DE102010014778A1 - Medical device for e.g. removing thrombus from curved blood vessel, has suction opening turnable towards calculus such that calculus is connected with suction element over low pressure laterally transferable from line and suction element - Google Patents

Abstract

The device has a catheter (30) comprising a suction line (20) and a suction element (10) that is convertible from a compressed state into an expanded state. The suction element and the line are connected with each other in a fluid-tight manner. The suction element forms state a hollow body (110) in the expanded state, and a fluid-tight shroud (11) comprises a radial inwardly directed suction opening (12). The opening is turnable towards a calculus (41) such that the calculus is connected with the suction element over low pressure laterally transferable from the line and the suction element.

Description

The invention relates to a medical device for removing concretions from hollow organs of the body according to the preamble of patent claim 1. In particular, the invention relates to a medical device for removing thrombi from blood vessels. Such a device is for example from the WO 2006/031410 A2 known.

Blood clots that form within blood vessels, particularly thrombi, may result in partial or complete occlusion of blood vessels. Such a closure is also referred to as thrombosis or embolism. A thrombosis or embolism can lead to a deficiency of tissue areas with nutrients, especially oxygen. Complete occlusion of a blood vessel that supplies nutrients to a tissue area presents the risk of ischemia to the affected tissue area, irreparably damaging the tissue.

In order to prevent or at least alleviate the health consequences of a vascular occlusion, it is advantageous from a medical point of view to eliminate the vascular occlusion as quickly as possible. One way to eliminate the vascular occlusion is drug thrombolysis, which dissolves the blood clot under the action of a drug. This drug therapy has the disadvantage that on the one hand the drug acts on the entire body cycle, which leads to strict criteria regarding the applicability of thrombolysis. For example, thrombolysis should not take place if a patient has previously undergone surgery. Furthermore, a relatively limited time window is available for the success of drug thrombolytic therapy. About three to four and a half hours after the event or the first symptoms of a vascular occlusion, the chances of success of a drug therapy decrease significantly.

An alternative to drug dissolution of blood clots are devices that allow mechanical removal of blood clots. Such a device is mentioned in the introduction WO 2006/031410 A2 described. The known device comprises a catheter in which a suction line is arranged longitudinally displaceable. The suction line is connected to a receiving basket, which is convertible from a compressed state to an expanded state. The receiving basket has a lattice-like structure that, in use, spans within the blood vessel to receive a blood clot. The blood clot is drawn into the receiving basket by a negative pressure, which is passed through the suction line in the area of the receiving basket.

Since blood clots often have an inhomogeneous structure, there is a risk when using the known device that the blood clot is divided into individual components under the influence of the negative pressure. In particular, there is a risk that a proximal portion of the blood clot is aspirated, while a distal portion of the thrombus remains in the blood vessel. To remove the entire thrombus or the entire blood clot, therefore, a multiple treatment with the known device is required. The risk that parts of the blood clot, in particular detach distal portions of the blood clot, also exists when retracting the receiving element. Upon retraction of the receiving basket, distal portions of the blood clot may rub along the vessel wall, so there is a risk of separating distal clot portions from proximal clot portions. Another disadvantage of the known device is that can be injured by the reticular structure of the receiving basket vessel walls, which can lead to a re-formation of thrombi or stenosis.

The invention is based on the object to provide a medical device for removing concretions from hollow organs of the body, which enables a safe and gentle removal of the concrements. Furthermore, the device should cause a rapid recanalization of the hollow body organ. Another object of the invention is to provide a medical device for treating concretions in hollow organs of the body.

According to the invention, this object is achieved by the subject matter of patent claims 1 and 17.

The invention is based on the idea of specifying a medical device for removing concretions from hollow organs of the body with a catheter comprising a suction line and at least one suction element. The suction element is convertible from a compressed state to an expanded state. The suction element is further connected to a distal end of the suction line, which is guided at least partially longitudinally displaceable within the catheter. The suction line is fluid-tightly connected to the suction element. The suction element forms a hollow body at least in the expanded state. The suction element has at least sections of a fluid-tight cover and at least one radially inwardly directed suction opening. The suction opening is in use a concretion zuwendbar such that the calculus is laterally connected to the suction by a transmissible via the suction line and the suction negative pressure.

The invention is based on the idea to place a suction or a hollow body formed by the suction laterally of a concretion in order to connect the calculus over the entire length with the intake. This prevents parts of the calculus from coming off. By means of the suction element, which comprises lateral and / or radially inwardly directed suction openings, it is achieved that the concrement can be removed in one piece from the hollow body organ. By the suction with the lateral or generally radially inwardly directed suction opening is further made possible to apply a vessel portion of the body cavity evenly with a negative pressure, wherein the negative pressure acts laterally. Thus concretions can be safely removed, which have a plurality of individual components which are arranged distributed over the vessel portion.

Due to the hollow body of the suction element formed in the expanded state is achieved that the negative pressure acts evenly on the suction opening, in particular distributed to a plurality of suction openings. The hollow body formed in the expanded state may have a radial force which prevents the suction element from collapsing under the influence of the negative pressure. In particular, the suction in the expanded state has a dimensional stability in such a way that the hollow body or the cavity is maintained within the hollow body. The hollow body may have different shapes. The hollow body may further comprise openings or openings. The hollow body may also be formed in the compressed state. Specifically, the hollow body may have a fixed, in particular non-expandable cross-section. The expansion of the suction causes no change in cross section, but for example, a change in position of the hollow body.

The suction element, in particular the hollow body, is preferably adapted to position itself laterally next to a concretion in the expanded state of the suction element. The fluid-tight cover ensures that a negative pressure generated outside the body, in particular at a proximal end of the suction line, is effectively conducted into the suction element or via the suction opening into the body hollow organ. Due to the radially inwardly directed arrangement of the suction opening, in particular laterally of the concretion, it is achieved that, by the action of the negative pressure, the concretion is connected laterally to the suction element.

With the device according to the invention, it is possible to remove concretions from body cavities quickly and reliably, whereby a rapid recanalization of the body hollow organ is effected.

The invention is particularly suitable for removing blood clots or thrombi from blood vessels. In general, the device according to the invention can be used for removing other concretions from any hollow body organs, in particular tubular or tubular body vessels.

In a preferred embodiment of the medical device according to the invention, the suction element has a distal end which is closed in a fluid-tight manner. By the fluid-tight sealed distal end of the suction of the hollow body formed in the expanded state of the suction can be completed in the axial direction. The negative pressure is thus effective mainly on the side suction openings. The suction power is thus increased. The fluid-tight sealed distal end of the suction prevents over-suction of body fluids, which could reduce the suction power. Alternatively, the hollow body or the suction element can have an axial opening at the distal end. The axial opening may face the calculus during use. In particular, the axial opening in use, so in the expanded state of the suction, be directed radially inward to suck a concretion laterally. In other words, the axial opening may form the radially inwardly directed suction opening.

The suction line may have at least one suction line extension which is connected to the suction element. In the expanded state of the suction, the Saugleitungsfortsatz may have an S-shaped curvature. Preferably, the Saugleitungsfortsatz on a fluid-tight cover or is formed tubular. By the S-shaped curvature ensures that the suction in use, in particular in the expanded state within a body hollow organ, the side of a concretion can be arranged. In particular, the suction element can be arranged along an inner surface of the hollow body member. The S-shaped curvature compensates for the offset of the catheter, which is preferably arranged centrally within the body hollow organ and in which the suction line is arranged, to the expanded suction element or to the hollow body of the expanded suction element.

The suction element or the hollow body may be formed substantially tubular in the expanded state. In particular, can the suction element form a hose-like continuation of the suction line and / or a Saugleitungsfortsatzes. Several suction openings are preferably arranged on one side. This means that the suction openings are substantially on a common line, which extend parallel to the longitudinal axis of the suction. The tubular design of the suction has the advantage that the suction well along a concretion, especially between the calculus and the vessel wall of the hollow body organ, can develop. The suction element can also extend over the entire length of the concretion, so that a secure adhesion or suction of several, especially all, concretion sections is achieved.

In the expanded state, the suction element can be aligned substantially in a straight line parallel to the catheter. The suction element or the hollow body of the suction element forms an elongate tubular portion which extends laterally along the concretion in use. At least when the suction is free, that is, for example, expanded under laboratory conditions or assumes the manufacturing state, the suction is aligned in a straight line parallel to the catheter. This does not exclude that the suction element is curved within a hollow body organ to follow the course of the body hollow organ. The suction element thus generally has a flexibility which makes it possible to adapt to the course of the hollow body of the body.

Alternatively, the suction element or the hollow body of the suction element in the expanded state of the suction element can be wave-shaped and / or spiral-shaped. The suction element can thus extend from the distal end of the suction line starting in a wavy or zigzag shape. The suction element can also spiral around a longitudinal axis, wherein the longitudinal axis may be, for example, an extension of the longitudinal axis of the catheter. The suction opening or the plurality of suction openings are preferably directed radially inwards with respect to the longitudinal axis of the spirally wound suction element. Both with the waveform, as well as with the spiral shape has the advantage that the contact surface between the suction and the concretion is increased, whereby an improved connection between the suction and the concretion is achieved.

The suction opening can form a gap in the expanded state of the suction element, which gap is bounded by two free longitudinal edges of the suction element. In the expanded state, the suction element can essentially have a C-shaped cross-sectional contour. The suction element may in particular comprise a film which, when released within the hollow body organ, rolls into a C-shape. The film or the suction element may comprise two free, preferably parallel, longitudinal edges. In the expanded state, the suction element is rolled around a longitudinal axis such that a gap is formed between the free longitudinal edges, which forms the suction opening. The suction opening, in particular the slot-shaped suction opening, can extend over the entire length of the suction element. It is also possible that the slit-shaped suction opening extends over a part of the suction element. Furthermore, a plurality of suction openings, which are formed in a slot shape, may be provided.

The suction element may have a plurality of suction openings, which are arranged distributed in the expanded state of the suction substantially pore-like on the circumference of the suction. Overall, the suction element may have a structuring, which may comprise, for example, a pore structure. By the pore structure is distributed over the circumference of the suction, it is ensured that the concretion is connectable to the suction by means of the negative pressure generated, regardless of the orientation of the suction. In particular, it is ensured by the suction openings or pores distributed over the circumference that in each case at least part of the suction openings faces the calculus.

In a further preferred embodiment of the medical device according to the invention, the suction element has at least two, in particular three suction arms. The suction arms are connected to a common suction line. In the expanded state, the at least two suction arms are arranged spaced from each other such that the suction element surrounds the concretion tentakelartig or in a krakenartig. This ensures that the calculus is applied from several sides simultaneously with a negative pressure. The connection between the suction element or generally the medical device and the calculus is thus improved. Furthermore, it is ensured by the plurality of suction arms, that the concrement in one piece or - with several separate Konkrementbestandteilen - the Konkrementbestandteile are completely removed from the hollow body organ. The suction arms are preferably formed by a respective hollow body of the suction. In the expanded state of use of the intake element, the intake arms can extend at least in sections laterally along the calculus to be removed.

Advantageously, at least one positioning element is provided, which with the suction and / or the suction line, in particular a Saugleitungsfortsatz, is connected. The positioning element can be converted from a compressed state into an expanded state such that the suction element, in particular a suction arm of the suction element in the expanded state of the suction element, can be arranged laterally next to a concretion. The positioning supports the lateral arrangement of the suction or suction. In particular, the positioning element can have an increased radial force, which ensures that the suction element or the suction arm is pressed laterally against a vessel wall of the body hollow organ, in particular between a concrement and a vessel inner wall, during release in a body hollow organ.

In a preferred embodiment, the positioning element in the expanded state forms an annular element, which is connected substantially tangentially with the suction element. The annular member has a cross-sectional diameter which is larger than the cross-sectional diameter of the suction member in the expanded state. Preferably, the annular member is adapted to fully expand within the hollow body member so that the annular member contacts the inner wall of the hollow body member. The annular element can thus expand completely in the body hollow organ. Since the suction element is tangentially connected to the annular element, it is arranged by the annular element in a position laterally of the concretion, in particular along the vessel inner wall. It is possible that the intake element is associated with a plurality of annular elements which are arranged distributed along the intake. The annular elements may generally have a lattice structure, in particular a stent-like structure. Preferably, two annular elements are provided, wherein a first annular member is disposed at a distal end of the suction member and a second annular member at a proximal end of the suction member. This avoids that, during expansion of the suction element, an annular element cuts through a concretion or penetrates a concretion. The distally or proximally arranged annular elements, however, can expand outside of the concretion. The annular elements may further have an expansion diameter that is greater than the vessel diameter of the body hollow organ to be treated. In this way, the hollow body member is slightly widened by the annular elements, whereby the positioning of the suction, in particular of the hollow body of the suction on one side of the concretion is facilitated.

The positioning element may alternatively have a conical shape in the expanded state, which is clamped between a plurality of Saugleitungsfortsätzen the suction line. The conical shape of the erection element ensures that the Saugleitungsfortsätze and thus the suction arms, evenly distributed over the circumference of a concretion. Thus, the positioning element causes an arrangement of the suction arms, in which the suction arms are arranged spaced apart both radially, and in the circumferential direction. At the same time, the conical shape of the positioning element can act as a flow divider, so that the flow of a body fluid into the body cavity can be positively influenced.

The suction element and / or the positioning element may each comprise, at least in sections, a net-like support structure, in particular a grid mesh or a laser-cut grid structure. The net-like support structure has the advantage for the suction element that the suction element has sufficient stability to sufficiently withstand the negative pressure in the expanded state. The advantage of the reticulated support structure is that the suction arms of the suction member are securely held in a spaced-apart arrangement. Furthermore, the support structure and in particular the mesh allows a favorable ratio between the space requirements, in particular the cross-sectional diameter of the suction or the positioning in the compressed state and the space required in the expanded state.

In a preferred embodiment, a filter element is further provided, which can be converted from a compressed state to an expanded state. The filter element forms a distal end of the suction element. The filter element may be formed umbrella-like in the expanded state. Further, in the expanded state, the filter element may have a tip that is substantially concentric with the catheter. Preferably, the filter element in the expanded state, in particular in the use state, can be placed distally of a concretion. The filter element advantageously prevents particles detaching from the concrement from being rinsed into body hollow organs located downstream, where they lead to further vascular occlusions. The filter element thus provides protection against re-embolism in distal areas. Moreover, the filter element can be adapted such that the area in which the negative pressure for suction of the calculus is generated, is locally limited. Furthermore, the filter element can additionally have suction openings, so that a negative pressure on the concretion can also be exerted via the filter element. The effective suction surface is thus increased.

The suction element may have a teardrop-shaped longitudinal contour in the expanded state. It is also possible that a plurality of suction elements are provided, wherein the at least two suction elements associated Saugleitungsfortsätze can be designed to have different lengths. The Saugleitungsfortsätze in this way each form a krakenartigen arm comprising one or more suction. The teardrop-shaped suction elements can be designed as suction cup-like components of the krakenartigen arm. The arms can embrace a concretion tentacle-like. The device may comprise a total of a plurality of suction and / or suction arms, which are distributed on the one hand in the circumferential direction around a concretion. On the other hand, the suction elements can be arranged distributed in the longitudinal direction of the calculus. Preferably, a plurality of suction elements are provided, which are arranged distributed both in the circumferential direction, as well as in the longitudinal direction of a concretion. Each suction element comprises at least one suction opening, which faces the calculus. The concretion is applied in this way from several sides and over the entire length of the negative pressure, so that a safe removal of the calculus is ensured. Even if the concrement breaks during transport from the body cavity into individual sections, they are further fixed by a respective part of the suction. In particular, an offset arrangement of intake elements is advantageous. For example, a plurality of suction line extensions may be provided, each comprising one or more suction elements, wherein the suction line extensions extend in the circumferential direction in a straight line along a concretion. The suction and / or suction arms in each case in the circumferential direction of adjacent Saugleitungsfortsätze can be arranged offset. The suction line extensions can be connected to a common suction line. By several, in particular teardrop-shaped, suction elements a rapid and safe removal of the concretion is advantageously ensured.

The suction element may have a flattened, in particular oval, cross-sectional contour in the expanded state. The suction opening may be formed in a flat side of the suction element. In particular, a plurality of suction openings are provided, which are formed in the flat side of the suction. Due to the flat shape and the formation of the suction openings in the flattened or flat side of the suction, the effective suction surface, ie the total cross-sectional area of the suction ports, which face the calculus, is increased. Overall, results from the flat, in particular oval, cross-sectional contour of the suction an enlarged docking surface of the suction against the calculus. Since the suction element is advantageously used in hollow body organs, which have a substantially circular cross-section, is achieved by the flattened or oval shape of the suction that the suction in the expanded state exerts a lower tension on the vessel walls of the body hollow organ. This is due in particular to the fact that a smaller proportion of the suction element rests against the vessel wall of the hollow body of the body due to the flattened shape. In particular, the shorter or steeper sides of the suction element abut against the vessel wall, whereas the flatter sides of the suction element are at a distance from the vessel wall. On the one hand, the flattened shape thus reduces the vascular tension for the body hollow organ, at the same time increases the effective contact surface on a concrement and, on the other hand, provides a recanalization region due to the distance of the flatter side of the suction element from the vessel wall. Specifically, with the flattened shape of the suction member, the concretion is displaced laterally, thereby releasing a flow passage in the body hollow member on an opposite side of the suction member. Thus, a rapid recanalization of a hollow body organ, such as a blood vessel, possible.

According to a secondary aspect, the invention is based on the idea of specifying a medical device for treating concretions in hollow organs of the body with a catheter and at least one contact element. The catheter includes a supply line. The contact element is convertible from a compressed state to an expanded state. Further, the contact element is fluidly connected to a distal end of the supply line, which is guided at least partially longitudinally displaceable within the catheter. The contact element has a hollow body with radially inwardly directed supply openings in the expanded state. In use, the supply openings are conducible to a calculus such that medicinal active substances can be brought laterally onto the calculus. In the hollow body of the contact element while a different pressure than outside of the hollow body is adjustable.

The structural design of the medical device substantially corresponds to the medical device described above, wherein the supply line structurally corresponds to the suction line and the contact element substantially constructive the suction. The difference, however, is that the supply line is not used primarily for sucking a concretion, but rather for supplying active ingredients to the calculus. For this purpose, the device preferably has a connection element for connecting a catheter at the proximal end of the catheter Drug container, such as a syringe, on. As well as the suction of the medical device described above, the contact element is positioned laterally next to a calculus, so that the medical agents act laterally on the calculus. In order to guide the medical agents to the calculus, a different pressure is adjustable in the hollow body, which is formed by the contact element, than the pressure which is present in the hollow body organ. In particular, in the hollow body, a higher pressure than in the Körperhohlorganeinstellbar. In other words, an overpressure is adjustable in the hollow body.

The invention will be explained in more detail below by means of embodiments with reference to the accompanying schematic drawings. Show in it

1 a perspective view of a medical device according to the invention according to a preferred embodiment in use;

2 a perspective view of the suction of the medical device according to 1 ;

3 a cross-sectional view of a medical device according to the invention according to a preferred embodiment in use;

4 a plan view of the suction of the medical device according to 3 ;

5 a side view of a medical device according to the invention according to a preferred embodiment in use;

6 a plan view of a suction of the medical device according to 5 ;

7 a cross-sectional view of a medical device according to the invention according to another preferred embodiment in use; and

8th to 14 in each case a side view of a medical device according to the invention according to a preferred embodiment in use.

The medical device according to the invention generally comprises a catheter 30 in which a suction line 20 is arranged longitudinally displaceable. The suction line 20 can be connected or connectable with a suction device known per se. In particular, the suction line can 20 through the catheter 30 extend and be connected to the suction device. Alternatively, the suction line 20 with the catheter 30 fluidly connected, in turn, with the suction device 20 connected is. The suction line 20 can in the catheter 30 be arranged longitudinally displaceable. Preferably, the catheter has 30 at a distal end, a stopper member resting on the inner circumference of the catheter 30 is arranged. The suction line 20 also has an abutment member connected to the abutment member of the catheter 30 cooperates to make a distal movement of the suction line 20 to limit. The stop element of the suction line 20 can be beneficial at a proximal end of the suction line 20 be arranged. Preferably, the stop element of the suction line 20 on an outer circumference of the suction line 20 arranged.

The suction line 20 is with a suction 10 connected or connectable. The connection between the suction and the suction line 20 can be solvable. Preferably, the suction element 10 with the suction line 20 firmly connected, in particular formed in one piece. The suction element 10 is convertible from a compressed state to an expanded state. The suction element 10 is thus expandable, wherein the suction 10 in the expanded state, a hollow guide or a hollow body 110 forms. In the expanded state, the intake 10 be tubular, pillow-shaped or teardrop-shaped. Preferably, the suction element 10 cylindrically shaped.

The suction element 10 has a fluid-tight cover 11 on. In the fluid-tight cover 11 is at least one suction opening 12 formed, which is aligned laterally. The suction opening 12 is over the hollow body 110 or the hollow guide, the suction 10 forms in the expanded state, and the suction line 20 fluidly connected to the suction device. The negative pressure generated in the suction device is therefore in the region of the suction opening 12 effective.

In use, the suction is 10 so alignable that the suction opening 12 a concrement 41 for example, a blood clot in a blood vessel 40 , facing. The suction opening 12 is preferably a concretion in use 41 facing, so that the negative pressure over the suction opening 12 on the calculus 41 acts. For this purpose, it can be advantageously provided that the suction line 20 such a torsionally rigid or torsionally stable structure that the suction 10 by actuation of a proximal end of the suction line 20 is rotatable. Alternatively or additionally, a guide wire may be provided which is connected to the suction element 10 connected is. By actuation of the guide wire at a proximal end of the suction 10 be rotated to the suction opening 12 on the calculus 41 align. The suction element 10 may further comprise marker elements comprising a radiopaque material. The marker elements allow easy positioning of the suction 10 during the treatment. The spatial arrangement of the suction 10 in the blood vessel 40 can be easily controlled and controlled in this way.

In this context, it should be noted that the terms proximal and distal refer to the arrangement of individual elements of the device with respect to the user. Proximally arranged elements are arranged closer to the user than distal elements.

In the context of the present application, the term negative pressure refers to a pressure which is lower than that within the body hollow organ or a blood vessel 40 prevailing pressure. In particular, a negative pressure in the context of the present application does not necessarily have a negative value. A negative pressure is rather present when the pressure in the region of the suction opening 12 the pressure in the blood vessel 40 below. Accordingly, an overpressure forms a pressure which is higher than that within the body hollow organ or a blood vessel 40 prevailing pressure. For all embodiments, it is generally stated that the intake 10 also suction openings 12 may not have the concretion in use 41 are facing. The generated negative pressure is therefore not just above the calculus 41 facing suction openings 12 but also from the concrement 41 remote suction openings 12 effective. Although in this case, not all of the negative pressure generated acts directly on the calculus 41 , The function of the suction element 10 However, it is still ensured, as an effective part of the generated negative pressure directly on the calculus 41 acts.

The suction element 10 can generally be a support structure 16 include. The support structure 16 may be formed like a net. For example, the support structure 16 a grid of wire elements. Different types of braids are possible. For example, the grid may have a 1-over-1 weave. In each case, a wire element crosses another wire element. It is also possible that the grid mesh comprises a 1-over-2 braiding, wherein a wire element crosses in each case two further wire elements in a crossing point of the grid mesh. Further possible types of braiding are, for example, a 2-over-2 braiding, a 2-over-3 braiding, a 1-over-3 braiding, a 3-over-3 braiding and the like. The grid mesh or generally the support structure 16 is with a cover 11 Mistake. In particular, the support structure 16 have a coating covering the cover 11 forms. The coating or the cover 11 may comprise a plastic, for example polyurethane.

Preferably, the suction element 10 a shape memory material, in particular a nickel-titanium alloy. Alternatively, the suction element may comprise a plastic. In particular, the suction can 10 be formed by a plastic tube in which the side suction openings 12 are formed. The suction element 10 can also be formed by a foil, the two free longitudinal edges 15 includes. The film can in the expanded state of the suction 10 be wrapped around a longitudinal axis, wherein the free longitudinal edges 15 spaced from each other are arranged such that the free longitudinal edges 15 a gap 121 limit. The gap 121 can the suction opening 12 form. The suction element has in this case a substantially C-shaped cross-sectional contour. Such a suction 10 is for example in 2 shown.

The suction element 10 generally has a compressed state in which the suction element 10 inside the catheter 30 is arranged. Furthermore, the suction element 10 an expanded state in which the suction element 10 outside the catheter 30 is arranged. In the expanded state, the suction element 10 either an overall enlarged cross-sectional diameter or is at least deflected from the original axial position. This means that the suction element 10 may be formed tubular or a tubular hollow body 110 forms, which in each case in the compressed, as well as in the expanded state has the same cross-sectional diameter. In the compressed state is the hollow body 110 or the suction 10 coaxial to the catheter 30 arranged. In the expanded state, the intake element is arranged 10 or at least the hollow body 110 the suction element 10 radially offset to the longitudinal axis of the catheter 30 to turn sideways to the calculus 41 to position. A suction element 10 , which in the expanded state radially offset to the longitudinal axis of the catheter 30 is arranged, for example, in 1 shown.

The suction according to 2 has a cover 11 on, which is formed from a flat foil. In the expanded state, the film or the cover 11 wound around a longitudinal axis, which adjusts the C-shaped cross-sectional contour. The cover 11 or generally the suction 10 includes two free longitudinal edges 15 , Which are arranged spaced apart in the expanded state. Between the two free longitudinal edges 15 is the gap 121 educated. The gap 121 serves as suction opening 12 , In use, the gap is 121 hence the calculus 41 facing. Specifically, it is provided that the intake 10 is aligned in use such that the gap 121 or in general the suction opening 12 the calculus 41 is facing. The suction element 10 according to 2 further includes a plurality of pores 122 , which are about the circumference and the length of the suction element 10 are arranged distributed. The pores 122 form further suction openings 12 in the cover 11 the suction element 10 , With the pores 122 it is achieved that a suction of the calculus 41 is possible when the gap 121 not on the calculus 41 is aligned. The main function of the pores 122 This is the flexibility of the intake 10 to increase. In this way it is achieved that the cover formed from a film 11 the suction element 10 or the film-like intake 10 is so flexible that the suction 10 the course of the blood vessel 40 or generally a hollow body organ can follow. The pores 122 can also be provided with a flexible plastic coating.

In general, the C-shaped structure of the suction element 10 according to 2 may be formed from a flat output element, wherein the planar output element on the one hand, a film, which is made for example by thin-film technology, in particular by sputtering technology, may include. On the other hand, the flat output element may be formed by a braided or laser-cut lattice structure. In both cases, the suction 10 be adapted such that it assumes the C-shape in the expanded state or is rolled during expansion in the C-shape. It is also possible that the free longitudinal edges 15 overlap in the expanded state, leaving no gap 121 is formed. The aspiration of the calculus 41 then takes place through the pores 122 ,

1 shows the suction 10 according to 2 as part of the medical device in use. The suction element 10 is with a suction line 20 connected longitudinally displaceable in the catheter 30 is arranged. The suction line 20 further comprises a suction line extension 21 in the expanded state of the suction element 10 is formed substantially S-shaped. This ensures that the radial offset between the catheter 30 , preferably centrally in the blood vessel 40 is arranged and the suction 10 , the side next to the calculus, in particular along the inner wall of the blood vessel 40 is arranged, is balanced.

To make sure the suction element 10 laterally next to the calculus 41 is positioned, are also two set-up 50 intended. The erection elements 50 each comprise an annular element 51 , each with an axial end of the suction 10 connected is. In particular, the annular element 51 tangential to the suction 10 connected. The annular element 51 has a cross-sectional diameter that is larger than the cross-sectional diameter of the suction element 10 is in the expanded state. The annular element 51 is analogous to the intake 10 expandable and expands upon discharge from the catheter 30 in the blood vessel 40 on. In this case, the annular element passes 51 in contact with the inner wall of the blood vessel 40 , which makes the tangential with the annular element 51 connected suction 10 laterally to the inner wall of the blood vessel 40 is urged. The annular element 51 preferably has a shape memory material, in particular a nickel-titanium alloy on. The annular element 51 can also include a plastic. It is advantageous if the annular element 51 has self-expanding properties. The annular element 51 may generally have a lattice structure, in particular a stent-like lattice structure. For example, the annular element 51 form a stent segment.

The suction element 10 further includes a distal end 13 which is preferably closed. The distal end 13 can also be open. In the embodiment according to 1 has the suction 10 a cylindrical shape. Alternatively, the suction 10 be formed substantially hollow cone-shaped, wherein the tip of the hollow cone, the distal end 13 forms. This ensures that the distal end 13 closed is. The negative pressure, via the suction line 20 in the intake 10 is guided, is thus mainly about the gap 121 and / or the pores 122 effective.

In 3 a further embodiment of the medical device is shown, wherein the suction 10 has a flat-oval cross-sectional contour in the expanded state. The flat-oval cross-sectional contour has two flattened and two strongly curved sides. In use, the strongly curved sides of the suction element 10 on the inner wall of the blood vessel 40 issue. At least one of the flattened sides comprises at least one suction opening 12 , Preferably, at least one of the flattened sides of several suction openings 12 arranged distributed. The suction openings 12 are turned in use to a calculus, so that the calculus 41 through the suction openings 12 or through the suction openings 12 acting negative pressure with the intake 10 is connectable.

The flat-oval shape of the intake 10 has the advantage that between the blood vessel wall and the calculus 41 a recanalization area 26 is exposed. In particular, with the flat oval suction 10 according to 3 a total of three areas within the blood vessel 40 provided. On the one hand is within the intake 10 a suction area 25 or a hollow guide in the hollow body 110 the suction element 10 formed when the suction 10 assumes the expanded state. About the suction area 25 the negative pressure acts on the suction openings 12 and thus on the calculus 41 , On the other hand, the recanalization area becomes 26 exposed so that body fluids, especially blood, on the calculus 41 can flow past. Nutrient supply to downstream tissue areas is thus rapidly restored. At the same time the calculus becomes 41 displaced laterally. In particular, the suction element forms 10 a displacement area 27 in which the calculus 41 is urged to the recanalization area 26 expose.

The suction element 10 according to 3 is in a plan view in 4 shown. The suction element 10 includes a mesh braid that with a cover 11 is covered. In particular, the grid of the suction is 10 with a cover 11 coated. The cover 11 may comprise a plastic, for example polyurethane. Through the grid mesh is achieved that the suction 10 has increased flexibility. Preferably, the mesh of the suction is the mesh 10 produced in a rotationally symmetrical shape and then converted into the flat-oval shape. For example, individual wire elements can be braided onto a rotationally symmetrical mandrel and converted into the oval cross-sectional contour after removal of the mandrel. Alternatively, the suction 10 a grid structure or support structure 16 which is produced by laser cutting from a solid material. The shape of the suction according to 3 is not limited to a strictly flat-oval contour. Rather, the flat-oval cross-sectional contour may also have at least one longer side, which is concave or convex curved. For example, the suction 10 have a sickle-shaped or moon-shaped cross-sectional contour. It is possible that a longer cross-sectional side of the suction 10 , in particular the side of the suction openings 12 , concave and the opposite longer cross-sectional side is convex. It can also be formed convex both longer cross-sectional sides.

The cover 11 can be both on the outer circumference, as well as on the inner circumference of the support structure 16 extend. It is also possible that the cover 11 in the wall plane of the net-like support structure 16 , in particular in mesh of the net-like support structure 16 , is arranged. The side suction openings 12 can in the cover 11 be formed so that within the suction openings 12 the support structure 16 exposed. It is also possible that the suction holes 12 through the support structure 16 extend. That means the support structure 16 in the area of the suction openings 12 is interrupted.

It is advantageous if the support structure 16 or the lattice structure has an increased Feinmaschigkeit and with the calculus 41 can get in contact. For example, the cover 11 on the inner circumference of the support structure 16 be applied so that the suction element 10 has a structuring on the outer circumference. In this way, the calculus can 41 or a thrombus grow into the support structure. It is also possible that the support structure 16 in the area of the suction openings 12 exposed, leaving the calculus 41 or the thrombus in the region of the suction openings 12 in the support structure 16 is pressed. The calculus 41 Thus, under the influence of the negative pressure, through the suction openings 12 acts in the suction holes 12 to be pulled. In this case, a part of the concretion material in the suction openings 12 inside bulge. In this way, an additional mechanical anchoring of the calculus 41 or the thrombus reached. It is also possible that the thrombus or the calculus 41 completely through at least one suction opening 12 in the hollow body 110 passing through the suction element 10 is formed, is pulled. Through the over the suction openings 12 on the thrombus or the calculus 41 acting negative pressure is in addition a biochemical connection between the intake 10 and the calculus 41 reached.

When the suction holes 12 are completely open, so the support structure 16 in the area of the suction openings 12 interrupted, the calculus can 41 at least partially in the intake 10 penetration. This can be achieved that the concretion of the suction openings 12 in the inner lumen or the hollow guide of the suction 10 is introduced. The calculus 41 or at least concretion particles can in this way within the suction 10 positioned and with the suction 10 from the blood vessel 40 be removed.

In general, the support structure 16 or the lattice structure may be produced by braiding, laser cutting, sputtering and / or etching. The grid structure or support structure 16 may have a different Feinmaschigkeit. For example, the lattice structure or support structure 16 in the area of the suction openings 12 a coarse mesh and in through the cover 11 covered areas include a fine-meshed structure. Such a configuration is particularly with regard to the manufacture of the suction 10 advantageous, because in the coating of the suction 10 the coarse-meshed areas take the coating hard, leaving the suction holes 12 be left open. The advantage of coarse-meshed areas of the intake 10 There is also the fact that due to the comparatively large meshes of the net-like support structure 16 the possibility is opened, the calculus 41 suck so that parts of the concretion material in the suction openings 12 bulge in and thus mechanically with the intake 10 get connected. The meshes of the netlike support structure 16 can also be designed so large that the calculus 41 completely through at least one suction opening 12 in the intake 10 , in particular a hollow body 110 passing through the suction element 10 is formed, is pulled.

The embodiment according to 3 and 4 has suction openings 12 on, on one side of the intake 10 are arranged. Alternatively, it is possible that the suction openings 12 over the entire circumference of the suction 10 are arranged distributed. Although is about the suction openings 12 that the calculus 41 body fluid may be sucked. The directly on the calculus 41 Although effective vacuum is thereby limited, but only slightly. The overall function of the suction element 10 is still guaranteed. The advantage of such a configuration, in which the suction openings 12 are arranged distributed over the entire circumference, however, is that the suction 10 can be positioned at will, without impairing the suction function.

In 5 is shown a further embodiment of the medical device, wherein the suction 10 essentially according to the embodiment according to 4 are structured. The medical device according to 5 has several such suction 10 on that with a common suction line 20 are connected. In particular, the suction line 20 two suction line extensions 21 in use tentacle-like around the concrement in use 41 are arranged. The suction line 20 can have more than two suction line extensions 21 , in particular three, four or five suction line extensions 21 , include. The suction line extensions 21 each have at least two suction 10 on, along the suction line extensions 21 spaced apart. The intake elements 10 or by the suction 10 formed hollow body 110 are with the suction line extensions 21 each fluidly connected. In this way it is ensured that the negative pressure generated externally and via the suction line 20 is effective, through the Saugleitungsfortsätze 21 into the intake elements 10 is transferable. The intake elements 10 passing over the suction line extensions 21 are connected together in a krakenartig over the calculus 41 arranged distributed. In this case, the Saugleitungsfortsätze 21 Arms with several suction cups or suction elements 10 ,

It is also possible that the suction line extensions 21 each a single suction 10 include, as in 6 shown. Here is the suction 10 at the distal end of the suction line extension 21 arranged. The suction element 10 has a substantially teardrop-like shape. In this way, an increased suction surface is provided. In particular, in the flattened areas of the teardrop-shaped suction element 10 more or comparatively large suction openings 12 be arranged so that the area over which the negative pressure is effective, is increased. It is also possible that the drop-shaped suction 10 according to 6 analogous to the embodiment according to FIG 1 and 2 has a C-shaped cross-sectional contour. For example, the suction 10 be rolled in the compressed state helical spring-like and unfold during expansion to a C-shaped suction 10 to form a gap on a flattened side 121 having. The gap 121 is a concrement in use 41 facing. It is possible that the suction line 20 several suction line extensions 21 comprises, at its distal end a C-shaped suction 10 is arranged, such as in 7 shown. The gap 21 the C-shaped suction 10 are each radially inward, ie in the direction of the calculus 41 aligned. The suction element 10 can also have a radial restoring force, so that the calculus 41 or the thrombus from the inner wall of the blood vessel 40 is pushed away. Due to the radial restoring force of the suction 10 is further ensured that the suction 10 through the influence of the calculus 41 is not compressed. The restoring force of the suction 10 thus ensures the maintenance of the hollow guide within the intake 10 or of the hollow body of the suction element formed in the expanded state 10 ,

The intake elements 10 may be on a plurality of circumferentially spaced arranged Saugleitungsfortsätzen 21 each offset from each other, as in 5 shown. In this way, a special good anchoring or connection of the calculus 41 with the suction 10 reached.

In the 8th to 12 Further embodiments of the medical device are shown, wherein the suction line 20 in each case three suction line extensions 21 includes, in hose-like suction arms 101 the suction element 10 pass. The hose-like suction arms 101 are beyond the scope of a calculus 41 apart arranged. The suction arms 101 or the suction 10 surround the calculus tentacular or krakenartig. Preferably, there are three suction arms 101 provided to each other at an angle of 120 degrees around the circumference of the concretion 41 are arranged distributed. It is also possible that a total of four or five intake arms 101 and corresponding four or five suction line extensions 21 are provided. The suction arms 101 include several suction openings 12 running the full length of the intake arms 101 or of the suction element 10 are arranged distributed. The suction arms 101 generally have flexibility so that the suction arms 101 the contour of the calculus 41 can adjust. Preferably, the suction arms 101 rectilinearly aligned in a preferred direction, in particular parallel to the catheter 30 , It is also possible, as in 8th shown that at least one suction 101 is formed wavy or zigzag. In this way, the contact surface between the suction 10 and the calculus 41 increases and efficiency in the removal of the calculus 41 improved. Moreover, causes the wavy or zigzag contour of the suction 101 that the suction arm 101 can shorten or lengthen. The device is thus particularly favorable for curved blood vessels 40 used.

To the tentacle-like clamping of the suction arms 101 To facilitate, can also be a positioning element 50 be provided. The positioning element 50 can be between the Saugleitungsfortsätzen 21 span. Preferably, the positioning element 50 , as in 8th represented, a conical shape 52 on. The conical shape 52 is formed in particular hollow cone-shaped. The conical shape 52 or generally the positioning element 50 may be a mesh braid or a laser-cut lattice structure or generally a support structure 16 include. The positioning element 50 can also be formed by spiral wound wire elements, in particular coils. The positioning element 50 generally has an increased radial force, so that during the expansion of the positioning element 50 the suction elements 10 spaced from each other. The positioning element 50 can provide such a high radial force that at least one suction arm 101 the suction element 10 within the calculus 41 expanded, with the elastic suction 101 can deform. The penetration of the suction arm 101 into the calculus 41 is possible because the calculus 41 Usually has a deformable structure, the expandable suction 10 diverts in some areas.

At least one suction element 10 can thus be in use within the calculus 41 to be ordered. The suction arm 101 can be in the calculus 41 anchor. It is also possible that the suction arm 101 or the suction 10 an anchoring section 14 having. Preferably, the anchoring portion 14 in a distal region of the suction arm 101 arranged. The anchoring section 14 can in the expanded state of the suction 10 radially in the direction of the calculus 41 be aligned to the concretion 41 to intervene, as in the 10 and 11 shown. The suction arm 101 can over the entire length, especially in the anchoring section 14 , Suction holes 12 exhibit. Preferably, the anchoring portion 14 a distal end 13 open, which is open. The negative pressure is thus also over the distal end 13 the suction arm 101 or of the suction element 10 effective, the distal end 13 within the thrombus or calculus 41 is arranged. The distal end of the suction arm 101 may form a funnel-shaped expansion, such that the effective suction surface of the opening at the distal end 13 is increased.

The anchoring section 14 can be straight radial to the calculus 41 extend into it. Alternatively, the anchoring section 14 be formed wavy or zigzag, as in 11 shown. The anchoring of the suction element 10 , in particular the suction arm 101 , with the calculus 41 is thus improved.

In a further embodiment according to 12 the medical device may be a filter element 60 or have a catch element with the distal end 13 the suction element 10 connected is. The filter element 60 can, in particular analogous to the positioning 50 , a lattice structure, in particular a laser-cut or a braided lattice structure. The filter element 60 can also have a cover 11 having the filter element 60 covered fluid-tight. The cover 11 can pores 122 or have a similar structuring. The filter element 60 is preferably adapted so that from the calculus 41 detaching particles are effectively retained. It is also possible that the filter element 60 a fluid-tight cover 11 comprising, wherein the filter element 60 expanded in the expanded state such that the blood vessel 40 through the blood vessel 60 is sealed. The suction arms 101 may also be at the distal end 13 have an opening, so that the negative pressure, via the suction line 20 and the suction element 10 , in particular the respective one hollow body 110 the suction element 10 forming suction arms 101 is transferred, even in the area of the filter element 60 is effective. About the filter element 60 can be provided in this way an increased suction. Advantageously, the filter element 60 formed substantially umbrella-like and includes a tip 61 in use, centric within the blood vessel 40 is arranged. The summit 61 is advantageously concentric with the catheter 30 or a longitudinal axis of the catheter 30 aligned. This applies to the expanded state of the filter element 60 , Further, the top is 61 preferably oriented such that the tip 61 pointing in the distal direction. The filter element 60 or the catch element supports the expansion of the suction 10 , In particular, the filter element causes 60 that the suction arms 101 , in particular their distal ends 13 , to the vessel wall of the blood vessel 40 invest. The filter element 60 therefore also has an expansion function.

In 13 another embodiment is shown in which the suction 10 is formed substantially tubular. The suction element 10 has several suction extensions 102 on, the brush-like over the circumference and the length of the Saugelements 10 are arranged. The suction processes 102 each have at their end faces or longitudinal end of a suction opening 12 on. Specifically, the suction extensions 102 form tubular elements or tubular extensions. The suction processes 102 can in the compressed state of the suction 10 be substantially flat or aligned mainly in the axial direction. The suction element 10 forms a hollow body 110 at which the suction processes 102 in the compressed state. The hollow body 110 itself can in the compressed state of the suction and in the expanded state of the suction 10 each have the same cross-sectional diameter, so be non-expandable. Alternatively, the hollow body 110 have a smaller cross-sectional diameter in the compressed state than in the expanded state. In the expanded state are the suction extensions 102 with respect to the hollow body 110 radially deflected and extend predominantly brush-like radially starting from the hollow body 110 , In the expanded state of the intake 10 or the suction extensions 102 can the suction extensions 102 in use in the calculus 41 to stretch in, as in the 13 and 14 shown.

14 shows a further variant of the medical device in which the suction 10 Ansaugfortsätze 102 having. In this case, the embodiment corresponds to 14 essentially in accordance with the exemplary embodiment 9 , where the suction arms 101 each suction extensions 102 include, in the expanded state of the suction 10 radially inwardly, in particular in the calculus 41 into, extend. It is possible that the suction extensions 102 not only at their axial ends suction openings 12 but also laterally along its tubular structure suction openings 12 exhibit. Thus, the entire effective suction surface of the suction 10 elevated. In the embodiment according to 14 expands the entire intake 10 , where the suction arms 101 Remove each other in the radial direction. At the same time it can be provided that the suction arms 101 , each one a hollow body 110 form, which are expandable. Further, in the expansion of the suction takes place 10 an expansion or an erection of the Ansaugfortsätze 102 ,

In general, the suction openings 12 or feed openings not only for sucking the concretion 41 be used, but also offer the possibility of medically active agents to the calculus 41 respectively. Such active substances or medicaments can be in particular antithrombogenic substances or coagulation-promoting substances. For example, it may be provided in a first treatment phase, a drug or an active ingredient via the supply openings or suction openings 12 to the calculus 41 to lead. After the delivery of the active ingredient can be at the suction openings 12 or supply openings are applied a negative pressure to the concretion 41 to suck. Alternatively it can be provided, medicinal substances to the suction openings 12 lead to a thrombogenic effect. In this way, the connection between the calculus 41 and the suction element 10 or contact element to be strengthened. In particular, in this way a biochemical reaction between the calculus 41 and the suction element 10 or contact element can be achieved, so that an improved adhesion of the calculus 41 , in particular a thrombus, to the suction element 10 or contact element is ensured. It is advantageous if a metering device is provided for supplying the medically active substances. Such a metering device may be, for example, a syringe. In particular, in the supply of thrombogenic substances can be ensured in this way that the thrombogenic agent does not have the suction openings 12 directly into the blood vessel 40 is initiated. Rather, it is achieved that the suction openings 12 are wetted with the thrombogenic agent to promote adherence of the thrombus. The above applies to all embodiments in the application.

For all embodiments, that the suction 10 , the suction line extension 21 , the positioning element 50 and / or the filter element 60 May include marker elements that provide increased radiopacity. In this way, the position of the individual elements, in particular of the suction, the Saugleitungsfortsatzes 21 , the positioning element 50 and / or the filter element 60 be checked in use. Particularly preferred is the use of marker elements in the region of the suction element 10 or the intake arms 101 to get the correct position of the suction ports 12 to control. Thus it can be seen when the suction openings 12 not the calculus 41 are positioned facing. By rotation or torsion of the suction line 20 or a guide wire, with the suction 10 The user can externally check the position of the suction openings 12 correct. The X-ray-visible marker elements provide the user with direct feedback on the current position of the suction openings 12 , Advantageously, it is therefore provided that in the region of the suction openings 12 Marker elements are arranged.

The suction line 20 may include a plastic. In particular, the suction line 20 be formed by a plastic tube. This also applies to the suction line extensions 21 , Preferred plastics are polyurethane, polytetrafluoroethylene, silicone or the like. It is possible that the suction line 20 and / or the suction line extensions 21 through a support structure 16 comprising a braid and / or spirally wound wire elements, in particular coils, are reinforced. The suction arms 101 can be used as an extension of the hoses of the suction line extensions 21 are formed and lateral openings, in particular suction openings 12 , include.

In the embodiments according to 10 and 11 , where anchoring sections 14 into the calculus 41 extend into it, at least 5, in particular at least 10, in particular at least 50, in particular at least 100, suction arms 101 or anchoring sections 14 be provided with a common suction line 20 connected, in particular fluidly connected, are. When the suction arms 101 laterally along a concrement 41 should extend, as in the embodiments according to 8th . 9 and 12 is a number of at least 2, in particular at least 3, in particular at least 5, in particular at least 10, suction arms 101 advantageous.

The suction line extension 21 and / or the suction element 10 preferably has an inner diameter of at most 0.7 mm, in particular at most 0.5 mm, in particular at most 0.3 mm, in particular at most 0.1 mm. The through the suction openings 12 Total provided suction surface, so the total area of all suction openings 12 , is preferably at least 0.5 mm ² , in particular at least 1.0 mm ² , in particular at least 5 mm ² , in particular at least 10 mm ² , in particular at least 50 mm ² , in particular at least 100 mm ² , in particular at least 200 mm ² .

LIST OF REFERENCE NUMBERS

10

suction

11

cover

12

suction opening

13

distal end

14

anchoring section

15

free longitudinal edge

16

support structure

20

suction

21

Saugleitungsfortsatz

25

suction area

26

Rekanalisationsbereich

27

displacement area

30

catheter

40

blood vessel

41

concretion

50

positioning element

51

annular element

52

conical shape

60

filter element

61

top

101

suction arm

102

Ansaugfortsatz

110

hollow body

121

gap

122

pore

QUOTES INCLUDE IN THE DESCRIPTION

This list of the documents listed by the applicant has been generated automatically and is included solely for the better information of the reader. The list is not part of the German patent or utility model application. The DPMA assumes no liability for any errors or omissions.

Cited patent literature

• WO 2006/031410 A2 [0001, 0004]

Claims (18)

Medical device for removing concrements ( 41 ) from hollow organs of the body with a catheter ( 30 ), which has a suction line ( 20 ), and at least one suction element ( 10 ), which is convertible from a compressed state to an expanded state, wherein the suction element ( 10 ) with a distal end of the suction line ( 20 ), which is at least partially longitudinally displaceable within the catheter ( 30 ), characterized in that the suction line ( 20 ) with the suction element ( 10 ) is fluid-tightly connected, wherein the suction element ( 10 ) at least in the expanded state a hollow body ( 110 ) forms and at least partially a fluid-tight cover ( 11 ) and at least one radially inwardly directed suction opening ( 12 ) which in use is a calculus ( 41 ) is such that the calculus ( 41 ) through one via the suction line ( 20 ) and the suction element ( 10 ) transmissible negative pressure laterally with the intake element ( 10 ) is connectable. Device according to claim 1, characterized in that the suction element ( 10 ) a distal end ( 13 ), which is closed in a fluid-tight manner. Device according to claim 1 or 2, characterized in that the suction element ( 10 ) is substantially tubular in the expanded state. Device according to claim 3, characterized in that the suction element ( 10 ) in the expanded state substantially rectilinearly parallel to the catheter ( 30 ) is aligned. Device according to claim 3, characterized in that the suction element ( 10 ) in the expanded state is wave-shaped and / or spirally formed. Device according to one of claims 1 to 5, characterized in that the suction opening ( 12 ) in the expanded state of the intake element ( 10 ) a gap ( 121 ) formed by two free longitudinal edges ( 15 ) of the suction element ( 10 ) is limited. Device according to one of claims 1 to 6, characterized in that the suction element ( 10 ) several suction openings ( 12 ), which in the expanded state of the suction ( 10 ) substantially pore-like on the circumference of the suction element ( 10 ) are arranged distributed. Device according to one of claims 1 to 7, characterized in that the suction element ( 10 ) at least two, in particular three, suction arms ( 101 ), which with a common suction line ( 20 ) and spaced apart in the expanded state are such that the suction ( 10 ) the calculus ( 41 ) tentakelartig or krakenartig encompasses. Device according to one of claims 1 to 8, characterized in that at least one positioning element ( 50 ) is provided, which with the suction ( 10 ) and / or the suction line ( 20 ) is connected and can be converted from a compressed state to an expanded state such that the suction element ( 10 ) in the expanded state laterally next to a calculus ( 41 ) can be arranged. Device according to claim 8, characterized in that the positioning element ( 50 ) in the expanded state an annular element ( 51 ), which is substantially tangential to the suction element ( 10 ), wherein the annular element ( 51 ) has a cross-sectional diameter which is greater than the cross-sectional diameter of the intake element ( 10 ) is in the expanded state. Device according to claim 8, characterized in that the positioning element ( 50 ) in the expanded state a conical shape ( 52 ), which between several Saugleitungsfortsätzen ( 21 ) of the suction line ( 20 ) and / or suction arms ( 101 ) of the suction element ( 10 ) is stretched. Device according to one of claims 1 to 10, characterized in that the suction element ( 10 ) and / or the positioning element ( 50 ) at least in sections a net-like support structure ( 16 ), in particular a grid mesh or a laser-cut grid structure. Apparatus according to claim 11, characterized in that the reticulated support structure ( 16 ) has a coating which forms the cover. Device according to one of claims 1 to 12, characterized in that a filter element ( 60 ), which can be converted from a compressed state into an expanded state and with the distal end (FIG. 13 ) of the suction element ( 10 ) connected is. Device according to claim 13, characterized in that the filter element ( 60 ) is umbrella-shaped in the expanded state and a tip ( 61 ) substantially concentric with the catheter ( 30 ) is aligned. Device according to at least one of claims 1 to 15, characterized in that the suction element ( 10 ) in the expanded state a flattened, in particular oval, cross-sectional contour having the suction opening ( 12 ) in a flat side of the suction element ( 10 ) is trained. Medical device for treating concrements ( 41 ) in hollow organs of the body with a catheter ( 30 ), which comprises a supply line, and at least one contact element, which is convertible from a compressed state to an expanded state, wherein the contact element with a distal end of the supply line is fluidly connected, at least partially longitudinally displaceable within the catheter ( 30 ) is guided, wherein the contact element in the expanded state, a hollow body ( 110 ) with radially inwardly directed feed openings which, in use, have a concretion ( 41 ) are such that medicinal active substances laterally to the concretion ( 41 ) can be brought, wherein in the hollow body ( 110 ) of the contact element, a pressure other than outside the hollow body is adjustable. Medical device according to claim 17, characterized in that in the hollow body ( 110 ) of the contact element is an overpressure adjustable.

Images