U.S. patent application number 17/658263 was filed with the patent office on 2022-07-21 for aneurysm treatment device.
This patent application is currently assigned to DePuy Synthes Products, Inc.. The applicant listed for this patent is DePuy Synthes Products, Inc.. Invention is credited to Lacey GOROCHOW, Juan LORENZO, Ariel SOTO DEL VALLE.
Application Number | 20220225997 17/658263 |
Document ID | / |
Family ID | |
Filed Date | 2022-07-21 |
United States Patent
Application |
20220225997 |
Kind Code |
A1 |
SOTO DEL VALLE; Ariel ; et
al. |
July 21, 2022 |
ANEURYSM TREATMENT DEVICE
Abstract
An implant having an elongated portion and an expandable braided
sack portion can be delivered through a catheter and implanted in
an aneurysm such that elongated portion loops within the braided
sack, the braided sack contacts a majority or all of the aneurysm
wall, and the braided sack at least partially occludes the aneurysm
neck.
Inventors: |
SOTO DEL VALLE; Ariel;
(Miami, FL) ; GOROCHOW; Lacey; (Raynham, MA)
; LORENZO; Juan; (Davie, FL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
DePuy Synthes Products, Inc. |
Raynham |
MA |
US |
|
|
Assignee: |
DePuy Synthes Products,
Inc.
Raynham
MA
|
Appl. No.: |
17/658263 |
Filed: |
April 7, 2022 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
16366235 |
Mar 27, 2019 |
11337706 |
|
|
17658263 |
|
|
|
|
International
Class: |
A61B 17/12 20060101
A61B017/12 |
Claims
1. An implant comprising: an expandable braided sack portion
comprising a free open end; an elongated looping portion joined to
the expandable braided sack portion; and a detachment feature
joined to the elongated looping portion and detachably attached to
a delivery system, wherein the implant is movable from a delivery
configuration sized to traverse through a lumen of a catheter of
the delivery system to an implanted configuration sized to secure
within an aneurysm, wherein in the delivery configuration, the
expandable braided sack portion extends from a distal end of the
implant, the elongated looping portion extends proximally from the
expandable braided sack portion, and the detachment feature is
positioned approximate a proximal end of the implant, wherein in
the delivery configuration, the expandable braided sack portion is
unattached to the delivery system, wherein in the implanted
configuration, the expandable braided sack portion is sized to
contact a majority of an interior wall of the aneurysm, is sized to
contain the elongated looping portion, and is sized to occlude at
least a portion of a neck of the aneurysm, wherein in the implanted
configuration, the free open end is positioned to be placed
approximate the neck, and wherein in the implanted configuration,
the elongated looping portion is sized to wind within the
expandable braided sack portion.
2. The implant of claim 1, wherein, in the delivery configuration,
the implant comprises a fold approximate the distal end of the
implant, the expandable braided sack portion encompasses at least a
portion of the elongated looping portion, and the free open end
encircles the elongated looping portion.
3. The implant of claim 1, wherein, in the delivery configuration,
the free open end is positioned at the distal end of the
implant.
4. The implant of claim 1, wherein, in the implanted configuration,
a fold defining a boundary between the elongated looping portion
and the expandable braided sack portion is positioned to be
implanted approximate a distal surface of the interior aneurysm
wall.
5. The implant of claim 1, wherein the elongated looping portion
and the expandable braided sack portion are portions of a
contiguous tubular braid.
6. The implant of claim 5, wherein, in the implanted configuration,
the elongated looping portion comprises a substantially uniform
circumference along a majority of its length, the length measurable
from the detachment feature to a fold defining a boundary between
the elongated looping portion and the expandable braided sack
portion.
7. The implant of claim 1, wherein the elongated looping portion
comprises an embolic coil, and wherein the expandable braided sack
portion comprises a tubular braid.
8. The implant of claim 1, wherein the implant consists of the
expandable braided sack portion, the elongated looping portion, and
the detachment feature.
9. The implant of claim 1, wherein the detachment feature remains
attached to the delivery system after detachment from the
implant.
10. An implant comprising: an expandable braided sack portion
comprising a free open end; an embolic coil joined to the
expandable braided sack portion by a connecting band; and a
detachment feature joined to the embolic coil and detachably
attached to a delivery system, wherein the implant is movable from
a delivery configuration sized to traverse through a lumen of a
catheter of the delivery system to an implanted configuration sized
to secure within an aneurysm, wherein in the delivery
configuration, the expandable braided sack portion extends from a
distal end of the implant, the embolic coil extends proximally from
the expandable braided sack portion, and the detachment feature is
positioned approximate a proximal end of the implant, wherein in
the delivery configuration, the expandable braided sack portion is
unattached to the delivery system, wherein in the implanted
configuration, the expandable braided sack portion is sized to
contact a majority of an interior wall of the aneurysm, is sized to
contain the embolic coil, and is sized to occlude at least a
portion of a neck of the aneurysm, wherein in the implanted
configuration, the free open end is positioned to be placed
approximate the neck, and wherein in the implanted configuration,
the embolic coil is sized to fit within the expandable braided sack
portion.
11. The implant of claim 10, wherein, in the delivery
configuration, the implant comprises a fold approximate the distal
end of the implant and a fold approximate the connecting band, the
expandable braided sack portion encompasses at least a portion of
the embolic coil, and the free open end encircles the embolic
coil.
12. The implant of claim 10, wherein, in the delivery
configuration, the free open end is positioned at the distal end of
the implant.
13. The implant of claim 10, wherein, in the implanted
configuration, the fold approximate the distal end of the implant
is positioned to be implanted approximate a distal surface of the
interior aneurysm wall.
14. The implant of claim 10, wherein the implant consists of the
expandable braided sack portion, the embolic coil, the connecting
band, and the detachment feature.
15. The implant of claim 10, wherein the detachment feature remains
attached to the delivery system after detachment from the
implant.
16. An implant comprising: an expandable braided sack portion
comprising a free open end; an elongated looping portion joined to
the expandable braided sack portion; and a detachment feature
joined to the elongated looping portion and detachably attached to
a delivery system, wherein the implant is movable from a delivery
configuration sized to traverse through a lumen of a catheter of
the delivery system to an implanted configuration sized to secure
within an aneurysm, wherein in the delivery configuration, the
expandable braided sack portion extends from a distal end of the
implant, the elongated looping portion extends proximally from the
expandable braided sack portion, and the detachment feature is
positioned approximate a proximal end of the implant, wherein in
the delivery configuration, the expandable braided sack portion is
unattached to the delivery system, wherein in the implanted
configuration, the expandable braided sack portion is sized to
contact a majority of an interior wall of the aneurysm, is sized to
contain the elongated looping portion, and is sized to occlude at
least a portion of a neck of the aneurysm, wherein in the implanted
configuration, the free open end is positioned to be placed
approximate the neck, wherein in the implanted configuration, the
elongated looping portion is sized to wind within the expandable
braided sack portion, and wherein in the implanted configuration,
the expandable braided portion is inverted.
17. The implant of claim 16, wherein, in the delivery
configuration, the implant comprises a fold separating the
expandable braided sack portion and the elongated looping
portion.
18. The implant of claim 17, wherein in the implanted
configuration, the fold is positioned near a distal surface of the
aneurysm wall.
19. The implant of claim 16, wherein the elongated looping portion
and the expandable braided sack portion are portions of a
contiguous tubular braid.
20. The implant of claim 16, wherein the elongated looping portion
comprises an embolic coil, and wherein the expandable braided sack
portion comprises a tubular braid.
Description
CROSS REFERENCE TO RELATED APPLICATION
[0001] The present application is a continuation application of
U.S. patent application Ser. No. 16/366,235 filed Mar. 27, 2019,
the entire contents of which are hereby incorporated by
reference.
FIELD OF INVENTION
[0002] The present invention generally relates to medical
instruments, and more particularly, to embolic implants for
aneurysm therapy.
BACKGROUND
[0003] Cranial aneurysms can be complicated and difficult to treat
due to their proximity to critical brain tissues. Prior solutions
have included endovascular treatment whereby an internal volume of
the aneurysm sac is removed or excluded from arterial blood
pressure and flow. Current alternatives to endovascular or other
surgical approaches can include intravascularly delivered treatment
devices that either fill the sac of the aneurysm with embolic
material or block the entrance or neck of the aneurysm. Both
approaches attempt to prevent blood flow into the aneurysm. When
filling an aneurysm sac, the embolic material clots the blood,
creating a thrombotic mass within the aneurysm. When treating the
aneurysm neck, blood flow into the entrance of the aneurysm is
inhibited, inducing venous stasis in the aneurysm and facilitating
a natural formation of a thrombotic mass within the aneurysm.
[0004] Current intravascularly delivered devices typically utilize
multiple embolic coils to either fill the sac or treat the
entrance. Naturally formed thrombotic masses formed by treating the
entrance of the aneurysm with embolic coils can improve healing
compared to aneurysm masses packed with embolic coils by reducing
possible distention from arterial walls and permitting
reintegration into the original parent vessel shape along the neck
plane. However, embolic coils delivered to the neck of the aneurysm
can potentially have the adverse effect of impeding the flow of
blood in the adjoining blood vessel; at the same time, if the
entrance is insufficiently packed, blood flow can persist into the
aneurysm. Treating certain aneurysm morphology (e.g. wide neck,
bifurcation, etc.) can required ancillary devices such a stents or
balloons to support the coil mass and obtain the desired packing
density. Once implanted, the coils cannot easily be retracted or
repositioned. Furthermore, embolic coils do not always effectively
treat aneurysms as aneurysms treated with multiple coils often
recanalize or compact because of poor coiling, lack of coverage
across the aneurysm neck, because of flow, or large aneurysm
size.
[0005] Alternatives to embolic coils are being explored, for
example a tubular braided implant is disclosed in US Patent
Publication Number 20180242979, incorporated herein by reference.
Tubular braided implants have the potential to easily, accurately,
and safely treat an aneurysm or other arterio-venous malformation
in a parent vessel without blocking flow into perforator vessels
communicating with the parent vessel. Compared to embolic coils,
however, tubular braided implants are a newer technology, and there
is therefore capacity for improved geometries, configurations,
delivery systems, etc. for the tubular braided implants.
[0006] There is therefore a need for improved methods, devices, and
systems for implants for aneurysm treatment.
SUMMARY
[0007] It is an object of the present invention to provide systems,
devices, and methods to meet the above-stated needs. Generally, in
examples herein, an implant having an elongated portion and an
expandable braided sack portion can be delivered through a catheter
and implanted in an aneurysm such that elongated portion loops
within the braided sack and the braided sack at least partially
occludes the aneurysm neck.
[0008] An example implant can include an expandable braided sack
portion, an elongated looping portion joined to the braided sack
portion, and a detachment feature joined to the elongated looping
portion. The implant can move from a delivery configuration to an
implanted configuration. In the delivery configuration, the implant
can be sized to be delivered through a lumen of a catheter to a
treatment site, and in the implanted configuration, the implant can
be sized to secure within an aneurysm. In the delivery
configuration, the expandable braided sack portion can extend from
a distal end of the implant, the elongated looping portion can
extend proximally from the expandable braided sack portion, the
detachment feature can be positioned near a proximal end of the
implant, and the detachment feature can be detachably attached to a
delivery system.
[0009] The expandable braided sack portion can be unattached to the
delivery system when the implant is in the delivery configuration,
in the implanted configuration, and throughout the transition from
the delivery configuration to the implanted configuration during
treatment of an aneurysm. In the implanted configuration, the
expandable braided sack portion can be sized to contact a majority
of an interior wall of the aneurysm, can contain the elongated
looping portion, and can occlude some or all of the opening of the
neck of the aneurysm. The expandable braided sack portion can have
a free end, and in the implanted configuration, the free open end
can be positioned at the aneurysm neck. In the implanted
configuration the elongated looping portion can wind within the
expandable braided sack portion.
[0010] In the delivery configuration the implant can have a fold at
its' distal end, the expandable braided sack portion can encompass
some of the elongated looping portion, and the free open end of the
expandable braided sack portion can encircle the elongated looping
portion. In the implanted configuration, a fold can define a
boundary between the elongated looping portion and the expandable
braided sack portion, and the fold can be positioned along a distal
surface of the interior aneurysm wall. the fold at the distal end
of the implant in the delivery configuration can be the same fold
positioned along the distal surface of the aneurysm wall in the
implanted configuration.
[0011] Alternatively, in the delivery configuration, the free open
end can be positioned at the distal end of the implant and the
implant can extend from the free open end at the distal end of the
implant to the detachment feature at the proximal end of the
implant. When the implant configured thusly, exits a catheter and
the braided sack portion enters the aneurysm, a fold can form, and
the fold can be positioned along a distal surface of the interior
aneurysm wall.
[0012] The elongated looping portion and the expandable braided
sack portion can be portions of a contiguous tubular braid. A fold
can define a boundary between the elongated looping portion and the
expandable braided sack portion, and the elongated looping portion
can have a length measurable from the fold to the detachment
feature. The elongated looping portion of the contiguous tubular
braid can have a substantially uniform circumference along most of
its length
[0013] Alternatively, the elongated looping portion can have an
embolic coil and the expandable braided sack portion can be a
tubular braid.
[0014] When the implant is implanted and left in an aneurysm at the
completion of an aneurysm treatment, the implant can include only
the sack portion, the elongated looping portion, and the detachment
feature. The implant need not have any other features such as
additional detachment features or anchoring elements.
[0015] An example method of treating an aneurysm can include one or
more of the following steps presented in no particular order, and
the method can include additional steps not included here. An
implant having an expandable portion and an embolic coiling portion
can be provided. The embolic coiling portion can be detachably
attached to a delivery system. The implant can be positioned within
a microcatheter such that the embolic coiling portion extends
distally from a proximal end of the implant, the expandable portion
extends proximally from the distal end of the implant, and the
expandable portion is unattached to the delivery system. The distal
end of the microcatheter can be positioned near the aneurysm neck.
The implant can be delivered through the microcatheter to the
distal end of the microcatheter. The expandable portion can be
expelled from the distal end of the microcatheter. The expandable
portion can be expanded to contact a majority of the interior wall
of the aneurysm. The embolic coiling portion can be expelled from
the distal end of the microcatheter. The embolic coiling portion
can be placed to wind within the expanded expandable portion. The
embolic coiling portion can be detached from the delivery
system.
[0016] When the implant is positioned in a microcatheter, a fold
can be positioned at the distal end of the implant and the
expandable portion can be positioned to encompass at least a
portion of the embolic coiling portion. Alternatively, when the
implant is positioned in a microcatheter, a free open end of the
implant can be positioned at the distal end of the implant.
[0017] The expandable portion can be anchored to the interior wall
of the aneurysm, and the expandable portion can be placed to
inhibit the embolic coiling portion from exiting a sac of the
aneurysm. The expandable portion can have a free open end, and the
free open end can be positioned at the aneurysm neck. The implant
can be folded to create a fold that defines a boundary between the
expandable portion and the embolic coiling portion. The fold can be
positioned near a distal surface of the interior aneurysm wall.
[0018] When the implant having the expandable portion and the
embolic portion is provided, a contiguous tubular braid can be
provided, and the expandable portion and the embolic portion can be
portions of the contiguous tubular braid. When the embolic coiling
portion of the contiguous braid is placed to wind within the
expanded expandable portion, a substantially uniform circumference
can be maintained along most of the length of the embolic coiling
portion. Alternatively, when the implant having the expandable
portion and the embolic portion is provided, a tubular braid joined
an embolic coil can be provided such that the tubular braid
includes the expandable portion and the embolic coil includes the
embolic portion.
[0019] A detachment feature can be provided and affixed to the
embolic coiling portion. The detachment feature can be detachably
attached to the delivery system. To implant the expandable portion,
embolic coiling portion, and the detachment feature in the
aneurysm, the detachment feature can be detached from the delivery
system. When the detachment feature is detached, only the
expandable portion, embolic coiling portion, and the detachment
feature can remain implanted in the implant.
[0020] Another example method for treating an aneurysm can include
one or more of the following steps presented in no particular
order, and the method can include additional steps not included
here. An implant can be provided having a braided portion and an
embolic portion. The braided portion can include a memory shape
material and can have a spherical or globular predetermined shape.
The embolic portion can be detachably attached to an implant
delivery system. The implant and the delivery system can be
positioned within a lumen of a microcatheter. When the implant and
the delivery system is positioned in the microcatheter, the braided
portion can be collapsed to fit in the lumen and positioned in the
lumen to extend proximally from the distal end of the implant, the
embolic portion can be positioned to extend distally from the
proximal end of the implant, and the delivery system can be
positioned to extend proximally from the embolic portion. The
implant and the delivery system can traverse through the lumen of
the microcatheter while the braided portion is unattached to the
delivery system. The implant can be expelled from the
microcatheter. When the implant is expelled, the braided portion
can be expelled from the microcatheter and expanded to form a sack
shape based on the spherical predetermined shape, the embolic
portion can be expelled from the microcatheter and coiled within
the sack shape of the braided portion. When the implant is
expelled, an opening can be positioned in the sack shape of the
braided portion can be positioned near the aneurysm neck, a fold
can be positioned to define a boundary between the braided portion
and the embolic portion near a distal surface of the aneurysm wall,
and the embolic portion can traverse through the opening in the
sack shape.
BRIEF DESCRIPTION OF THE DRAWINGS
[0021] The above and further aspects of this invention are further
discussed with reference to the following description in
conjunction with the accompanying drawings, in which like numerals
indicate like structural elements and features in various figures.
The drawings are not necessarily to scale, emphasis instead being
placed upon illustrating principles of the invention. The figures
depict one or more implementations of the inventive devices, by way
of example only, not by way of limitation.
[0022] FIGS. 1A through 1C are illustrations of an example implant
in a collapsed or delivery configuration (FIG. 1A), a cross section
of the collapsed implant of FIG. 1A (FIG. 1C), and the example
implant in an implanted or expanded configuration (FIG. 1B)
according to aspects of the present invention;
[0023] FIGS. 2A through 2E are illustrations of an example implant
during implantation steps according to aspects of the present
invention;
[0024] FIGS. 3A and 3B are illustrations of an example implant in a
collapsed or delivery configuration (FIG. 3A) and in an implanted
or expanded configuration (FIG. 3B) according to aspects of the
present invention;
[0025] FIGS. 4A and 4B are illustrations of an example implant in a
collapsed or delivery configuration (FIG. 4A) and in an implanted
or expanded configuration (FIG. 4B) according to aspects of the
present invention;
[0026] FIGS. 5A through 5E are illustrations of an example implant
during implantation steps according to aspects of the present
invention;
[0027] FIGS. 6A and 6B are illustrations of an example implant in a
collapsed or delivery configuration (FIG. 6A) and in an implanted
or expanded configuration (FIG. 6B) according to aspects of the
present invention; and
[0028] FIGS. 7 through 10 are flow diagrams outlining example
method steps for treating an aneurysm according to aspects of the
present invention.
DETAILED DESCRIPTION
[0029] As object of the present invention is to provide an embolic
implant suitable for endovascular treatment of an aneurysm in a
patient. The implant can have two parts that can reshape upon
delivery to a treatment site.
[0030] FIG. 1A illustrates an example implant 200 in a collapsed or
delivery configuration. In the delivery configuration, the implant
200 can be sized to be delivered to a treatment site through a
catheter inserted in vasculature of a patient. FIG. 1C illustrates
a cross sectional view of the collapsed implant 200 as indicated in
FIG. 1A. FIG. 1B illustrates the example implant 200 illustrated in
FIG. 1A in an expanded or implanted configuration. In the implanted
configuration, the implant 200 can be positioned in a sac 12 of an
aneurysm 10 to divert blood flow from a neck 16 of the aneurysm 10
and fill the sac 12 with embolic material. The embolic material in
the aneurysm sac 12 can promote the formation of a thrombotic mass
in the aneurysm 10, and the diversion of blood flow from the
aneurysm neck 16 can induce venous stasis in the aneurysm and
reduce the likelihood that the aneurysm recanalizes after an
aneurysm treatment procedure.
[0031] Referring collectively to FIGS. 1A through 1C, the implant
100 can include an elongated portion 204, an expandable sack
portion 202, and a detachment feature 230. The elongated portion
204 and the expandable sack portion 202 can each be braided. The
expandable sack portion 202 and elongated portion 204 can be
manufactured as two separate structures or as a contiguous braided
structure. Braided portions can be made from braided Nitinol,
cobalt, chromium, plastic, or other suitable material. Portions of
the implant 200 can be made from a memory shape material having a
predetermined shape and a deformed shape. The memory shape material
can be in the deformed shape when the implant 200 is in the
delivery configuration and can move toward the predetermined shape
when the implant 200 is in the expanded or implanted configuration.
When implanted, the memory shape material can be restricted by
anatomical geometries and the memory shape material can take a
shape that approaches the predetermined shape but does not match
the predetermined shape due to the anatomical restrictions.
[0032] The detachment feature 230 can be joined to the elongated
portion 204, and the detachment feature 230 can be detachably
attached to a delivery system when the implant 200 is delivered
through a catheter to a treatment site.
[0033] Referring to FIG. 1A, in the delivery configuration, the
detachment feature 230 can be positioned at the proximal end 212 of
the implant 200, the elongated portion 204 can extend distally from
the detachment feature 230 to a fold 203 positioned at a distal end
214 of the implant 200, and the expandable braided sack portion 202
can extend proximally from the fold 203. In the delivery
configuration, the expandable braided sack portion 202 can extend
distally from the fold 203 to wrap around a part of the length L of
the elongated portion 204, and the expandable braided sack portion
202 can have an open end 226 that circles the elongated portion
204. The open end 226 is preferably simply the open end of a braid
without any ancillary attachments. The open end 226 need not be
attached to a delivery system as the implant 200 is delivered
through a catheter to the treatment site or as the implant 200 is
deployed within the aneurysm. Strands of the braid 210 at the open
end 226 can be free, cut ends; or, alternatively, the strands at
the open end 226 be closed, meaning strands within the braid at the
open end are attached to each other by glue, weld, etc. or the
strands bend back at the open end. Free cut ends can have an
advantage of being easier to manufacture while the closed ends can
have an advantage of being more atraumatic compared to the cut
ends.
[0034] Referring to FIGS. 1A and 1B, the implant 200 can include
memory shape material and can be pre-shaped such that the
expandable braided sack portion 202 forms a globular or spherical
shape and a fold 203 separates the elongated looping portion 204
from the expandable braided sack portion 202. The memory shape
material can be heat set into the predetermined shape. The
spherical shape, fold 203, and the loops of the elongated portion
can be shaped by heat setting. The implanted shape illustrated in
FIG. 1B can be based on the predetermined shape and the shape of
the interior wall 14 of the aneurysm 10. To collapse the implant
from the predetermined shape so that it can be delivered through a
catheter, the elongated looping portion 204 can be extended and
straightened and the sack portion 202 can be compressed around the
elongated looping portion 204. The fold created when the implant
was pre-shaped can be further folded to define a boundary between
the sack portion 202 and the elongated looping portion 204 when the
implant 200 is in the delivery configuration.
[0035] Referring to FIG. 1B, in the implanted configuration, the
expandable braided sack portion 202 can expand to contact a
majority of the interior wall 14 of the aneurysm 10. The fold 203
can be positioned near a distal surface 15 of the aneurysm wall 14.
The elongated portion 204 can wind within the aneurysm sac 12 and
within the braided sack portion 202. By anchoring within the sac
12, the expandable braided sack portion 202 can maintain proper
positioning of the implant 200 in the aneurysm 10 and prevent
portions of the implant 200, such as the elongated portion 204,
from extending into a blood vessel 20a, 20b, 21 or exiting the
aneurysm sac 12.
[0036] The free open end 226 of the expandable braided sack portion
202 can define an opening in the sack when the implant is in the
implanted or pre-shaped configuration, and when implanted, the
opening can be positioned near the aneurysm neck 16. The opening
can be sized such that a portion of the expandable braided sack
portion 202 extends across the aneurysm neck 16 to occlude the
neck. The elongated portion 204 can enter the aneurysm sac 12 and
the sack of the expandable braided sack portion 202 through the
opening. The elongated portion 204 can wind or loop around in a
complex coiled shape within the expandable braided sack portion 202
and within the aneurysm sac 12. The looped elongated portion 204
can press against the braided sack 202 and provide a force against
an interior surface of the braided sack 202 to press an exterior
surface of the braided sack 202 to the aneurysm wall 14 to further
secure the anchoring of the braided sack 202 within the aneurysm
sac 12.
[0037] The looped elongated portion 204 can fill a majority of the
aneurysm sac 12. The implanted braided sack 202 can be a braided
mesh with a porosity sized to inhibit blood flow into the aneurysm
10. The elongated portion can have a substantially uniform
circumference 206 along much or all of its length L, and it can
maintain the substantially uniform circumference 206 as it moves
from the delivery configuration to the implanted configuration.
[0038] FIGS. 2A through 2E are illustrations of an example implant
during implantation steps. FIG. 2A illustrates an implant 200
positioned within a catheter 600 near an aneurysm 10. The aneurysm
10 is illustrated positioned at a bifurcated blood vessel having a
stem vessel 21, a first side branch vessel 20a, and a second side
blood vessel 20b. The catheter 600 can approach the aneurysm 10
from the stem vessel 21. It is contemplated that example implants
200 disclosed herein can be used for treating sidewall vessels
according to methods described herein and as would be understood by
a person of ordinary skill in the art. At the instant illustrated
in FIG. 2A, the implant 200 is collapsed in the catheter 600. The
implant 200 can include memory shape material that is in a deformed
shape while it is collapsed in the catheter 600.
[0039] FIG. 2B illustrates the implant 200 during implantation. The
implant 200 can include an expandable braided sack portion 202 and
an elongated embolic portion 204. As the implant 200 is translated
distally through the catheter 600, a fold 203 can be positioned at
a distal end 214 of the implant 200, and the expandable braided
sack portion 202 and the elongated looping portion 204 can extend
proximally from the fold 203. Configured thusly, the braided sack
portion 202 can be oriented in the catheter 600 so that when the
implant 200 is pushed distally out of the catheter 600, the braided
sack portion 202 is pushed out of the catheter 600 and into the sac
12 before a majority of the elongated looping portion 204 is begins
to exit the catheter 600.
[0040] FIG. 2C illustrates the implant 200 after the braided sack
portion 202 has exited the catheter 600 and expanded within the
aneurysm 12. The braided sack portion 202 can expand to contact all
or a majority of the interior wall 14 of the aneurysm 10. The
braided sack 202 can expand toward the predetermined shape upon
exiting the catheter 600. Contact with warm bodily fluid can cause
the memory shape material in the braided sack 202 to move to the
predetermined shape. The free open end 226 can define an opening in
the braided sack 202, and the opening can be positioned at the
aneurysm neck 16.
[0041] A fold 203 defining a boundary between the expanded braided
sack 202 and the elongated portion 204 can be positioned near a
distal surface 15 of the aneurysm wall 14. At the stage of
implantation illustrated in FIG. 2C, the elongated portion 204 can
extend from the fold 203, through the opening in the braided sack
202, and into the catheter 600.
[0042] FIG. 2D illustrates the elongated portion 204 exiting the
catheter 600, entering the braided sack portion 202 through the
free open end 226, and winding within the sack 202. As the
elongated portion 204 exits the catheter 600, the elongated portion
204 can maintain its circumference 206 as it exits the catheter
600. The elongated portion 204 can wind or loop within the aneurysm
sac 12 in response to contacting an interior surface of the
expanded braided sack 202. Additionally, or alternatively, the
elongated portion 204 can include memory shape material having a
predetermined shape and a deformed shape. The predetermined shape
can be a complex looped shape, and the deformed shape can be
substantially straight. The elongated portion 204 can wind or loop
within the aneurysm sac 12 in response to the memory shape material
moving from the deformed shape toward the predetermined shape as
the elongated portion 204 contacts blood as it exits the catheter
600. Additionally, or alternatively, the elongated portion 204 can
include a flexible elastically deformable material having a relaxed
shape that is a looped shape. The flexible elastically deformable
material can be uncoiled to a substantially straight strand during
delivery through a catheter and can collapse into the looped shape
upon exiting the catheter 12.
[0043] At the instant illustrated in FIG. 2D the detachment feature
230 can remain attached to a delivery system. While the implant 200
is attached to the delivery system, the delivery system can be
pulled proximally to withdraw all or portions of the implant 200.
The delivery system can subsequently be pushed distally to
reposition the implant 200.
[0044] FIG. 2E illustrates the implant 200 in a final implanted
configuration such as described in relation to FIG. 1B. The
detachment feature 230 can be moved distally by the delivery system
past the plane of the aneurysm 16, through the open end 226 of the
expanded sack portion 202, and into the aneurysm sac 12 prior to
detachment from the delivery system. The elongated portion 204 can
have a predetermined shape configured to facilitate the movement of
the detachment feature 230 past the plane of the aneurysm neck 16
once the implant 200 is implanted. Additionally, or alternatively,
the delivery system can be manipulated to place the detachment
feature 230 within the sack portion 202. Once the implant 200 is
implanted as illustrated in FIG. 2E, the delivery system can be
detached and withdrawn, and the microcatheter 600 can be moved or
extracted from the patient.
[0045] The open end 226 can remain open at the completion of the
implantation, and the elongated portion 204, once secured within
the sack 202, can be coiled near the opening defined by the open
end 226 in such a way that blood flow is obstructed from entering
the opening. In other words, sack 202 can occlude a portion of the
neck 16 around the perimeter of the neck, and the elongated portion
204 can occlude the neck 16 at the opening in the sack 202 defined
by the open end 226.
[0046] FIG. 3A illustrates an example implant 200a in a collapsed
or delivery configuration. In the delivery configuration, the
implant 200a can be collapsed to a size that can be delivered to a
treatment site through a catheter inserted in vasculature of a
patient. FIG. 3B illustrates the example implant 200a illustrated
in FIG. 3A in an expanded or implanted configuration. In the
implanted configuration, the implant 200a can be positioned in a
sac 12 of an aneurysm 10 to divert blood flow from a neck 16 of the
aneurysm 10 and fill the sac 12 with embolic material. The embolic
material in the aneurysm sac 12 can promote the formation of a
thrombotic mass in the aneurysm 10, and the diversion of blood flow
from the aneurysm neck 16 can induce venous stasis in the aneurysm
and reduce the likelihood that the aneurysm recanalizes after an
aneurysm treatment procedure.
[0047] Comparing the example implant 200a illustrated in FIGS. 3A
and 3B to the implant 200 illustrated in FIGS. 1A through 2E, the
elongated portion 204a of the implant 200a in FIGS. 3A and 3B can
be an embolic coil 204a rather than a braid 204 as illustrated in
FIGS. 1A through 2E. The implant 200a illustrated in FIGS. 3A and
3B can be implanted following a procedure like that illustrated in
FIGS. 2A through 2E.
[0048] Referring collectively to FIGS. 3A and 3B, the implant 200a
can include the embolic coil 204a, an expandable braided sack
portion 202a, a detachment feature 230a, and a connecting band 222
joining the embolic coil 204a to the expandable braid 202a. The
connecting band 222 can include radiopaque material to facilitate
visibility of the implant 200a under X-ray. The expandable braided
sack portion 202a can be braided. Portions of the implant 200a,
including the embolic coil 204a, can be made from a memory shape
material having a predetermined shape and a deformed shape. The
memory shape material can be in the deformed shape when the implant
200a is in the delivery configuration and can move toward the
predetermined shape when the implant 200a is in the expanded or
implanted configuration. When expanded or implanted, the memory
shape material can be restricted by anatomical geometries and the
memory shape material can take a shape that approaches the
predetermined shape but does not match the predetermined shape due
to the anatomical restrictions.
[0049] The detachment feature 230a can be joined to the elongated
portion 204a, and the detachment feature 230a can be detachably
attached to a delivery system when the implant 200a is delivered
through a catheter to a treatment site.
[0050] Referring to FIG. 3A, in the delivery configuration, the
detachment feature 230a can be positioned at the proximal end 212a
of the implant 200a, the elongated portion 204 can extend distally
from the detachment feature 230a to the connecting band 222, the
braided portion 202a can have a fold 203a positioned at a distal
end 214a of the implant 200a, and the expandable braided sack
portion 202a can extend proximally from the fold 203a. In the
delivery configuration, the expandable braided sack portion 202a
can extend distally from the fold 203a to wrap around a part of the
length L' of the embolic coil 204a, and the expandable braided sack
portion 202a can have a free open end 226a that circles the embolic
coil 204a. Strands of the braided portion 202a at the open end 226a
can be free, cut ends; or, alternatively, the strands at the open
end 226a be closed, meaning strands within the braid at the free
open end 226a are attached to each other by glue, weld, etc. or the
strands bend back at the open end 226a. Free cut ends can have an
advantage of being easier to manufacture while the closed strand
ends can have an advantage of being more atraumatic compared to the
cut ends.
[0051] Referring to FIGS. 3A and 3B, the implant 200a can include
memory shape material and can be pre-shaped such that the
expandable braided sack portion 202a forms a globular or spherical
shape and the braid can have a fold 203a near the connecting band
222. The memory shape material can be heat set into the
predetermined shape. The implanted shape illustrated in FIG. 3B can
be based on the predetermined shape and the shape of the interior
wall 14 of the aneurysm 10. To collapse the implant from the
predetermined shape so that it can be delivered through a catheter,
the embolic coil 204a can be extended and straightened and the sack
portion 202a can be compressed around the elongated looping portion
204a. The fold created when the implant was pre-shaped can be
further folded and positioned at the distal end 214a of the implant
200a when the implant 200a is in the delivery configuration.
[0052] Referring to FIG. 3B, in the implanted configuration, the
expandable braided sack portion 202a can expand to contact a
majority of the interior wall 14 of the aneurysm 10. The fold 203a
can be positioned near a distal surface 15 of the aneurysm wall 14.
The embolic coil 204a can wind within the aneurysm sac 12 and
within the braided sack portion 202a. By anchoring within the sac
12, the expandable braided sack portion 202a can maintain proper
positioning of the implant 200a in the aneurysm 10 and prevent
portions of the implant 200a, such as the embolic coil 204a, from
extending into a blood vessel 20a, 20b, 21 or exiting the aneurysm
sac 12.
[0053] The free end 226a of the expandable braided sack portion
202a can define an opening in the sack when the implant 200a is in
the implanted or pre-shaped configuration, and when implanted, the
opening can be positioned near the aneurysm neck 16. The opening
can be sized such that a portion of the expandable braided sack
portion 202a extends across the aneurysm neck 16 to occlude the
neck. The embolic coil 204a can enter the aneurysm sac 12 and the
sack of the expandable braided sack portion 202a through the
opening. The elongated portion 204a can wind or loop around in a
complex coiled shape within the expandable braided sack portion
202a and within the aneurysm sac 12. The looped elongated portion
204a can press against the braided sack 202a and provide a force
against an interior surface of the braided sack 202a to press an
exterior surface of the braided sack 202a to the aneurysm wall 14
to further secure the anchoring of the braided sack 202a within the
aneurysm sac 12.
[0054] The looped embolic coil 204a can fill a majority of the
aneurysm sac 12. The implanted braided sack 202a can be a braided
mesh with a porosity sized to inhibit blood flow into the aneurysm
10.
[0055] As an alternative to shaping the implant in the delivery
configuration such that the expandable braided sack portion 202,
202a envelopes the elongated portion 204, 204a as illustrated in
FIGS. 1A and 3A, the implant can be elongated in the delivery
configuration as illustrated in FIGS. 4A and 6A. The implant 200
illustrated in FIGS. 1A and 1B can have an essentially identical
predetermined shape and/or implanted configuration compared to the
implant 300 illustrated in FIGS. 4A and 4B. Likewise, the implant
200a illustrated in FIGS. 3A and 3B can have an essentially
identical predetermined shape and/or implanted configuration
compared to the implant 300a illustrated in FIGS. 6A and 6B.
[0056] Comparing FIGS. 1B and 4B, once implanted, the implants 200,
300 formed of a contiguous tubular braid 210, 310 can be
indistinguishable. Likewise, comparing FIGS. 3B and 6B, once
implanted, the implants 200a, 300a formed of a braided portion
202a, 302a and an embolic coil 204a, 304a can be indistinguishable.
Significant difference between the implants 200, 200a illustrated
in FIGS. 1A through 3B and the implants 300, 300a illustrated in
FIGS. 4A through 6B include presence of the fold 203, 203a or lack
thereof in each respective deformed shape, position of the free
open end 226, 226a, 314, 314a during delivery, and process of
expanding the expandable braided portion 202, 202a, 302, 302a
within the aneurysm 10 during treatment.
[0057] Referring to FIGS. 4A and 4B, an implant 300 can include a
contiguous tubular braid 310 and a detachment feature 330. As
illustrated in FIG. 4A, in the delivery configuration, the
detachment feature 330 can be positioned at the proximal end 312 of
the implant 300, the elongated portion 304 can extend distally from
the detachment feature 330, the expandable braided sack portion 302
can extend distally from the elongated portion 304, and the
expandable braided sack portion 302 can have a free open end
positioned at the distal end 314 of the implant 300. In the
delivery configuration, the implant 300 need not have any
discernable boundary to indicate which portion of the tubular braid
310 is the elongated looping portion 304 and which portion is the
expandable sack portion 302. Strands at the open end 314 can be
free, cut ends; or, alternatively, the strands at the open end 314
be closed, meaning strands within the braid at the free open end
314 are attached to each other by glue, weld, etc. or the strands
bend back at the open end 314. Free cut ends can have an advantage
of being easier to manufacture while the closed strand ends can
have an advantage of being more atraumatic compared to the cut
ends.
[0058] The implant 300 can include memory shape material and can be
pre-shaped such that the expandable braided sack portion 302 forms
a globular or spherical shape and a fold 303 separates the
elongated looping portion 304 from the expandable braided sack
portion 302. The memory shape material can be heat set into the
predetermined shape. The implanted shape illustrated in FIG. 4B can
be based on the predetermined shape and the shape of the interior
wall 14 of the aneurysm 10. To collapse the implant 300 from the
predetermined shape (similar to the implanted configuration
illustrated in FIG. 4B) to the deformed shape (such as illustrated
in FIG. 4A) so that it can be delivered through a catheter, the
elongated looping portion 304 can be extended and straightened, the
sack portion 302 can be inverted and stretch, and the fold 303 can
be opened and flattened.
[0059] Referring to FIG. 4B, in the implanted configuration, the
expandable braided sack portion 302 can expand to contact a
majority of the interior wall 14 of the aneurysm 10. The fold 303
can be positioned near a distal surface 15 of the aneurysm wall 14.
The elongated portion 304 can wind within the aneurysm sac 12 and
within the braided sack portion 302. By anchoring within the sac
12, the expandable braided sack portion 302 can maintain proper
positioning of the implant 300 in the aneurysm 10 and prevent
portions of the implant 300, such as the elongated portion 304,
from extending into a blood vessel 20a, 20b, 21 or exiting the
aneurysm sac 12.
[0060] The free end 314 of the expandable braided sack portion 302
can define an opening in the sack when the implant is in the
implanted or pre-shaped configuration, and when implanted, the
opening can be positioned near the aneurysm neck 16. The opening
can be sized such that a portion of the expandable braided sack
portion 302 extends across the aneurysm neck 16 to occlude the
neck. The elongated portion 304 can enter the aneurysm sac 12 and
the sack of the expandable braided sack portion 302 through the
opening. The elongated portion 304 can wind or loop around in a
complex coiled shape within the expandable braided sack portion 302
and within the aneurysm sac 12. The looped elongated portion 304
can press against the braided sack 302 and provide a force against
an interior surface of the braided sack 302 to press an exterior
surface of the braided sack 302 to the aneurysm wall 14 to further
secure the anchoring of the braided sack 302 within the aneurysm
sac 12.
[0061] The looped elongated portion 304 can fill a majority of the
aneurysm sac 12. The implanted braided sack 302 can be a braided
mesh with a porosity sized to inhibit blood flow into the aneurysm
10. The elongated portion can have a substantially uniform
circumference 306 along much or all of its length, and it can
maintain the substantially uniform circumference 306 as it moves
from the delivery configuration to the implanted configuration.
[0062] FIGS. 5A through 5E are illustrations of an example implant
300 during implantation steps. FIG. 5A illustrates an implant 300
positioned within a catheter 600 near an aneurysm 10. The aneurysm
10 is illustrated positioned at a bifurcated blood vessel having a
stem vessel 21, a first side branch vessel 20a, and a second side
blood vessel 20b. The catheter 600 can approach the aneurysm 10
from the stem vessel 21. It is contemplated that example implants
300 disclosed herein can be used for treating sidewall vessels
according to methods described herein and as would be understood by
a person of ordinary skill in the art. At the instant illustrated
in FIG. 5A, the implant 300 is collapsed in the catheter 600. The
implant 300 can include memory shape material that is in a deformed
shape while it is collapsed in the catheter 600.
[0063] FIG. 5B illustrates the implant 300 during implantation. The
implant 300 can include an expandable braided sack portion 302 and
an elongated embolic portion 304. As the implant 300 is translated
distally through the catheter 600, the free open end 314 of the
expandable braided sack portion 302 can be positioned at a distal
end 314 of the implant 300, the expandable portion 302 can extend
proximally from its free open end 314, and the elongated embolic or
looping portion 304 can extend proximally from the expandable
portion 302. Configured thusly, the expandable portion 302 can be
completely expelled from the catheter 600 before the elongated
portion 304 begins to exit the catheter 600.
[0064] As illustrated in FIG. 5B, the expandable braided sack
portion 302 can begin to invert after exiting the catheter 600. The
free open end 314 can encircle the braid 310, and portions of the
braid 310 can be translated through the opening of the free open
end 314. The free end 314 of the implant 300 need not be attached
to a delivery system for the braided sack portion 302 to invert.
The inversion can be a result of the braided sack portion 302
moving toward its predetermined shape.
[0065] FIG. 5C illustrates the implant 300 after the braided sack
portion 302 has exited the catheter 600 and expanded within the
aneurysm 12. The braided sack portion 302 can expand to contact all
or a majority of the interior wall 14 of the aneurysm 10. The
braided sack 302 can expand toward the predetermined shape upon
exiting the catheter 600. Contact with warm bodily fluid can cause
the memory shape material in the braided sack 302 to move to the
predetermined shape. The free open end 314 can define an opening in
the braided sack 302, and the opening can be positioned at the
aneurysm neck 16.
[0066] A fold 303 defining a boundary between the expanded braided
sack 302 and the elongated portion 304 when in the implant 300 is
in the implanted configuration can be positioned near a distal
surface 15 of the aneurysm wall 14. At the stage of implantation
illustrated in FIG. 5C, the elongated portion 304 can extend from
the fold 303, through the opening in the braided sack 302, and into
the catheter 600.
[0067] FIG. 5D illustrates the elongated portion 304 exiting the
catheter 600, entering the braided sack portion 302 through the
free open end 314, and winding within the sack 302. As the
elongated portion 304 exits the catheter 600, the elongated portion
304 can maintain its circumference 306 as it exits the catheter
600. The elongated portion 304 can wind or loop within the aneurysm
sac 12 in response to contacting an interior surface of the
expanded braided sack 302. Additionally, or alternatively, the
elongated portion 304 can include memory shape material having a
predetermined shape and a deformed shape. The predetermined shape
can be a complex looped shape, and the deformed shape can be
substantially straight. The elongated portion 304 can wind or loop
within the aneurysm sac 12 in response to the memory shape material
moving from the deformed shape toward the predetermined shape as
the elongated portion 304 contacts blood as it exits the catheter
600. Additionally, or alternatively, the elongated portion 304 can
include a flexible elastically deformable material having a relaxed
shape that is a looped shape. The flexible elastically deformable
material can be uncoiled to a substantially straight strand during
delivery through a catheter and can collapse into the looped shape
upon exiting the catheter 12.
[0068] At the instant illustrated in FIG. 5D the detachment feature
330 can remain attached to a delivery system. While the implant 300
is attached to the delivery system, the delivery system can be
pulled proximally to withdraw all or portions of the implant 300.
The delivery system can subsequently be pushed distally to
reposition the implant 300.
[0069] FIG. 5E illustrates the implant 300 in a final implanted
configuration such as described in relation to FIG. 4B. The
detachment feature 330 can be moved distally by the delivery system
past the plane of the aneurysm 16, through the open end 314 of the
expanded sack portion 302, and into the aneurysm sac 12 prior to
detachment from the delivery system. The elongated portion 304 can
have a predetermined shape configured to facilitate the movement of
the detachment feature 314 past the plane of the aneurysm neck 16
once the implant 300 is implanted. Additionally, or alternatively,
the delivery system can be manipulated to place the detachment
feature 314 within the sack portion 302. Once the implant 300 is
implanted as illustrated in FIG. 5E, the delivery system can be
detached and withdrawn, and the microcatheter 600 can be moved or
extracted from the patient.
[0070] The open end 314 can remain open at the completion of the
implantation, and the elongated portion 304, once secured within
the sack 302, can be coiled near the opening defined by the open
end 314 in such a way that blood flow is obstructed from entering
the opening. In other words, sack 302 can occlude a portion of the
neck 16 around the perimeter of the neck, and the elongated portion
304 can occlude the neck 16 at the opening in the sack 302 defined
by the open end 314.
[0071] FIG. 6A illustrates an example implant 300a in a collapsed
or delivery configuration. In the delivery configuration, the
implant 300a can be collapsed to a size that can be delivered to a
treatment site through a catheter inserted in vasculature of a
patient. FIG. 6B illustrates the example implant 300a illustrated
in FIG. 6A in an expanded or implanted configuration. In the
implanted configuration, the implant 300a can be positioned in a
sac 12 of an aneurysm 10 to divert blood flow from a neck 16 of the
aneurysm 10 and fill the sac 12 with embolic material. The embolic
material in the aneurysm sac 12 can promote the formation of a
thrombotic mass in the aneurysm 10, and the diversion of blood flow
from the aneurysm neck 16 can induce venous stasis in the aneurysm
and reduce the likelihood that the aneurysm recanalizes after an
aneurysm treatment procedure.
[0072] Comparing the example implant 300a illustrated in FIGS. 6A
and 6B to the implant 300 illustrated in FIGS. 4A through 5E, the
elongated portion 304a of the implant 300a in FIGS. 6A and 6B can
be an embolic coil 304a rather than a braid 304 as illustrated in
FIGS. 4A through 5E. The implant 300a illustrated in FIGS. 6A and
6B can be implanted following a procedure like that illustrated in
FIGS. 5A through 5E.
[0073] Referring collectively to FIGS. 6A and 6B, the implant 300a
can include the embolic coil 304a, an expandable braided sack
portion 302a, a detachment feature 330a, and a connecting band 322
joining the embolic coil 304a to the expandable braid 302a. The
expandable braided sack portion 302a can be braided. Portions of
the implant 300a, including the embolic coil 304a, can be made from
a memory shape material having a predetermined shape and a deformed
shape. The memory shape material can be in the deformed shape when
the implant 300a is in the delivery configuration and can move
toward the predetermined shape when the implant 300a is in the
expanded or implanted configuration. When expanded or implanted,
the memory shape material can be restricted by anatomical
geometries and the memory shape material can take a shape that
approaches the predetermined shape but does not match the
predetermined shape due to the anatomical restrictions.
[0074] The detachment feature 330a can be joined to the elongated
portion 304a, and the detachment feature 330a can be detachably
attached to a delivery system when the implant 300a is delivered
through a catheter to a treatment site.
[0075] Referring to FIG. 6A, in the delivery configuration, the
detachment feature 330a can be positioned at the proximal end 312a
of the implant 300a, the elongated portion 304 can extend distally
from the detachment feature 330a to the connecting band 322, the
braided portion 302a can extend distally from the connecting band
322, and the braided portion 302a can have a free open end 314a
positioned at a distal end of the implant 300a. Strands of the
braided portion 302a at the open end 314a can be free, cut ends;
or, alternatively, the strands at the open end 314a be closed,
meaning strands within the braid at the free open end 314a are
attached to each other by glue, weld, etc. or the strands bend back
at the open end 314a. Free cut ends can have an advantage of being
easier to manufacture while the closed strand ends can have an
advantage of being more atraumatic compared to the cut ends.
[0076] Referring to FIGS. 6A and 6B, the implant 300a can include
memory shape material and can be pre-shaped such that the
expandable braided sack portion 302a forms a globular or spherical
shape and the braid can have a fold 303a near the connecting band
322. The memory shape material can be heat set into the
predetermined shape. The implanted shape illustrated in FIG. 6B can
be based on the predetermined shape and the shape of the interior
wall 14 of the aneurysm 10. To collapse the implant from the
predetermined shape so that it can be delivered through a catheter,
the embolic coil 304a can be extended and straightened, the sack
portion 302a can be inverted and stretched, and the fold 303 can be
opened and flattened.
[0077] Referring to FIG. 6B, in the implanted configuration, the
expandable braided sack portion 302a can expand to contact a
majority of the interior wall 14 of the aneurysm 10. The fold 303a
can be positioned near a distal surface 15 of the aneurysm wall 14.
The embolic coil 304a can wind within the aneurysm sac 12 and
within the braided sack portion 302a. By anchoring within the sac
12, the expandable braided sack portion 302a can maintain proper
positioning of the implant 300a in the aneurysm 10 and prevent
portions of the implant 300a, such as the embolic coil 304a, from
extending into a blood vessel 20a, 20b, 21 or exiting the aneurysm
sac 12.
[0078] The free end 314a of the expandable braided sack portion
302a can define an opening in the sack when the implant 300a is in
the implanted or pre-shaped configuration, and when implanted, the
opening can be positioned near the aneurysm neck 16. The opening
can be sized such that a portion of the expandable braided sack
portion 302a extends across the aneurysm neck 16 to occlude the
neck. The embolic coil 304a can enter the aneurysm sac 12 and the
sack of the expandable braided sack portion 302a through the
opening. The elongated portion 304a can wind or loop around in a
complex coiled shape within the expandable braided sack portion
302a and within the aneurysm sac 12. The looped elongated portion
304a can press against the braided sack 302a and provide a force
against an interior surface of the braided sack 302a to press an
exterior surface of the braided sack 302a to the aneurysm wall 14
to further secure the anchoring of the braided sack 302a within the
aneurysm sac 12.
[0079] The looped embolic coil 304a can fill a majority of the
aneurysm sac 12. The implanted braided sack 302a can be a braided
mesh with a porosity sized to inhibit blood flow into the aneurysm
10.
[0080] FIG. 7 is a flow diagram outlining example method steps for
treating an aneurysm. The method steps can be implemented by
example devices presented herein or by other means as would be
known to one of ordinary skill in the art.
[0081] Referring to method 700 outlined in FIG. 7, in step 702, an
implant having an expandable portion and an embolic coiling portion
can be provided. In step 704, the embolic coiling portion can be
detachably attached to a delivery system. In step 706, the implant
can be positioned in a microcatheter with the embolic coiling
portion extending distally from a proximal end of the implant, the
expandable portion extending proximally form the distal end of the
implant, and the expandable portion being unattached to the
delivery system. In step 708, the distal end of the microcatheter
can be positioned near an aneurysm neck. In step 710, the implant
can be delivered through the microcatheter to the distal end of the
microcatheter. In step 712, the expandable portion can be expelled
from the distal end of the microcatheter. In step 714, the
expandable portion can expand to contact most of the interior wall
of the aneurysm. In step 716, the embolic coiling portion can be
expelled from the distal end of the microcatheter. In step 718, the
embolic coiling portion can be placed to wind within the expanded
expandable portion. In step 720, the embolic coiling portion can be
detached from the delivery system.
[0082] Referring to method 800 outlined in FIG. 8, in step 810, an
implant having an embolic portion and a braided portion having a
memory shape material can be provided. In step 820, the braided
portion can be shaped to have a spherical predetermined shape. In
step 830, the embolic portion can be attached to an implant
delivery system so that it can later be detached. In step 840, the
implant and the delivery system can be positioned within a
microcatheter. In step 850, the implant and delivery system can
traverse through the microcatheter while the braided portion is
unattached to the delivery system. In step 860, the implant can be
expelled from the microcatheter.
[0083] Step 840 in method 800, positioning the implant and the
delivery system in the microcatheter, can include sub steps as
illustrated in FIG. 9. In sub step 842, the braided portion can be
collapsed to fit within the microcatheter. In sub step 844, the
braided portion can be positioned to extend proximally from a
distal end of the implant. In sub step 846, the embolic portion can
be positioned to extend distally from a proximal end of the
implant. In sub step 848, the delivery system can be positioned to
extend proximally form the embolic portion.
[0084] Step 860 in method 800, expelling the implant from the
microcatheter, can include sub steps as illustrated in FIG. 10. In
sub step 862, the braided portion can be expelled from the
microcatheter. In sub step 864, the braided portion can be expanded
to form a sack shape based on the spherical predetermined shape. In
sub step 866, the embolic portion can be expelled from the
microcatheter. In sub step 868, the embolic portion can be coiled
within the sack shape of the braided portion.
[0085] The descriptions contained herein are examples of
embodiments of the invention and are not intended to limit the
scope of the invention. As described herein, the invention
contemplates many variations and modifications of an implant,
system, or method that can be used to occlude and fill an aneurysm.
Variations can include but are not limited to combining elements of
various embodiments, utilizing alternative geometries of elements
and components described herein, utilizing alternative materials
for each component or element (e.g. radiopaque materials, memory
shape materials, etc.), utilizing additional components including
components to deliver the implant to a treatment site, position the
implant at a treatment site, retract the implant, and/or eject a
portion of the implant from a catheter, utilizing additional
component to perform functions describe herein, and utilizing
additional components to perform functions not described herein,
for example. These modifications would be apparent to those having
ordinary skill in the art to which this invention relates and are
intended to be within the scope of the claims which follow.
* * * * *