Patent Description:
The present invention generally relates to medical devices, and, more particularly, to medical devices for removing vascular obstructions.

Obstruction removal systems/devices may operate by lodging the obstruction in a component of the removal system. In some cases, the obstruction may dislodge. Dislodgement of the obstruction substantially increases the risk for potential complications, such as stroke or heart attack. Thus, it is desirable to secure the obstruction safely for removal from the body.

<CIT> discloses an obstruction removal device having a retrieval component used to engage an obstruction within the vasculature and a sheath component that is capable of inverting to fold over the obstruction and the retrieval component. The sheath component helps contain the obstruction and minimizes trauma to the blood vessel during the removal process.

<CIT> discloses a device with structures for removing obstructions from body lumens. Such devices have applicability in through-out the body, including clearing of blockages within the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.

<CIT> discloses a device for securing a cover of a retrieval device while the retrieval device is resheathed to a more proximal position within a delivery sheath. The retrieval device includes a securing element configured to grip the cover when the retrieval device is pulled proximally, to thereby secure the cover.

The obstruction removal system according to the invention is defined in claim <NUM>. The surgical methods disclosed are not claimed.

An obstruction removal system is disclosed. In one or more embodiments, the obstruction removal system includes a guide catheter configured to be inserted within a vasculature and a delivery tool having a distal end configured to be inserted within the guide catheter and disposed proximate to an obstruction in the vasculature. The obstruction removal system further includes a removal tool disposed at the distal end of the delivery tool. The removal tool is configured to at least partially separate an obstruction from an inner surface of a vasculature. An expandable member is also coupled to the delivery tool. The expandable member includes a proximal end that is free or slidably coupled to the delivery tool. The proximal end of the expandable member is configured to invert or slide toward a distal end of the expandable member, thereby causing the expandable member to surround at least a portion of the obstruction and the removal tool so that the obstruction is captured between the expandable member and the removal tool, when the delivery tool is withdrawn from the vasculature to remove the removal tool and the obstruction from the vasculature.

More generally, an obstruction removal device is disclosed. In one or more embodiments, the obstruction removal device includes a removal tool disposed at a distal end of a delivery tool and configured to at least partially separate an obstruction from an inner surface of a vasculature. The obstruction removal device also includes an expandable member coupled to the delivery tool. The expandable member includes a proximal end that is free or slidably coupled to the delivery tool. The proximal end of the expandable member is configured to invert or slide toward a distal end of the expandable member, thereby causing the expandable member to surround at least a portion of the obstruction and the removal tool so that the obstruction is captured between the expandable member and the removal tool, when the delivery tool is withdrawn from the vasculature to remove the removal tool and the obstruction from the vasculature.

A method for removing an obstruction from a vasculature is also disclosed. In one or more embodiments, the method includes the steps of: inserting a guide catheter within the vasculature; extending a delivery tool through the guide catheter so that a distal end of the delivery tool is disposed proximate to the obstruction in the vasculature; removing at least a portion of the obstruction in the vasculature with a removal tool disposed at the distal end of the delivery tool, wherein the removal tool is configured to at least partially separate the obstruction from an inner surface of the vasculature; and surrounding at least a portion of the obstruction and the removal tool with an expandable member coupled to the delivery tool, the expandable member including a proximal end that is free or slidably coupled to the delivery tool, wherein the proximal end of the expandable member is configured to invert or slide toward a distal end of the expandable member, so that the obstruction is captured between the expandable member and the removal tool, when the delivery tool is withdrawn from the vasculature to remove the removal tool and the obstruction from the vasculature.

Referring generally to <FIG>, an obstruction removal system is described, in particular, an obstruction removal system configured to selectively deploy a removal tool with an expandable member in a vasculature to reduce the risks associated with removal of an obstruction. The expandable member may be used to prevent the obstruction from dislodging from the removal tool and passing to a potentially more dangerous area (e.g. causing a total blockage, blocking a portion of a vital vasculature, etc.). In this regard, a physician may determine whether an obstruction is prone to risk and selectively deploy the removal tool with the expandable member.

<FIG> illustrate one or more embodiments of an obstruction removal system <NUM>. As shown in <FIG>, the obstruction removal system <NUM> includes a guide catheter <NUM> (e.g., any suitable guide catheter, aspiration catheter, or any other suitable tube) configured to be inserted through a vasculature <NUM> to a position proximate to an obstruction <NUM>. Referring now to <FIG>, the obstruction removal system <NUM> further includes an obstruction removal device comprising a removal tool <NUM> and an expandable member <NUM> configured to be inserted through the guide catheter <NUM>. For example, the removal tool <NUM> and the expandable member <NUM> may be coupled or formed on/near a distal end of a delivery tool <NUM> that is configured to be inserted through the guide catheter <NUM>. In embodiments, the delivery tool <NUM> may be a guide wire or tube. In this regard, the removal tool <NUM> may be fixed to the distal end of the guide wire or tube, and the expandable member <NUM> may be fixed or slidably coupled to the guide wire or tube at a position near the removal tool <NUM>.

In embodiments, the obstruction removal device (i.e., the removal tool <NUM> and the expandable member <NUM> on the delivery tool <NUM>) may be at least partially housed within an intermediate catheter <NUM> (e.g., any suitable intermediate catheter, microcatheter, or any other suitable tube) during insertion. The intermediate catheter <NUM> may be used to contain and keep the removal tool <NUM> and the expandable member <NUM> from expanding within the guide catheter <NUM>. This may provide one or more advantages, such as, but not limited to, reducing friction between the removal tool <NUM>/expandable member <NUM> and the guide catheter <NUM>, permitting the removal tool <NUM> and the expandable member <NUM> to be inserted through the distal opening of the guide catheter <NUM>, and preventing the removal tool <NUM>/expandable member <NUM> from prematurely engaging the obstruction <NUM>.

<FIG> illustrates the obstruction removal device deployed within the vasculature <NUM> in proximity to an obstruction <NUM>. The delivery tool <NUM> (e.g., a guide wire and/or tube) is configured to be inserted within the guide catheter <NUM> and disposed proximate to the obstruction <NUM> in the vasculature <NUM>. For example, the delivery tool <NUM>, carrying the end-mounted the removal tool <NUM> and the expandable member <NUM>, may be fed through the guide catheter <NUM> using the intermediate catheter <NUM> to contain/sheathe the removal tool <NUM> and the expandable member <NUM> during their insertion.

Referring now to <FIG>, the intermediate catheter <NUM> may be configured to unsheathe the removal tool <NUM> and the expandable member <NUM> so that the removal tool <NUM> can engage the obstruction <NUM> in the vasculature <NUM>. For example, after reaching a desired position within the vasculature <NUM>, the intermediate catheter <NUM> may be pulled back (and/or the delivery tool <NUM> may be pushed forward relative to the intermediate catheter <NUM>) to unsheathe the removal tool <NUM> and the expandable member <NUM> so that the removal tool <NUM> can engage the obstruction <NUM>.

The removal tool <NUM> is configured to at least partially separate the obstruction <NUM> from the inner surface of the vasculature <NUM> (e.g., from the vessel wall). In embodiments, the removal tool <NUM> comprises a conical or umbrella-shaped section (e.g., a conical and/or umbrella shaped net-like structure or mesh) configured to at least partially surround the obstruction <NUM>. In other embodiments, the removal tool <NUM> comprises a differently shaped net-like structure or mesh configured to at least partially surround the obstruction <NUM> (e.g., a semi-circular or cylindrical structure, or the like).

In embodiments where the delivery tool <NUM> comprises a guide wire disposed within a tube, the distal end of the removal tool <NUM> may be attached to the guide wire and another (mid) portion of the removal tool may be attached to the tube so that moving the guide wire independent of (e.g., relative to) the tube causes the removal tool <NUM> to expand or collapse, much like an umbrella. Additionally, or alternatively, the removal tool <NUM> may be formed from a shape memory and/or super elastic alloy (e.g., Nitinol) so that the removal tool <NUM> automatically expands when it is unsheathed. For example, the removal tool <NUM> may be guided past the obstruction <NUM>, unsheathed, and then pulled back to scrape/scoop the obstruction <NUM> off the inner surface of the vasculature <NUM>.

The expandable member <NUM> includes a distal end <NUM> that is fixedly or slidably coupled to the delivery tool <NUM> and a proximal end <NUM> that is slidably coupled to the delivery tool <NUM>. The expandable member <NUM> may be positioned so that, during its deployment, the distal end <NUM> is located in between the removal tool <NUM> and the proximal end <NUM>.

As shown in <FIG>, when the delivery tool <NUM> is withdrawn (e.g., pulled back into the guide catheter <NUM> and/or intermediate catheter <NUM>), the proximal end <NUM> of the expandable member <NUM> may be configured to slide toward the distal end <NUM> of the expandable member <NUM>, thereby causing the expandable member <NUM> to surround at least a portion of the obstruction <NUM> and the removal tool <NUM> so that the obstruction <NUM> is captured between the expandable member <NUM> and the removal tool <NUM>. In embodiments, when the proximal end <NUM> of the expandable member <NUM> slides toward the distal end <NUM> of the expandable member <NUM> as a result of the delivery tool <NUM> being removed from the vasculature <NUM> to remove the removal tool <NUM> and the obstruction <NUM> from the vasculature <NUM>, a middle portion <NUM> of the expandable member <NUM> is configured to fold over the distal end <NUM> of the expandable member <NUM> and at least a portion of the removal tool <NUM>, so that the obstruction <NUM> is captured between the expandable member <NUM> and the removal tool <NUM>. For example, when the delivery tool <NUM> is pulled back through the guide catheter <NUM> and/or intermediate catheter <NUM>, the resulting friction between the middle portion <NUM> of the expandable member <NUM> and the inner surface of the vasculature <NUM> (e.g., as shown <FIG>), the guide catheter <NUM>, or the intermediate catheter <NUM> may cause the middle portion of the expandable member <NUM> to fold over the removal tool <NUM> so that the obstruction <NUM> is captured between the expandable member <NUM> and the removal tool <NUM>. Additionally, or alternatively, when the delivery tool <NUM> is pulled back through the guide catheter <NUM> and/or intermediate catheter <NUM>, the resistance from fluid in the vasculature <NUM> may cause the middle portion of the expandable member <NUM> to fold over the removal tool <NUM> so that the obstruction <NUM> is captured between the expandable member <NUM> and the removal tool <NUM>. Furthermore, as shown in <FIG>, in some embodiments, the intermediate catheter <NUM> (or guide catheter <NUM>) may be used to urge the expandable member <NUM> to invert and/or fold over itself.

<FIG> illustrates the obstruction <NUM> captured between the expandable member <NUM> and the removal tool <NUM>, as the delivery tool <NUM> is being withdrawn from the vasculature <NUM> to remove the removal tool <NUM> and the obstruction <NUM> from the vasculature <NUM>. For example, the delivery tool <NUM> may be pulled back into the guide catheter <NUM> and/or intermediate catheter <NUM> to remove the obstruction <NUM> that is captured between the expandable member <NUM> and the removal tool <NUM> from the vasculature <NUM>.

As shown in <FIG>, the intermediate catheter <NUM> with the delivery tool <NUM> and the obstruction <NUM> that is captured between the expandable member <NUM> and the removal tool <NUM> may be pulled back through the guide catheter <NUM> to remove the obstruction <NUM> from the vasculature <NUM>. The delivery tool <NUM> with the obstruction removal device (including removal tool <NUM> and expandable member <NUM>) and the obstruction <NUM> may be withdrawn through the intermediate catheter <NUM>, as depicted in <FIG>. Alternatively, the delivery tool <NUM> with the obstruction <NUM> that is captured between the expandable member <NUM> and the removal tool <NUM> may be pulled directly through the guide catheter <NUM> (without use of an intermediate catheter <NUM>).

<FIG> illustrate another embodiment of the obstruction removal system <NUM>, wherein the expandable member <NUM> has a distal end <NUM> coupled to the delivery tool <NUM> and a proximal end <NUM> that is configured to move freely. For example, the expandable member <NUM> may comprise a conical/umbrella-shaped net or mesh structure with one end fixedly or slidably coupled to the delivery tool <NUM> and one free/open end.

As shown in <FIG> and <FIG>, when the obstruction removal device (i.e., the removal tool <NUM> and the expandable member <NUM> on the delivery tool <NUM>) is being guided through the vasculature <NUM> to the obstruction <NUM>, the expandable member <NUM> may be oriented so that the proximal end <NUM> of the expandable member <NUM> is facing away from the removal tool <NUM>. Then, as shown in <FIG>, when the delivery tool <NUM> is withdrawn (e.g., pulled back into the guide catheter <NUM> and/or intermediate catheter <NUM>), the proximal end <NUM> of the expandable member <NUM> may be configured to invert toward the distal end <NUM> of the expandable member <NUM>, thereby causing the expandable member <NUM> to surround at least a portion of the obstruction <NUM> and the removal tool <NUM> so that the obstruction <NUM> is captured between the expandable member <NUM> and the removal tool <NUM>. In embodiments, the proximal end <NUM> of the expandable member <NUM> is configured to invert and drape over the distal end <NUM> of the expandable member <NUM> and at least a portion of the removal tool <NUM> as the delivery tool <NUM> is withdrawn from the vasculature <NUM> to remove the removal tool <NUM> and the obstruction <NUM> from the vasculature <NUM>. For example, when the delivery tool <NUM> is pulled back through the guide catheter <NUM> and/or intermediate catheter <NUM>, the resulting friction between the proximal (i.e., free) end <NUM> of the expandable member <NUM> and the inner surface of the vasculature <NUM>, the guide catheter <NUM>, or the intermediate catheter <NUM> may cause the expandable member <NUM> to invert and drape over the removal tool <NUM> so that the obstruction <NUM> is captured between the expandable member <NUM> and the removal tool <NUM>. Additionally, or alternatively, when the delivery tool <NUM> is pulled back through the guide catheter <NUM> and/or intermediate catheter <NUM>, the resistance from fluid in the vasculature <NUM> may cause the expandable member <NUM> to invert and drape over the removal tool <NUM> so that the obstruction <NUM> is captured between the expandable member <NUM> and the removal tool <NUM>.

Referring now to <FIG>, various embodiments of the removal tool <NUM> are shown and described. Embodiments of the removal tool <NUM> illustrated in <FIG> may be employed with any embodiments of the obstruction removal system <NUM> illustrated in <FIG> or otherwise described herein.

In embodiments, such as those illustrated in <FIG>, the obstruction removal device may include a passive removal tool <NUM>. In this regard, the removal tool <NUM> may be configured to expand upon deployment (e.g., unsheathing) from the intermediate catheter <NUM>. The removal tool <NUM> may include a distal end <NUM> (e.g., tip coil) that is fixed to a distal end of the delivery tool <NUM> (e.g., delivery tube or wire) and a proximal end <NUM> that is fixed or slidably coupled to another portion of the delivery tool <NUM> such that an obstruction landing area <NUM> on the delivery tool <NUM> is defined between the proximal end <NUM> of the removal tool <NUM> and the distal end <NUM> of the expandable member <NUM>. The ends of the removal tool <NUM> and/or expandable member <NUM> comprise marker bands that are coupled to the delivery tool <NUM>.

<FIG> illustrate embodiments of the obstruction removal device including an active removal tool <NUM>. In this regard, the removal tool <NUM> may be selectively expanded or collapsed. For example, the removal tool <NUM> may be expanded or collapsed by actuating two portions of a delivery tool <NUM> (e.g., a delivery wire 108A and a delivery tube 108B) relative to one another. The removal tool <NUM> may include a distal end <NUM> (e.g., tip coil) that is fixed to a distal end of the delivery wire 108A and a proximal end <NUM> that is fixed to a distal end of the delivery tube 108B, either directly or via an obstruction landing area <NUM> between the proximal end <NUM> of the removal tool <NUM> and the distal end <NUM> of the expandable member <NUM> (as shown).

In embodiments, the expandable member <NUM> may be coupled to the delivery tube 108B such that the obstruction landing area <NUM> is defined between the proximal end <NUM> of the removal tool <NUM> and the distal end <NUM> of the expandable member <NUM>. The obstruction landing area <NUM> may comprise a wire mesh portion that connects the removal tool <NUM> and the expandable member <NUM> together. The expandable member <NUM> and the removal tool <NUM> are portions of a continuous wire mesh structure.

The ends of the removal tool <NUM> and/or expandable member <NUM> comprise marker bands that are coupled to respective portions of the delivery wire 108A and tube 108B. As shown in <FIG>, respectively, the removal tool <NUM> may be collapsed by pushing the delivery wire 108A through the delivery tube 108B (or pulling the delivery tube 108B away from the distal end of the delivery wire 108A) and may expanded by pulling the delivery wire 108A through the delivery tube 108B (or pushing the delivery tube 108B toward the distal end of the delivery wire 108A).

<FIG> illustrate embodiments of the obstruction removal device including an active removal tool <NUM> and an active expandable member <NUM>. In this regard, the removal tool <NUM> and the expandable member <NUM> may be selectively expanded or collapsed. For example, the removal tool <NUM> may be expanded or collapsed by actuating two portions of a delivery tool <NUM> (e.g., a delivery wire 108A and a delivery tube 108B) relative to one another. The removal tool <NUM> may include a distal end <NUM> (e.g., tip coil) that is fixed to a distal end of the delivery wire 108A and a proximal end <NUM> that is connected to the distal end <NUM> of the expandable member <NUM> via an obstruction landing area <NUM> between the proximal end <NUM> of the removal tool <NUM> and the distal end <NUM> of the expandable member <NUM>. The obstruction landing area <NUM> may comprise a wire mesh portion that connects the removal tool <NUM> and the expandable member <NUM> together. The expandable member <NUM> and the removal tool <NUM> are portions of a continuous wire mesh structure.

The ends of the removal tool <NUM> and/or expandable member <NUM> comprise marker bands that are coupled to respective portions of the delivery wire 108A and tube 108B. As shown in <FIG>, the proximal end <NUM> of the expandable member <NUM> may be coupled to a distal end of the delivery tube 108B so that pulling the delivery tube 108B back relative to the delivery wire 108A (or extending the delivery wire 108A forward relative to the delivery tube 108B) causes the removal tool <NUM> and the expandable member <NUM> to collapse; and conversely, pulling the delivery wire 108A back relative to the delivery tube 108B (or pushing the delivery tube 108B forward relative to the delivery wire 108A) causes the removal tool <NUM> and the expandable member <NUM> to expand.

As shown in <FIG>, <FIG>, and <FIG>, in some embodiments, the removal tool <NUM> may include a support frame <NUM> (e.g., one or more rigid or semi-rigid structures) that provide structural reinforcement for the removal tool <NUM> when the removal tool <NUM> is in a deployed (i.e., expanded) configuration. The support frame <NUM> may be configured to collapse (e.g., fold toward the delivery tool <NUM>) when the removal tool <NUM> is in a collapsed configuration. Additionally, or alternatively, the removal tool <NUM> may include non-uniform wire mesh. For example, the removal tool <NUM> structure may comprise thicker, stronger, and/or denser wire mesh toward the distal end <NUM> of the removal tool <NUM> to provide a stronger conical/funnel shaped structure when the removal tool <NUM> is deployed/expanded and thinner, weaker, and/or less dense wire mesh toward the proximal end <NUM> of the removal tool <NUM> to provide flexibility for the removal tool <NUM> to expand/collapse more easily.

In the embodiments illustrated in <FIG>, or combinations thereof, the expandable member <NUM> may be configured to transition between contracted/collapsed and expanded states. The expandable member <NUM> may be configured to transition between the contracted and expanded states in any suitable way, including, but not limited to, unsheathing the expandable member <NUM> to allow expansion and sheathing/re-sheathing the expandable member <NUM> to induce contraction.

The expanded state may allow the expandable member <NUM> to surround at least a portion of the removal tool <NUM> and/or the obstruction <NUM>. The contracted state may be suitable for insertion and removal of the obstruction removal device (including expandable member <NUM> and removal tool <NUM>) through the guide catheter <NUM> and/or intermediate catheter <NUM>. For example, when the expandable member <NUM> is in the collapsed/contracted state, after surrounding at least a portion of the removal tool <NUM> and/or the obstruction <NUM>, the expandable member <NUM> and the removal tool <NUM> may be withdrawn through the guide catheter <NUM> and/or the intermediate catheter <NUM> to remove the obstruction <NUM> from the vasculature <NUM>.

Benefits of surrounding at least a portion of the removal tool <NUM> and/or the obstruction <NUM> with the expandable member <NUM> may include, but are not limited to, smaller cross-sectional area, reduced friction on a vessel wall, reduced likelihood of catching on an opening of the guide catheter <NUM> and/or intermediate catheter <NUM>, and reduced likelihood of obstruction dislodgement.

Referring generally to embodiments of the obstruction removal system <NUM> disclosed herein, the expandable member <NUM> may be configured to transition between a first configuration and a second configuration, or between a contracted state and an expanded state, in any number of ways, including, but not limited to, unsheathing (e.g., withdrawal of the intermediate catheter <NUM> or extension through the guide catheter <NUM>), disengagement of locking members (e.g., wires, hooks, etc.) attached to the expandable member <NUM>, use of shape memory alloys (e.g., Nitinol), or the like. It is envisioned that when the expandable member is in an expanded state, the expandable member may take up a substantial portion of the cross-section of the vasculature <NUM>.

In embodiments, the expandable member <NUM>, removal tool <NUM>, and the obstruction <NUM> are withdrawn into the guide catheter <NUM> and removed from the vasculature <NUM>. In some embodiments, the expandable member <NUM>, removal tool <NUM>, and the obstruction <NUM> may be further withdrawn into the intermediate catheter <NUM>. The expandable member <NUM> may surround at least a portion of the obstruction <NUM> to prevent dislodging and may also assist in compressing the obstruction <NUM> into the guide catheter <NUM> and/or the intermediate catheter <NUM> (e.g., by tension, cinching, crimping, etc.).

Surrounding at least a portion of the removal tool <NUM> and/or obstruction <NUM> with the expandable member <NUM> may serve several functions including, but not limited to, reducing a likelihood that the removal tool <NUM> snags (e.g. on an inner surface/vessel wall of the vasculature <NUM> or an opening of the guide catheter <NUM>), reducing a profile of the obstruction <NUM> for removal through the guide catheter <NUM> and/or intermediate catheter <NUM>, and/or securing the obstruction <NUM> to prevent dislodgement from the removal tool <NUM>.

In embodiments, the removal tool <NUM> and/or expandable member <NUM> may comprise a wire mesh. Such a wire mesh may include wires made of a flexible material (e.g. nitinol, cobalt chromium, polymer mesh (e.g., PET or nylon), or the like), where the wires (e.g. <NUM> to <NUM> or more wires), have a certain diameter (e.g. from <NUM> to <NUM> (. <NUM> inches to. <NUM> inches)), and have certain material properties (e.g. strength, coefficient of friction with blood, resistance to plastic deformation, etc.) suitable for engaging the obstruction <NUM> and/or removal tool <NUM>. The wire mesh can be can be single ply or multiple plies. Furthermore, the wire mesh may include various sets of wires (e.g. support wires with larger diameters, wires to engage a vessel wall, wires to engage a portion of the obstruction or obstruction removal device, radiopaque or radiodense wires, etc.).

Any number of the presently disclosed elements may be suitable for imaging by a non-invasive imaging technology (e.g. X-ray, CT scans, etc.). For instance, the guide catheter <NUM>, intermediate catheter <NUM>, delivery tool <NUM>, removal tool <NUM>, expandable member <NUM>, and/or any additional components may comprise radiodense or radiopaque material (e.g. titanium, tungsten, barium sulfate, zirconium oxide, Drawn Filled Tube (DFT), or the like) suitable for insertion in a human body. In some embodiments, the removal tool <NUM> and the expandable member <NUM> are both portions of a common wire mesh structure formed from a radiodense or radiopaque material (e.g. DFT).

It is to be understood that any number of components of the obstruction removal system <NUM> may be attached by any suitable means including, but not limited to, welding, adhesive, mechanical fastening, interference fittings, etc. For example, the delivery tool <NUM> may be attached to the removal tool <NUM> and/or expandable member <NUM> by such means. Alternatively, or additionally, two or more of the components may be portions of a common structure (e.g., a common mold or print).

It is envisioned that there may be multiple orders in which one or more devices of the obstruction removal system <NUM> are deployed. Factors for determining an order may include, but are not limited to, vasculature properties (e.g. vasculature size, vasculature geometries, branches of the vasculature, vasculature wall strength, etc.), blood pressure, blood flow direction, duration of operation (i.e. does patient require a reduced operating time for safety concerns), size of obstruction, or the configuration of the obstruction removal device.

Referring generally to <FIG>, a method of removing an obstruction from a vasculature <NUM> may include, but is not limited to, the steps of: deploying the guide catheter <NUM> through the patient's vasculature <NUM> to a position near the obstruction <NUM>; extending the delivery tool <NUM> with the end-mounted removal tool <NUM> through the guide catheter <NUM> so that the distal end of the delivery tool <NUM> is disposed proximate to the obstruction <NUM> in the vasculature <NUM> (with/without the use of the intermediate catheter <NUM>); removing at least a portion of the obstruction <NUM> in the vasculature <NUM> by at least partially separating the obstruction <NUM> from an inner surface of the vasculature <NUM> with the removal tool <NUM>; and surrounding at least a portion of the obstruction <NUM> and the removal tool <NUM> with the expandable member <NUM>, wherein the proximal end <NUM> of the expandable member <NUM> is configured to invert or slide toward the distal end <NUM> of the expandable member <NUM>, so that the obstruction <NUM> is captured between the expandable member <NUM> and the removal tool <NUM>, when the delivery tool <NUM> is withdrawn from the vasculature <NUM> to remove the removal tool <NUM> and the obstruction <NUM> from the vasculature <NUM>.

It is to be understood that implementations of the methods disclosed herein may include one or more of the steps described herein. Further, such steps may be carried out in any desired order and, in some implementations, two or more of the steps may be carried out simultaneously with one another. Two or more of the steps disclosed herein may be combined in a single step, and in some implementations. , one or more of the steps may be carried out as two or more sub-steps.

It is also to be understood that usage of terminology in the present disclosure is not intended to be limiting. For example, as used herein, an "obstruction" may refer to any vascular obstruction, including but not limited to, a blood clot, plaque (e.g. fat, cholesterol, etc.), internal structure/growth, foreign object, or the like.

Claim 1:
An obstruction removal system, comprising:
a guide catheter (<NUM>) configured to be inserted within a vasculature (<NUM>);
a delivery tool (<NUM>) having a distal end configured to be inserted within the guide catheter (<NUM>) and disposed proximate to an obstruction (<NUM>) in the vasculature (<NUM>); and
a continuous wire mesh structure (<NUM>, <NUM>, <NUM>) coupled to the delivery tool (<NUM>), wherein respective portions of the continuous wire mesh structure form:
a removal tool (<NUM>) disposed at the distal end of the delivery tool (<NUM>) and configured to at least partially separate the obstruction (<NUM>) from an inner surface of the vasculature (<NUM>), wherein the removal tool (<NUM>) comprises a conical or umbrella-shaped section configured to at least partially surround the obstruction;
an expandable member (<NUM>) coupled to the delivery tool (<NUM>), the expandable member (<NUM>) including a proximal end (<NUM>) that is slidably coupled to the delivery tool (<NUM>), wherein the proximal end (<NUM>) of the expandable member (<NUM>) is configured to invert or slide toward a distal end (<NUM>) of the expandable member (<NUM>), thereby causing the expandable member (<NUM>) to surround at least a portion of the obstruction (<NUM>) and the removal tool (<NUM>) so that the obstruction (<NUM>) is captured between the expandable member (<NUM>) and the removal tool (<NUM>), when the delivery tool (<NUM>) is withdrawn from the vasculature (<NUM>) to remove the removal tool (<NUM>) and the obstruction (<NUM>) from the vasculature (<NUM>); and
an obstruction landing area (<NUM>) between the removal tool (<NUM>) and the expandable member (<NUM>), wherein the ends of the removal tool (<NUM>) and the expandable member (<NUM>) comprise marker bands that are coupled to the delivery tool (<NUM>).