U.S. patent application number 13/867680 was filed with the patent office on 2013-09-12 for embolic coils.
The applicant listed for this patent is Christopher J. Elliott, Patrick G. O'Connor. Invention is credited to Christopher J. Elliott, Patrick G. O'Connor.
Application Number | 20130238012 13/867680 |
Document ID | / |
Family ID | 36062500 |
Filed Date | 2013-09-12 |
United States Patent
Application |
20130238012 |
Kind Code |
A1 |
Elliott; Christopher J. ; et
al. |
September 12, 2013 |
EMBOLIC COILS
Abstract
Embolic coils, as well as related methods, devices, and
compositions, are disclosed.
Inventors: |
Elliott; Christopher J.;
(Hopkinton, MA) ; O'Connor; Patrick G.; (Mallow,
IE) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Elliott; Christopher J.
O'Connor; Patrick G. |
Hopkinton
Mallow |
MA |
US
IE |
|
|
Family ID: |
36062500 |
Appl. No.: |
13/867680 |
Filed: |
April 22, 2013 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
11000741 |
Dec 1, 2004 |
8425550 |
|
|
13867680 |
|
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Current U.S.
Class: |
606/200 |
Current CPC
Class: |
A61B 17/12113 20130101;
A61B 17/1215 20130101; A61B 17/12145 20130101; A61B 17/12022
20130101 |
Class at
Publication: |
606/200 |
International
Class: |
A61B 17/12 20060101
A61B017/12 |
Claims
1.-30. (canceled)
31. An embolic coil including a wire comprising a plurality of
adjacent windings, the embolic coil having a primary structure
including first and second regions defined by first and second
outer diameters, respectively, wherein the first region includes a
fiber while the second region lacks fibers.
32. The embolic coil of claim 31, wherein an intermediate region
having one or more outer diameters between the first and second
outer diameters is interposed between the first and second regions,
the intermediate region lacking fibers.
33. The embolic coil of claim 32, wherein the embolic coil
comprises a plurality of repeating segments, each segment having
the following structure: first region, intermediate region, second
region, intermediate region.
34. The embolic coil of claim 33, wherein each of the first and
second regions comprise two adjacent coils.
35. The embolic coil of claim 33, wherein the second outer diameter
is greater than the first outer diameter.
36. The embolic coil of claim 31, wherein he first outer diameter
is at most about 0.025 inches.
37. The embolic coil of claim 31, wherein the second outer diameter
is at most about 0.03 inches.
38. The embolic coil of claim 31, wherein the second diameter is
not more than twice the first diameter.
39. The embolic coil of claim 31, wherein a ratio of the second
diameter to the first diameter is about 1.01 to 1.
40. The embolic coil of claim 31, wherein a pitch between windings
of the first region is less than a pitch between windings of the
second region.
41. The embolic coil of claim 31 having, a secondary structure
selected from the group consisting of J-shaped, diamond shaped,
vortex-shaped, and spiral-shaped.
42. An embolic coil having a primary structure comprising a
plurality of repeating segments, each segment including a first
portion with a first outer diameter and a second portion with a
second outer diameter greater than the first outer diameter, each
segment including a fiber disposed only in the first portion.
43. The embolic coil of claim 41 having a secondary structure
selected from the group consisting of J-shaped, vortex-shaped,
diamond-shaped and spiral-shaped.
44. A method of delivering an embolic coil to a body of a patient,
the method comprising: providing a delivery catheter having a lumen
loaded with an embolic coil, the embolic coil comprising a
plurality of repeating segments, each segment including a first
portion having a first outer diameter and including a
thrombosis-promoting material, and a second portion having a second
outer diameter greater than the first outer diameter, wherein the
thrombosis-promoting, material is concentrated in pockets defined
by the first and second portions when the embolic coil is within
the lumen; inserting the delivery catheter into a body of a
patient; and expelling the embolic coil from the lumen into the
body of the patient.
45. The method of claim 44, wherein the thrombosis-promoting
material is a fiber.
Description
TECHNICAL FIELD
[0001] The invention relates to embolic coils, as well as related
methods, devices, and compositions.
BACKGROUND
[0002] Therapeutic vascular occlusions (embolizations) are used to
prevent or treat pathological conditions in situ. Embolic coils can
be used to occlude vessels in a variety of medical applications.
Delivery of embolic coils (e.g., through a catheter) can depend on
the size and/or shape of the coils. Some embolic coils include
fibers that can, for example, enhance thrombosis at a treatment
site.
SUMMARY
[0003] In one aspect, the invention features an embolic coil that
includes a wire having a primary shape with a first outer diameter
and a second outer diameter that is smaller than the first outer
diameter. The embolic coil is configured to fit within the lumen of
a subject.
[0004] In another aspect, the invention features a method of making
an embolic coil, the method including forming a wire into a primary
shape with a first outer diameter and a second outer diameter that
is smaller than the first outer diameter to form the embolic
coil.
[0005] In another aspect, the invention features a medical device
that includes a tubular body (e.g., a catheter) with a lumen, and
at least one embolic coil (e.g., multiple, embolic coils) disposed
within the lumen. The embolic coil includes a Wire that has a
primary shape with a first outer diameter and a second outer
diameter that is smaller than the first outer diameter.
[0006] In another aspect, the invention features a method that
includes administering at least one embolic coil (e.g., multiple
embolic coils) to a subject. The embolic coil includes a wire that
has a primary shape with a first outer diameter and a second outer
diameter that is smaller than the first outer diameter.
[0007] In another aspect, the invention features a method of using
a medical device that includes a tubular body (e.g., a catheter)
with a lumen, and at least one embolic coil (e.g., multiple embolic
coils) disposed within the lumen. The embolic coil includes a wire
that has a primary shape with a first outer diameter and a second
outer diameter that is smaller than the first outer diameter. The
method includes inserting the tubular body into the lumen of a
subject, and delivering the embolic coil into the lumen of the
subject.
[0008] Embodiments may also include one or more of the
following.
[0009] The embolic coil can have an effective column strength of
from 0.005 pound to about 0.05 pound.
[0010] The first outer diameter can be at most about 0.03 inch
(e.g., from about 0.014 inch to about 0.016 inch), and/or the
second outer diameter can be at most about 0.025 inch (e.g., from
about 0.012 inch to about 0.013 inch). In some embodiments, the
difference between the first outer diameter and the second outer
diameter can be at most about 0.024 inch (e.g., from 0.001 inch to
0.004 inch). In certain embodiments, the ratio of the first outer
diameter to the second outer diameter can be at least about 1.05:1,
and/or at most about 1.5:1. For example, the ratio of the first
outer diameter to the second outer diameter can be from about
1.05:1 to about 1.5:1.
[0011] In some embodiments, a region of the wire that has the first
outer diameter can have a length of at most about 35 centimeters.
In certain embodiments, a region of the wire that has the second
outer diameter can have a length of at most about 10 millimeters
(e.g., at most about five millimeters).
[0012] The wire can have a diameter of from 0.001 inch to 0.005
inch (e.g., 0.003 inch), and/or a restrained length of at most
about 250 inches. The wire in its primary shape can have a length
that is at least about 20 centimeters. The wire can include a metal
(e.g., platinum). The wire can have a secondary shape, such as a J,
a diamond, a vortex, or a spiral.
[0013] The embolic coil can include at least one fiber that is
attached (e.g., tied) to the wire (e.g., to a region of the wire
that has the second outer diameter). The fiber can include
polyethylene terephthalate and/or nylon. In certain embodiments,
the fiber can have a length of from about 0.5 millimeter to about
five millimeters.
[0014] Forming a wire into a primary shape can include applying a
temperature of about 25.degree. C. to the wire and/or winding the
wire around a mandrel. The mandrel can have a third outer diameter
and a fourth outer diameter that is smaller than the third outer
diameter. In some embodiments, the third outer diameter can be at
most about 0.03 inch. In certain embodiments, the fourth outer
diameter can be at most about 0.025 inch. The mandrel can include
stainless steel. The mandrel can have a lubricious coating (e.g.,
including polytetrafluoroethylene). The mandrel can include a
shape-memory material. In some embodiments, the mandrel can be
formed of an erodible or dissolvable material (e.g., an erodible or
dissolvable polymer, metal, or metal alloy). In certain
embodiments, the mandrel can be hollow.
[0015] The method can further include attaching (e.g., bonding) at
least one fiber to the wire (e.g., to a region of the wire having
the second outer diameter). In some embodiments, the fiber can be
attached to the wire by compressing the fiber between a first
winding of the wire and a second winding of the wire. In certain
embodiments, the fiber can be adhesive bonded to the wire.
[0016] Forming a wire into a primary shape can include applying a
first tension to the wire to wind a first region of the wire around
a mandrel, and applying a second tension to the wire to wind a
second region of the wire around the mandrel. The second tension
can be greater than the first tension. In some embodiments, the
first tension can be from about four grams to about 80 grams (e.g.,
from about 10 grams to about 80 grams, from about 25 grams to about
29 grams). In certain embodiments, the second tension can be from
about 15 grams to about 100 grams (e.g., from about 30 grams to
about 40 grams). The difference between the second tension and the
first tension can be from about five grams to about 90 grams.
[0017] The method can further include forming the wire into a
secondary shape (e.g., a J, a diamond, a vortex, or a spiral).
Forming the wire into a secondary shape cart include applying a
temperature of about 1100.degree. F. to the wire and/or winding the
wire in its primary shape around a mandrel. The mandrel can be a
stainless steel mandrel. In some embodiments, the mandrel can be
plated with chrome.
[0018] The method can further include combining the embolic coil
with a pharmaceutically acceptable medium.
[0019] The medical device can include a pusher wire. In some
embodiments, the pusher wire can be disposed Within the lumen of
the tubular member or tubular body, and attached to the embolic
coil.
[0020] In some embodiments, the method of administration can be by
a catheter. In certain embodiments, the method of administration
can be by a device that has an internal opening, and that is
configured to fit within a lumen of a subject. The embolic coil can
be disposed within the internal opening of the device.
[0021] The method can further include using a pusher and/or a
saline flush to deliver the embolic coil from the device. In some
embodiments, the method can be used to treat aneurysms,
arteriovenous malformations, traumatic fistulae, tumors, and
combinations thereof. In certain embodiments, the method can
include embolizing a lumen of a subject. In some embodiments, the
embolic coil can be used in a transarterial chemoembolization
procedure. Delivering the embolic coil into the lumen of the
subject can include detaching (e.g., chemically detaching,
electrolytically detaching) the embolic coil from the pusher wire.
The embolic coil can be mechanically detached from the pusher wire.
In some embodiments, the method can further include withdrawing the
embolic coil into the lumen of the tubular body.
[0022] Embodiments can include one or more of the following
advantages.
[0023] In some embodiments, an embolic coil can exhibit relatively
good occlusive properties to when delivered to a location of
interest within a subject. This can, for example, allow the embolic
coil to be used to occlude a vessel (e.g., to embolize a tumor),
treat an aneurysm, treat an arteriovenous malformation, and/or
treat a traumatic fistula.
[0024] In certain embodiments, an embolic coil can have a
relatively low likelihood of sticking to the wall of a delivery
catheter. This can, for example, reduce the possibility of
complications resulting from the embolic coil sticking to the wall
of the delivery catheter when the embolic coil is being delivered
to a location of interest within a subject.
[0025] In some embodiments, an embolic coil can have a relatively
high effective column strength. This can, for example, allow the
embolic coil to be delivered to a location of interest within a
subject even if the embolic coil undergoes seine sticking to the
wall of the delivery catheter during delivery of the embolic
coil.
[0026] In certain embodiments, an embolic coil can have a
relatively low likelihood of sticking to the wall of a delivery
catheter, while also exhibiting relatively good occlusive
properties when delivered to a location of interest within a
subject.
[0027] In some embodiments, an embolic coil can have a relatively
high effective column strength, while also exhibiting relatively
good occlusive properties when delivered to a location of interest
within a subject.
[0028] In certain embodiments, an embolic coil can have a
relatively low likelihood of sticking to the wall of a delivery
catheter, while also having a relatively high effective column
strength, so that even if the embolic coil does stick to the wall
of the delivery catheter, the coil can be pushed to a sufficient
extent to overcome the sticking and deliver the coil from the
catheter.
[0029] In some embodiments, an embolic coil can have a relatively
low likelihood of sticking to the wall of a delivery catheter, a
relatively high effective column strength, and relatively good
occlusive properties when delivered to a location of interest
within a subject.
[0030] Features and advantages are in the description, drawings,
and claims.
DESCRIPTION OF DRAWINGS
[0031] FIG. 1A is a side view of an embodiment of an embolic coil
in a delivery device.
[0032] FIG. 1B is a side view of the embolic coil of FIG. 1A.
[0033] FIGS. 2A-2C illustrate the delivery of an embodiment of an
embolic coil to the site of an aneurysm.
[0034] FIG. 3A is a perspective view of an embodiment of an embolic
coil.
[0035] FIG. 3B is a perspective view of an embodiment of an embolic
coil.
[0036] FIG. 3C is a perspective view of an embodiment of an embolic
coil.
[0037] FIG. 3D is a perspective view of an embodiment of an embolic
coil.
[0038] FIG. 4A is a side view of an embodiment of a process for
forming an embolic coil.
[0039] FIG. 4B is a side view of an embodiment of a mandrel used in
the process shown in FIG. 4A.
[0040] FIG. 5A is a side view of an embodiment of a mandrel.
[0041] FIGS. 5B and 5C are illustrations of an embodiment of a
process for forming an embolic coil using the mandrel of FIG.
5A.
[0042] FIG. 6 is a side view of an embodiment of an embolic
coil.
DETAILED DESCRIPTION
[0043] FIG 1A shows an embolic coil delivery system 8, which
includes a catheter 10 with a lumen 120. An embolic coil 14, formed
out of a wire 16, is disposed within lumen 12. As FIG. 1B shows,
embolic coil 14 includes regions 20 of relatively large outer
diameter and regions 22 of relatively small outer diameter, to
which fibers 24 are attached. Regions 20 have an outer diameter
"OD.sub.20" and a length "L.sub.20", and regions 22 have an outer
diameter "OD.sub.22" and a length "L.sub.22". Because fibers 24 are
attached to wire 16 in regions 22 of relatively snail outer
diameter, embolic coil 14 can be accommodated within lumen 12 of
catheter 10, with a relatively low likelihood of substantial
contact between fibers 24 and wall 26 of lumen 12. This can be
advantageous, for example, because if fibers 24 come into
sufficient contact with wall 26, then fibers 24 can adhere to wall
26, which can complicate the delivery of embolic coil 14 from
catheter 10 to a treatment site.
[0044] In general, the design of embolic coil 14 can result in
embolic coil 14 having a relatively high effective column strength.
The effective column strength of embolic coil 14 is the column
strength (the compression load at which embolic coil 14 will
buckle) of embolic coil 14 when embolic coil 14 is constrained
within lumen 12 of catheter 10. The presence of regions 20 of
relatively large outer diameter in embolic coil 14 can limit the
likelihood that embolic coil 14 will buckle, because outer diameter
"OD.sub.20" of regions 20 can be selected such that regions 20 are
relatively close to wall 26 of catheter 10. Because embolic coil 14
has a relatively high effective column strength, embolic coil 14
can also have good pushability. Thus, even if fibers 24 adhere to
wall 26 of lumen 12, embolic coil 14 may be sufficiently pushable
to overcome the adhesion. Furthermore, an embolic coil with a
relatively high effective column strength can, for example, be less
likely to buckle during deployment from a delivery device than a
comparable embolic coil with a relatively low effective column
strength. In some embodiments (e.g., embodiments in which outer
diameter "OD.sub.20" is about 0.012 inch or about 0.035 inch),
embolic coil 14 can have an effective column strength of at least
0.005 pound (e.g., at least 0.007 pound, at least about 0.01 pound,
at least about 0.03 pound), and/or at most about 0.05 pound (e.g.,
at most about 0.03 pound, at most about 0.01 pound, at most 0.007
pound).
[0045] In general, outer diameter "OD.sub.20", the relatively large
outer diameter, is selected to provide strength to embolic coil 14,
while also allowing embolic coil 14 to fit within lumen 12 of
catheter 10. In some embodiments, outer diameter "OD.sub.20" can be
at most about 0.03 inch. In certain embodiments (e.g., for an
intermediate-sized embolic coil), outer diameter "OD.sub.20" can be
from about 0.014 inch to about 0.016 inch (e.g., from about 0.014
inch to about 0.015 inch), In some embodiments (e.g., for a
relatively small embolic coil), outer diameter "OD.sub.20" can be
at most about 0.01 inch.
[0046] Generally, outer diameter "OD.sub.22", the relatively small
outer diameter, is selected to accommodate fibers 24 and to limit
the amount of contact between fibers 24 and wall 26 of lumen 12. In
certain embodiments, outer diameter "OD.sub.22" can be at most
about 0.025 inch. In some embodiments (e.g., for a relatively large
embolic coil), outer diameter "OD.sub.22" can be from about 0.012
inch to about 0.021 inch (e.g., from about 0.012 inch to about
0.013 inch, from about 0.019 inch to about 0.021 inch). In certain
embodiments (e.g., for an intermediate-sized embolic coil), outer
diameter "OD.sub.22" can be from about 0.01 inch to about 0.012
inch. In some embodiments (e.g., for a relatively small embolic
coil), outer diameter "OD.sub.22" can be from 0.006 inch to 0.008
inch.
[0047] Typically, as the difference between outer diameter
"OD.sub.20" and outer diameter "OD.sub.22" increases, longer fibers
may be accommodated on embolic coil 14. In general, as the
difference between outer diameter "OD.sub.20" and outer diameter
"OD.sub.22" decreases, the likelihood of kinking by embolic coil 14
may decrease. In embodiments, the difference between outer diameter
"OD.sub.20" and outer diameter "OD.sub.22" typically can be at most
about 0.024 inch (e.g., at most about 0.01 inch). For example, the
difference between outer diameter "OD.sub.20" and outer diameter to
"OD.sub.22" can be from 0.001 inch to 0.004 inch (e.g., from 0.001
inch to 0.003 inch).
[0048] Generally, as the ratio of outer diameter "OD.sub.20" to
outer diameter "OD.sub.22" increases, longer fibers may be
accommodated on embolic coil 14. Typically, as the ratio of outer
diameter "OD.sub.20" to outer diameter "OD.sub.22" decreases, the
likelihood of kinking by embolic coil 14 may decrease. In some
embodiments, the ratio of outer diameter "OD.sub.20" to outer
diameter "OD.sub.22" can be at least about 1.05:1 (e.g., at least
about 1.08:1, at least about 1.2:1, at least about 1.25:1, at least
about 1.4:1), and/or at most about 1.5:1 (e.g., at most about
1.4:1, at most about 1.25:1, at most about 1.2:1, at most about
1.08:1). In certain embodiments, the ratio of outer diameter
"OD.sub.20" to outer diameter "OD.sub.22" can be from about 1.05:1
to about 1.5:1 (e.g., from about 1.2:1 to about 1.4:1).
[0049] While lengths "L.sub.20" and "L.sub.22" can generally be
selected as desired, in some embodiments lengths "L.sub.20" and
"L.sub.22" can be selected to achieve certain properties (e.g.,
effective column strength). In general, as the ratio of "L.sub.20"
to "L.sub.22" increases, the effective column strength of embolic
coil 14 increases. Alternatively or additionally, fibers 24 may be
more protected from over-exposure to blood during delivery, thereby
resulting in a decrease in the occurrence of premature thrombosis.
Typically, as the ratio of "L.sub.20" to "L.sub.22" decreases, the
effective column strength of embolic coil 14 can decrease.
Generally, as the difference between "L.sub.20" and "L.sub.22"
increases, the effective column strength of embolic coil 14 can
increase. In general, as the difference between "L.sub.20" and
"L.sub.22" decreases, the effective column strength of embolic coil
14 can decrease.
[0050] In some embodiments, length "L.sub.20" can be at least about
0.4 centimeter (e.g., at least about one centimeter, at least about
two centimeters, at least about five centimeters, at least about 10
centimeters, at least about 20 centimeters, at least about 30
centimeters), and/or at most about 35 centimeters (e.g., at most
about 30 centimeters, at most about 20 centimeters, at most about
10 centimeters, at most about five centimeters, at most about two
centimeters, at most about one centimeter). For example, length
"L.sub.20" can be from about 0.4 centimeter to about 20 centimeters
(e.g., from about one centimeter to about 20 centimeters, from
about five centimeters to about 10 centimeters).
[0051] In certain embodiments, length "L.sub.22" can be at least
about 0.5 millimeter (e.g., at least about one millimeter, at least
about two millimeters, at least about 2.5 millimeters, at least
about three millimeters, at least about four millimeters, at least
about five millimeters, at least about eight millimeters), and/or
at most about 10 millimeters (e.g., at most about eight
millimeters, at most about five millimeters, at most about four
millimeters, at most about three millimeters, at most about 2.5
millimeters, at most about two millimeters, at most about one
millimeter). For example, length "L.sub.22" can be from about one
millimeter to about two millimeters.
[0052] The length of embolic coil 14 when fully extended within
lumen 12 of catheter 10 generally can be selected to allow embolic
coil 14 to fit within a delivery device such as catheter 10. In
some embodiments embolic coil 14 can be relatively long yet still
exhibit good effective column strength so that, for example, even
though embolic coil 14 is long, it is sufficiently stiff to be
delivered with little or no buckling. In some embodiments, a
relatively long embolic coil (which can also exhibit good effective
column strength) can be used instead of multiple shorter embolic
coils. In some instances, using a single relatively long embolic
coil rather than multiple shorter embolic coils can, for example,
reduce the time associated with an embolization procedure, increase
the efficiency of an embolization procedure, and/or reduce the
likelihood of complications associated with an embolization
procedure. In certain embodiments, embolic coil 14 can have a fully
extended length of at least about 0.5 centimeter (e.g., at least
about 2.3 centimeters, at least about five centimeters, at least
about 10 centimeters, at least about 15 centimeters, at least about
20 centimeters, at least about 30 centimeters), and/or at most
about 40 centimeters (e.g., at most about 30 centimeters, at most
about 20 centimeters, at most about 15 centimeters, at most about
10 centimeters, at most about five centimeters, at most about 2.3
centimeters). In certain embodiments, embolic coil 14 can have a
fully extended length of from about 0.5 centimeter to about 40
centimeters (e.g., from about 2.3 centimeters to about 30
centimeters, from about five centimeters to about 25
centimeters).
[0053] As shown in FIG. 1B, embolic coil 14 is formed of windings
of wire 16, such as windings 17 and 19. In general, there is little
to no space between consecutive windings (e.g. windings 17 and 19)
of embolic coil 14. Fibers 24 are tightly fitted between
consecutive windings within regions 22 of embolic coil 14.
[0054] The pitch of an embolic coil is the sum of the thickness of
one winding of wire 16 (e.g., winding 17) and the amount of space
between that winding and a consecutive winding (e.g., winding 19).
In some embodiments, embolic coil 14 can have a pitch of at most
about 0.01 inch (e.g., about 0.003 inch). Because the windings of
embolic coil 14 are flush with each other, the pitch of embolic
coil 14 is equal to the diameter of wire 16.
[0055] The diameter of wire 16 can be selected, for example, based
on the desired properties (e.g., size, strength) and/or
applications of embolic coil 14. In some embodiments, wire 16 can
have a diameter of from 0.001 inch to 0.005 inch (e.g., from 0.0015
inch to 0.005 inch, from 0.002 inch to 0.003 inch, from 0.00225
inch to 0.003 inch). In certain embodiments, wire 16 can have a
diameter of 0.003 inch. In some embodiments (e.g., embodiments in
which embolic coil 14 is used for peripheral vascular
applications), wire 16 can have a diameter of at least about 0.004
inch. In certain embodiments (e.g., embodiments in which embolic
coil 14 is used for neurological applications), wire 16 can have a
diameter of at most about 0.002 inch, Alternatively or
additionally, wire 16 can have a restrained length of at most about
250 inches (e.g., at most about 200 inches, at most about 185
inches, at most about 150 inches, at most about 100 inches, at most
about 50 inches).
[0056] Wire 16 can be fainted of for example, one or more metals or
metal alloys, such as platinum, a platinum alloy (e.g., a
platinum-tungsten alloy), stainless steel, nitinol, and
Elgiloy.RTM. (from Elgiloy Specialty Metals).
[0057] Fibers 24 are typically formed of one or more materials that
can enhance thrombosis (e.g., at a target site). Examples of
materials from which fibers 24 can be made include polyethylene
terephthalate (e.g., Dacron.RTM.), nylon, and collagen. Fibers 24
can have a length of from about 0.5 millimeter to about five
millimeters (e.g., about 2.5 millimeters). In some embodiments, the
length of fibers 24 can be selected so that fibers 24 can fit
within regions 22 of relatively small outer diameter without
bunching up.
[0058] Embolic coils can generally be used in a number of different
applications, such as neurological application and/or peripheral
applications. In some embodiments, embolic coils can be used to
occlude a vessel, and/or to treat an aneurysm (e.g., an
intercranial aneurysm), an arteriovenous malformation (AVM), or a
traumatic fistula. In some embodiments, embolic coils can be used
to embolize a tumor (e.g., a liver tumor). In certain embodiments,
embolic coils can be used in transarterial chemoembolization
(TACE).
[0059] FIGS. 2A-2C show the use of embolic coil 14 to fill and
occlude an aneurysmal sac. FIG. 2A shows embolic coil 14, loaded
into lumen 12 of catheter 10, and a pusher wire 50 disposed outside
of catheter 10. In some embodiments, embolic coil 14 can be
disposed within a carrier fluid (e.g., a saline solution, a
contrast agent, a heparin solution) while embolic coil 14 is within
lumen 12 of catheter 10. In FIG. 2B, catheter 10 is delivered into
a lumen 51 of a subject, and pusher wire 50 is inserted into lumen
12 of catheter 10, such that it contacts embolic coil 14. Pusher
wire 50 is then used to push embolic coil 14 out of catheter 10,
into lumen 51, and toward an aneurysmal sac 52 formed in wall 49 of
lumen 51. FIG. 2C shows embolic coil 14 filling aneurysmal sac 52
after embolic coil 14 has been pushed out of catheter 10 by pusher
wire 50. By filling aneurysmal sac 52, embolic coil 14 helps to
occlude aneurysmal sac 52. This occlusion of aneurysmal sac 52 can
be accelerated by fibers 24, which can enhance thrombosis within
aneurysmal sac 52. An accelerated embolization procedure can
benefit the subject by, for example, reducing exposure time to
fluoroscopy.
[0060] In general, embolic coil 14 has a primary shape and a
secondary shape. Embolic coil 14 exhibits only its primary shape
when embolic coil 14 is fully extended within lumen 12 of catheter
10 (as shown in FIG. 1A). As embolic coil 14 exits catheter 10,
however, embolic coil 14 further assumes its secondary shape, which
allows embolic coil 14 to fill aneurysmal sac 52. Typically, the
primary shape of embolic coil 14 is selected for deliverability,
and the secondary shape of embolic coil 14 is selected for
application (e.g., embolization of an aneurysm).
[0061] As FIGS. 3A-3D illustrate, an embolic coil can have any of a
number of different secondary shapes, which can depend on the
particular application for the embolic coil. For example, FIG. 3A
shows an embolic coil 100 with a spiral secondary shape, which can
be used, for example, to provide a supportive framework along a
vessel wall. Alternatively or additionally, an embolic coil with a
spiral secondary shape can be used to hold other embolic coils that
are subsequently delivered to the target site. FIG. 3B shows an
embolic coil 110 with a vortex secondary shape, which can be used,
for example, to close the center of a target site (e.g., a vessel
or an aneurysm) that is to be occluded, and/or to occlude a target
site in conjunction with an embolic coil such as embolic coil 100
(FIG. 3A). As shown in FIG. 3C, an embolic coil 120 can have a
diamond secondary shape, which, like the vortex secondary shape,
can used, for example, to close the center of a target site (e.g.,
a vessel or an aneurysm) that is to be occluded, and/or to occlude
a target site in conjunction with an embolic coil such as embolic
coil 100 (FIG. 3A). FIG. 3D shows an embolic coil 130 with a
secondary shape in the form of a J, which can be used, for example,
to fill remaining space in an aneurysm that was not filled by other
coils. In some embodiments, an operator (e.g., a physician) can
hook the curved portion of embolic coil 130 into a coil or coil
mass that has already been deployed at a target site, and then
shape the straighter portion of coil 130 to fill the target
site.
[0062] FIG. 4A illustrates a process for forming an embolic coil
(e.g., embolic coil 14) in its primary shape, and FIGS. 5A-5C show
a process for forming the secondary shape of the embolic coil.
[0063] As shown in FIG. 4A, a coil-forming apparatus 200 includes a
mandrel 210 held by two rotatable chucks 220 and 230. A spool 240
of wire 250 is disposed above mandrel 210, and is attached to a
moving device 260. To form an embolic coil in its primary shape,
chucks 220 and 230 are activated so that they rotate in the
direction of arrows A2 and A3, thereby rotating mandrel 210. Moving
device 260 also is activated, and moves spool 240 in the direction
of arrow A1. The rotation of mandrel 210 pulls wire 250 from spool
240 at a predetermined pull-off angle, and causes wire 250 to wrap
around mandrel 210. As FIG. 4A shows, the pull-off angle (.alpha.)
is the angle between axis PA1, which is perpendicular to
longitudinal axis LA1 of mandrel 210, and the portion 280 of wire
250 between spool 240 and coil 270. In some embodiments, .alpha.
can be from about one degree to about six degrees (e.g., from about
1.5 degrees to about five degrees, from about 1.5 degrees to about
2.5 degrees, about two degrees). In certain embodiments, a
controller (e.g., a programmable logic controller) can be used to
maintain the pull-off angle in coil-firming apparatus 200. Because
mandrel 210 is rotating as it is pulling wire 250 from spool 240,
and because moving device 260 is moving spool 240 in the direction
of arrow A1, wire 250 forms a coil 270 in a primary shape around
mandrel 210. Coil 270 can be formed, for example, at room
temperature (25.degree. C.).
[0064] Mandrel 210, also shown in FIG. 4B, has regions 212 of
relatively small outer diameter "OD.sub.212" with a length
"L.sub.212", and regions 214 of relatively large outer diameter
"OD.sub.214" with a length "L.sub.214". Because coil 270 is formed
by wrapping wire 250 around mandrel 210, coil 270 has regions of
relatively small outer diameter and regions of relatively large
outer diameter that correspond to regions 212 and 214 of mandrel
210.
[0065] After coil 270 has been formed, chucks 220 and 230, and
moving device 260, are deactivated, and portion 280 of wire 250.
Mandrel 210 is then released from chuck 220, and coil 270 is pulled
off of mandrel 210. In some embodiments, mandrel 210 can be coated
with a lubricious coating (e.g., polytetrafluoroethylene, such as
Teflon.RTM.) in one or more sections in order to aid in the removal
of coil 270 (e.g., to reduce friction and/or snagging). In certain
embodiments, the middle section of mandrel 210 is coated, while the
ends of mandrel 210 remained uncoated. In some embodiments, mandrel
210 can be hollow, such that after coil 270 has been formed on
mandrel 210, pressure can be applied to mandrel 210, causing
mandrel 210 to collapse, and thereby making it easier to pull coil
270 off of mandrel 210. Alternatively or additionally, mandrel 210
may be formed of a shape-memory material, such that the size of
mandrel 210 can be decreased by cooling mandrel 210. In some such
embodiments, mandrel 210 can be cooled prior to removal of coil
270, thereby making it easier to remove coil 270 from mandrel 210.
In certain embodiments, mandrel 210 can be formed of an erodible or
dissolvable material (e.g., an erodible or dissolvable polymer,
metal, or metal alloy). In some such embodiments, after coil 270
has been formed, mandrel 210 can be eroded or dissolved (e.g., by
applying an eroding or dissolving agent to mandrel 210), leaving
coil 270.
[0066] While coil 270 might lose some of its primary shape as it is
pulled off of mandrel 210, coil 270 can generally return to its
primary shape shortly thereafter, because of memory imparted to
coil 270 during formation. In some embodiments, after coil 270 has
been removed from mandrel 210, one or both of the ends of coil 270
can be heated and melted to form rounder, more biocompatible (e.g.,
atraumatic) ends.
[0067] In some embodiments, outer diameter "OD.sub.212," of regions
212 of relatively small outer diameter can be at most about 0.025
inch (e.g., from about 0.012 inch to about 0.013 inch).
Alternatively or additionally, length "L.sub.212" of regions 212 of
relatively small outer diameter can be at most about five
millimeters.
[0068] In certain embodiments, outer diameter "OD.sub.214" of
regions 214 of relatively large outer diameter can be at most about
0.03 inch (e.g., about 0.015 inch). Alternatively or additionally,
length "L.sub.214" of regions 214 of relatively large outer
diameter can be at most about 35 centimeters.
[0069] In some embodiments, the difference between outer diameter
"OD.sub.214" and outer diameter OD.sub.212'' can be at most about
0.024 inch (e.g., 0.003 inch). Alternatively or additionally, the
ratio of outer diameter "OD.sub.214" to outer diameter "OD.sub.212"
can be from about 1.05:1 to about 1.5:1 (e.g., from about 1.2:1 to
about 1.4:1).
[0070] Mandrel 210 can be formed of, for example, a metal or a
metal alloy, such as stainless steel. In some embodiments, mandrel
210 can be formed of one or more polymers, Such as Teflon.RTM.
(polytetrafluoroethylene) or Delrin.RTM. (polyoxymethylene). As
described above, in some embodiments, mandrel 210 can be formed of
a shape-memory material. An example of a shape memory material is
Nitinol.
[0071] Mandrel 210 can be formed, for example, by a wire extrusion
process. In certain embodiments, mandrel 210 can be formed by
grinding the mandrel material into the shape of mandrel 210 (e.g.,
using a centerless grind). In some embodiments, mandrel 210 can be
formed by using a lathe and/or laser to cut or ablate sections of
the mandrel material (e.g., to form regions 212 of relatively small
outer diameter). Alternatively or additionally, mandrel 210 can be
formed by etching the mandrel material (e.g., using photochemical
etching). In certain embodiments, mandrel 210 can be formed by
polymeric or metal injection molding.
[0072] While mandrel 210 is shown as having relatively sharp edges
211, in some embodiments, mandrel 210 can have, relatively rounded
edges.
[0073] The tension of mandrel 210 as it is held between chucks 220
and 230 preferably is sufficiently high to avoid vibration of
mandrel 210 during the winding process, and sufficiently low to
avoid stretching of mandrel 210 during the winding process. In some
instances, significant stretching of mandrel 210 during the winding
process could cause coil 270 to have a smaller primary shape than
desired, and/or could make it relatively difficult to remove coil
270 from mandrel 210. In embodiments, the tension of mandrel 210
can be from about 100 grams to about 1,000 grams (e.g., from about
300 grams to about 600 grams, from about 400 grams to about 500
grams). For example, the tension of mandrel 210 can be about 506
grams.
[0074] Wire 250 typically can be wound around mandrel 210 at a
tension of from about 10 grams to about 100 grams (e.g., from about
four grams to about 50 grams, from about six grams to about 40
grams, from about 22 grams to about 32 grams, about 27 grams).
[0075] In embodiments, the length of coil 270 in its primary shape
and while under tension on mandrel 210 can be from about 10
centimeters to about 250 centimeters (e.g., from about 50
centimeters to about 200 centimeters, from about 130 centimeters to
about 170 centimeters, from about 144 centimeters to about 153
centimeters, from about 147 centimeters to about 153 centimeters).
For example, the length of coil 270 in its primary shape and while
under tension on mandrel 210 can be about 132 centimeters or about
147 centimeters. Coil 270 may recoil to some extent (e.g., by at
most about five centimeters) when portion 280 of wire 250 is
severed, such that coil 270 will be somewhat smaller once it has
been removed from mandrel 210. In embodiments, coil 270 can have a
length of from about five centimeters to about 225 centimeters
(e.g., from about 25 centimeters to about 170 centimeters, from
about 120 centimeters to about 140 centimeters, from about 137
centimeters to about 140 centimeters) after being removed from
mandrel 210. After coil 270 has been removed from mandrel 210, coil
270 can be cut into smaller coils.
[0076] Once coil 270 has been formed in its primary shape, coil 270
can be further shaped into a secondary shape, as shown in FIGS,
5A-5C.
[0077] FIG. 5A shows a mandrel 310 used to form the secondary shape
of coil 270. While is mandrel 310 is shaped to form a diamond,
other types of mandrels can be used to form other secondary shapes.
Mandrel 310 is formed of a diamond-shaped block 320 with grooves
330 cut into its surface. As shown in FIGS. 5B and 5C, primary coil
270 is wrapped around mandrel 310, such that coil 270 fills grooves
330, creating the secondary shape. The ends of coil 270 are then
attached (e.g., pinned) to mandrel 310, and coil 270 is
heat-treated at a temperature of from about 100.degree. F. to about
2000.degree. F. (e.g., from about 500.degree. F. to about
1500.degree. F., from about 1010.degree. F. to about 1125.degree.
F.) to impart memory to coil 270. For example, coil 270 can be
heat-treated at a temperature of about 1100.degree. F. In some
embodiments, the heat treatment of coil 270 can last for a period
of from about 10 minutes to about 40 minutes (e.g., about 25
minutes). After being heat-treated, coil 270 is unwrapped from
mandrel 310. The removal of coil 270 from mandrel 310 allows coil
270 to reassume its secondary shape. In some embodiments, after
coil 270 has been removed from mandrel 310, one or both of the ends
of coil 270 can be heated and melted to form rounder, more
biocompatible (e.g., atraumatic) ends.
[0078] Mandrel 310 can be formed from, for example, a metal such as
stainless steel. In some embodiments, mandrel 310 can be formed of
a plated metal (e.g., chrome-plated stainless steel).
[0079] After coil 270 has been removed from mandrel 310, fibers can
be attached to coil 270. In some embodiments, coil 270 is stretched
prior to attaching fibers, so that coil 270 is in its extended
primary shape, and is then loaded onto a fibering mandrel (e.g., a
fibering mandrel from Sematool Mold and Die Co., Santa Clara,
Calif.). In some embodiments, fibers can be tied to wire 250 and/or
wrapped around wire 250. In certain embodiments, fibers can be
snapped in between windings of wire 250 of coil 270. Alternatively
or additionally, fibers can be bonded (e.g., adhesive bonded) to
wire 250 of coil 270.
[0080] While certain embodiments have been described, the invention
is not so limited.
[0081] As an example, in some embodiments, a coil with a primary
shape having regions of relatively small outer diameter and regions
of relatively large diameter can be formed by winding a wire around
a mandrel with a constant diameter, and varying the tension that is
applied to the to wire. For example, a tension of from about 10
grams to about 100 grams (e.g., from about six grams to about 50
grams, from about 30 grams to about 40 grams) can be applied to
form regions of relatively small outer diameter, and a tension of
from about four grains to about 80 grams (e.g., from about four
grams to about 40 grams, from about 25 grams to about 29 grams) can
be applied to form regions of relatively large outer diameter. In
certain embodiments, the difference between the tension used to
form regions of relatively small outer diameter and the tension
used to form regions of relatively large outer diameter can be from
about five grams to about 90 grams (e.g., from about 20 grams to
about 80 grams, from about 30 grams to about 50 grams),
[0082] As another example, while embodiments have been described in
which an embolic coil has two different outer diameters, in certain
embodiments, an embolic coil can have more than two (e.g., three,
four, five, 10, 15, 20) different outer diameters. For example, an
embolic coil can have regions of relatively small outer diameter,
regions of intermediate outer diameter, and regions of relatively
large outer diameter.
[0083] As an additional example, while embodiments have been
described in which regions of an embolic coil that have the same
outer diameter also have the same length, regions of an embolic
coil that have the same outer diameter need not have the same
length. For example, an embolic coil Can have regions of relatively
small outer diameter that have varying lengths. Alternatively or
additionally, the embolic coil can have regions of relatively large
outer diameter that have varying lengths.
[0084] As a further example, in some embodiments, consecutive
windings of an embolic coil can have a space between them of at
most about 0.01 inch (e.g., at most about 0.005 inch, from about
0.001 inch to about 0.005 inch). The space between consecutive
windings in an embolic coil can be used, for example, to
accommodate a material that enhances thrombosis, such as fibers
that enhance thrombosis.
[0085] As another example, while embodiments have been described in
which the pitch of an embolic coil is substantially the same in
different regions of the embolic coil, in certain embodiments, the
pitch of an embolic coil can differ in different regions of the
embolic coil. For example, some regions of an embolic coil can have
a pitch of 0.003 inch, while other regions of an embolic coil can
have a pitch of 0.004 inch. In some embodiments, an embolic coil
can have a region of relatively large outer diameter with a
relatively small pitch (e.g., about 0.001 inch), and a region of
relatively small outer diameter with a relatively large pitch
(e.g., about 0.007 inch).
[0086] As a further example, while an embolic coil with two
different outer diameters has been shown, in some embodiments, an
embolic coil can have more than two different outer diameters. For
example, FIG. 6 shows an embolic coil 400, which is formed out of a
wire 402, and which has multiple windings of different outer
diameters. Windings 404 have a relatively small outer diameter
"OD.sub.404", windings 406 have an intermediate outer diameter
"OD.sub.406", and windings 408 have a relatively large outer
diameter "OD.sub.408". Fibers 410 are attached to embolic coil 400
in the area of windings 404.
[0087] As an additional example, while a pushable embolic coil has
been shown, in some embodiments an embolic coil can alternatively
or additionally be a detachable embolic coil. For example, the
embolic coil can be temporarily attached to a pusher wire. The
embolic coil can be, e.g., mechanically detachable and/or
chemically detachable. In some embodiments, the embolic coil can be
electrolytically detachable. In certain embodiments, the embolic
coil can be a Guglielmi Detachable Coil (GDC) or an Interlocking
Detachable Coil (IDC). Detachable embolic coils are described, for
example, in Twyford, Jr. et al,, U.S. Pat. No. 5,304,195, and
Guglielmi et al., U.S. Pat. No. 5,895,385, both of which are hereby
incorporated by reference.
[0088] As a further example, in some embodiments, a saline flush
can be used to deliver an embolic coil from a delivery device. In
certain embodiments, the saline flush can be used in conjunction
with a pusher wire.
[0089] As another example, multiple (e.g., two, three, four)
embolic coils can be delivered using one delivery device.
[0090] As an additional example, in some embodiments, a treatment
site can be occluded by using coils in conjunction with other
occlusive devices. For example, coils can be used with embolic
particles such as those described in Raiser et al,, U.S. Published
Patent Application No. 2003/0185896 A1, and in U.S. Patent
Application Publication No. US 2004/0096662 A1, published on May
20, 2004, both of which are hereby incorporated by reference. In
some embodiments, coils can be used in conjunction with one or more
embolic gels. Embolic gels are described, for example, in U.S.
patent application Ser. No. 10/927,868, tiled on Aug. 27, 2004, and
entitled "Embolization", which is hereby incorporated by
reference,
[0091] Other embodiments are in the claims,
* * * * *