Patent Publication Number: US-2018028223-A1

Title: Rotational thrombectomy wire

Description:
This application is a continuation in part of application Ser. No. 13/456,555, filed Apr. 26, 2012, which claims priority from provisional application Ser. No. 61/486,425, filed May 16, 2011, and is a continuation in part of Ser. No. 13/303,339, filed Nov. 23, 2011, which claims priority from provisional application Ser. No. 61/431,169, filed Jan. 10, 2011, and is a continuation in part of Ser. No. 13/095,329, filed Apr. 27, 2011, which claims priority from provisional application Ser. No. 61/334,412, filed May 13, 2010. The entire contents of each of these applications are incorporated herein by reference. 
    
    
     BACKGROUND 
     Technical Field 
     This application relates to a rotational thrombectomy wire for clearing thrombus from native vessels and grafts. 
     Background of Related Art 
     There have been various attempts to break up clots and other obstructing material in grafts or native vessels. One approach is through injection of thrombolytic agents such as urokinase or streptokinase. These agents, however, are expensive, require lengthier hospital procedures and create risks of drug toxicity and bleeding complications as the clots are broken. 
     Other approaches to breaking up clots involve mechanical thrombectomy devices. For example, U.S. Pat. No. 5,766,191 discloses a cage or basket composed of six memory wires that expand to press against the inner lumen to conform to the size and shape of the lumen. This multiple wire device is expensive and can be traumatic to the graft, possibly causing damage, since as the basket rotates, the graft is contacted multiple times by the spinning wires. Other risks associated with the basket include the possibility of catching onto the graft itself and tearing the graft as well as catching and tearing the suture at the anastomotic site. Additionally, the basket can become filled with a clot which would then require time consuming withdrawal of the basket, cleaning the basket and reinserting it into the lumen. This device could be traumatic if used in the vessel, could denude endothelium, create vessel spasms and has the potential for basket and drive shaft fracture. 
     U.S. Pat. No. 6,090,118, incorporated herein by reference in its entirety, discloses a wire rotated to create a standing wave to break-up or macerate thrombus. The single wire is less traumatic than the aforedescribed basket device since it minimizes contact with the graft wall while still effectively mechanically removing thrombotic material. 
     U.S. Pat. No. 7,037,316 discloses another example of a rotational thrombectomy wire for breaking up clots in grafts. The thrombectomy wire has a sinuous shape at its distal end and is contained within a sheath in a substantially straight non-deployed position. When the sheath is retracted, the distal portion of the wire is exposed to enable the wire to return to its non-linear sinuous configuration. The wire is composed of two stainless steel wires wound side by side with an elastomeric tip at the distalmost end. Actuation of the motor causes rotational movement of the wire, creating a wave pattern, to macerate thrombus. Thus, it provides the additional advantages of increased reliability and consistency in creating the wave pattern since the wave pattern created by the standing wave of the &#39;118 patent will depend more on the rotational speed and the stiffness of the wire. Additionally, the sinuous configuration enables creation of a wave pattern at a lower rotational speed. 
     Although the sinuous wire of the &#39;316 patent is effective in proper clinical use to macerate thrombus in dialysis grafts, it is not best suited for use in native vessels. US patent publication no. US 2006/0106407 (now U.S. Pat. No. 7,819,887), the entire contents of which are incorporated herein by reference, discloses a thrombectomy wire better suited for use in native vessels (and can also be used for deep vein thrombosis and pulmonary embolisms). 
     In neurovascular thrombectomy procedures, the thrombectomy wire needs to navigate tortuous vessels. That is, the wire is inserted through the femoral artery and then must navigate small and tortuous vessels as it is advanced to the smaller cerebral arteries of the brain. Within the brain, the carotid and vertebrobasilar arteries meet to form the circle of Willis. From this circle, other arteries, e.g., the anterior cerebral artery, the middle cerebral artery and the posterior cerebral artery, arise and travel to various parts of the brain. Clots formed in these cerebral arteries can cause stroke and in certain instances death of the patient. 
     Due to the size and curves of the vessels en route to the cerebral arteries from the femoral artery, as well as the size and structure of cerebral arteries themselves, access is difficult. If the thrombectomy device is too large then navigation through the small vessels, which can be as small as 1 mm, would be difficult. Also, if the device is too stiff, then it can damage the vessel walls during insertion. On the other hand, if the device is too flexible, it will lack sufficient rigidity to be advanced around the vessel curves and can be caught in the vessel. Consequently, it would be advantageous to provide a thrombectomy device for breaking cerebral clots that strike the optimal balance of flexibility and stiffness, thus effectively having the insertability of a tracking guidewire while enabling high speed rotation to effectively macerate clots without damaging vessels. Additionally, in certain clinical applications, it would be advantageous to have the wire attachable to the motor by a user so the wire can be initially inserted into the vasculature without the bulk of the motor housing. 
     SUMMARY 
     The present disclosure provides in one aspect an assembly for breaking up vascular thrombus or other obstructive material. The assembly comprises a motor housing having a motor contained therein, a motor shaft extending from the motor, a first housing, a rotational thrombectomy wire and a second housing. The first housing is positioned at a distal end of the motor shaft and has a first magnet positioned therein recessed from a distal edge of the first housing. The distal edge of the first housing has a first plurality of teeth. A second housing is positioned at a proximal end of the thrombectomy wire and has a second magnet positioned therein recessed from a proximal edge of the second housing. The proximal edge of the second housing has a second plurality of teeth intermeshing with the first plurality of teeth when the wire is coupled to the motor shaft. The first and second magnets provide an attractive force between the first and second housings to intermesh the first plurality of teeth and the second plurality of teeth, the first and second plurality of teeth slipping when a torque of the motor shaft exceeds a predetermined value. 
     The distal end of the thrombectomy wire can be non-linear in configuration. In some embodiments, the non-linear distal end of the wire can be J-shaped in configuration; in other embodiments, the non-linear distal end of the wire can be sinuous shaped. The assembly can further include an introducer sheath having a lumen wherein the thrombectomy wire is slidable within the lumen. 
     The first and second housings are preferably removably coupled. 
     In one embodiment, the first housing includes a first gap and the second housing includes a second gap, the first magnet axially movable within the first gap as the first housing rotates and the second magnet axially movable in the second gap as the second housing rotates. A first plug can be provided to close the first gap and a second plug can be provided to close the second gap. 
     Preferably, the distal edge of the first housing forms a wavy pattern and the proximal edge of the second housing forms a wavy pattern. 
     In accordance with another aspect of the disclosure, an assembly for breaking up vascular thrombus or other obstructive material is provided comprising a motor housing having a motor contained therein, a motor shaft extending from the motor, a first housing positioned at a distal end of the motor shaft, a rotational thrombectomy wire, and a second housing positioned at a proximal end of the thrombectomy wire. The first housing has a first magnet positioned therein and the second housing has a second magnet positioned therein. The first and second magnets provide an attractive force for the first and second housings. A cover forms a clutch positioned over an end of one of the first and second housings. 
     In some embodiments, the first magnet flares a distal end of the first housing when inserted therein to provide frictional engagement. In some embodiments, the cover is in the form of a disc, the disc being formed of a polymeric material and forming a clutch. In some embodiments, the polymeric disc is a latex sheet of material. In some embodiments, the cover is composed of a material that wears away after a period of use. 
     The assembly can further include a sheath, wherein exposure of the wire from the sheath enables a distal portion of the wire to assume a non-linear configuration. In some embodiments, a vacuum can be provided to remove particles from the vessel. 
     In some embodiments, operatively coupling the motor to the thrombectomy wire occurs prior to inserting the thrombectomy wire through the sheath. In other embodiments, operatively coupling the motor to the thrombectomy wire occurs subsequent to inserting the thrombectomy wire through the sheath. 
     The thrombectomy wire in some embodiments can be inserted into the cerebral artery. In some embodiments, the thrombectomy wire is inserted into the circle of Willis. 
     In accordance with another aspect of the present disclosure, an assembly insertable into a lumen of a patient is provided comprising a motor housing having a motor contained therein, a motor shaft extending from the motor, a first coupler positioned at the motor shaft having a first magnet (or first ferromagnetic material) positioned therein adjacent a distal end, a rotational wire, and a second coupler positioned at a proximal portion of the wire. The second coupler has a second magnet (or second ferromagnetic material) positioned therein adjacent a proximal end. The second coupler is engageable with the first coupler to operably connect the rotational wire to the motor shaft. The first and second magnets provide an attractive force between the first and second couplers to maintain a connection of the first and second couplers so rotation of the first coupler rotates the second coupler. 
     In some embodiments, a distal end of the rotational wire is non-linear in configuration, and in some embodiments it can be J-shaped in configuration and in other embodiments it can be sinuous shaped. 
     In some embodiments, the first coupler has a plurality of recesses to form a female coupler and the second coupler has a plurality of projecting members to form a male coupler. The first and second couplers can be removably coupled. 
     In some embodiments, the motor housing includes a projecting member and a hub is positioned at a proximal portion of the rotational wire, the hub engaging with the projecting member to interlock the wire and motor shaft. The hub can include a cutout forming a first abutment wall engageable with a second abutment wall on the projecting member. In some embodiments, rotation of the motor shaft causes the hub to move from a first release position to a second interlocked position. In some embodiments, reverse rotation of the hub moves the hub from the interlocked position to the release position to enable removal of the second coupler from the first coupler. 
     In some embodiments, the projecting member has an arrow like configuration. The assembly can include a second cutout in the hub and a second projecting member in the motor housing, the second cutout engageable with the second projecting member. 
     In accordance with another aspect of the present disclosure, an assembly insertable into a lumen of a patient is provided comprising a motor housing having a motor contained therein, a motor shaft extending from the motor, a first coupler positioned at the motor shaft, a rotational wire, and a second coupler positioned at a proximal portion of the rotational wire. The second coupler is engageable with the first coupler to operably connect the rotational wire to the motor shaft, wherein prior to actuation of the motor the second coupler can be removed from the first coupler by application of an axial force and subsequent to actuation of the motor the second coupler cannot be removed from the first coupler by application of an axial force. 
     In some embodiments, a hub is provided at a proximal portion of the wire, the hub having an engagement surface engageable with a surface within the motor housing such that application of the axial force cannot separate the second coupler from the first coupler. In some embodiments, rotation of the hub in a direction opposite a direction of rotation of the motor shaft moves the hub to a position to enable removal of the second coupler by an axial force in a distal direction. 
     In some embodiments, the first coupler has a plurality of recesses to form a female coupler and the second coupler has a plurality of projecting members to form a male coupler. 
     In accordance with another aspect of the present disclosure, a method for connecting a rotational wire to a motor assembly to perform a surgical procedure is provided comprising providing a first coupler associated with a motor shaft, providing a wire assembly at a proximal portion of a rotational wire, the wire assembly including a second coupler, connecting the second coupler to the first coupler, and actuating a motor to rotate the wire assembly to move the wire assembly from a release position to an interlocked position with respect to the motor. 
     In some embodiments, the step of connecting the second coupler to the first coupler includes inserting the second coupler and a portion of the rotational wire into a motor housing containing the motor. In some embodiments, the step of actuating the motor rotates the wire assembly so that an engagement surface engages a blocking surface within the motor housing. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       Preferred embodiment(s) of the present disclosure are described herein with reference to the drawings wherein: 
         FIG. 1  is a perspective view of a first embodiment of a thrombectomy apparatus of the present invention; 
         FIG. 1A  is a perspective view of an alternate embodiment of the apparatus; 
         FIG. 2  is an exploded view of the proximal portion of the thrombectomy apparatus of  FIG. 1 ; 
         FIG. 2A  is a perspective view of one embodiment of the motor housing attachable to the thrombectomy wire; 
         FIG. 2B  is an exploded view of the motor housing of  FIG. 1  showing the components for operatively connecting the motor to the thrombectomy wire; 
         FIG. 2C  is a side view in partial cross-section of the coupler of  FIG. 2B ; 
         FIG. 2D  is a perspective view of the coupler of  FIG. 2C ; 
         FIG. 2E  is a side view in partial cross section illustrating the connection of the internal components of the motor housing; 
         FIG. 2F  is a side view showing the wire operatively connected to the motor shaft by the coupler of  FIG. 2C ; 
         FIG. 3  is a side view in partial cross-section of the apparatus of  FIG. 1 ; 
         FIG. 3A  is longitudinal cross-sectional view taken along line  3 A- 3 A of  FIG. 1 ; 
         FIG. 4  is a side view of the apparatus of  FIG. 1  showing the rotational wire in a non-linear position corresponding to a position exposed from the introducer sheath; 
         FIG. 4A  is an enlarged view of the distal portion of one embodiment of the thrombectomy wire having a sinuous configuration; 
         FIG. 4B  is an enlarged view of the distal portion of an alternate embodiment of the thrombectomy wire having a J-tip configuration; 
         FIG. 5  is a longitudinal cross-sectional view of the distal portion of the thrombectomy wire of the apparatus of  FIG. 1 ; 
         FIG. 6  is an anatomical view showing select cerebral arteries; 
         FIG. 7  is a front anatomical view showing select cerebral arteries, including the circle of Willis; 
         FIG. 8  illustrates insertion of a guide catheter through the femoral artery and into the cerebral artery over a tracking guidewire; 
         FIG. 9  is a view similar to  FIG. 8  illustrating withdrawal of the tracking guidewire; 
         FIG. 9A  is a perspective view illustrating attachment of the RHV to the introducer catheter; 
         FIG. 10  illustrates insertion of the RHV and introducer catheter through the guide catheter and into the circle of Willis; 
         FIG. 10A  is a perspective view illustrating insertion of the introducer sheath into the RHV; 
         FIG. 10B  is a perspective view illustrating attachment of the connector tube to the introducer sheath; 
         FIG. 10C  is a perspective view of another introducer catheter; 
         FIG. 10D  is a side view showing attachment of the RHV and introducer catheter of  FIG. 10C ; 
         FIG. 11  illustrates insertion of the thrombectomy wire of  FIG. 1  into the RHV and through the introducer catheter, and continued advancement of the wire from the introducer catheter so the distal portion of the wire is positioned in the circle of Willis; 
         FIG. 12  is a side view in partial cross section similar to  FIG. 2E  showing an alternate embodiment of a coupler for coupling the thrombectomy wire to the motor; 
         FIG. 13  is a perspective view of the coupler of  FIG. 12 ; 
         FIG. 14  is a cross-sectional view of the coupler of  FIG. 13  shown within the motor housing coupling the motor shaft to the thrombectomy wire; 
         FIG. 15  is a perspective view of an alternate embodiment of the coupler for coupling the thrombectomy wire to the motor; 
         FIG. 16  is a front view of the housing of  FIG. 15  for receiving the motor shaft; 
         FIG. 17  is a cross-sectional view of the coupler of  FIG. 15  shown within the motor housing coupling the motor shaft to the thrombectomy wire; 
         FIG. 18  is a perspective view of another alternate embodiment of the coupler for coupling the thrombectomy wire to the motor; 
         FIG. 19  is a cross-sectional view of the female coupler of  FIG. 18 ; 
         FIG. 20  is a cross-sectional view of the male coupler of  FIG. 18 ; 
         FIG. 21  is a cross-sectional view of the coupler of  FIG. 18  shown within the motor housing coupling the thrombectomy wire to the motor shaft; 
         FIG. 22A  is a side view showing the male coupler being inserted into the motor housing for coupling to the female coupler of the motor; 
         FIG. 22B  is a side view similar to  FIG. 22A  showing the male coupler inserted further into the motor housing; 
         FIG. 22C  is a side view similar to  FIG. 22B  showing the male coupler inserted further into the motor housing with the wire hub moving past the projection on the housing; 
         FIG. 22D  is a side view similar to  FIG. 22C  showing the male and female couplers fully engaged prior to rotation of the wire hub to lock the thrombectomy wire to the motor (the arrow indicating the direction of rotation of the motor to lock the components); 
         FIG. 22E  is a side view similar to  FIG. 22D  illustrating rotation of the wire hub to lock the thrombectomy wire to the motor (the arrow indicating the direction of rotation to release the wire from the motor); 
         FIG. 22F  is a side view similar to  FIG. 22E  showing the wire hub rotated to enable release of the male coupler from the female coupler; 
         FIG. 22G  is a view similar to  FIG. 22E  showing the wire hub and male coupler being withdrawn from the motor housing; 
         FIG. 23  is a perspective view of the motor housing, with one of the housing halves removed to show internal components, showing connection of the wire to the motor by the male and female couplers; 
         FIG. 24A  is a close up perspective view of the male and female couplers showing the male coupler connected to the female coupler but not yet locked in place, corresponding to the position of  FIG. 22D ; and 
         FIG. 24B  is a close up perspective view similar to  FIG. 24A  showing the male coupler rotated to move the wire hub into the interlocked position within the motor housing, and corresponding to the position of  FIG. 22E . 
     
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS 
     Referring now in detail to the drawings where like reference numerals identify similar or like components throughout the several views,  FIG. 1  illustrates a first embodiment of the thrombectomy apparatus of the present invention. 
     The thrombectomy apparatus of  FIG. 1  is designated generally by reference numeral  10 . With reference to  FIGS. 1 and 2 , the apparatus includes a motor housing  12 , a rotational thrombectomy wire  30 , a rotating hemostatic valve (RHV)  40 , an introducer sheath  60  and a telescoping tube or tubular connector  80 . The RHV  40  is connectable to an introducer catheter  100  discussed below in conjunction with the method of use. The introducer sheath  60  is insertable into the RHV  40  to facilitate insertion of the thrombectomy wire  30  through the introducer catheter  100 . 
     The thrombectomy apparatus or assembly  10  disclosed herein provides a rotational thrombectomy wire as a separate unit from a catheter. That is, the thrombectomy wire  30  is provided as a separate unit insertable through the RHV  40  which has a distal end  52  connected to a proximal end of the introducer catheter  100  to access the surgical site. The introducer sheath  60  aids insertion of the thrombectomy wire  30  into the RHV  40  and through the introducer catheter  100 , with the walls of the introducer sheath  60  maintaining the non-linear distal end of the wire  30  in a substantially straightened (substantially linear) configuration as it enters the RHV  40 . 
     Additionally, the thrombectomy wire  30  of the present invention can be slid within the introducer sheath  60  and introducer catheter  100  prior to connection to the motor, if desired. This can aid introduction and manipulation of the wire  30  since it is less cumbersome and of lighter weight than if the motor housing  12  was attached during manipulation of the wire. However, it is also contemplated that the wire  30  could be attached to the motor housing  12  prior to insertion through the introducer sheath  60 , RHV  40  and the introducer catheter  100  and thus the wire  30  would be slidable within the introducer sheath  60  (and introducer catheter  100 ) with the motor housing  12  attached. Thus, the motor housing  12  can be attached to the wire at a desired time prior to or during the procedure. 
     Turning to the specific components of the thrombectomy apparatus  10 , and with reference to  FIGS. 1-4 , the motor housing  12 , which also forms a handle portion, has two identical housing halves  13   a ,  13   b . A motor  14  is seated within recess  14   a  of housing half  13   a  and the opposing recess of housing half  13   b  and has a motor drive shaft  15  extending therefrom. Tabs  15   b  ( FIG. 3 ) help secure the motor  14  within the housing  12 . A gear reducer (not shown) could optionally be provided to reduce by way of example the rotational speed of the motor  52  from 15,000 rpm to 1500 rpm, 750 rpm, 150 rpm, etc. One or more batteries  16 , such as a 3 Volt battery, is positioned in recess  17   a  of housing half  13   a  and the opposing recess of housing half  13   b  for powering the motor  14 . The battery(s)  16  can be contained within a compartment in the housing  12  accessible by removing a battery door. The motor drive shaft  15  connects to a proximal end of the thrombectomy wire  30  by various couplings, such as for example a snap fit wherein cap  31  is frictionally fit within the lumen  15   a  of the motor drive shaft  15 . Various other types of connections are also contemplated. A printed circuit board can also be provided within the housing  30  and is designated by reference numeral  18 . 
     Motor housing  12  includes a distal tubular portion  22  having a tab in the form of a ring  24  which fits within a groove in the tube connector  80 , best shown in  FIG. 3  to connect the motor housing  12  to tube connector  80  described below. 
     Switch  19  extends though recess  21  in housing half  13   a  and in a corresponding recess in housing half  13   b . A potentiometer (not shown) can optionally be wired to the motor to enable dialing the motor speed up or down to adjust the rotational speed of the thrombectomy wire  30  to adjust for various procedures and/or clot locations and sizes. In a preferred embodiment, the potentiometer is used as a two terminal variable resistor, i.e. a rheostat, by not connecting the third terminal. In this manner, in the initial position, the motor speed is at the desired minimum and rotation of a knob (or in alternate embodiments sliding of a knob) progressively increases the motor speed. Thus, the on/off switch  19  extending from the housing  12  is electrically connected to the motor  15  to turn on the motor  15  to activate the apparatus, i.e. rotate the wire  30 . 
     Turning to the other components illustrated in  FIGS. 2-4 , rotating hemostatic valve (RHV)  40  is connectable to an introducer catheter  100  (see  FIG. 9A ). A conventional introducer catheter can be utilized or alternatively a specially designed catheter for use with the apparatus of the present invention. As is standard, the RHV  40  is rotatable with respect to the catheter  100  to alter the orientation of the side arm  56 . 
     Side arm  56  extends from the tubular portion  46  and has a port  57  for introduction of fluids and/or application of vacuum as described below. Luer lock is provided at the distal end  52  of RHV  40  to connect to the introducer catheter as threads  51   a  of rotation knob  51  threadingly engage proximal threads of the introducer catheter  100 . Tube extension  48  fits within the lumen of the introducer catheter  100  when attached. Washers  49   a ,  49   b  help to provide a seal against fluid flow. 
     Tubular portion  46  of RHV  40  includes a lumen  55  extending therethrough to slidably receive the tubular portion  62  of the introducer sheath  60 . Proximal cap  58  at proximal end  54  has internal threads  59  to threadingly attach to external proximal threads  47  for attachment of the cap  58  to the RHV  40 . Further, a crush ring  43  and distal ring  44  are seated within the internal lumen  55  of the tubular portion  46 . Thus, as cap  58  is tightened on RHV  40  by rotation, it compresses rings  43  and  44  against the tubular portion  62  of introducer sheath  60  extending therethrough to connect the introducer sheath  60  to the RHV  40  (see  FIG. 3A ). A proximal seal  45  can also be provided. Flange  46   a  on the proximal end  54  of RHV  40  interacts with lip  58   a  of cap  58  to allow loosening of cap  58  to release introducer sheath  60  without cap  58  detaching from RHV  40 . 
     Side arm  56  of RHV  40  has a lumen  53  in fluid communication with lumen  55  of tubular portion  46 . Fluids such as imaging dye can be injected through the arm  56 , flowing through the lumens  53  and  55 , i.e. through the space between the outer wall of the introducer sheath  60  and the inner wall of lumen  55  and then through the space between the thrombectomy wire  30  the inner wall of the introducer catheter  100  and, exiting a distal opening  103  ( FIG. 10 ) in the introducer catheter  100  to flow into the vessel. This imaging dye can be used to provide an indication that fluid flow has resumed in the vessel. 
     The side arm  56  can also be used for vacuum to suction particles detached from the vessel by the rotational wire  30 . The particles would flow into the distal opening  103  of the introducer catheter  100  and through the space between the wire  30  and the inner wall of the introducer catheter  100 , then exiting through lumen  53  and port  57  into a suction tube (not shown). 
     It should also be appreciated that the guide catheter  150  discussed in conjunction with the method of use can also have a side arm for injection of fluid (see e.g., side arm  152  of  FIG. 8 ). 
     In the alternate embodiment of  FIG. 1A , the RHV  40 ′ does not have a side arm. In this embodiment, a guide catheter with a side arm can be used for injection and suction. Otherwise the components are identical to the components of  FIG. 1  and for convenience, the corresponding components are labeled with “prime” designations e.g., rotational knob  51 ′, cap  58 ′, introducer sheath  60 ′, connector tube  80 ′ and locking cap  83 ′. 
     The tubular portion  62  of introducer sheath  60 , as noted above, extends through the lumen  55  of RHV  40  and terminates either within RHV  40  or at a proximal portion of the lumen of the introducer catheter  100 . The tubular portion  62  preferably has a stiffness greater than the stiffness of the thrombectomy wire  30  to maintain the wire  30  in a straightened position during passage of wire  30  into the RHV  40  for subsequent passage through the lumen of the introducer catheter  100  to the surgical site. 
     Proximal end  65  of introducer sheath  60  is attachable to connector tube  80 . Preferably, the enlarged proximal end  65  has a threaded flange  67  as shown in  FIG. 3A  to threadingly engage the internal threads  85  on the distal cylindrical locking cap  83  at the distal end  82  of tubular connector  80 . A valve can be provided within the distal end  82  of the connector tube  80  in addition or instead of a valve in a proximal end  65  of the introducer sheath  60  to seal escape of fluid to improve the vacuum through the side arm  56 . 
     Note the tube  80  and introducer sheath  60  can alternatively be provided as one unit, attached together and positioned over the thrombectomy wire  30 . However, in alternative embodiments, the wire  30  is inserted through the introducer sheath  60  and manipulated through the introducer catheter  100  to the surgical site. Once positioned, the connector tube  80  is then threadingly attached at the distal end  82  to the introducer sheath  60  as noted above and at a proximal end  84  to the motor housing  12 . In this version, the connector tube  80  can be positioned over the wire  30  prior to insertion of the wire  30  through introducer sheath  60  or after insertion through the sheath  60 . The wire  30  can be packaged with the sheath  60  and the tube  80  positioned thereover, or packaged apart from the sheath  60  and tube  80 . 
     Proximal end  84  of connector tube  80  is configured for attachment to the motor housing  12  by an external ring  24  on tip  22  of motor housing  12 . Ring  24  is seated within an internal groove of connector tube  80 , as shown in  FIG. 3 , to provide a snap fit. Other types of attachment are also contemplated. The proximal end of the wire  30  is attached to the drive shaft  15  of the motor  14 . In one embodiment, end cap  31  of wire  30  is snap fit within opening  15   a  in motor shaft  15 . Other ways to attach the wire  30  and motor shaft  15  are also contemplated such as a bayonet mount for example. 
     As can be appreciated, by having a detachable motor housing  12 , different handles with different motor speeds and/or different batteries can be utilized by attachment to the wire  30 . This can even be achieved during the same surgical procedure. 
     In some embodiments, the housing can be detached, sterilized and reused after recharging of the battery or replacing the battery. 
     In some embodiments, as an alternative to direct connection to the motor shaft, the proximal end of wire  30 , after insertion to the surgical site or prior to insertion, can be attached at a proximal end to a coupler tube which is connected to a gear reducer. The connection of the motor and thrombectomy wire can be a friction fit, a magnetic coupling or a twist connect, e.g. a bayonet connection, by way of example, such as that shown in co-pending patent application Ser. No. 13/095,329, filed Apr. 27, 2011, the entire contents of which are incorporated herein by reference. 
       FIGS. 2A-2F  show an alternative mechanism for operatively connecting the thrombectomy wire and motor. Motor housing  210  is composed of two housing halves  212   a ,  212   b  which form the handle of the apparatus. Seated within the recess  213  in motor housing  210  is motor  214  electrically connected to two batteries  216 . Switch  218  extends through opening  220  in motor housing  210  for access by the user. Attached to motor shaft  222 , which extends distally from motor  214 , is magnetic coupler  230  for magnetic coupling of the thrombectomy wire to the motor housing  210 . Electrical wire  226  electrically connects switch  218  to post  214   a  of motor  214 . Wire  229  connects the switch  218  to the positive terminal of battery  216  and wire  228  connects the negative terminal of battery  216  to motor post  214   b.    
     The magnetic coupler includes a tube or housing  230 , preferably made of PVC, although other materials are also contemplated. Tube  230  has a proximal portion  234  which receives motor shaft  222  and a distal portion  236 . A first magnet  242  is positioned in the distal portion  236  of the tube  230 , and due to its transverse dimension being larger than the transverse dimension of tube  230 , forces the tube  230  to flare outwardly into flared portion  233 , thereby providing a tight frictional fit. A disc  240 , which can be made of a polymeric or of other material, but is preferably in the form of a Latex sheet, is provided over the distal edge  238  of tube  230  to maintain the first magnet  242  within the tube  230 . The disc  240  functions as a clutch for torque transfer from the motor  214  to the thrombectomy wire  30 . The motor shaft  222 , extending distally from motor  214 , extends into the proximal end of the tube  226  and is frictionally engaged thereto. 
     A second magnet is contained in housing  246  which is attached to the proximal end of the thrombectomy wire  30  by gluing, overmolding, or other attachment methods. When desired to attach the thrombectomy wire  30  to the motor housing  210 , the thrombectomy wire  30  is inserted into the reduced diameter portion  217  of motor housing  214  until the magnetic attraction between the second magnet and first magnet  242  maintains a magnetic connection. In this manner, when motor  214  is actuated by switch  218 , motor shaft  222  rotates to thereby rotate magnetically coupled thrombectomy wire  30 . Note the torque is transferred to the wire  30  due to the disc  240  functioning as a clutch. 
     As noted above, the disc  240  can be in the form of a polymeric sheet. The sheet can be designed to wear off after a period of time, thus wearing away the clutch, resulting in the loss of the ability to transfer torque. In this way, over-use of the apparatus can be prevented, and the apparatus can advantageously be designed for one time use in a single procedure. 
     An alternative embodiment for coupling the motor to the thrombectomy wire is illustrated in  FIGS. 12-14 . In this embodiment, housing  330  has a proximal portion  334  which frictionally receives the motor shaft  222  and a distal portion  336 . The distalmost edge  338  is in a wavy pattern forming a toothed design. A first magnet  340  is positioned in the distal portion  336 , recessed from the distalmost edge  338 . 
     A second housing  350  is attached to the proximal end of the thrombectomy wire  30 . The second housing  350  has a distal portion  352  to frictionally receive the wire  30  and a proximal portion  354 . The proximalmost edge  358  is in a wavy pattern forming a toothed design configured to mate with the toothed design at the distalmost edge  338  of housing  330 . A second magnet  360  is positioned in the proximal portion  354 , recessed distally from the proximalmost edge  358 . In this manner, first and second magnets  340 ,  360  do not come into contact but provide an attractive coupling force to attach the wire  30  and motor shaft  222  of motor  214 . 
     The first plurality of teeth  337  of first housing  330  intermesh with the second plurality of teeth  357  of the second housing  350  so that upon rotation of the motor shaft  222 , the coupled housings  330 ,  350  rotate. Due to the interaction of the teeth  337  of housing  330  with the teeth  357  of housing  350 , rotation of housing  330  causes housing  350  to rotate which thereby rotates the wire  30  attached to housing  350 . These housings  330 ,  350  operate as a clutch mechanism. That is, if during use, the torque of the motor shaft  222  exceeds a preset value, indicating for example that the wire is caught on material in the vessel, the teeth  337 ,  357  of the housings  330 ,  350 , slip such that housing  330  rotation no longer rotates housing  350 . Due to the spacing of magnets  340 ,  360  from each other, as a result of their mounting within the recess or pockets of the respective housings  330 ,  350 , the force at which the housings (clutch) slip is entirely dependent on the interaction of the teeth. That is, this coupling design forms a clutch which when the torque of the motor shaft exceeds a predetermined value, the teeth slip so the teeth are no longer operably intermeshed. Thus, the torsional load at which the coupling slips depends on the friction between the teeth, thereby relying solely on the coefficient of friction of the housing materials and the angle/geometry of the teeth. Slippage occurs when torsional force is greater than frictional force and the magnetic force holding the housings together. If the magnets were in direct contact, the frictional engagement of the magnets in addition to the interaction of the teeth would affect the slippage point. By relying solely on the teeth, the design is simplified. The press-fit of the magnets into the recessed pockets also facilitates manufacture. 
     In the alternate embodiment of  FIGS. 15 and 16 , the housings  430 ,  450 , are similar to housings  330 ,  350  and have distalmost and proximalmost edges  438 ,  458 , respectively, which are in a wavy pattern forming teeth  437 ,  457 , which intermesh to rotate the second housing  450  as the first housing  430  is rotated by the rotating motor shaft  222 . However, in this embodiment, spherical magnets are provided within a gap in the housings  430 ,  450  to allow movement, e.g., rolling, of the magnets. 
     More specifically, housing  430  has a proximal portion  434  which receives the motor shaft  222  and a distal portion  436 . The distalmost edge  438  is in a wavy pattern forming a toothed design. A first substantially spherical magnet  440  is positioned in the distal portion  436  in an internal cavity  433 , recessed proximally from the distalmost edge  438 . The internal cavity  433  forms a gap  435  proximal of magnet  440 . A plug  439  is press fit in a proximal opening of the cavity  433  to secure the magnet  440  within the cavity  433 . The motor shaft  222  can be mounted in a proximal opening in plug  439  such as by an interference fit. The magnet  440  can move within the gap  435 . In this manner, as the housing  430  rotates, the magnet  440  does not rotate with the housing  430  and can float or roll within the gap  435 . 
     A second housing  450  is attached to the proximal end of the thrombectomy wire  30 . The second housing  450  has a distal portion  454  to frictionally receive the wire  30  and a proximal portion  452 . The proximalmost edge  458  is in a wavy pattern forming a toothed design configured to mate with the toothed design at the distalmost edge  438  of housing  430 . A second substantially spherical magnet  460  is positioned in the proximal portion  452 , recessed distally from the proximalmost edge  458 . The housing  450  has an internal cavity  453  forming a gap  455  distal of magnet  460 . A plug  459  is press fit in a proximal opening of the cavity  453  to secure the magnet  460  within the cavity  453 . The thrombectomy wire  30  can be mounted in a distal opening of plug  459  such as by an interference fit. The magnet  460  can move within the gap  455 . In this manner, as the housing  450  rotates, the magnet  460  does not rotate with the housing and can float or roll within the gap  455 . Note as with the embodiment of  FIGS. 13 and 14 , the first and second magnets  440 ,  460  do not come into contact but provide an attractive coupling force to attach the wire  30  and motor  214 . The placement of the magnets in recessed pockets has the advantages described above. 
     The teeth  437 ,  457 , of the respective housings  430 ,  450  intermesh so that upon rotation of the motor shaft  222 , the attached housing  430  rotates. Due to the interaction of the teeth  437  of housing  430  with the teeth  457  of housing  450 , rotation of housing  430  causes housing  450  to rotate which thereby rotates the wire  30  attached to housing  450 . During such rotation, magnets  440 ,  460  can move, e.g., float or roll, within the gaps  433 ,  453  of housings  430 ,  450 , respectively. The gaps can be sufficiently large relative to the magnets to enable the magnets to freely float therein, i.e., not only move axially but move in three dimensions. These housings  430 ,  450 , as in the embodiment of  FIGS. 13 and 14 , operate as a clutch mechanism. If during use, the torque of the motor shaft exceeds a preset value, indicating that the wire is caught on a vessel, the teeth  437 ,  457  of the housings  430 ,  450 , respectively, slip such that housing  430  rotation no longer rotates housing  450 . Due to the spacing of magnets  440 ,  460  from each other, as a result of their mounting within recess of the respective housing  430 ,  450 , the force at which the housings (clutch) slip is entirely dependent on the interaction of the teeth  437 ,  457 . That is, as in the embodiment of  FIGS. 13 and 14 , this coupling design forms a clutch which when the torque of the motor shaft exceeds a predetermined value, it causes the teeth  437 ,  457  to slip so the teeth are no longer operably intermeshed. Thus, the torsional load at which the coupling slips depends on the friction between the teeth, thereby relying solely on the coefficient of friction of the housing materials and the angle/geometry of the teeth. Slippage occurs when torsional force is greater than frictional force and the magnetic force holding the housings together. If the magnets were in direct contact, the frictional engagement of the magnets in addition to the interaction of the teeth would affect the slippage point. By relying solely on the teeth, the design is simplified. The press-fit of the magnets into the recessed pockets also facilitates manufacture. 
       FIGS. 18-21  illustrate an alternate embodiment for coupling the motor to the thrombectomy wire. In this embodiment, a male coupler (connector)  510  is attached to a proximal end of the thrombectomy wire  30 . Female coupler (connector)  520  is frictionally attached to the motor shaft  222 . More specifically, wire  30  is frictionally engaged within opening  512  of male coupler  510  and motor shaft  222  is frictionally engaged within opening  522  of female coupler  520 . A first magnet  524  is positioned within female coupler  520  and is preferably substantially flush with outer edge  526 . Female coupler  520  has a plurality of recesses  528  separated by ribs or walls  529  to receive the projections or prongs  518  of the male coupler  510 . Projections  518  can have an angled end  518   a  to provide a lead in for coupling to the female connector  520 . Male coupler  510  has a second magnet  514  preferably substantially flush with outer edge  516  of the cylindrical portion. The male coupler  510  is inserted into the motor housing  530  until the magnetic attraction between magnet  514  and magnet  524  of female coupler  520 , positioned within the motor housing  530 , maintains a magnetic connection. In this manner, when motor  214  is actuated, motor shaft  222  rotates to thereby rotate magnetically coupled thrombectomy wire  30  as rotation of female coupler  520  rotates male coupler  510 . Note this embodiment differs from the previously described embodiments in that the magnetic coupler does not act as a clutch; it only acts to couple the wire  30  to the motor  214 . Also note that although two magnets  514 ,  524  are described, it is also contemplated that in an alternate embodiment only one magnet is provided in either the male or female coupler and the other coupler instead of a magnet has a ferromagnetic material such as steel. 
     Turning now to  FIGS. 22A-24B , an alternate embodiment of the engagement of the wire assembly  500  with the motor housing  230  is illustrated. With initial reference to  FIG. 22A , the wire assembly  500  on a proximal end of the thrombectomy wire  30  includes a hub  550 , which can contain a valve therein (not shown), a cap  552 , and a hypotube  554  extending between cap  552  and male connector  510 . Thrombectomy wire  30  extends through these components for connection to the male connector  510 . Hub  550  includes a plurality of cutouts or recessed regions  560  along spaced apart walls  562  forming an engagement surface or abutment wall  564  as described below. Ramped surface  565  helps guide the hub  552  along ramp  572  described below. 
     Motor housing  530  includes an arrow shaped projecting member or projection  570  on an inner wall thereof which interlocks with the hub  550  of the wire assembly  500 . Preferably, there are two projecting members  570  spaced apart about 180 degrees along the inner wall of the motor housing  530 . Projecting member  570  has a distal facing arrow configuration with sloped surface  572  to facilitate insertion of the male connector  510  and a ledge or abutment wall  574 . When engagement surface or abutment wall  564  of hub  550  contacts the ledge  574  of projecting member  570 , the wire assembly  500  is locked in place with respect to the motor housing  230  and thus locked with respect to the female coupler  520  and motor  514  so that a distal pulling force by the user does not disconnect the male connector  510  from the female connector  520 . When the hub  552  is rotated as described below the interlock (or abutment) is disengaged to allow the user to separate the male connector  510  from the female connector  520  to thereby separate the thrombectomy wire  30  from the motor  214 . This is described in detail below in conjunction with the method. Note the interlock is illustrated in  FIG. 23  wherein one of the housing halves of the motor housing  230  is removed to expose the inner components for clarity. 
     Generally, in use, the male connector  510  is inserted into engagement with the female connector  520  and the magnetic attraction of magnets  514  and  524  maintain these components coupled together. When they are first coupled, the connector  510  can be separated from female connector  520  by a distal pulling force greater than the magnetic force. However, the components of this embodiment are configured so that when the motor is initially actuated, and motor shaft  222  is rotated, it rotates the wire assembly  500  including the hub  550 . Such rotation of hub  550  places the engagement surfaces  564  of hub  550  into abutment with ledge  574  of both projecting members  570 . This can best be understood with reference to  FIGS. 22A-22G  which depict the method steps of connection and interlocking of the wire assembly  500  and motor  214 . 
     Turning first to  FIG. 22A , the wire assembly  500  is shown being inserted into motor housing  230 , with the male coupler  510  still distal of projecting member  570  but being moved in a proximal direction as shown by the arrow. As the wire assembly  500  is moved proximally further into the motor housing  230 , the male coupler  510  and cap  552  move past the projecting member  570  as shown in  FIG. 22B . Upon further advancement of the wire assembly  500  into motor housing  230 , a portion of hub  550  extends proximally of the projecting member  570  ( FIG. 22C ), with insertion aided by ramped surface  565  of hub  550 .  FIG. 22D  illustrates full insertion of the wire assembly  500  so that male coupler  510  is fully engaged with female coupler  520 , with the attraction force of magnets  514  and  524  holding these couplers  510 ,  520  together. At this point, although cutout  560  of hub  550  is axially aligned with projecting member  570  of motor housing  230 , it is not in radial alignment so the user can disconnect the male coupler  510  from the female coupler  520  to remove the thrombectomy wire  230  from the housing  230  if desired by applying an axial distal force sufficient to overcome the magnetic force. This can be considered a or a non-interlocked position. Note that only one cutout  560  is described herein, it being understood that preferably another cutout spaced about 180 degrees apart from the illustrated cutout would engage another arrow-like projection member spaced about 180 degrees from the illustrated projecting member  570 . 
       FIG. 22D  also shows, by a representative arrow, the direction of rotation of the motor shaft  222  (and hub  550 ) to interlock the wire assembly  500  with the motor assembly. When the motor  214  is actuated, such as by a switch as described above, the motor shaft  22  rotates which rotates the female connector  520  which causes rotation of the male connector  510  and the attached wire  30 , as well as the attached hub  550 . Such rotation, e.g., about a one quarter turn, although a greater or lesser turn is also contemplated, causes radial alignment of the cutout  560  and projecting member  570  to move the hub  550  out if its release/non-interlocked position to an engaged or interlocked position. That is, the wall  564  of hub  550  engages the wall  574  of the projecting member  570 , the wall  574  thereby forming a blocking surface. This position is shown in  FIG. 22E  In this interlocked (locked) or blocking position, the wire assembly  500  cannot be separated from the motor housing  230  by a mere pulling of the wire assembly  500  in an axial distal direction because of the abutment of walls  564  and  574 . This rotation for interlocking engagement can also be seen in the close up views of  FIGS. 24A and 24B  wherein  FIG. 24  shows the hub  550  prior to rotation and  FIG. 24B  shows the hub  550  after rotation to the interlocked position. Again, as noted above, only one wall  564  is described herein, it being understood that preferably another wall  564  of a cutout  560  spaced about 180 degrees apart from the illustrated cutout  560  would engage another wall  574  on an arrow-like projecting member spaced about 180 degrees from the illustrated projecting member  570 . 
       FIG. 22E  also shows, by a representative arrow, the direction of rotation of the hub  550  in order to move the hub  550  from the interlocked position to the release position to enable removal of the wire assembly  500  from the motor assembly. As shown, the hub  550  is rotated in the opposite direction of that to interlock the hub  550  with the projecting member  570 . When rotated in the direction of the arrow, e.g., about one quarter turn, although a greater or lesser turn is also contemplated, the cutout  560  and associated wall  564  are no longer radially aligned, as shown in  FIG. 22F , so that the hub  550  can be moved distally past the projecting member  570  to separate the wire assembly  500  from the motor housing  230  as shown in  FIG. 22G . Again, note that in the illustration for rotation for disconnection (release), only one cutout  560  and only one projecting member  570  are described herein, it being understood that preferably another wall  564  spaced about 180 degrees apart from the illustrated wall  564  of cutout  560   t  would disengage from another wall  574  of another arrow-like projecting member  570  spaced about 180 degrees from the illustrated projecting member  570 . 
     Note the step of operatively coupling the thrombectomy wire to the motor housing, e.g., motor housing  210  or  230 , using any of the foregoing coupling embodiments can occur prior to the step of inserting the thrombectomy wire through the introducer sheath and catheter. Alternatively, the step of operatively coupling the thrombectomy wire to the motor housing, e.g., motor housing  210  or  230 , using any of the foregoing embodiments can occur subsequent to the step of inserting the thrombectomy wire through the introducer sheath and catheter. 
       FIG. 5  illustrates the thrombectomy wire  30  of the present invention. The wire  30  has a distal coiled tip  91 . In preferred embodiments, the distal coiled tip (and underlying cable) is angled with respect to the longitudinal axis.  FIG. 4A  shows the wire of  FIG. 5  forming a sinuous shape. In  FIG. 4B , an alternative embodiment of the wire is illustrated, wherein the wire  130  forms a J-tip which creates a standing wave upon rotation. In the J-tip configuration, due to the angle, when the wire is rotated by the motor at sufficient speed at least one vibrational node is formed. Details of this creation of a standing wave are described in U.S. Pat. No. 6,090,118, the entire contents of which are incorporated herein by reference. 
     In the embodiment of  FIG. 4A , the wire  30  forms a substantially sinuous shape, resembling a sine curve. More specifically, wire  30  of  FIG. 4A  has a substantially linear portion extending through most of its length, from a proximal region, through an intermediate region, to distal region  36 . At the distal region  36 , wire  30  has a sinuous shape in that as shown it has a first arcuate region  33  facing a first direction (upwardly as viewed in the orientation of  FIG. 4A ) and a second arcuate region  35 , spaced longitudinally from the first arcuate region  33 , facing a second opposite direction (downwardly as viewed in the orientation of  FIG. 4A ). These arcuate regions  33 ,  35  form “peaks” to contact vascular structure as the wire  30  rotates. This angled (non-linear) distal portion includes a coiled portion with a covering material to block the interstices of the coil as discussed below. Note in a preferred embodiment, the amplitude of the proximal wave (at region  33 ) is smaller than the amplitude of the distal wave (at region  35 ), facilitating movement in and out of the catheter. 
     When the wire  30  is fully retracted within the introducer catheter  100  (as in  FIG. 3 ), the curved regions of the wire  30  are compressed so the distal region  36  is contained in a substantially straight or linear non-deployed configuration. When the introducer catheter  100  is retracted by proximal axial movement (see the arrow of  FIG. 4 ), or the wire is advanced with respect to the introducer catheter  100  or the wire  30  and catheter  100  are both moved in the respective distal and proximal directions, the distal region  36  of the wire  30  is exposed to enable the wire  30  to return to its non-linear substantially sinuous configuration shown in  FIG. 4A  (and  FIG. 4 ) for rotation about its longitudinal axis within the lumen of the vessel. 
     Thus, as can be appreciated, the wire  30  is advanced within the introducer catheter  100  which is attached at its proximal end to the distal end of the RHV  40 . When at the desired site, the wire  30  and introducer catheter are relatively moved to expose the wire  30  to assume its non-linear shape for motorized rotational movement to break up thrombotic material on the vessel wall. If a J-tip wire, such as wire  130 , is utilized, the wire  130  can be rotated within the introducer catheter to re-orient the wire  130 . 
     The flexible tubular portion  62  of the introducer sheath  60  can optionally contain one or more braided wires embedded in the wall to increase the stiffness. Such braided wires would preferably extend the length of the sheath. 
     In an embodiment of the coiled tip being composed of shape memory material, the memorized configuration is sinuous or s-shaped as in  FIG. 4A . In the state within the introducer catheter  100 , the wire is in a substantially linear configuration. This state is used for delivering the wire to the surgical site. When the wire is exposed to warmer body temperature, the tip transforms to its austenitic state, assuming the s-shaped memorized configuration. Alternatively, the coiled tip of the wire can be compressed within the wall of the introducer catheter and when released, assumes its shape memorized non-linear shape. The coiled tip can alternatively be a radiopaque coil/polymer pre-shaped to an “S”. 
     Details of the wire  30  will now be described with reference to  FIG. 5 . These details are the same for wire  130 , the only difference being that instead of the distal coiled tip being sinuous shaped in the deployed position, the distal tip is in J-configuration. Note it is also contemplated that in an alternate embodiment the distal tip can be substantially straight (substantially linear) in both the covered and deployed (exposed) position. For convenience, details will be discussed with reference to wire  30 . Wire  30  has a core  32  having a proximal portion  34  (see  FIG. 2 ) and a distal portion  37 . Transition region  38  of core  32  is tapered distally so that the diameter of the distal portion  37  of core  32  is less than the diameter of the proximal portion  34 . A uniform diameter portion  37   a  extends distal of tapered portion  37 . The taper can be formed by removing a coating, such as a PTFE coating, placed over the core  32  and a grinding of the core  32 . In one embodiment, the core  32  is a solid material made of a nickel titanium alloy, although other materials are also contemplated. The core  32  can also be formed from a hypotube with a tapered body attached, e.g. welded, to the distal end of the hypotube. 
     The core  32  is connected to a cable  90 . The cable  90  can be formed of a plurality of wires twisted together such as a 1×19 wire for example. The twisted wires can be surrounded by additional wires or a sheath. The core  32  is tapered to accommodate connection to cable  90 . Hypotube  92  is placed over the distalmost end of the core  32  (the uniform diameter portion  37   a ) and the proximalmost end of the cable  90  and is attached thereto by a number of methods, including but not limited to, laser welding, soldering or crimping. The hypotube  92  thereby forms a coupler for joining the core  32  and cable  90  as these components are positioned within the hypotube  92 . The hypotube can have a diameter of about 0.010 inches, although other dimensions are contemplated. 
     The cable  90  in one embodiment has a variable stiffness such that the proximal portion  94  is stiffer, e.g., has a tighter braid, than a distal portion  96  to increase the flexibility of the distal portion  96 . In other embodiments, the cable  90  is of uniform stiffness. The cable  90  can be of substantially uniform diameter. Various covering materials, e.g., coating, jackets and/or shrink wraps, can be used as an alternative or in addition to vary the stiffness of the cable  90 . 
     A torque tube  97  is positioned over the cable  90 . The torque tube  97  extends from a tapered region of the core  32 , terminating at the distal coil  91 . The torque tube  97  can be soldered at (proximal) end  97   a  to the core  32  and at distal end  97   b  to the cable  90 . The torque tube  97  can also be attached, e.g., soldered or laser welded, to a proximal end of the coil. 
     A polymer coating(s) and/or jacket(s) can be placed over the torque tube  97  to cover the interstices in the cable  90  and provide a smooth surface. In one embodiment, a PTFE shrink wrap tubing  98  is placed over the torque tube  97  and over a portion of the core  32 , preferably extending over the tapered transition region  38  of core  32  to terminate at a proximal end adjacent the uniform diameter region of the core  32 . At a distal end, the shrink wrap  98  terminates at the end where the torque tube  97  terminates. 
     Coiled tip  91  is positioned over a distal portion of the cable  90 , and preferably over the distal tip. The coil tip  91  in one embodiment is composed of a soft and malleable material such as platinum and has a uniform pitch and diameter. The distalmost tip of the cable  90  can have a laser welded ball to which the coil  91  is welded to enhance retention of the coil  91  and cable  90 . The coiled tip region has a substantially sinuous configuration. In an alternate embodiment, the coiled tip region has a J-tip configuration, as shown for example in  FIG. 4B . The coiled tip region can alternatively have a substantially linear configuration in the deployed/uncovered position. In each of these embodiments, preferably a covering such as a jacket, shrink wrap or coating covers the coil  91 . In a preferred embodiment, a polyamide such as a nylon or Pebax covering  99  is heat fused over the coil  91 , to melt into the interstices. In some embodiments, a heat shrink tubing  99   a , such as FEP, is placed over the heat fused nylon coating. The covering  99 , and heat shrink tubing  99   a , terminate adjacent a distal end of the torque tube  97  and adjacent a distal end of the shrink wrap  98 . 
     By way of example only, the components of wire  30  can have the approximate dimensions set forth in the table below. It should be understood that these dimensions are being provided by way of example as other dimensions are also contemplated. These are also approximate values. 
     
       
         
           
               
               
               
             
               
                   
               
               
                   
                 APPROXIMATE OUTER 
                 APPROXIMATE 
               
               
                 COMPONENT 
                 DIAMETER 
                 LENGTH 
               
               
                   
               
             
            
               
                   
               
            
           
           
               
               
               
               
            
               
                 Core 32 (proximal non 
                 .016 inches 
                 139.5 
                 cm 
               
               
                 tapered portion) 
               
               
                 Core tapered portion 
                 .016 inches to .0095 inches 
                 4.35 
                 inches 
               
               
                 Distal coil 91 
                 .016 inches 
                 3.0 
                 inches 
               
               
                 Torque tube 97 
                 .013 inches 
                 8.0 
                 inches 
               
               
                 Shrink tube 98 
                 .014 inches 
                 10.35 
                 inches 
               
               
                 Cable 90 
                 .010 inches 
                 8.2 
                 inches 
               
               
                   
               
            
           
         
       
     
     The covering material, e.g. coating, jackets, and or shrink wraps, helps to prevent bending or knotting of the wire which could otherwise occur in native vessels. The covering also increases the torsional strength of the wire and also strengthens the wire to accommodate spasms occurring in the vessel. The coating also blocks the interstices of the coil  91  to provide a less abrasive surface. The various coating and/or jackets and/or shrink wrap can be made of PET, Teflon, Pebax, polyurethane or other polymeric materials. The material helps to prevent the native vessel from being caught in the coil  90  and reduces vessel spasms. 
     The use of the thrombectomy apparatus  10  will now be described. The use, by way of example, is shown and described with respect to the embodiment of  FIG. 1  with the sinuous tip of  FIG. 4 , it being understood that the wire embodiment of  FIG. 4B  would be utilized in a similar manner. It is also shown for use in the cerebral arteries but use in other vessels is also contemplated. 
     An access sheath (not shown) is inserted into the vessel and then a guidewire, e.g. 0.035 or 0.038 inches in diameter, and a guide catheter  150  are inserted through the sheath and advanced through the vasculature. The guidewire is removed and a smaller diameter guidewire G, e.g. 0.014 inch diameter, and the introducer catheter  100 , are inserted through the guide catheter  150  and access sheath with the guidewire G in the femoral artery F and located via imaging. The introducer catheter  100  is advanced to the desired site through the vascular system into the cerebral arteries A, for example through the Circle of Willis C (see  FIGS. 6, 7 and 8 ). Once at the site, the guidewire G is withdrawn as shown in  FIG. 9 . Note the introducer catheter  100  is preferably inserted with the RHV  40  attached. That is, the tubular portion  46  of the RHV  40  is inserted through the introducer catheter  100  (see  FIG. 10 ) and attached thereto by rotation of cap  51  as shown in  FIG. 9A . In the alternate embodiment of  FIGS. 10C and 10D , RHV  40  is attached to thread  124  of the winged luer fitting of introducer catheter  120  by rotation of cap  51  and/or winged handle  122 . Note in an alternate embodiment, instead of the RHV  40  attached prior to introduction of the introducer catheter  100  through the guide catheter  150 , it can be attached after introduction of catheter  100  through guide catheter  150 . 
     The introducer sheath  60  is inserted through the RHV  40 , and attached to the RHV  40  by rotation of cap  58  as shown in  FIG. 10A . The thrombectomy wire  30  is inserted through the lumen of the introducer sheath  60 , through the lumen of the RHV  40  and into the lumen of the introducer catheter  100 . The introducer catheter  100  extends from the guide catheter  150  as shown in  FIG. 10 , but the wire  30  remains inside the introducer catheter  100 . The distal end of the wire  30  is then exposed from the introducer catheter  100  at the target surgical site by relative movement of the wire  30  and introducer sheath  100 . Note the wire  30  can be attached to the motor drive shaft  15  at this point or can be attached before exposed or at any other time in the procedure such as prior to insertion of the wire  30  through the introducer sheath  60 . Attachment is achieved by connection of the connector tube  80  to the introducer sheath  60  (see  FIG. 10B ) and attachment of the proximal end of the connector  80  to the motor housing  12  or by other methods, such as a magnetic coupling as described above. The wire  30  extends through the connector tube and attachment of the wire  30  (which extends through connector  80 ) to the motor drive shaft  15 . As noted above, alternatively, the connector tube  80  can be connected to the introducer sheath  60  prior to attachment to the motor housing  12 , or alternatively connected after the wire  30  is at the surgical site and exposed from the introducers sheath. The alternate embodiments described herein for coupling the wire to the motor shaft could also be utilized. 
     With the wire  30  exposed from the introducer catheter  100 , switch  19  on housing  12  is actuated to turn on the motor thereby causing wire  30  to rotate about its longitudinal axis to break up/macerate thrombus. 
     The macerated particles can be removed by suction through side arm  56  of RHV  40  as the particles travel in the space between wire  30  and introducer catheter  100  and RHV  40 . The introducer catheter  100  can optionally have a side port(s) and/or the guide catheter  150  can optionally have a side port(s) such as side port  152  for aspirating the small macerated particles in addition to or alternative to side arm  56  of RHV  40 . 
     The delivery sheath can include a balloon to block blood flow and allow aspiration in the blocked space. 
     While the above description contains many specifics, those specifics should not be construed as limitations on the scope of the disclosure, but merely as exemplifications of preferred embodiments thereof. Those skilled in the art will envision many other possible variations that are within the scope and spirit of the disclosure as defined by the claims appended hereto.