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1. (WO2017040681) THROMBECTOMY DEVICES AND TREATMENT OF ACUTE ISCHEMIC STROKE WITH THROMBUS ENGAGEMENT
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What is claimed is:

1. A filter device comprising a guide structure, an anchor secured at a fixed location on the guide structure having a central axis, a slide positioned over the guide structure, an a filter cartridge secured on one end to the anchor and on the other end to the slide, wherein the filter cartridge comprise a plurality of polymer fibers in a bundle in an un-deployed configuration, and one or more metal elements radially below relative to the central axis the bundle of polymer fibers secured around the guide structure, wherein the metal elements have a deployed configuration with the slide approaching closer to the anchor with the metal elements forming a curved structure extending radially outward, and wherein the device has an un-deployed low profile configuration and an unconstrained deployed configuration with the furthest radial extent of the metal elements being below a mat of fibers.

2. The filter device of claim 1 wherein metal elements comprise three or more unbraided elements.

3. The filter device of claim 1 wherein metal elements comprise braided wires.

4. The filter device of any one of claims 1-3 wherein metal elements comprise three to ten elements with a circumference from about 0.0005 inches (12 microns) to about 0.025 inches (600 microns).

5. The filter device of any one of claims 1-4 wherein filter cartridge further comprises metal wires in the bundle with the polymer fibers from about 1 % to about 10% of the number of strands being metal wire and having a diameter from about 0.0001 inches (2.4 microns) to about 0.002 inches (48 microns).

6. The filter device of any one of claims 1-5 wherein the filter cartridge is self actuating, wherein the metal elements comprise a spring metal with a shape memory that assumes a preselected shape upon release of constraint of the filter cartridge.

7. The filter device of any one of claims 1-5 further comprising an overtube connected to the slide and extending in a proximal direction over the guide structure, wherein relative movement of the overtube and the guide structure transitions the filter cartridge from a low profile delivery configuration to a radially extended deployed configuration.

8. The filter device of claim 7 wherein the overtube comprises a polymer tube.

9. The filter device of any one of claims 1-8 wherein the metal elements have an unconstrained radial extent no more than about 94% of the furthest unconstrained radial extent of the polymer fibers

10. A stent retriever comprising a tether and a self-extending structure extending in a distal direction from the tether, the self-extending structure comprising an open metal frame that extends without constraint into a generally cylindrical shape with a slit along the length of the cylinder and a polymer cover extending around and adhered to the exterior of the open metal frame wherein the polymer cover has a slit along the slit of the metal frame.

11. The stent retriever of claim 10 wherein the tether comprises a metal wire.

12. The stent retriever of claim 10 or claim 11 wherein the open metal frame comprises nitinol.

13. The stent retriever of any one of claims 10-12 wherein the polymer film comprises a spun nanofiber webbing.

14. The stent retriever of any one of claims 10-12 wherein the polymer film comprises expanded polytetrafluoroethylene.

15. The stent retriever of any one of claims 10-14 wherein the self extending structure further comprises a polymer coating along the interior of the metal frame.

16. The stent retriever of any one of claims 10-15 further comprising porous polymer material extending in a distal direction from the metal frame.

17. A treatment device comprising a microcatheter, an extendable atherectomy component secured to the outer surface of the microcatheter, and a sheath slideable over the exterior of the microcatheter, wherein the microcatheter has an outer diameter from about IFr to about 3.5Fr and an inner lumen extending along the length of the catheter, wherein extendable atherectomy component is mounted on the exterior of the microcatheter at or near the distal end of the microcatheter, and wherein the sheath can extend over the extendable atherectomy component in a low profile delivery configuration and has a configuration moved in a proximal direction over the microcatheter with the extendable atherectomy component unconstrained with respect to extend radially outward.

18. The treatment device of claim 17 wherein the atherectomy component is a stent retriever comprises an open metal frame.

19. The atherectomy device of claim 18 wherein the frame is attached to the microcatheter at or near the distal end of the frame.

20. The atherectomy device of claim 18 wherein the frame is attached to the microcatheter at or near the proximal end of the frame.

21. The atherectomy device of claim 18 wherein the frame is attached to the microcatheter at or near the distal end of the frame and at or near the proximal end of the frame.

22. The atherectomy device of any one of claims 17-21 wherein the sheath comprises a handle providing for the manual sliding of the sheath over the microcatheter, the sheath having a position configured to cover an un-extended atherectomy device and a position uncovering the atherectomy device.

23. The atherectomy device of any one of claims 17-22 further comprising a stent loaded in the interior of the microcatheter.

24. A treatment system comprising a guide structure, an atherectomy component connected to the guide structure, a microcatheter comprising a lumen through which the guide structure can slidably move, and a stent mounted on the exterior of the microcatheter near the distal end of the microcatheter.

25. The treatment system of claim 24 wherein the stent is self extending and a sheath slidable engaged with the outer surface of the microcatheter wherein the sheath has a configuration with the sheath extended over the stent in an undeployed configuration and a configuration with the sheath drawn in a relative proximal position relative to the microcatheter with the stent unconstrained with respect to self extension.

26. The treatment system of claim 24 or claim 25 wherein the atherectomy component is self extending and has a stent retriever structure.

27. The treatment system of any one of claims 24-26 further comprising a fiber based filter attached to the guide structure distal to the atherectomy component.

28. A method for the removal of obstructive material from a blood vessel, the method comprising:

deploying a filter device mounted on a guide structure from the lumen of a microcatheter in a blood vessel downstream from an obstruction;

deploying a stent and a atherectomy component in the blood vessel proximal to the position of the deployed embolic protection device using a microcatheter wherein either the stent or the atherectomy device are deployed from the exterior of the microcatheter and the other component is deployed from the interior of the microcatheter; and

performing an atherectomy procedure to disrupt thrombus for removal at the site of the deployed stent with the deployed filter device in place while suction is applied from a proximal position with an aspiration catheter.

29. The method of claim 28 wherein the filter device comprises polymer fibers delivered as an unwoven bundle bound at both ends to supports and metal elements configured radially below the polymer fibers and configured to deploy radially to a position no more than about 80% of the radial extension of the polymer fibers.

30. The method of claim 28 or claim 29 wherein the atherectomy component comprises a stent retriever secured to the exterior of the microcatheter with a sheath covering the stent retriever in a deployment configuration with release from the sheath resulting in self-extension of the stent retriever to deploy the stent retriever.

31. The method of any one of claims 28-30 wherein the stent is self extending.

32. The method of claim 31 wherein the stent is delivered on the surface of the microcatheter covered with a sheath that is withdrawn to release the self extending stent and wherein the atheterectomy device is a stent retriever that is deployed connected to a support structure delivered from the interior of the microcatheter.