sectional area is between 10 mm 2  and 100 mm 2 . In another embodiment, the first central lumen cross-sectional area is between 15 mm 2  and 50 mm 2 . In another embodiment, the first central lumen cross-sectional area is between 20 mm 2  and 30 mm 2 . In another embodiment, the first axial length is between 5 cm and 50 cm. In another embodiment, the first axial length is between 10 cm and 30 cm. In one embodiment, the second central lumen cross-sectional area is between 1 mm 2  and 10 mm 2 . In another embodiment, the second central lumen cross-sectional area is between 2 mm 2  and 5 mm 2 . In another embodiment, the second axial length is between 10 cm and 100 cm. In another embodiment, the second axial length is between 20 cm and 60 cm. 
     The proximal end  42  of the tubular mesh  30  is integrally joined to the proximal end piece  24 , such as, for example, by either mechanical means or by chemical means, such as, for example, by an adhesive such as an epoxy, or both by mechanical and by chemical means, by other suitable means such as spot welding or laser welding, as will be understood by those with skill in the art with reference to this disclosure. 
     In one embodiment, the wires  40  of the tubular mesh  30  comprise a material selected from the group consisting of cobalt-chromium-nickel-molybdenum-iron alloy specified by ASTM F1058 and ISO 5832-7, stainless steel and a ferrous alloy containing cobalt, chromium, nickel, molybdenum, manganese, carbon, and beryllium, such as Elgiloy® (Combined Metals of Chicago, L.L.C. Elk Grove Village, Ill. US). 
     In one embodiment, the cap  26  of the occlusion removing structure  18  comprises a small band that is crimped over the distal end of the wires  40  of the tubular mesh  30 , bringing the distal end of the tubular mesh  30  to a tapered point. In a preferred embodiment, the cap comprises a material selected from the group consisting of cobalt-chromium-nickel-molybdenum-iron alloy specified by ASTM F1058 and ISO 5832-7, stainless steel and a ferrous alloy containing cobalt, chromium, nickel, molybdenum, manganese, carbon, and beryllium, such as Elgiloy® (Combined Metals of Chicago, L.L.C. Elk Grove Village, Ill. US). 
     Referring now to  FIG. 1 ,  FIG. 2  and  FIG. 5 , the device  10  further comprises a distracting structure  20  (second component) for distracting the occlusion removing structure  18  from a radially expanded and axially contracted first state to a radially contracted and axially expanded second state. The distracting structure  20  comprises a proximal end  50  and a distal end  52 . The proximal end  50  of the distracting structure  20  comprises a first connector  54  configured to mate with the proximal end of the second connector, as disclosed below. In one embodiment, as shown, the first connector  54  comprises a luer lock-type “female” fitting with a threaded flange open distally. The first connector  54  can, however, be any suitable connector, as will be understood by those with skill in the art with reference to this disclosure. 
     The distal end  52  of the distracting structure  20  comprises an elongated tube or rod  56  comprising a proximal end  58 , a distal end  60 , an axial length defined by the distance between the proximal end  58  and the distal end  60 , and an outer surface  62  defining an outer circumference. The proximal end  58  of the elongated tube  56  is joined to the first connector  54 . In a preferred embodiment, the proximal end  58  of the elongated tube  56  is integrally joined to the first connector  54 . In one embodiment, the tube or rod  56  comprises two segments, as shown in  FIG. 4 , a proximal segment  64  and a distal segment  66 . When the elongated tube or rod  56  comprises two segments, the distal segment  66  is relatively more laterally flexible than the proximal segment  64 . 
     The elongated tube or rod  56  comprises a material suitable for forcing the tubular mesh  30  into the radially contracted and axially expanded first state by increasing the axial length of the tubular mesh  30  from the first axial length to the second axial length, as will be understood by those with skill in the art with reference to this disclosure. In one embodiment, the elongated tube or rod  56  comprises a material selected from the group consisting of stainless steel and a flexible polymer. In one embodiment, the elongated tube or rod  56  comprises a material having a tensile strength of between 75 and 150 kpsi. 
     In one embodiment, the axial length of the elongated tube or rod  56  is at least 90% of the combined length of the second axial length of the tubular mesh  30  and the axial length of the attaching and locking structure  22 , as disclosed below, when the attaching and locking structure  22  is attached to the proximal end piece  24  of the occlusion removing structure  18 . In another embodiment, the axial length of the elongated tube or rod  56  is at least 95% of the combined length of the second axial length of the tubular mesh  30  and the axial length of the attaching and locking structure  22  when the attaching and locking structure  22  is attached to the proximal end piece  24  of the occlusion removing structure  18 . In another embodiment, the axial length of the elongated tube or rod  56  is at least 99% of the combined length of the second axial length of the tubular mesh  30  and the axial length of the attaching and locking structure  22  when the attaching and locking structure  22  is attached to the proximal end piece  24  of the occlusion removing structure  18 . In another embodiment, the axial length of the elongated tube or rod  56  is at least 100% of the combined length of the second axial length of the tubular mesh  30  and the axial length of the attaching and locking structure  22  when the attaching and locking structure  22  is attached to the proximal end piece  24  of the occlusion removing structure  18 . In another embodiment, the axial length of the elongated tube or rod  56  is at least 105% of the combined length of the second axial length of the tubular mesh  30  and the axial length of the attaching and locking structure  22  when the attaching and locking structure  22  is attached to the proximal end of the occlusion removing structure  18 . In another embodiment, the axial length of the elongated tube or rod  56  is at least 110% of the combined length of the second axial length of the tubular mesh  30  and the axial length of the attaching and locking structure  22  when the attaching and locking structure  22  is attached to the proximal end piece  24  of the occlusion removing structure  18 . 
     Referring now to  FIG. 1 ,  FIG. 2  and  FIG. 6 , the device  10  further comprises an attaching and locking structure  22  (third component). The attaching and locking structure  22  serves two functions. First, the attaching and locking structure  22  mates with the proximal end piece  24  of the occlusion removing structure  18  to allow the occlusion removing structure  18  to be removed from a tubular structure while keeping the tubular structure in position. Second, the attaching and locking structure  22  serves to lock the occlusion removing structure  18  to the distracting structure  20 , thereby maintaining the occlusion removing structure  18  in a radially contracted and axially expanded second state when the distracting structure  20  distracts the occlusion removing structure  18  from a radially expanded and axially contracted first state to the radially contracted and axially expanded second state. 
     The attaching and locking structure  22  comprises two non-integral sections, a first section  68  and a second section  70 . As can be seen, the first section  68  comprises a proximal end  72  and a distal end  74 . The proximal end  72  of the first section  68  comprises a second connector  76  for mating with the first connector  54  of the distracting structure  20 , and for mating with the third connector, disclosed below, of the second section  70 . The second connector  76  comprises a central axial lumen  78 . In one embodiment, as shown particularly in  FIG. 2  and  FIG. 6 , the proximal end of the second connector  76  comprises a “male” extension that is configured to mate with the threaded flange of the “female” fitting of the first connector  54 . Further as shown particularly in  FIG. 2  and  FIG. 6 , the distal end of the second connector  76  comprises a “female” fitting with a threaded flange open distally for mating with the third connector, disclosed below, of the second section  70 . The second connector  76  can, however, be any suitable connector, as will be understood by those with skill in the art with reference to this disclosure. 
     The distal end  74  of the first section  68  of the attaching and locking structure  22  comprises a rigid tube  80  comprising a proximal end  82 , a distal end  84 , an axial length between the proximal end  82  and the distal end  84 , an outer surface  86 , an inner surface  88 , and a central lumen defined by the inner surface  88 . In a preferred embodiment, as shown, the distal end  84  of the rigid tube  80  is tapered. 
     The second section  70  of the attaching and locking structure  22  comprises a proximal end  90  and a distal end  92 . The proximal end  90  of the second section  70  comprises a third connector  94  for mating with the distal end of the second connector  76  of the first section  68 . The third connector  94  comprises a central axial lumen  96 . In one embodiment, as shown, the third connector  94  comprises a “male” extension that is configured to mate with the threaded flange of the “female” fitting of the second connector  76 . The third connector  94  can, however, be any suitable connector, as will be understood by those with skill in the art with reference to this disclosure. 
     The proximal end  90  of the second section  70  comprises two legs  98  that are split axially from near the proximal end  90 , through the distal end  92  of the second section  70 . The distal end of the legs  98  form a fourth connector  100  configured to mate with the proximal end piece  24  of the occlusion removing structure  18 . 
     The three components of the device  10 , the occlusion removing structure  18  (first component), the distracting structure  20  (second component), and the attaching and locking structure  22  (third component) are joined together non-integrally to form the assembled device  10  as follows. The fourth connector  100  of the second section  70  is mated to the proximal end piece  24  of the occlusion removing structure  18 . The distal end  74  of the first section  68  is advanced completely through the central lumen of the third connector  94  of the second section  70  until the second connector  76  of the first section  68  mates with the third connector  94  of the second section  70 , radially expanding the legs  98  and fourth connector  100  and, thereby, attaching the attaching and locking structure  22  to the occlusion removing structure  18 . Next, the distal end  52  of the distracting structure  20  is advanced completely through the first section  68  from the proximal end  72  of the first section  68  through the distal end  74  of the first section  44 , through the proximal end piece  24  of the occlusion removing structure  18  and through the central lumen of the tubular mesh  30 , until the distal end  52  of the distracting structure  20  contacts the cap  26  of the occlusion removing structure  18 , thereby distracting the occlusion removing structure  18  from the radially expanded and axially contracted first state to the radially contracted and axially expanded second state. Then, the first connector  54  of the distracting structure  20  is mated to the second connector  76 , thereby locking the occlusion removing structure  18  in the second state, and creating an assembled device  10 . 
     In another embodiment, the present invention is a kit for placing an occlusion removing structure in a tubular structure with a substantially closed distal end. The kit comprises a device according to the present invention, and further comprises instructions on how to use the device. In one embodiment, the instructions disclose the steps in a method according to the present invention. 
     In another embodiment, the present invention comprises a method for placing an occlusion removing structure into a tubular structure with a substantially closed distal end. The tubular structure has a proximal end, a distal end, and a wall comprising an outer surface and an inner surface defining an axial lumen. In one embodiment, the tubular structure further comprises one or more than one connector at the proximal end for attaching to a suction device, an irrigation device or both a suction device and an irrigation device. In a preferred embodiment, the tubular structure comprises one or more than one aperture in the wall. 
     In one embodiment, the method for placing an occlusion removing structure into a tubular structure with a substantially closed distal end comprises providing a device according to the present invention, and placing the occlusion removing structure of the device in the tubular structure. In another embodiment, the method comprises providing a device according to the present invention in the radially contracted and axially expanded second state, placing the occlusion removing structure of the device in the tubular structure; and allowing the occlusion removing structure to assume the radially expanded and axially contracted first state. 
     In a preferred embodiment, placing results in the distal end of the occlusion removing structure being positioned at or near the distal end of the tubular structure. In a preferred embodiment, the method comprises providing an assembled device for placing an occlusion removing structure in a tubular structure with a substantially closed distal end according to the present invention. Placing an occlusion removing structure in the tubular structure can be performed before the tubular structure becomes occluded, or can be performed after an occlusion has been removed from the tubular structure, such as, for example, to replace an occlusion removing structure that has been removed so that another occlusion can be removed from the tubular structure if the tubular structure becomes occluded again. The method will now be disclosed in detail. 
     First, the method comprises providing an assembled device for placing an occlusion removing structure in a tubular structure with a substantially closed distal end according to the present invention having the characteristics as disclosed in this disclosure. The device comprises an occlusion removing structure in a radially contracted and axially expanded second state, a distracting structure and an attaching and locking structure. In a preferred embodiment, the device provided is a device according to the present invention with all of the attributes disclosed in this disclosure. Then, the distal end of the device is inserted into the proximal end of the tubular structure, and the distal end of the device is advanced through the central lumen of the tubular structure until the occlusion removing structure is entirely within the tubular structure, or until the distal end of the tubular structure contacts the substantially closed distal end of the tubular structure. 
     Next, the method comprises disconnecting the first connector from the second connector, and withdrawing the distracting structure from the device, while maintaining at least a portion of the tubular mesh within the tubular structure, thereby converting the tubular mesh from the radially contracted and axially expanded second state to the radially expanded and axially contracted first state. In a preferred embodiment, the outer surface of the tubular mesh contacts at least part of the inner surface of the wall of the tubular structure when the tubular mesh is in the first state, thereby limiting the further radial expansion of the tubular mesh. 
     In one embodiment, the method further comprises disconnecting the second connector from the third connector and withdrawing the first section of the attaching and locking structure from the second section of the attaching and locking structure, thereby allowing the legs of the second section to contract radially and unlock the fourth connector from the proximal end piece of the occlusion removing structure. Then, the second section of the attaching and locking structure is removed from the occlusion removing structure, thereby leaving the occlusion removing structure in the tubular structure. 
     In one embodiment, after placing the occlusion removing structure, the proximal end of the tubular mesh extends proximally outside of the proximal end of tubular structure, and the method further comprises separating the tubular mesh from the proximal end piece, such as for example, by cutting the tubular mesh at or near the proximal end of the tubular mesh. In a preferred embodiment, the method further comprises attaching the cut end of the tubular mesh to a structure to secure the cut ends of the wires of tubular mesh. 
     In another embodiment, the method comprises allowing the tubular structure to become occluded with occluding material, and then withdrawing the occlusion removing structure from the tubular structure after the tubular structure becomes occluded with occluding material. In one embodiment, withdrawing the occlusion removing structure from the tubular structure after the tubular structure becomes occluded with occluding material comprises, first, inserting the fourth connector of the second section of the attaching and locking structure into the proximal end piece of the occlusion removing structure. Next, the distal end of the first section of the attaching and locking structure is advanced completely though the proximal end of the second section, thereby radially expanding the legs of the second section and locking the fourth connector to the proximal end piece of the occlusion removing structure. The second connector of the first section is then connected to the third connector of the second section. The occlusion removing structure, along with the attaching and locking structure, is then retracted proximally, distracting the tubular mesh and, thereby, holding the occluding material within the tubular mesh as the occlusion removing structure is withdrawn from the tubular structure. 
     In one embodiment, the tubular structure is within a space or cavity within a human or within a non-human animal. In another embodiment, the space or cavity is created by a surgical procedure. In another embodiment, the space or cavity is selected from the group consisting of the abdominal cavity, the bladder, the intestines, the intracranial cavity, the mediastinum, the nasal passages, the stomach, the renal pelvis and the ureter. In another embodiment, the space or cavity is created during a surgical procedure on the back, breast, chest, head, hip or vertebral column. In one embodiment, the tubular structure has become occluded with an occluding material within a space or cavity within a human or within a non-human animal. 
     Although the present invention has been discussed in considerable detail with reference to certain preferred embodiments, other embodiments are possible. Therefore, the scope of the appended claims should not be limited to the description of preferred embodiments contained in this disclosure.