CN105055061A - Vascular stenting for aneurysms - Google Patents

Abstract

Described herein are flexible implantable occluding devices that can, for example, navigate the tortuous vessels of the neurovasculature. The occluding devices can also conform to the shape of the tortuous vessels of the vasculature. In some embodiments, the occluding devices can direct blood flow within a vessel away from an aneurysm or limit blood flow to the aneurysm. Some embodiments describe methods and apparatuses for adjusting, along a length of the device, the porosity of the occluding device. In some embodiments, the occluding devices allow adequate blood flow to be provided to adjacent structures such that those structures, whether they are branch vessels or oxygen- demanding tissues, are not deprived of the necessary blood flow. A plurality of stents, for example at least partially overlapping, can be used. Some embodiments describe various methods for confirming the occlusion of an aneurysm or for dislodging material from a vessel wall.

Description

For aneurysmal vascular stent

The application is the divisional application that name is called " for aneurysmal vascular stent ", the applying date is on April 14th, 2010, international application no is PCT/US2010/031092, national applications number is the PCT application of 201080024873.6.

The cross reference of related application

Which is hereby incorporated by reference in following application: the U.S. Patent application No.11/136 being filed on May 25th, 2005,395; Be filed in the U.S. Patent application No.11/136 on May 25th, 2005,398; Be filed in the U.S. Patent application No.11/420 on May 24th, 2006,025; Be filed in the U.S. Patent application No.11/420 on May 24th, 2006,027; Be filed in the U.S. Patent application No.11/420 on May 24th, 2006,023; And be filed in the U.S. Patent application No.60/574 on May 25th, 2004,429.

Technical field

The present invention relates in general to the implantable device for using in patient body, especially, relates to the method and apparatus for intraluminal stent.

In body, tube chamber can varying sized, shape and/or patency, and this change can bring challenge or the relevant body function of impact.Such as, the wall of vascular system, especially arterial wall can be called aneurysmal pathologic and dilates.Aneurysm is the spherical evagination of arterial wall.This is the result that blood vessel wall weakens because of disease, injury or congenital malformation.Aneurysm has thin and by the wall portion of fragility, has the trend of breaking and usually causes because of hypertension or cause deterioration.Aneurysm appears in the different piece of health; Modal is abdominal aortic aneurysm (AAA) and brain or cerebral aneurysm.Only have aneurysm not always threat to life, but they can produce serious health consequences, such as, if aneurysm is broken in the brain, can cause apoplexy.In addition, the aneurysm of breaking also can cause death.

Summary of the invention

One aspect of the present invention provides a kind of highly flexible implantable blocking device, and it easily can guide the curved blood vessel of neural vascular system.In addition, blocking device easily can adapt to the shape of the curved blood vessel of vascular system.In addition, blocking device can guide away from the blood flow in aneurysmal blood vessel; In addition, this blocking device allows enough blood flows to be supplied to adjacent structure, makes these structures (no matter they are branch vessel or aerobic tissue) can not lose necessary blood flow.

Blocking device can also change and leads to aneurysmal blood flow, but keeps leading to surrounding tissue and endovascularly wish blood flow.In this case, still allow some blood to arrive aneurysm, but be not enough in aneurysm, produce the laminar flow damaged its thin-walled.As an alternative, flowing is intermittent, thus provides time enough to the blood coagulation in aneurysm or packing material solidification.

Blocking device has enough flexibilities with the vascular system of abundant access expansion and the original crooked route of reform of nature blood vessel.Be the ability that it can bend and bend according to one of important attribute of blocking device of the present invention, thus there is the shape of IC vascular system.These characteristics concerning more important than crown expansion neurovascular blocking device because IC vascular system is less and more bending.

In general, the present invention relates to for the treatment of aneurysmal method and apparatus.Especially, the aneurysmal method that process has a cervical region comprises and being arranged in the vessel lumen at aneurysm present position place by vascular blocking device, thus guides blood flow away from aneurysmal cervical region.Blood is trapped in aneurysmal tube chamber can produce thromboembolism in aneurysm.Blocking device, across the width of aneurysm trunk (stem), makes it hinder blood to aneurysmal flowing or minimize it.Blocking device is all very soft in its materials and structures.Therefore, blocking device easily can be guided through the blood vessel in bending blood vessel, particularly brain.Because blocking device is soft, need very little active force that blocking device is deflected with the blood vessel being guided through neural vascular system, this is very main for operating surgeon.

Except flexibility, the feature of blocking device is that this blocking device can have uneven braiding structure, wherein, towards on the surface of aneurysm neck, surface more diametrically, has the braiding strand of more highdensity braiding strand or different size.In one embodiment, be permeable hardly towards aneurysmal surface, surface is diametrically high-permeability.This structure will guide blood flow away from aneurysm, but keep the blood flow leading to main blood vessel (being wherein furnished with blocking device) side branch.

In another embodiment, blocking device has uneven braiding quantity along the longitudinal axis of this blocking device.This provides bending natural tendency to blocking device, thus adapts to bending blood vessel.This reduce blocking device and be applied to stress in blood vessel wall, thus make aneurysm rupture can energy minimization.In addition, because blocking device is natural torsion, which eliminate necessity that catheter tip is bending.At present, when bending blocking device is contained on catheter tip, described tip has the curved shape of blocking device.Blocking device can be pre-installed in conduit and plunger can be utilized to carry, and blocking device is released by described plunger when needed from conduit.Blocking device can be positioned in conduit under compression.When leaving conduit, it can expand as the size of existing tube chamber, keeps the patency of tube chamber and allows blood flow to pass through tube chamber.Blocking device can have network and the size of grid split shed can change along the length of blocking device.The size of mesh openings can be controlled by the braiding quantity for forming grid.

According to an aspect of the present invention, blocking device can be used by such as neck reconstruction or gas cell remodeling, endovascular aneurysm to be retrofited.Blocking device can be used to form the barrier remained on by blocking material in aneurysm, due to the cause of the mesh-density of the blocking device in aneurysm region, the material introduced can not be left from aneurysm.

In another aspect of this invention, a kind of device for obstructing arterial tumor is disclosed.This device is tube, and it has the multiple perforation be distributed on component wall.This device is positioned at bottom the aneurysm of covering aneurysm neck, thus the proper flow of aneurysm main body is led in interference, thus produces thrombosis and finally block aneurysm.

In another aspect of this invention, this device is the tubular articles of braiding.Braiding strand has the band of rectangular cross section, the tinsel with circular cross section or polymerization strand.

In another embodiment, manufacture and have the device of braiding structure to adapt to the curved blood vessel in health, wherein, the density of fabric provides enough rigidity and radial strength.In addition, this device can utilize the active force being less than 10 grams to compress.This enables this device when arterial wall is beaten and tremulous pulse adapts.Equally, this device can be bending when applying to be less than the active force of 5 gram per centimeters.

On the other hand, this device can comprise blocking device, and it has the first mesh-density and has the second mesh-density in the second portion in a part, and described first and second mesh-densities are different.In another example, the first mesh-density and/or the second mesh-density can regulate.Such as, input motion can determine the first and/or second mesh-density.

The present invention includes blocking device layout system and method in the blood vessel.Blocking device can be used to pass through the reconstruct of such as neck reconstruction or sacculus makes endovascular aneurysm reconstruct.Blocking device can be used to form the barrier be blocked in by blocking material in aneurysm, such as well-known turn or viscous fluid, as " ONYX " that Microtherapeutics produces, the material introduced can not be discharged from aneurysm.Equally, opening period, the length of blocking device can regulated according to the friction produced between blocking device and catheter inside surface.Under this thing happens, the stretched length of blocking device and peripheral dimension can be changed by the doctor carrying out performing the operation as required.

One aspect of the present invention comprises a kind of system for supporting and open blocking device.Described system comprises guide sheath and the assembly for carrying blocking device.Described assembly comprises elongated flexible member, and it has the support member of the blocking device retaining member of the first end for reception congestion device, the retaining member of locating for the nearside of the second end of reception congestion device and the part around elongated flexible member that it is positioned with blocking device.

Another aspect of the present invention comprises a kind of system for supporting and open blocking device.Described system comprises the assembly for carrying blocking device.Described assembly comprises slender member, and it comprises flexible distal tip portion, the retaining member for the first end of reception congestion device and the part around elongated flexible member to support the support member of blocking device.

Another aspect of the present invention comprises a kind of introducing by blocking device in blood vessel and the method for opening.Described method comprises to be introduced the slender jacket of the guide sheath of carrying Yarn guide component in conduit and makes Yarn guide component release from sheath and enter the step conduit.Described method also comprises makes end of conduit locate near aneurysm, makes a part for Yarn guide component release from conduit and while being opened aneurysm region by blocking device, make the step that a part for Yarn guide component rotates.

On the other hand, elongated flexible member supports blocking device and makes it open, and blocking device can expand according to input pressure and shrink.Such as, air fluid pressure can be applied to blocking device to make blocking device expand or to shrink by flexible member.

Other side of the present invention comprises the method corresponding with device described herein and system.

In certain embodiments, describe the method in stenter to implant patient vessel, comprise and elongate body is provided, the tube chamber that described elongate body comprises proximal portion, extremity and extends between described proximal portion and described extremity; Described extremity is inserted in patient vessel; Described extremity is advanced in the blood vessel, until this distal location is in target location; The support being in compressed configuration is advanced in the tube chamber of this elongate body relative to described elongate body; When the extremity of this support is released from the extremity of described elongate body, the extremity of described support is allowed to be expanded to expanded configuration and to contact blood vessel wall; After being in expanded configuration with at the extremity of described support and contacting blood vessel wall, support described in axial compression is to change the porosity of this support by making the proximal portion of this support advance relative to the extremity of this support.

In certain embodiments, described method also comprises the aneurysm place making support be positioned at blood vessel generation.In certain embodiments, support axial compression is made to reduce the porosity of support.In certain embodiments, support axial compression is made to reduce the blood flow flowing to vascular aneurysms.In certain embodiments, after the described extremity expansion of permission also support described in axial compression, the proximal portion near the described support of this extremity is larger than the axial compression of this extremity.In certain embodiments, described method also comprises the porosity by reducing the support adjacent with aneurysm and reduces and come from aneurysmal clot and move.

Some embodiments are also included in and allow after the extremity of described support expands in the blood vessel, to make all or part of compression reaction of the extremity of this support to compressed configuration.In certain embodiments, the extremity of described support is return in described elongate body by all or part of making described extremity and is compressed.In certain embodiments, the extremity of described support by advancing described elongate body and compressing on this extremity.Some embodiments also comprise makes the extremity of described support move to different positions; Described support is advanced in the tube chamber of this elongate body relative to described elongate body; With allow the extremity of described support at described different position automatic expansion to expanded configuration.Some embodiments also comprise takes out support from blood vessel.

Some embodiments in stenter to implant patient vessel comprised providing and comprise extremity and proximal portion and the support with compressed configuration and expanded configuration, described support is configured to be changed to expanded configuration from compressed configuration and have variable orifice porosity when being in expanded configuration; Make described support in patient vessel, be advanced to current region; The extremity of described support is expanded in described target location; After expanding at described extremity, make the proximal portion of described support relative to extremity axial advance, proximal portion porosity be changed relative to extremity porosity; Expand in patient vessel with making the proximal portion of described support.

Some embodiments also comprise the aneurysm place making support be positioned at blood vessel generation.Some embodiments also comprise reducing by reducing the proximal portion porosity adjacent with aneurysm relative to extremity porosity and come from aneurysmal clot and move.In certain embodiments, change proximal portion porosity to comprise relative to extremity porosity reduction proximal portion porosity.In certain embodiments, the blood flow that proximal portion porosity reduces to flow to vascular aneurysms is changed.In certain embodiments, after making extremity expansion and make proximal portion axial advance, a part for proximal portion is larger than extremity axial compression.

Some embodiments are also included in and make after support extremity expands in the blood vessel, to make support extremity compression reaction to compressed configuration.In certain embodiments, the extremity of described support compresses by making this extremity return in described elongate body.In certain embodiments, the extremity of described support by advancing elongate body and compressing on this extremity.Some embodiments also comprise makes the extremity of described support move to different positions; Reexpand in the blood vessel when not making support shift out from patient's vascular system with making the extremity of described support.

Some embodiments in stenter to implant patient vessel comprised providing and comprise extremity and proximal portion and the support with compressed configuration and expanded configuration, described support is configured to have adjustable orifice porosity; The extremity of described support is expanded in patient vessel, makes described extremity have the first porosity; With the described proximal portion of adjustment, make when expanding in patient vessel, this proximal portion has second porosity different from the first porosity.

Some embodiments also comprise the aneurysm place making support be positioned at blood vessel generation.Some embodiments also comprise reducing by reducing the proximal portion porosity adjacent with aneurysm relative to extremity porosity and come from aneurysmal clot and move.In certain embodiments, proximal portion is regulated to reduce to flow to the blood flow of vascular aneurysms.In certain embodiments, regulate proximal portion to comprise and reduce proximal portion porosity relative to extremity porosity.In certain embodiments, after making extremity expansion and regulate proximal portion, a part for proximal portion is larger than extremity axial compression.Some embodiments are also included in and make after support extremity expands in the blood vessel, to make support extremity compression reaction to compressed configuration.

Some embodiments in stenter to implant patient vessel are comprised and makes support be advanced to process position in the blood vessel; In the side of process position, the extremity of described support is expanded in the blood vessel, make after inflation, described extremity has extremity wall, and it has the first porosity; After the extremity expansion making described support, regulate the pars intermedia of described support, make when regulating, described pars intermedia has pars intermedia wall, and it has the second porosity being less than the first porosity; With after the described pars intermedia of adjustment, the proximal portion of described support is expanded, and make after inflation, described proximal portion has proximal portion wall, and it has three porosity.

Some embodiments also comprise the aneurysm place making support be positioned at blood vessel generation.In certain embodiments, the pars intermedia wall of described expansion is positioned at aneurysm place.In certain embodiments, pars intermedia is regulated to reduce the blood flow flowing to vascular aneurysms.In certain embodiments, the second porosity of described pars intermedia wall is adjusted at least one that be less than in the first porosity and three porosity.Some embodiments also comprise makes blood vessel engage with extremity.In certain embodiments, make proximal portion expansion comprise and make proximal portion expanded radially.Some embodiments also comprise makes blood vessel engage with proximal portion.In certain embodiments, the second porosity is adjusted at least one that be less than in the first porosity and three porosity.

Some embodiments also comprise makes the extremity of described support return back to contracted configurations, thus after permission extremity expands in the blood vessel, reduces the contact between extremity and blood vessel.In certain embodiments, the extremity of described support is returned to contracted configurations by making this extremity return in described elongate body.In certain embodiments, the extremity of described support by advancing elongate body and being returned to contracted configurations on extremity.Some embodiments are also included in and make after the extremity of described support is returned to contracted configurations, make the extremity of described support move to diverse location in patient body; Expand in described different position with making the extremity of described support.Some embodiments also comprise takes out support from blood vessel.

Some embodiments in stenter to implant patient vessel being comprised makes support expand in the blood vessel, and described support has wall portion, and described wall portion has the first porosity when unrestricted; Being arranged in the described support of described blood vessel with regulating, the pars intermedia of described wall portion being had be different from the second porosity of the first porosity.In certain embodiments, the second porosity is less than the 4th porosity of the three porosity of the proximal portion of described wall portion and the extremity of described wall portion.Some embodiments also comprise the aneurysm place making support be positioned at blood vessel generation.In certain embodiments, described pars intermedia is positioned at aneurysm place and expands.In certain embodiments, the second porosity is adjusted at least one that be less than in the first porosity, the three porosity of proximal portion of described wall portion and the 4th porosity of the extremity of described wall portion.Some embodiments are also included in and make after support expands in the blood vessel, to make support pressure be reduced to contracted configurations.In certain embodiments, described support is compressed to contracted configurations by making the extremity of this support return to delivery catheter from blood vessel.Some embodiments are also included in and make after described support pressure is reduced to contracted configurations, to make described support in patient vessel, move to different positions; Expand in described different position with making described support.

Some embodiments of process patient vessel comprise makes support be advanced in patient vessel, and described support has the tube chamber extended between mount proximal end and rack far end; Make described support expand into second state with the second cross sectional dimensions being greater than the first cross sectional dimensions from first state with the first cross sectional dimensions, described support has the second state stent length being less than the first state stent length; With make the Part I of described support be compressed to the third state, described support is had be less than the third state stent length of described second state stent length; Wherein, make described support expand from the first state and comprise axial compression and the expanded radially by making support unrestricted of this support of permission; Wherein, the Part I of support described in axial compression is included in when support is in the second state and applies axial compressive force to support.

Some embodiments also comprise the described support of permission by making this support unrestricted from third state axial expansion to the second state.In certain embodiments, the support being in the third state has the 3rd cross sectional dimensions, and it is identical with the second cross sectional dimensions substantially.

Some embodiments relate to for the support in patients with implantation blood vessel, comprise the proximal portion with near-end; There is the extremity of far-end; From described near-end to the inner support length of described remote extension; Define the inner support wall of the tube chamber extended between described near-end and described far-end, described inner support wall has transmission structure and expanded configuration; Wherein, when being in expanded configuration, inner support wall has porosity, and it changes at the separation point position place near extremity by changing inner support length.

In certain embodiments, the porosity of cradle wall reduces when stent length reduces.In certain embodiments, when stent length changes, the cradle wall porosity at separation point position place changes relative to the cradle wall porosity at least one place in proximal portion and extremity.In certain embodiments, when stent length reduces, the cradle wall porosity at separation point position place reduces relative to the cradle wall porosity at proximal portion and extremity place.In certain embodiments, support axial compression is made to reduce the porosity of support.In certain embodiments, support is automatically changed to expanded configuration from transmission structure when unrestricted.

In certain embodiments, described support carries out radial contraction by increasing stent length after becoming expanded configuration from transmission structural change.In certain embodiments, described support carries out radial contraction by the propelling of conduit on expanding stent after becoming expanded configuration from transmission structural change.In certain embodiments, described support comprises support and is in the second stent length when the first stent length when transmitting structure and support are in expanded configuration, and described second stent length is shorter than described first stent length.In certain embodiments, the bracket holes porosity at separation point position place can reduce by making stent length reduce by more than the second stent length.In certain embodiments, when being in expanded configuration, when significantly not changing support cross sectional dimensions, cross sectional dimensions across tube chamber, the porosity at separation point position place changes by changing stent length.In certain embodiments, when being in expanded configuration, described stent length can reduce when significantly not changing the radial cross-section size of support tube chamber.

Some embodiments describe and a kind ofly comprise elongate body for by the system in stenter to implant patient vessel, its main body tube chamber having proximal portion, extremity and extend from described proximal portion to described extremity, and described extremity is configured to extend in patient vessel; With the support that can be expanded to expanded configuration from compressed configuration, described support have near-end, far-end, from described near-end to the support tube chamber of described remote extension and the cradle wall under expanded configuration with adjustable orifice porosity; Wherein, the support be under compressed configuration is configured to slide location and change to expanded configuration when described support is released from main body tube chamber in main body tube chamber; Wherein, when the far-end of support is in expanded configuration, adjustable orifice porosity is by making mount proximal end relative to rack far end propelling or returning and regulate.

In certain embodiments, adjustable orifice porosity can regulate along cradle wall length in multiple separation point position.In certain embodiments, when support is in expanded configuration, adjustable orifice porosity can advance towards rack far end along with mount proximal end at the separation of cradle wall, position spaced apart and reduce.In certain embodiments, when support is in expanded configuration, adjustable orifice porosity can exit from rack far end along with near-end at the separation of cradle wall, position spaced apart and increase.In certain embodiments, when support is in expanded configuration, support axial compression is made to reduce the porosity at least partially of described support.In certain embodiments, support is automatically changed to expanded configuration from transmission structure when unrestricted.In certain embodiments, described support carries out radial contraction by increasing stent length after becoming expanded configuration from transmission structural change.In certain embodiments, described support has the length proximally distally extended; With when being in expanded configuration, described stent length can reduce when significantly not changing the radial cross-section size of support tube chamber.

Some embodiments relate to a kind of for the support in patients with implantation tube chamber, comprise proximal portion and extremity; Define the cradle wall extended to described extremity from described proximal portion, described cradle wall has compressed configuration and expanded configuration; Wherein, when being in expanded configuration, cradle wall has variable orifice porosity, and it regulates by the relative motion of described proximal portion relative to described extremity.

In certain embodiments, the porosity of described cradle wall can regulate in the position of the multiple spaced apart between described proximal portion and described extremity.In certain embodiments, when the stent length extended from described proximal portion to described extremity reduces, the porosity of described cradle wall reduces.In certain embodiments, when the stent length extended from described proximal portion to described extremity changes, the porosity of the cradle wall in the first area between described proximal portion and described extremity changes relative to the porosity of the cradle wall being arranged in described proximal portion and at least one second area located of described extremity.In certain embodiments, when stent length reduces, the porosity in first area reduces relative to the porosity in second area.In certain embodiments, when support is in expanded configuration, support axial compression is made to reduce the porosity of described support.In certain embodiments, described support has the proximally portion distad length that extends of portion; With when being in expanded configuration, described stent length can reduce when significantly not changing the radial cross-section size of support tube chamber.

Some embodiments relate to a kind of for the support in patients with implantation body, comprise the cradle wall with adjustable orifice porosity, and the porosity at least partially of described cradle wall can be regulated when described support is positioned at patient body.

Some embodiments disclose a kind of for the support in patients with implantation blood vessel, comprise the cradle wall being configured to change between compressed configuration and expanded configuration, the pars intermedia that described cradle wall has proximal portion, extremity and extends between described proximal portion and described extremity; Wherein, the pars intermedia of described support has variable orifice porosity, and it can regulate when described extremity is in expanded configuration.

In certain embodiments, the porosity of described pars intermedia reduces when the stent length extending to described extremity from described proximal portion reduces.In certain embodiments, the porosity of pars intermedia changes by changing pars intermedia length.In certain embodiments, when the length of described pars intermedia reduces, the porosity of this pars intermedia reduces relative to the porosity at least one place in described proximal portion and described extremity.In certain embodiments, when support is in expanded configuration, support axial compression is made to reduce the porosity of described pars intermedia.In certain embodiments, described support has the proximally portion distad length that extends of portion; With when being in expanded configuration, described stent length can reduce when significantly not changing the radial cross-section size of described support.

Some embodiments describe the method for process patient vessel, comprising: provide elongate body, the tube chamber that described elongate body comprises the proximal portion with near-end, the extremity with far-end and extends between described near-end and described far-end; There is provided and comprise extremity and proximal portion and the support with compressed configuration and expanded configuration, described support is configured to change to expanded configuration from compressed configuration; The extremity of described elongate body is made to be advanced to the process position of patient vessel; The support being in compressed configuration is distad moved relative to described elongate body; In patient vessel, make support extremity be changed to expanded configuration from compressed configuration, support extremity is engaged with blood vessel wall; Process blood vessel, makes the material in blood vessel remove at least in part blood vessel wall at least in part; Described elongate body is return relative to support proximad, makes support proximal portion be changed to expanded configuration from compressed configuration; And the material collected between support and blood vessel wall.

Some embodiments also comprise makes support proximal portion be changed to expanded configuration from compressed configuration.In certain embodiments, process blood vessel is included in and makes before proximal portion is changed to expanded configuration, to make the inflation near support extremity in blood vessel.In certain embodiments, process blood vessel wall is included in and makes before proximal portion is changed to expanded configuration, to excise material from the blood vessel wall near support extremity.In certain embodiments, process blood vessel comprises the inflated made in support, thus increases the cross sectional dimensions of expanding stent.In certain embodiments, described material comprises at least one in speckle and clot.

Some embodiments describe the method processing patient vessel during Ink vessel transfusing program, comprising: make the extremity of support expand in the side in angiostenosis region; The proximal portion of the support being positioned at narrow zone is expanded; The diameter of the vessel lumen being positioned at narrow zone is increased; And the speckle chip resulted from during utilizing support to be collected in program between support and blood vessel wall.

In certain embodiments, make extremity expansion comprise and make extremity advance relative to delivery catheter and allow extremity automatic expansion.Some embodiments are also included in when extremity expands and blood vessel wall are engaged with support extremity.Some embodiments also comprise makes proximal portion advance relative to extremity and reduce the porosity of extremity relative to support another part.In certain embodiments, the porosity reducing extremity comprises makes porosity change between about 30% and about 5%.In certain embodiments, increase diameter makes the inflation near expansion extremity before being included in and making the expansion of support proximal portion.In certain embodiments, increase diameter makes the inflation near expansion extremity after being included in and making the expansion of support proximal portion.Some embodiments excise material from the blood vessel wall near support extremity before being also included in and making proximal portion expansion.In certain embodiments, excise material from blood vessel wall to comprise cutting element is rotated around support.

Some embodiments describe the method for process patient vessel, comprising: make support be advanced to narrow zone in patient vessel, described support has extremity and proximal portion; Support extremity in narrow zone distally is expanded; Make to expand in the support proximal portion of narrow zone nearside; With after extremity expansion and before proximal portion expansion, utilize the chip between support filter holder and blood vessel wall.

Some embodiments also comprise the chip collected between support and blood vessel wall.Some embodiments also comprise suction chip to be taken out in patient body by chip.Some embodiments also comprise the diameter increasing the vessel lumen in narrow zone by making endovascular inflation.Some embodiments also comprise the diameter increasing the vessel lumen in narrow zone by making the inflation in support.In certain embodiments, make extremity expansion comprise and make extremity advance relative to delivery catheter and allow extremity automatic expansion.In certain embodiments, making extremity expansion comprise makes blood vessel wall engage with support extremity.Some embodiments also comprise makes proximal portion advance relative to extremity and reduce the porosity of extremity relative to support another part.In certain embodiments, the porosity reducing extremity comprises makes porosity change between about 30% and about 5%.Some embodiments excise material from the blood vessel wall near support extremity before being also included in and making proximal portion expansion.In certain embodiments, described excision makes cutting element rotate around support before being included in and making proximal portion expansion.

Some embodiments relate to a kind of system for the treatment of patient vessel, comprising: elongate body, the tube chamber that described elongate body comprises the proximal portion with near-end, the extremity with far-end and extends between described near-end and described far-end; To be configured to rest in described elongate body and the support advanced relative to described elongate body, described support has extremity and proximal portion, and described support is configured to change between compressed stent structure with expanding stent structure; And blood processor, it is by the speckle material in cutting narrow zone or increase the cross sectional dimensions being arranged in the vessel lumen in angiostenosis region by making narrow zone expand; Wherein, the extremity of described support is configured to engage blood vessel wall when the far-end relative to elongate body distad advances and is changed to expansion distally structure from compression distally structure; Wherein, the proximal portion of described support is configured to pass and makes support advance relative to elongate body and engage blood vessel wall and be changed to expansion nearside structure from compression nearside structure; Wherein, when the expansion extremity of support engages blood vessel wall, described extremity collects the chip removed from narrow zone by blood processor.

In certain embodiments, when unrestricted in expanding stent structure, described support has the porosity of about 60% to about 85%.In certain embodiments, when unrestricted in expanding stent structure, described support has the porosity of about 65% to about 75%.In certain embodiments, described support can be in expanding stent structure time axial compression, described porosity can when not significantly change support external diameter be reduced to about 5% to about 30%.In certain embodiments, the support being in expanding stent structure can carry out regulating so that the corresponding multiple positions between proximal portion and extremity reduce the porosity of support.In certain embodiments, be in expanding stent structure support can along support in multiple change in location with the porosity at least one position with about 5% to about 30%.In certain embodiments, described elongate body comprises expandable members, and it expands when support extremity is in expansion distally structure and support proximal portion is in compression nearside structure.In certain embodiments, blood processor comprises the cutting element of cutting speckle material.In certain embodiments, described cutting element rotates around the compression proximal portion of support when extremity expands and engages blood vessel wall.In certain embodiments, cutting element rotates around elongate body.

Some embodiments describe a kind of device for filtering blood samples of patients during Ink vessel transfusing program, comprising: the support with extremity and proximal portion, and described support is configured to change between compressed stent structure and expanding stent structure; And blood processor, it is by the speckle material in cutting narrow zone or increase the cross sectional dimensions being arranged in the vessel lumen in angiostenosis region by making narrow zone expand; Wherein, the extremity of described support is configured to engage blood vessel wall and is changed to expansion distally structure from compression distally structure; Wherein, when the expansion extremity of support engages blood vessel wall, described extremity collects the chip removed from narrow zone by blood processor.

In certain embodiments, the proximal portion of described support is configured to engage blood vessel wall and is changed to expansion nearside structure from compression nearside structure.In certain embodiments, described elongate body comprises expandable members, and it expands when support extremity is in expansion distally structure and support proximal portion is in compression nearside structure.In certain embodiments, expansion extremity plays the work of filter in order to limit chip with blood downstream through expansion extremity.In certain embodiments, blood processor comprises the cutting element of cutting speckle material.In certain embodiments, cutting element rotates around the compression proximal portion of support.In certain embodiments, when unrestricted in expanded configuration, described support has the porosity of about 60% to 85%.In certain embodiments, when unrestricted in expanded configuration, described support has the porosity of about 65% to about 75%.In certain embodiments, described support can be in expanding stent structure time axial compression, described porosity can when not significantly change support external diameter be reduced to about 5% to about 30%.In certain embodiments, porosity can be reduced to about 3%, about 10%, about 20%, about 25%, about 35%, about 40%, about 45%, about 50% and about 55%.In certain embodiments, the support being in expanding stent structure can carry out regulating the porosity reducing support with the corresponding multiple positions between proximal portion and extremity.In certain embodiments, be in expanding stent structure support can along support in multiple change in location with the porosity at least one position with about 5% to about 30%.

In certain embodiments, support can use in other tube chamber of health.Such as, in certain embodiments, support can use in the ureter of patient body, urethra and fallopian tube.

Some embodiments describe the aneurysmal method in process patient vessel, comprising: there is in aneurysmal blood vessel the first stent expansion making to have the first mount proximal end and the first rack far end, making the first support from extending to away from the aneurysmal second position near aneurysmal primary importance; Second stent expansion with the second mount proximal end and the second rack far end is made in the first support, when making when the second stent expansion and engage the first support, second support is contiguous aneurysm axial location substantially, second mount proximal end is located away from the first mount proximal end, second rack far end is located near the first rack far end, thus hinders blood to flow into aneurysm from blood vessel.

In certain embodiments, be less than by means of only flowing into aneurysmal blood during the first support if flow into aneurysmal blood by the first support and the second support.In certain embodiments, the second near-end is adjacent substantially with the first near-end.In certain embodiments, the first support has porosity identical substantially with the second support when unrestricted.Some embodiments part also comprised along respective holder regulates the porosity of at least one in the first support and the second support.In certain embodiments, described adjustment comprises reduction holes porosity.In certain embodiments, porosity reduces by making at least one axial compression in the first support and the second support.

Some embodiments relate to the aneurysmal method in process patient vessel, comprising: make the first stent expansion in the blood vessel, make the first support extend near the aneurysmal second position from the primary importance away from vascular aneurysms; Make the second stent expansion with in the first support, make the second support contiguous aneurysm location substantially.

In certain embodiments, the first support has porosity identical substantially with the second support when unrestricted.Some embodiments part also comprised along respective holder regulates the porosity of at least one in the first support and the second support.In certain embodiments, adjustment hole porosity comprises reduction holes porosity.In certain embodiments, porosity reduces by making at least one axial compression in the first support and the second support.In certain embodiments, be less than by means of only flowing into aneurysmal blood during the first support if flow into aneurysmal blood by the first support and the second support.

Some embodiments relate to a kind of for the braided support in patients with implantation blood vessel, comprising: multiple braiding strands with average strand thickness, and the open area of described multiple braiding strands between strand has hole; Wherein, described support can be expanded to expanded configuration from compressed configuration; Wherein, described hole has average pore length; Wherein, described support has the porosity equal with the ratio of stent patency surface area and support total surface area; Wherein, when support is in expanded configuration, bracket holes porosity is multiplied by average open cell length and is equal to or less than about 0.3mm.

In certain embodiments, each braided members comprises the band that width is greater than thickness.In certain embodiments, each braided members comprises the band that width equals thickness substantially.In certain embodiments, the porosity of a part for described support can reduce by making this part axial compression of described support.In certain embodiments, the axial compression part of described support carries out axial expansion when unrestricted.In certain embodiments, the porosity of a part for described support can be reduced to about 5% to about 50%.In certain embodiments, when support is in expanded configuration, bracket holes porosity is multiplied by average pore length and is multiplied by average strand thickness and is equal to or less than about 0.023mm ².

Some embodiments relate to a kind of for the braided support in patients with implantation blood vessel, comprising: multiple braiding strands with average strand thickness, and the open area of described multiple braiding strands between strand has hole; Wherein, described support can be expanded to expanded configuration from compressed configuration; Wherein, described hole has average pore length; Wherein, described support has the porosity equal with the ratio of stent patency surface area and support total surface area; Wherein, when support is in expanded configuration, bracket holes porosity is multiplied by average strand thickness and is equal to or less than about 0.002in (roughly 0.05mm).

In certain embodiments, average strand thickness is less than about 0.004in (roughly 0.1mm).In certain embodiments, average strand thickness is equal to or less than about 0.003in (roughly 0.076mm).In certain embodiments, average strand thickness is equal to or less than about 0.002in (roughly 0.05mm).In certain embodiments, average strand thickness is equal to or less than about 0.001in (roughly 0.025mm).In certain embodiments, when support is in expanded configuration, average strand thickness is multiplied by average pore length and is equal to or less than about 0.0328mm ².In certain embodiments, described hole has the average pore area limited by the inner edge of border strand, and described average pore area is about 2.2 × 10 ^-5in ²(roughly 0.014mm ²) to about 12.3 × 10 ^-5in ²(roughly 0.08mm ²).In certain embodiments, when support is in expanded configuration, it is about 2.2 × 10 that average strand thickness is multiplied by average pore area ^-9in ³(roughly 3.6 × 10 ^-5mm ³) to about 3.69x10 ^-7in ³(roughly 0.006mm ³).

Some embodiments relate to a kind of for the braided support in patients with implantation blood vessel, comprising: multiple braiding strands with average strand thickness, and the open area of described multiple braiding strands between strand has hole; Wherein, described support can be expanded to expanded configuration from compressed configuration; Wherein, described hole has average pore length; Wherein, described support has the porosity equal with the ratio of stent patency surface area and support total surface area; Wherein, when support is in expanded configuration, average pore length is multiplied by average strand thickness and is equal to or less than about 9.4 × 10 ^-5in ²(roughly 0.06mm ²).

In certain embodiments, average pore length is multiplied by average strand thickness and is equal to or less than about 6.8 × 10 ^-5in ²(roughly 0.04mm ²).In certain embodiments, average pore length is multiplied by average strand thickness and is equal to or less than about 5 × 10 ^-5in ²(roughly 0.03mm ²).

In certain embodiments, a kind of aneurysmal method processed on patient chest in blood vessel is provided.Described method is included in the first stent expansion having and aneurysmal breast makes to have the first mount proximal end and the first rack far end in blood vessel, and the first support is extended to away from the aneurysmal second position near aneurysmal primary importance.Described method is also included in the first support the second stent expansion making to have the second mount proximal end and the second rack far end, when making when the second stent expansion and engage the first support, second support is contiguous aneurysm axial location substantially, second mount proximal end is located away from the first mount proximal end, second rack far end is located near the first rack far end, thus hinders blood to flow in aneurysm from blood vessel breast.In certain embodiments, on breast, blood vessel comprises cerebral arteries.In certain embodiments, on breast, blood vessel comprises at least one in common carotid artery, internal carotid artery, external carotid artery and branch thereof.

In certain embodiments, a kind of aneurysmal method processed in patient chest in blood vessel is provided.Described method is included in the first stent expansion having in aneurysmal intrathoracic blood vessel and make to have the first mount proximal end and the first rack far end, and the first support is extended to away from the aneurysmal second position near aneurysmal primary importance.Described method is also included in the first support the second stent expansion making to have the second mount proximal end and the second rack far end, when making when the second stent expansion and engage the first support, second support is contiguous aneurysm axial location substantially, second mount proximal end is located away from the first mount proximal end, second rack far end is located near the first rack far end, thus hinders blood to flow into aneurysm from intrathoracic blood vessel.In certain embodiments, intrathoracic blood vessel comprises at least one in ascending aorta, descending aorta, aortic arch and branch thereof.In certain embodiments, descending aorta comprises at least one in thoracic aorta, ventral aorta and branch thereof.

In certain embodiments, a kind of aneurysmal method processed under patient chest in blood vessel is provided.Described method is included in the first stent expansion having and make to have the first mount proximal end and the first rack far end under aneurysmal breast in blood vessel, and the first support is extended to away from the aneurysmal second position near aneurysmal primary importance.Described method is also included in the first support the second stent expansion making to have the second mount proximal end and the second rack far end, when making when the second stent expansion and engage the first support, second support is contiguous aneurysm axial location substantially, second mount proximal end is located away from the first mount proximal end, second rack far end is located near the first rack far end, thus hinders blood to enter in aneurysm from vessel flow breast.In certain embodiments, under breast, blood vessel comprises at least one in renal artery, common iliac artery and branch thereof.

In certain embodiments, a kind of aneurysmal method processed in patient chest vascellum laterale is provided.Described method is included in the first stent expansion having in aneurysmal breast vascellum laterale and make to have the first mount proximal end and the first rack far end, and the first support is extended to away from the aneurysmal second position near aneurysmal primary importance.Described method is also included in the first support the second stent expansion making to have the second mount proximal end and the second rack far end, when making when the second stent expansion and engage the first support, second support is contiguous aneurysm axial location substantially, second mount proximal end is located away from the first mount proximal end, second rack far end is located near the first rack far end, thus hinders blood to flow into aneurysm from breast vascellum laterale.In certain embodiments, breast vascellum laterale comprises at least one in brachial artery, transverse cervical artery, suprascapular artery, dorsal scapular artery and branch thereof.

Some embodiments describe the aneurysmal method in process patient vessel, comprising: make the first stent expansion in the blood vessel, make the first support extend near the aneurysmal second position from the primary importance away from vascular aneurysms; Make the second stent expansion in the blood vessel, wherein, after the second stent expansion, the second support is close to aneurysm location substantially and the first support is overlapping with the second support.

Some embodiments describe the aneurysmal method in process patient vessel, comprise: make the first stent expansion in the blood vessel, wherein, after the first stent expansion, the first support extends near the aneurysmal second position from the primary importance away from vascular aneurysms; Make the second stent expansion in the blood vessel, wherein, after the second stent expansion, the second support is close to aneurysm location substantially and the first support is overlapping at least in part with the second support.

Some embodiments describe the aneurysmal method in process patient vessel, comprise: make the first stent expansion in the blood vessel, wherein, after the first stent expansion, the first support extends near the aneurysmal second position from the primary importance away from vascular aneurysms; Make the second stent expansion in the blood vessel, wherein, after the second stent expansion, the second support extends to from the 3rd position away from vascular aneurysms near aneurysmal 4th position.

Some embodiments describe the aneurysmal method in process patient vessel, comprise: make the first stent expansion in the blood vessel, wherein, after the first stent expansion, the first support extends near the aneurysmal second position from the primary importance away from vascular aneurysms; The second stent expansion is made with in the first support.

Some embodiments describe the method in the aneurysm in stenter to implant blood vessel, comprising: provide elongate body, it tube chamber comprising proximal portion, extremity and extend between described proximal portion and described extremity; Being inserted by described extremity comprises in aneurysmal blood vessel; Described extremity is advanced in the blood vessel, until this extremity is near aneurysm; The support being in compressed configuration is advanced in the tube chamber of this elongate body relative to described elongate body; First support is expanded in the blood vessel, and expanding stent is from extending near the aneurysmal second position away from aneurysmal primary importance; With after making stent expansion and when confirm on image the fluid stream in aneurysm blocked at least about 30% time, elongate body is taken out from blood vessel.

Some embodiments describe the method for obstructing arterial tumor at least in part, comprising: transporter is advanced in the blood vessel, until the contiguous aneurysm of the extremity of transporter; Make across aneurysmal stent expansion; Make aneurysm imaging; Aneurysmal degree of congestion is determined after making stent expansion; With determining that aneurysm main body has been blocked after at least about 30%, transporter is taken out from blood vessel.

Some embodiments describe the aneurysmal method of process, comprising: transporter is advanced comprising in aneurysmal blood vessel, until the contiguous aneurysm of the extremity of described device; First support is expanded in the blood vessel, and the first support of expansion extends to aneurysmal second side from aneurysmal first side; With determine aneurysm occlusion at least about 30% time transporter is taken out from blood vessel.

Supplementary features of the present invention and advantage will be described below and will partly be become apparent by description, or can obtain in the embodiment of this invention.Structure by particularly pointing out in text description and claim and accompanying drawing thereof realizes and obtains by advantage of the present invention.

Should be appreciated that general remark above and following detailed description are examples and illustrative and be further described the present invention's theme required for protection for providing.

Accompanying drawing explanation

Accompanying drawing is used for understanding the present invention further, comprises in this manual and forms its part, which show aspects more of the present invention and be used from description one and explain principle of the present invention.

Fig. 1 is aneurysm, leads to the schematic diagram of aneurysmal blood flow and branch vessel.

Fig. 2 A and 2B shows the embodiment processing aneurysmal blocking device.

Fig. 3 shows in conduit Fig. 2 A and 2B illustrated embodiment that are in compressive state.

Fig. 4 A shows the embodiment for the treatment of aneurysmal blocking device.

Fig. 4 B and 4C shows the cross section of the part that can be used for the band forming blocking device shown in Fig. 4 A.

Fig. 5 shows in conduit the blocking device being in compressive state, and it utilizes plunger to be released by from conduit.

Fig. 6 shows and opens and the compression blocking device shown in the Fig. 5 being in swelling state in conduit outside.

Fig. 7 show across aneurysm neck, bifurcated and branch vessel be positioned at vessel lumen open blocking device.

Fig. 8 show schematically show and is positioned at the blocking device of vessel lumen and the change of blood flow direction.

Fig. 9 shows compared with blocking device of the present invention, and bending force acts on the effect in conventional stent.

Figure 10 shows the flexibility of the blocking device compared with conventional stent by the deformation extent produced because of applied force.

Figure 11 A, 11B, 11C, 11D, 11E, 11F and 11G show the nonhomogeneous density of the fabric providing required blocking device.

Figure 12 shows the difference of the mesh-density aspect that the nonhomogeneous density due to the braiding of blocking device causes.

Figure 13 shows the change mesh-density blocking device covering aneurysm neck.

Figure 14 and 15 shows the embodiment of vascular blocking device, and wherein, at close aneurysm neck place, mesh-density is uneven relative to axis.

Figure 16 shows the bifurcated blocking device according to the embodiment of the present invention, and wherein, the blocking device that two density is lower is combined to form single branching device for multi.

Figure 17 shows the embodiment of the knitting element of the grid in blocking device.

Figure 18 shows the example of the knitting element of the grid in blocking device.

Figure 19 shows the example of another knitting element of the grid in blocking device.

Figure 20 shows the knitting element of the blocking device be fitted in blood vessel diameter.

Figure 21 is the viewgraph of cross-section of the example of protection turn.

Figure 22 shows the example of the stripe size determining the blocking device protected in turn or transporter.

Figure 23 shows another example of the stripe size determining the blocking device protected in turn or transporter.

Figure 24 shows the example according to multiple band determination strip width.

Figure 25 show the blocking device in blood vessel PPI and be in free standing condition blocking device PPI between relation.

Figure 26 shows the example of the maximum stripe size be fitted in protection turn.

Figure 27 shows the relation between the opening size of the knitting element in blocking device and the PPI of network.

Figure 28 shows the relation of the braiding PPI of Ink vessel transfusing PPI and 32 band blocking devices.

Figure 29 shows for 32 band blocking devices, and percentage ratio covers the relation between braiding PPI.

Figure 30 shows for 32 band blocking devices, the graph of a relation that the opening size of the knitting element in blocking device changes with the braiding PPI of network.

Figure 31 shows the example of the mesh-density adjustment means for regulating the mesh-density in blocking device.

Figure 32 shows the example opening blocking device being positioned at vessel lumen across aneurysm neck, bifurcated and branch vessel.

Figure 33 shows the example of the blocking device being in compressed configuration.

Figure 34 shows the example of the blocking device being in expanded configuration.

Figure 35 shows the example of the blocking device being in super expanded configuration.

Figure 36 A, 36B and 36C show the various examples of relation between the length of blocking device and diameter.

Figure 37 shows the embodiment processing aneurysmal blocking device.

Figure 38 shows the example of the blocking device opened in another blocking device.

Figure 39 shows the example of two blocking devices with lap.

Figure 40 shows the viewgraph of cross-section of the example of the blocking device opened in another blocking device.

Figure 41 shows the example of two blocking devices with lap.

Figure 42 shows the embodiment processing aneurysmal multiple blocking device.

Figure 43 is the cross section of blocking device conveying assembly according to one aspect of the invention and blocking device.

Figure 44 shows the conduit shown in Figure 43 and guide sheath.

Figure 45 is the partial sectional view of guide sheath shown in Figure 44, and the Yarn guide component of blocking device is equipped with in described guide sheath delivery.

Figure 46 is the cross section of Yarn guide component shown in Figure 45.

Figure 47 is the schematic diagram of Yarn guide component shown in Figure 46.

Figure 48 is the second schematic diagram of Yarn guide component shown in Figure 46.

Figure 49 shows blocking device and is positioned at a part for the Yarn guide component outside conduit, and how the near-end of blocking device starts to open at Ink vessel transfusing.

Figure 50 shows the step in the method that blocking device is opened.

Figure 51 shows opening according to the blocking device of one aspect of the invention.

Figure 52 is the schematic diagram of Yarn guide component according to another embodiment of the present invention.

Figure 53 is the schematic diagram opening blocking device after being opened by Yarn guide component shown in Figure 52.

Figure 54 shows the example carrying out the expansion blocking device expanded in response to pressure.

Figure 55 shows the blocking device shown in the Figure 54 after negative pressure is applied to blocking device.

Figure 56 shows the example of release blocking device far-end while the near-end of blocking device keeps being attached on transporter.

Figure 57 shows the example of the blocking device that part is opened.

Figure 58 shows another example of the blocking device that part is opened.

Figure 59 shows blocking device example shown in Figure 58 of reorientating of proximad in the blood vessel.

Figure 60 shows the example of expansion blocking device.

Figure 61 shows example shown in blocking device Figure 60 after Ink vessel transfusing is reorientated.

Figure 62 shows the example of the blocking device being in retracted mode.

Figure 63 shows the example of reorientating blocking device while blocking device is retracted.

Figure 64 is the sectional view of the conduit of delivery Yarn guide component, and described Yarn guide component is equipped with support according to an embodiment of the invention.

Figure 65 shows and is arranged in the example that blood vessel processes the conduit of position.

Figure 66 shows the example of the support that part is in the blood vessel opened.

Figure 67 shows the example of the sacculus expanding to process narrow zone in the blood vessel, and the support that wherein part is opened plays the work of filter in order to catch the speckle chip (plaquedebris) coming from process.

Figure 68 shows the example of the sacculus being retracted to contraction state.

Figure 69 shows the example of the support opened completely in the blood vessel.

Figure 70 is the sectional view of the conduit of delivery Yarn guide component, and described Yarn guide component is equipped with support according to another embodiment of the present invention.

Figure 71 is the perspective view of the conduit with cutting tool according to an embodiment of the invention.

Figure 72 shows the example of the cutting tool of the conduit for the treatment of Ink vessel transfusing narrow zone, and the support that wherein part is opened plays the work of filter in order to catch the speckle chip coming from process.

Figure 73 is the sectional view of the delivery conduit of Yarn guide component and the cutting tool according to disclosed embodiment.

Figure 74 shows and is arranged in blood vessel and processes the conduit of position and the example of cutting tool.

Figure 75 shows conduit and cutting tool separates the example advanced in the blood vessel.

Figure 76 shows layout another supravasal cutting tool in the blood vessel and the example of conduit.

Figure 77 shows the example of the support opened in the narrow zone of blood vessel.

Figure 78 shows the example being arranged in the sacculus opening support.

Figure 79 shows at the example opening in support the sacculus expanding to process narrow zone.

Figure 80 is the sectional view being arranged in the sacculus on Yarn guide component according to the disclosed embodiments.

Figure 81 shows the example of the support opened in the narrow zone of blood vessel, and the sacculus wherein on Yarn guide component is positioned at the support opened.

Figure 82 shows the sacculus be arranged on Yarn guide component expands to process narrow zone example at the support opened.

Detailed description of the invention

In following detailed description, many details are set forth to fully understand the present invention.But, it will be apparent for a person skilled in the art that the present invention can implement when lacking these details of part.In other cases, in detail the well-known structure of display and method in order to avoid interference the understanding of the present invention.

Flexible vascular device

Fig. 1 shows typical cerebral aneurysm 10.The cervical region 11 of aneurysm 10 typically can limit the opening of about 2-25mm.Should be appreciated that blood vessel 13 is connected to the tube chamber 12 of aneurysm 10 by cervical region 11.As shown in Figure 1, the blood flow 3 in blood vessel 13 is flowed by tube chamber 12 and flows into aneurysm.In response to the constant blood flow flowed in aneurysm, the wall portion 14 of tube chamber 12 continues expansion and bears very large risk of rupture.When the blood in aneurysm 10 makes the pressure acted in wall portion 14 exceed wall intensity, aneurysm rupture.One aspect of the present invention can prevent or reduce this probability of breaking.Bifurcated 15 and side branch 16 is also show in Fig. 1.

Fig. 2 shows an embodiment of the vascular arrangement 200 according to one aspect of the invention.In the embodiment shown, blocking device 200 has by outer surface 21, inner surface 24 and the tubular structure substantially 22 that limits of thin-walled that extends between described surperficial 21,24.Multiple opening 23 extends and allows fluid to flow to blood vessel wall from the inside of vascular arrangement 200 between surface 21,24.Vascular arrangement 200 can radial compression and longitudinally adjustment.

In certain embodiments, term vascular arrangement can use interchangeably with vascular blocking device and blocking device.These terms are broad terms and have its its ordinary meaning, comprise that (unless expressly stated or with describe do not conform to) this explanation describes or be hereby incorporated by other of support or other vascular arrangement is illustrated described by each support and other vascular arrangement.

Before Fig. 3 to show in patient's vascular system release, in conduit 25 and conduit 25, be in the blocking device 200 of compressive state.

Fig. 4 shows another embodiment of the blocking device 30 with two or more the strand materials 31,32 reeled in a spiral manner.This material weaves by this way and forms network 33.The gap 34 being appreciated that the size that the number of turns (at least in part) on the per unit length of the thickness of strand material, strand quantity and blocking device 30 determines grid 33 and being formed.Such as, the size of gap 34 and/or grid 33 can be determined by the quantity of the strand material 31,32 reeled in a spiral manner.In certain embodiments, any amount of woven fabric strip (such as, 5,8,10,13,15 or 16 woven fabric strip) up to 16 woven fabric strip can be used.In certain embodiments, 16-32 woven fabric strip (such as, 20,23,25,27,30 or 32 woven fabric strip) can be used.In certain embodiments, the woven fabric strip of more than 32 can be used, such as 35,40,48,50,55,60,80,100 or more woven fabric strip.In certain embodiments, 48 woven fabric strip are used.

Therefore, the strand material of such as band can intersect to form braiding structure.The intersection of strand material radially or axially can be formed on the surface of forming device such as weaving mandrel.When strand material intersection axially path time, such as, the material that intersects can intersect according to fixing or variable frequency.As the example that strand material intersects with fixed frequency, the strand material of intersection can along any 1.0 inches of (roughly 0.25mm) axial path on forming device (such as, weaving mandrel) surface to show thread count.When strand material intersection radially path or circumferential paths time, the interval of strand material can evenly or changeably distribute.At strand material radially or in circumferential paths example (wherein, interval is uniformly distributed), interval radially can be determined according to following formula:

(π) × (forming device diameter)/(# band/2)

Figure 18 show radially with the knitting element in PPI (picks per inch) direction or the example of eyelet.The element (that is, knitting element) of any single braiding can combine to be formed on the surface of forming device (such as, braiding mandrel) mesh-structured, as shown in figure 17.Fabric can hinder or disturb the fluid stream (such as, blood) of some types in patient's tube chamber (such as, blood vessel).Braiding or network, density, shape etc. can determine endovascular flowing at least in part when blocking device opens in the blood vessel.Each parameter of fabric or grid can also control flowing by user.

Parameter for the flowing determining the blocking device by comprising network, density, shape etc. comprises the surface coverage of blocking device and the perforation size of braiding or network.Each in these parameters can characterize the geometry of fabric or grid further.Surface coverage can be defined as (surface area)/(total surface area), and wherein, surface area is the surface area of framework or solid member, and total surface area is the surface area of whole element (that is, framework and opening).

Perforation size can be defined as the greater depth limiting perforated openings.To interference or the effect being played enhancing by the flowing of fabric or grid can be stoped reducing the braiding structure increasing surface coverage while perforation size.Each parameter of surface coverage and perforation size can be improved further by changing the width of strand material (such as, band), the strand quantity increasing the strand material limiting fabric and/or increase PPI.

Braiding as above or network can be limited further by different parameters, described parameter such as comprises strand (such as, band) quantity, the width of each band/strand, braiding PPI and/or the diameter (such as, axle diameter) etc. of forming device.In certain embodiments, the diameter of each strand is about 0.001in (roughly 0.025mm) to 0.0014in (roughly 0.036mm).In certain embodiments, the diameter of each strand is about 0.0005in (roughly 0.0127mm) to 0.0020in (roughly 0.05mm).In certain embodiments, the diameter of each strand is less than or equal to about 0.0005in (roughly 0.0127mm) or is greater than about 0.0020in (roughly 0.05mm).

According to mesh parameter, lower limb length and band angle can be determined.Lower limb length can limit the side length of knitting element.Such as, if knitting element is diamond shape as shown in figure 17, a length of side of diamond weave element is " lower limb is long ".Band angle can limit by two of knitting element angles that intersecting lateral faces is formed.In example shown in Figure 17, band angle is formed in the angle between two adjacent sides of diamond weave element.The spaced radial of the knitting element in network can limit knitting element width radially.Figure 18 shows the example of the long and band angle of the spaced radial of knitting element, lower limb.

The spaced radial of grid can be determined as follows according to formula 1:

Spaced radial=(π) × forming device diameter/(# band/2) formula 1

Knitting element can put into blood vessel according to the spaced radial of blood vessel or diameter.The spaced radial of grid can regulate according to the diameter of blood vessel.Such as, if blood vessel diameter is little, spaced radial can be adjusted to less size while keeping the lower limb of knitting element long.Equally in this example, band angle can also be regulated to regulate spaced radial to obtain.Regulate band angle can also change the interval of knitting element along PPI direction.

Figure 19 shows the spaced radial of the network determined in blocking device and the example of band angle.In this example, grid or fabric comprise 16 cross strap, and wherein, the width of each band is about 0.004in (roughly 0.1mm), and on the forming device of such as mandrel, be woven into diameter be about 4.25mm and 65PPI.Therefore, in this example, the quantity of knitting element is 16, strip width is about 0.004in (roughly 0.1mm), the diameter (such as, axle diameter) being spaced apart about 1/65=0.01538in (roughly 0.39mm) and forming device along PPI direction is about 4.25mm.Therefore, spaced radial can be calculated as follows: spaced radial=(π) × forming device diameter/(# band/2)=(3.14) × (0.425/2.54)/(16/2)=0.0657in (roughly 1.67mm).Figure 19 shows the example that spaced radial is the knitting element of about 0.0657in (roughly 1.67mm).In addition, the lower limb of this example is long is about 0.0337in (roughly 0.86mm), band angle is about 153.65 degree, knitting element along the interval (based on band angle and lower limb are long) in PPI direction for about 0.0154in (roughly 0.39mm).

In certain embodiments, weave patterns can comprise " on 11 time 1 " pattern.In certain embodiments, weave patterns can comprise " on 12 times 2 " pattern.In certain embodiments, weave patterns can comprise other modification of fabric.

Figure 20 shows example shown in the Figure 19 after knitting element puts into applicable blood vessel diameter.In this example, spaced radial is adjusted to smaller length to adapt to less blood vessel diameter.Lower limb is long keeps about 0.0337in (roughly 0.86mm), and band angle is changed according to radially spaced change.In this example, spaced radial is adjusted to about 0.06184in (roughly 1.57mm), and band angular adjustment is to about 132.79 degree.Equally, the interval in knitting element PPI direction also changes.In this example, knitting element increases to about 0.0270in (roughly 0.69mm) along the interval in PPI direction from about 0.0154in (roughly 0.39mm).

Form 1 shows variable PPI, strip width (RW) or the grid of band quantity or the additional example of braiding structure.In addition, each braiding structure in form 1 can produce the structure at Ink vessel transfusing with same percentage coverage.

Table 1

# band	16	32	48	64
					Fabric diameter (mm)	4.25	4.25	4.25	4.25
Fabric diameter (in)	0.16732	0.16732	0.16732	0.16732
					PPI	65.00	130.00	275.00	260.00
RW(mils)	4.0000	2.0000	1.3000	1.0000
					Node separation (ppi)	0.01538	0.00769	0.00364	0.00385
Node separation (radial direction)	0.06571	0.03285	0.02190	0.01643
					Band angle (ppi)	153.65	153.65	161.13000	153.62
Lower limb long (in)	0.03374	0.01687	0.0111	0.00844
					Blood vessel diameter (mm)	4	4	4	4
Endovascular device node separation	0.06184	0.03092	0.02061	0.01546
					Ink vessel transfusing band angle (ppi)	132.79	132.79	136.37	132.70
Endovascular device node separation (ppi)	0.02702	0.01351	0.00825	0.00677
					Endovascular device PPI	37.01	74.04	121.21	147.72
Area (in is closed in endovascular device braiding 2)	0.00024814	0.00006203	0.00002641	0.00001551
					Endovascular device braiding open area (in 2)	0.00058741	0.00014680	0.00005861	0.00003681
Endovascular device coverage	29.7％	29.7％	31.06％	29.64％
					The endovascular device gross area (in 2)	0.00083555	0.00020883	0.00008502	0.00005232
Endovascular device pore size (mm)	1.317	0.658	0.430	0.329

Blocking device can put into protection turn to strengthen blocking device placement in the blood vessel.Equally, blocking device can be contained in and be positioned over endovascular transporter, such as, in conduit.The size of blocking device or size can be determined according to the size of the protection turn of accommodation blocking device, transporter or conduit.Such as, the strand of network or the quantity of band of the blocking device putting into corresponding protection turn, transporter or conduit can be determined, make blocking device open in the blood vessel before effectively store or storage.In an example, the strand of blocking device can be overlapping according to double-decker, comprises internal layer and skin, described outer layer protection turn.

In certain embodiments, braided diameter 0.25mm larger than the blood vessel size of recommending.In certain embodiments, when support is placed on Ink vessel transfusing, the support percentage coverage of blood vessel wall is about 1/3 or 33% of total surface area.In certain embodiments, braiding PPI (picks per inch, or per inch intersect line number) be 275PPI.In certain embodiments, fabric is made on metal-cored or mandrel, and fabric can not be overstocked to hinder fabric to take off from metal-cored or mandrel.In certain embodiments, the PPI of support (time in implantable intravascular) is about 100PPI.In certain embodiments, the diameter of the strand of support is about 0.001in (roughly 0.025mm) to about 0.0014in (roughly 0.036mm).In certain embodiments, the strand quantity selected by support is based on the hope diameter of support.Such as, in certain embodiments, it is the support of about 2.75mm to about 4.25mm that 48 strands are used for diameter, it is the support of about 4.5mm to about 6.0mm that 64 strands are used for diameter, it is 6.0mm and above support that 72 strands are used for diameter, and it is 2.5mm and following support that 32 strands are used for diameter.In certain embodiments, selected strand quantity is based on the diameter of delivery catheter.

In an example, the shell such as protecting turn, transporter or conduit holding blocking device can have constant dimensions or diameter, and can determine that the feature of blocking device is to coordinate described shell.Such as, can according to the hope size determination stripe size of shell or width.Like this, the size (or diameter) of shell (such as, protecting turn, transporter or conduit) is constant for having the various blocking devices of different size or quantity band.

Figure 21 shows the example of the viewgraph of cross-section of protection turn.In this example, the strand in the network of the blocking device protecting turn or band quantity is determined.The turn of protection shown in Figure 21 comprises the circular cross section with certain diameter.Strand or the band with predetermined thickness or size put into protection turn, make the inner surface of the exterior surface protection turn of strand/band.The inner surface of strand/band forms the concave surface in protection turn.Second strand/band puts into protection turn, makes the inner peripheral surface that the exterior surface of the second strand/band contacts with the concave surface previously putting into the strand/band protecting turn.Determine the midpoint at circle protection turn, the angle (that is, " arc angle ") from an edge of the second strand/band to the opposite edges of the second strand/band.According to these measured values, the quantity of the strand or band with preliminary dimension or thickness is determined as follows: (arc angle) × (# band/2)≤360 degree (i.e. # band≤720 degree/angle).

In the example illustrated in fig. 21, the band utilizing about 0.001in to be multiplied by 0.004in (roughly 0.025mm is multiplied by 0.1mm) makes blocking device.In the center of protection turn, from protection turn mid point to first straight line at an edge of internal layer band and from protect turn mid point to the opposite edges of internal layer band the second straight line the arc angle of strip member be about 34.14 degree.Therefore, the number of computations of band is less than or equal to about 720 degree/34.14 degree=20 bands.

Table 2 shows the additional example for the network of blocking device being loaded the different designs in protection turn.

Table 2

# band	16	32	64
				Protection turn ID (in)	0.017	0.017	0.017
Strip width (in)	0.004	0.002	0.001
				Beam thickness (in)	0.001	0.001	0.001
Inner circle angle	36.98	17.83	8.84
				The maximum # band installed in inner circle	9.73	20.19	40.72
# band in inner circle	8	16	32

Figure 22 shows another example of the stripe size determining the blocking device protected in turn or transporter.In this example, blocking device has grid based on beam thickness or braiding structure.As shown in figure 22, the diameter protecting turn or transporter 2301 is about 0.0170in (roughly 0.43mm).First band 2302 puts into the outer surface of protection turn or transporter 2301.Second band 2303 is placed to and contacts with the inner circumferential of protecting turn or transporter 2301, and wherein, described inner peripheral surface is the periphery tangent with the inner surface of the first band 2302.Second band 2303 is placed in inner peripheral surface, and the side end of the second band 2303 is contacted with the inner peripheral surface of protection turn or transporter 2301.As shown in figure 22, calculate and extend to arc angle between the first straight line of the side end of the second band 2303 and the second straight line extending to the end side of the second band 2303 from the mid point of protection turn or transporter 2301 from protection turn or the mid point of transporter 2301.

In this example, the full-size of the first and second bands 2302,2303 is determined according to formed arc angle.Such as, in order to allow to protect turn or transporter 2301 inner surface in have 8 bands, arc angle may be calculated (360 degree)/8=45 degree, as shown in figure 22.According to miter angle, it is the inner surface that 8 bands of about 0.001in (roughly 0.025mm) put into protection turn or transporter 2301 that maximum strip width is defined as about 0.00476in (roughly 0.12mm) to allow thickness.When using at this, term " maximum " is broad terms, and for representing the hope upper limit of (non-limiting) special parameter, term " minimum " is broad terms, for representing the hope lower limit of (non-limiting) special parameter.In certain embodiments, the parameter (being described as maximum) illustrated here can expand to and is greater than or exceedes maximum magnitude, and the parameter (being described as minimum) illustrated here can expand to and is less than or exceedes minimum zone.

In another example, use narrower strip width with compensative material tolerance variation and curvature.Study widely according to applicant and test, it is found that, the margin of tolerance being applied to about 20% of strip width can compensate the change of this material tolerances.Figure 23 shows 20% margin of tolerance or the buffering of the strip width being applied to blocking device.

In this example, 20% additional bands (that is, 1.20x8=9.6 band) is needed at blocking device.By calculating angle as above, the Breadth Maximum of band can be determined according to the desired number of 9.6 bands.Particularly, arc angle may be calculated (360 degree)/9.6=37.7 degree.According to above-mentioned calculating, the Breadth Maximum of band can be defined as about 0.00405in (roughly 0.1mm), as shown in figure 23.Therefore, in this example, 20% buffering is applied with the Breadth Maximum (roughly 0.1mm) allowing about 9.6 bands protected in turn or transporter to have about 0.00405in.

Table 3 provides the additional example of the strip width for different beam thickness.In example shown in table 3, beam thickness scope is about 0.0007in (roughly 0.018mm) to about 0.0015in (roughly 0.038mm).

Table 3

Beam thickness (in)	Calculate Breadth Maximum (in)	20% buffer width (in)
			0.0005	0.00543	0.00463

0.0006	0.00530	0.00452
			0.0007	0.00516	0.00440
0.0008	0.00503	0.00428
			0.0009	0.00490	0.00417
0.0010	0.00476	0.00405
			0.0011	0.00463	0.00393
0.0012	0.00450	0.00382
			0.0013	0.00436	0.00370
0.0014	0.00422	0.00358
			0.0015	0.00409	0.00346

In another example, the blocking device comprising 32 bands is described.Figure 24 shows the example of the strip width determining the 32 band blocking devices can putting into protection turn or transporter 2501 according to band quantity.In this example, protection turn or transporter 2501 have the diameter of about 0.017in (roughly 0.43mm), and the maximum strip width of inner peripheral surface can putting into protection turn or transporter 2501 provides approximately the arc angle of (360 degree)/(32/2)=22.5 degree, as shown in figure 24.Therefore, in order to place 16 bands along the inner peripheral surface of protection turn 2501, strip width is defined as about 0.00266in (roughly 0.068mm), and thickness is about 0.00080in (roughly 0.02mm), as shown in figure 24.Similarly, 20% buffering can be applied to strip width think narrower strip width provide to material tolerances change compensation.In this example, the strip width of change can be determined according to the new arc angle condition of about (360 degree)/1.92=18.75 degree.Table 4 is provided for the maximum strip width of 32 band blocking devices.

Table 4

Beam thickness (in)	Calculate Breadth Maximum (in)	20% buffer width (in)
			0.0005	0.00288	0.00242
0.0006	0.00281	0.00235
			0.0007	0.00273	0.00229
0.0008	0.00266	0.00223
			0.0009	0.00258	0.00216

0.0010

0.00251

0.00210

Alternatively, the band of greater number can be comprised in blocking device.Such as, strand or band can be increased to and be greater than 32, such as, 40,44,48,50,56,60,64,70,76,80,90,100 or more.For the band of any desired number, angle or beam thickness determination strip width can be calculated according to as above.In addition, can cushion to strip width application, as mentioned above.

In another example, blocking device excessive for blood vessel can be used.Such as, blocking device can be anchored in lumen of vessels by larger than lumen of vessels size blocking device better.Figure 25 show the blocking device being arranged in blood vessel appropriate position PPI (" Ink vessel transfusing PPI ") and be in free standing condition blocking device PPI (" weaving PPI ") between relation.Chart in Figure 25 is pointed out, for often kind of design, the PPI being in the blocking device of appropriate position in blood vessel when the thread count of the blocking device being in free standing condition increases close to maximum.Such as, for the design of 4mm blood vessel, when the PPI of self-support blocking device increases, the PPI of the blocking device in blood vessel increases, until Ink vessel transfusing PPI reaches about 45.When Ink vessel transfusing PPI reaches about 45, braiding PPI increases the increase only causing Ink vessel transfusing PPI minimum degree further.Equally as shown in figure 25, different blood vessel designs (such as, the design of 3mm blood vessel or the design of 5mm blood vessel) causes similar situation, and wherein, Ink vessel transfusing PPI is close to the maximum for height braiding thread count.

Similarly, Figure 28 shows the Ink vessel transfusing PPI of 32 band blocking devices and the relation of braiding PPI.In example shown in Figure 28, the PPI (" Ink vessel transfusing PPI ") of the blocking device in blood vessel when the PPI (" braiding PPI ") of the blocking device being in free standing condition increases close to higher limit.Figure 28 also show the design of interchangeable blood vessel.Shown in the example of blood vessel design as shown in figure 28, for the design of often kind of blood vessel, Ink vessel transfusing PPI when weaving PPI and increasing progressively close to higher limit.

Similarly, the coverage of blocking device can based on the strip width weaving PPI.Figure 26 show band have the width of about 0.00467in (roughly 0.12mm), the thickness of 0.001in (roughly 0.025mm) and as put into protection turn the example compared with big band size.As shown in figure 26, coverage is close to the higher limit of about 65-100PPI scope.In this example, coverage percentage ratio for 0.001in × 0.00467in (roughly 0.025mm × 0.12mm) band progressively close to about 40%, progressively close to about 34% for 0.001in × 0.004in (0.025mm × 0.1mm) band.

Figure 29 shows for 32 band blocking devices, and percentage ratio covers the relation between braiding PPI.As shown in figure 29, % coverage weave PPI increase time close to higher limit.Such as, for comprising the blocking device of about 0.0008 × 0.00266in (roughly 0.02 × 0.068mm) band, percentage ratio coverage when weaving PPI and increasing above about 150 close to the higher limit of about 43%.Equally, for comprising the blocking device of about 0.0008 × 0.0020in (roughly 0.02 × 0.05mm) band, percentage ratio coverage when weaving PPI and increasing above about 150 close to the higher limit of about 35%.

Figure 27 shows the relation between the opening size of the knitting element in blocking device and the PPI of network.When PPI increases, the opening size that fluid (such as, blood) is flow through or interval reduce.When the PPI of network reaches about 100, the opening size of knitting element when being arranged in blood vessel appropriate position is progressively close to minima.In example shown in Figure 27, for the stripe size of about 0.001 × 0.004in (roughly 0.025 × 0.1mm), be arranged in the opening size of the knitting element of the network of blocking device in blood vessel close to about 1280 microns or less.Similarly, for the stripe size of about 0.001 × 0.00467in (roughly 0.025 × 0.12mm), be arranged in the opening size of the knitting element of the network of blocking device in blood vessel close to about 1220.

Figure 30 shows for 32 band blocking devices, the relation between the opening size of the knitting element in blocking device and the braiding PPI of network.As shown in figure 30, knitting element opening size weave PPI increase time close to lower limit.Such as, for comprising the blocking device of about 0.0008 × 0.00266in (roughly 0.02 × 0.068mm) band, opening size when weaving PPI and increasing above about 150 close to the lower limit being approximately less than 600 microns.Equally, for comprising the blocking device of about 0.0008 × 0.0020in (roughly 0.02 × 0.05mm) band, opening size when weaving PPI and increasing above about 150 close to the lower limit of about 640.

Blocking device 30 can without the need to applying radial expansion force, such as radial compression and expanded radially when balloon-expandable.Blocking device 30 is by two strands (31,32) formation that reels in opposite direction.Alternatively, the strand that can be greater than 2 along different directions winding.Such as, can to reel 8,10,12,14,22,28,30,32,36,40,44,48,52,58,64,70,86,90,110,116,120,128,136,150 or more strands along different directions.In an embodiment, strand 31,32 is shape of rectangular ribbon (see Fig. 4 C).Band by known flexible material, can comprise such as nitinol (Nitinol), platinum and stainless shape-memory material and is formed.In certain embodiments, blocking device 30 is made up of platinum/8% tungsten and 35NLT (cobalt-nickel alloy, it is the low titanium-type of MP35N alloy) alloy-steel wire.

Band as the braided material of strand 31,32 can comprise rectangular cross section 35 (Fig. 4 C).As shown in figures 4 c and 7, extend surface 36,37 (thickness) between wall portion 38 compared with, the surface 36 engaged with vascular inner surface has longer size (width).Compared with having the tinsel of circle (circle) cross section, the band with rectangular cross section has larger reply (expansion) power for identical wall thickness.In addition, flat strip allows the more compact compression of blocking device 200 and produces less wound because it is distributed on larger surface area by expanding radial force to blood vessel wall when opening.Similarly, the device that flat strip is more soft for given mesh-density formation, because their surface area (width) is larger than round line apparatus for given thickness.

Although illustrated embodiment discloses and a kind ofly has rectangular cross section and length is greater than the band of thickness, the band for the alternative embodiment of disclosed blocking device can comprise square cross section.In another embodiment, the Part I of band can comprise the first shape of rectangular cross section, and the Part II 39 (Fig. 4 B) of band can comprise the circle of rectangular cross section, ellipse, avette or replacement shape.Such as, the end section of band can have automatic adjustment or oval cross-section, and the intermediate cross-section of band can have rectangular cross section.

In alternative embodiment as above, blocking device 30 can be formed by the band of winding more than two strands.In an embodiment, blocking device 30 can comprise as many as 16 strands of bands.In another embodiment, such as, blocking device 30 can comprise as many as 32 strands of bands, as many as 48 strands of bands, as many as 60 strands of bands, as many as 80 strands of bands, as many as 100 strands of bands, as many as 150 strands of bands or be greater than 150 strands of bands.By utilizing the standard technique making support expanded radially, people can manufacture the blocking device 30 with space 34, and described hole is greater than thickness or the linear diameter of band.Band can have different width.In this embodiment, different bands can have different width to provide support structure to blocking device 30 and blood vessel wall.Band according to disclosed embodiment can also be formed by different materials.Such as, one or more band can be formed by biocompatible metal material, such as material disclosed herein, and one or more band can be formed by bioavailable polymer.

Fig. 5 shows and is positioned at the Ink vessel transfusing blocking device 30 that conduit 25 is in radial compression.In one embodiment, blocking device 30 can be physically attached on catheter tip.This can realize by being limited in distal catheter portion by blocking device 30.Conduit 25 is slowly advanced in seal wire (not shown) by plunger 50, and when the tip of conduit 25 arrives aneurysm, blocking device departs from from described tip.Blocking device 30 expand into blood vessel size, and the surface of blocking device 30 is relative with blood vessel wall 15, as shown in Figure 6.

With reference to figure 7, blocking device 30 opens in the tube chamber of cerebrovascular 13 with aneurysm 10.Open period at it, before the bifurcated 15 of blocking device 30 and far-end 45 to fixedly positioning against the wall of the lumen of blood vessel 13 and exceed the cervical region 11 of aneurysm 10, the near-end 43 of blocking device 30 fixedly positioning against the wall of the lumen of blood vessel 13.After blocking device 30 is correctly positioned at the desired location of blood vessel 13 inside (see Fig. 7), partly due to the cause of the minimum thickness of wall portion 38, flowing in the tube chamber of aneurysm 10 obviously reduces, and the axial flow simultaneously in blood vessel 13 can not be subject to appreciable impact.

The fluid entering aneurysm 10 is subject to the control of band mesh-density and final surface coverage.Have and will have radial direction (side direction) flowing of reduction compared with the region of macrolattice density.On the contrary, have and more radial fluid will be allowed by blocking device 30 compared with the region of small grid density.As described below, blocking device 30 can have longitudinal extension (side direction) region of different densities.In each area, their circumferential density can be constant or change.This provide the fluid of the varying number by adjacent side region.By having the position in the region of greater density in radiographic method identification blood vessel, thus can determine the relative position of blocking device 30 and aneurysm 10 and various vessel branchings 15,16.Blocking device 30 can also comprise the impervious marker of ray.

Flow to aneurysm 10 or the blood that flows reduces to cause the active force be applied in wall portion 14 to reduce wherein, correspondingly reduce the risk of vessel rupture.When the blood active force and volume that enter aneurysm 10 are reduced by blocking device, such as, laminar flow in aneurysm 10 stops, and the blood in aneurysm starts to stagnate motionless.Contrary with the continuous-flow of the tube chamber 12 by aneurysm 10, blood stasis causes the thrombosis in aneurysm 10.This contributes to preventing aneurysm rupture equally.In addition, be positioned at the density of the part at bifurcated 15 place due to blocking device 30, the opening (space) 34 in blocking device 30 allows the vasotropic bifurcated 15 of blood flow Continuous Flow and side branch 16.If bifurcated 15 is positioned at aneurysmal downstream, as shown in Figure 8, the existence of blocking device 30 still provides away from aneurysm 10 to blood and flows into the passage of bifurcated 15.

In certain embodiments, the mesh-density of blocking device 30 can regulate to cause postponing to block.Such as, the mesh-density of blocking device 30 can be configured to reduce gradually the flowing flowing into aneurysm 10, thus make blocking device 30 open after a specified time in aneurysm 10, produce a large amount of thrombosis to process aneurysm.In certain embodiments, a large amount of thrombosis refers to the blood clotting of in aneurysm 10 about 90% to about 95%.In certain embodiments, a large amount of thrombosis refers to the blood clotting of in aneurysm 10 about 50% to 99%.In certain embodiments, a large amount of thrombosis refers to the blood clotting of in aneurysm 10 about 80% to about 95%.In certain embodiments, a large amount of thrombosis refers to the blood clotting of in aneurysm 10 about 70% to about 98%.In certain embodiments, a large amount of thrombosis refers to the blood clotting of in aneurysm 10 about 60% to 99%.In certain embodiments, a large amount of thrombosis refers in aneurysm 10 blood clotting being less than or equal to about 50%.In certain embodiments, a large amount of thrombosis refers to that aneurysm 10 inner blood condenses in a large number, and the risk (such as being caused by blood flow 3) that aneurysm 10 is broken reduces or eliminates.

In certain embodiments, make blocking device 30 with after processing aneurysm about 3 months to postponing to be limited to when blocking relevant.In certain embodiments, about 2 months to about 4 months are limited to time.In certain embodiments, about 1 month to about 5 months is limited to time.In certain embodiments, the time limit is less than or equal to about 1 month or is greater than about 5 months.In certain embodiments, about 2 week is limited to time to about 4 week.In certain embodiments, about 3 week is limited to time to about 6 week.

The mesh-density of blocking device 30 can suitably regulate to realize for postponing the best time limit of blocking.In certain embodiments, the mesh-density obtained for postponing the best time limit of blocking is about 60% to about 95%.In certain embodiments, the mesh-density obtained for postponing the best time limit of blocking is about 30% to about 60%.In certain embodiments, the mesh-density in best time limit obtained for postponing to block is less than or equal to about 30% or be greater than about 95%.In certain embodiments, mesh-density can be combined with the further feature of support and postpone to block to obtain.Such as, mesh-density can combine with the specific features of single strand (such as, cross section, diameter, girth) or braiding structure.

In certain embodiments, to fully block the relevant time be make blocking device 30 open to process aneurysm after about 3 hours.In certain embodiments, the time is about 2 hours to about 4 hours.In certain embodiments, about 1 hour to about 5 hours is limited to time.In certain embodiments, the time limit is less than or equal to about 1 hour or is greater than about 5 hours.In certain embodiments, about 2 hours to about 4 hours are limited to time.In certain embodiments, about 3 hours to about 6 hours are limited to time.

In certain embodiments, deployment method comprises described by device patients with implantation vascular system, makes this device in internal blood vessel and extends past aneurysm along blood vessel.In certain embodiments, the method comprises Post operation supervision aneurysm to confirm aneurysmal obstruction.In certain embodiments, monitoring that aneurysm comprises makes aneurysm imaging to confirm that aneurysm is blocked completely or at least in part by known formation method.In certain embodiments, described method provides one or more transporter, and it contributes to described device and opens in the blood vessel, in patient body, keep appropriate location, until confirm that aneurysm is blocked wholly or in part.Such as, in certain embodiments, transporter can remain in patient body, until aneurysm image confirming aneurysm blocks 70%.In certain embodiments, transporter can remain in patient body, until aneurysm has been blocked exceed about 30%.Therefore, after device opens, aneurysmal image can be made to monitor the progress of aneurysm occlusion.If aneurysm does not block, the process (such as, attachment device being opened) likely carrying out adding is to contribute to aneurysmal obstruction.Blocked about 30% to about 70%, more particularly, in certain embodiments, when about 50% in confirmation aneurysm, transporter takes out subsequently in patient body.

Blocking device described herein has flexible to meet the curvature of vascular system.This and the coronary stent making vascular system substantially meet its shape differ widely.Meet the ability of vascular system shape (such as, radially compress, axis bending etc. along support or vascular system) much more important than some coronary stents for some neural blood vessel blocking devices, this is because the vascular system in brain is less and more bending.Table 5 and 6 shows the feature of neural blood vessel blocking device required for protection.In order to prove that disclosed blocking device has ideal flexural property, carry out following experiments.The blocking device that the present inventor manufactures is placed on stayed surface 90 as shown in Figure 9.About 0.5in (roughly 12.7mm) of blocking device 30 is not supported.Subsequently, measure active force and be applied to not by the tip supported, until blocking device is from about 90 degree of starting point deflection.The similar length of coronary stent bears identical moment of flexure.Table 5 shows result.Similar with the compression stress reduced, blocking device of the present invention needs the moment of flexure of a low magnitude (being in a ratio of 0.005lb-in (roughly 0.0006Nm) with the 0.05lb-in (roughly 0.006Nm) for coronary stent).In certain embodiments, braiding structure, stent diameter, band quantity can be regulated with other parameter, make bending force be about 0.0005lb-in (roughly 0.00006Nm) to about 0.05lb-in (roughly 0.006Nm).In certain embodiments, bending force can be about 0.00025lb-in (roughly 0.00003Nm) approximately 0.03lb-in (roughly 0.003Nm), about 0.003lb-in (roughly 0.0003Nm) to about 0.05lb-in (roughly 0.006Nm), about 0.005lb-in (roughly 0.0006Nm) to about 0.01lb-in (roughly 0.001Nm), about 0.01lb-in (roughly 0.001Nm) to about 0.05lb-in (roughly 0.006Nm), about 0.0025lb-in (roughly 0.0003Nm) to about 0.01lb-in (roughly 0.001Nm).In certain embodiments, bending force can be less than about 0.005lb-in (roughly 0.0006Nm) or be greater than about 0.05lb-in (roughly 0.006Nm).

Table 5

Compressibility stronger compared with coronary stent (that is, how many compression can be realized for given active force or great active force should be applied in order to the compression realizing wishing) can also be provided according to blocking device of the present invention.Compared with highly compressible device, the endovascular device of high compression can not can apply larger active force to blood vessel wall.This has significant clinical impact to brain vasculature, because be disadvantageous for the endovascular device with low compressibility.In certain embodiments, braiding structure, stent diameter, band quantity and other parameter can be regulated, make the compression stress needed for compressed stent 50% initial diameter be about 0.01lb (roughly 0.005kg) to about 0.5lb (roughly 0.23kg).In certain embodiments, compression stress can be about 0.05lb (roughly 0.02kg) to about 0.15lb (roughly 0.07kg), about 0.07lb (roughly 0.03kg) to about 0.1lb (roughly 0.05kg), about 0.03lb (roughly 0.013kg) to about 0.18lb (roughly 0.08kg), about 0.08lb (roughly 0.036kg) are to about 0.19lb (roughly 0.086kg) and about 0.04lb (roughly 0.018kg) to about 0.3lb (roughly 0.14kg).In certain embodiments, bending force can be less than about 0.01lb (roughly 0.005kg) or be greater than about 0.5lb (roughly 0.23kg).

Table 6

Figure 33-36 shows the additional of blocking device 3000 and/or other embodiment.Blocking device 3000 can expand or compress.Such as, whole blocking device 3000 or blocking device 3000 a part can vertically, radial or both compressions or expand.Blocking device 3000 can expand according to blocking device 3000 or compress and have different structures or state.In certain embodiments, when blocking device 3000 is in a certain state, blocking device 3000 can keep identical state when acting on blocking device 3000 without any applied external force.In certain embodiments, when blocking device 3000 is in a certain state, blocking device 3000 can change different states into when acting on blocking device 3000 without any applied external force.

Such as, blocking device 3000 comprises wall portion 3014, and it can change over expanded configuration (such as, being in free state) automatically from compressed configuration (such as, being in restricted state), or vice versa.Wall portion 3014 can also change over super expanded configuration (such as, another restricted state) from expanded configuration, and vice versa.Wall portion 3014 can apply expansive force and/or apply compression stress along any direction along any direction, thus allows blocking device 3000 to change into another state from any state.In certain embodiments, wall portion 3014 can have spring constant k, and it makes support need to change into from the free state expanded the active force of compressive state.In certain embodiments, the spring constant of support and/or filament is configured to make active force be about 0.2lb (roughly 0.09kg) to about 0.02lb (roughly 0.009kg).Such as, the active force changing support can be 0.02lb (roughly 0.009kg) to 0.1lb (roughly 0.05kg) in certain embodiments, can be 0.1lb (roughly 0.05kg) to about 0.15lb (roughly 0.068kg) in certain embodiments, be 0.15lb (roughly 0.068kg) to about 0.2lb (roughly 0.09kg) in certain embodiments.In certain embodiments, spring constant makes active force be less than or equal to about 0.02lb (roughly 0.009kg) or be more than or equal to about 0.2lb (roughly 0.09kg).The wall thickness that wall portion 3014 can also have the structure according to blocking device 3000 and change.In certain embodiments, when blocking device 3000 is in compressed configuration, wall thickness is that about 2 strands are thick to about 4 strands.In certain embodiments, when blocking device 3000 is in compressed configuration, wall thickness is that about 4 strands are thick to about 6 strands.In certain embodiments, when blocking device 3000 is in compressed configuration, wall thickness is thick for being less than or equal to about 2 strands or being greater than about 6 strands.In certain embodiments, when blocking device 3000 is in expanded configuration, wall thickness is that about 2 strands are thick to about 4 strands.In certain embodiments, when blocking device 3000 is in expanded configuration, wall thickness is thick for being less than or equal to about 2 strands or being greater than about 4 strands.In certain embodiments, when blocking device 3000 is in super expanded configuration (exceeding the structure of free wxpansion structure), wall thickness is that about 2 strands are thick to about 5 strands.In certain embodiments, when blocking device 3000 is in super expanded configuration, wall thickness is thick for being less than or equal to about 2 strands or being greater than about 5 strands.

In another example, Figure 33 shows the blocking device 3000 being in compressed configuration.Blocking device 3000 can be in compressed configuration, such as, when it is stored in conduit 25 shown in Fig. 5 time.The wall portion 3014 being in the blocking device 3000 of compressed configuration can apply expanding radial force and axial compressive force to change over expanded configuration from compressed configuration.Figure 34 shows the blocking device 3000 being in expanded configuration.Therefore, after blocking device 3000 is arranged into blood vessel from conduit, blocking device can change over expanded configuration as shown in figure 34 from compressed configuration as shown in figure 33.

Blocking device 3000 can also change over super expanded configuration from expanded configuration, as shown in figure 35.The wall portion 3014 being in the blocking device 3000 of super expanded configuration can apply axial compressive force so that blocking device 3000 is returned to expanded configuration from super expanded configuration.In certain embodiments, the mesh-density of blocking device 3000 increases when blocking device 3000 changes over super expanded configuration from expanded configuration.In certain embodiments, the mesh-density being in the blocking device 3000 of expanded configuration is about 25% to about 35%.In certain embodiments, the mesh-density being in the blocking device 3000 of expanded configuration is about 35% to about 50%.In certain embodiments, the mesh-density being in the blocking device 3000 of expanded configuration is less than or equal to about 25% or be greater than about 50%.Correspondingly, in certain embodiments, the mesh-density being in the blocking device 3000 of super expanded configuration is about 50% to about 70%.In certain embodiments, the mesh-density being in the blocking device 3000 of super expanded configuration is about 70% to about 95%.In certain embodiments, the mesh-density being in the blocking device 3000 of super expanded configuration is less than or equal to about 50% or be greater than about 95%.

In addition, a part for whole blocking device 3000 or blocking device 3000 can expand or compress.Correspondingly, the mesh-density of the mesh-density of whole blocking device 3000 or a part for blocking device 3000 can reduce according to applying corresponding expansive force or compression stress to blocking device 3000 or increase.

In addition, the length of blocking device 3000 can expand vertically according to blocking device 3000 or compress and change.The length of blocking device 3000 can reduce when blocking device 3000 compresses vertically.Alternatively, the length of blocking device 3000 can increase when blocking device 3000 expands vertically.Such as, the length 3008 being in the blocking device 3000 of expanded configuration (Figure 34) can be less than or be substantially equal to the length 3004 of the blocking device 3000 being in compressed configuration (Figure 33).This can occur because the wall portion 3014 being in the blocking device 3000 of compressed configuration applies axial compressive force to change over expanded configuration.Similarly, the length 3008 being in the blocking device 3000 of expanded configuration (Figure 34) can be greater than or be substantially equal to the length 3012 of the blocking device 3000 being in super expanded configuration (Figure 35).This can occur because the wall portion 3014 being in the blocking device 3000 of super expanded configuration applies axial expansion power to change over expanded configuration.

The diameter of blocking device 3000 can also radially expand according to blocking device 3000 or compress and change.Diameter represents the cross section open area of blocking device 3000.Correspondingly, the cross section open area of blocking device 3000 radially expands according to blocking device 3000 or compresses and change.The diameter of blocking device 3000 can reduce when blocking device 3000 radially compresses.Alternatively, the diameter of blocking device 3000 can increase when blocking device 3000 radially expands.Such as, the diameter 3006 being in the blocking device 3000 of expanded configuration (Figure 34) can be greater than or be substantially equal to the diameter 3002 of the blocking device 3000 being in compressed configuration (Figure 33).This can occur because the wall portion 3014 being in the blocking device 3000 of compressed configuration applies expanding radial force to change over expanded configuration.Similarly, the diameter 3006 being in the blocking device 3000 of expanded configuration (Figure 34) can be less than or be substantially equal to the diameter 3010 of the blocking device 3000 being in super expanded configuration (Figure 35).This can occur because the wall portion 3014 being in the blocking device 3000 of super expanded configuration applies radial compression force to change over expanded configuration.

In certain embodiments, the diameter of blocking device 3000 can not increase when changing over super expanded configuration from expanded configuration.Such as, applying axial compressive force (thus reducing length 3008) to the blocking device 3000 being in expanded configuration can not make the diameter of blocking device 3000 increase to change over super expanded configuration.In certain embodiments, the length such as, by applying compression stress or expansive force change blocking device 3000 can not change the diameter of blocking device 3000.In certain embodiments, the diameter such as, by applying radial compression force or expansive force change blocking device 3000 can not change the length of blocking device 3000.Figure 36 A, 36B and 36C show the different instances of relation between the length of blocking device 3000 and diameter.As shown in Figure 36 A, point 3602 represents greater depth and the small diameter of blocking device 3000.Point 3602 represents that blocking devices 3000 can " stretch " greater depth 3612 and small diameter 3614 that arrive.That is, by applying axial expansion power and/or radial compression force to blocking device 3000, blocking device 3000 can reach this point 3602.

Can according to blocking device 3000 deal with, manufacture blocking device 3000 material therefor, use any storage of blocking device 3000 or the size of deploying device or other factors to change greater depth 3612 or the small diameter 3614 of blocking device 3000.In certain embodiments, the greater depth 3612 of blocking device 3000 is about 2 times to about 5 times of drift 3616.In certain embodiments, the greater depth 36110 of blocking device 3000 is about 5 times to about 10 times of drift 3616.In certain embodiments, greater depth 3612 is less than or equal to about 2 times or be greater than about 10 times of drift 3616 of drift 3616.In certain embodiments, when blocking device 3000 is positioned in conduit, there is greater depth 3612.Greater depth 3612 can be longer or shorter than conduit.In certain embodiments, when blocking device 3000 is positioned in conduit, greater depth 3612 is that about 40mm is to about 60mm.In certain embodiments, when blocking device 3000 is positioned in conduit, greater depth 3612 is that about 25mm is to about 75mm.In certain embodiments, when blocking device 3000 is positioned in conduit, greater depth 3612 is less than or equal to about 25mm or is greater than about 75mm.

In certain embodiments, the small diameter 3614 of blocking device 3000 is about 1% to about 5% of free diameter 3618.In certain embodiments, small diameter 3614 is about 0.5% to about 10% of free diameter 3618.In certain embodiments, small diameter 3614 is about 2% to about 15% of free diameter 3618.In certain embodiments, small diameter 3614 is about 3% to about 20% of free diameter 3618.In certain embodiments, small diameter 3614 is less than or equal to about 0.5% of free diameter 3618 or is greater than about 20% of free diameter 3618.In certain embodiments, when blocking device 3000 is positioned in conduit, there is small diameter 3614.In certain embodiments, when blocking device 3000 is positioned in conduit, small diameter 3614 is about 0.026in (roughly 0.66mm) to about 0.027in (roughly 0.069mm).In certain embodiments, when blocking device 3000 is positioned in conduit, small diameter 3614 is about 0.020in (roughly 0.5mm) to about 0.03in (roughly 0.76mm).In certain embodiments, when blocking device 3000 is positioned in conduit, small diameter 3614 is less than or equal to about 0.020in (roughly 0.5mm) or is greater than about 0.03in (roughly 0.76mm).

Interval 3608 (as the interval 3608a in Figure 36 A, 3608b, 3608c, 3608d, 3608e to 3608n) represent any state of the blocking device 3000 when blocking device 3000 is in compressed configuration and/or becomes expanded configuration (or vice versa) from compressed configuration.In certain embodiments, the length of blocking device 3000 can not change with the diameter of blocking device 3000.In certain embodiments, the length of blocking device 3000 with blocking device 3000 diameter in any way, such as in a linear fashion, in inverse ratio mode, exponentially or logarithmic and changing.

Point 3604 represents drift 3616 and the free diameter 3618 of the blocking device 3000 when blocking device 3000 is in expanded configuration.Can also according to blocking device 3000 deal with, manufacture blocking device 3000 material therefor, use any storage of blocking device 3000 or the size of deploying device or other factors to change drift 3616 or the free diameter 3618 of blocking device 3000.Such as, drift 3616 can suitably be long enough to process aneurysm, such as, be at least longer than aneurysmal cervical region.In certain embodiments, drift 3616 is that about 8mm is to about 10.5mm.In certain embodiments, drift 3616 is that about 5mm is to about 15mm.In certain embodiments, drift 3616 is less than or equal to about 5mm or is greater than about 15mm.

The free diameter 3618 of blocking device 3000 is at least generally greater than the diameter of the blood vessel that blocking device 3000 opens wherein.That is, free diameter 3618 can be greater than blood vessel diameter, the probability that the frictional force that the Contact of blocking device 3000 and blood vessel wall is produced is shifted out by blood vessel even as big as avoiding or reduce blocking device 3000.In certain embodiments, free diameter 3618 is that about 2.25mm is to about 5.25mm.In certain embodiments, free diameter 3618 is that about 1.75mm is to about 6.5mm.In certain embodiments, free diameter 3618 is less than or equal to about 1.75mm or is greater than about 6.5mm.

In certain embodiments, the strand quantity that can be used for blocking device 3000 depends on free diameter 3618.In certain embodiments, for the free diameter 3618 of about 2.75mm to about 4.25mm, blocking device 3000 can use about 48 strands.In certain embodiments, for the free diameter 3618 of about 4.5mm to about 6.0mm, blocking device 3000 can use about 64 strands.In certain embodiments, for the free diameter 3618 being more than or equal to about 6.0mm, blocking device 3000 can use about 72 strands.In certain embodiments, for the free diameter 3618 being less than or equal to about 2.5mm, blocking device 3000 can use about 32 strands.These scopes and numerical value can character desirably, such as diameter and porosity and change.

The free position of the blocking device 3000 of interval 3610 expressions when blocking device 3000 is in super expanded configuration and/or becomes super expanded configuration (or vice versa) from expanded configuration.In certain embodiments, the length such as reducing blocking device 3000 by applying axial compressive force can not make the diameter of blocking device 3000 increase.On the contrary, diameter can keep identical substantially, as shown in interval 3610.

Point 3606 represents smaller length 3620 and the larger diameter 3618 of blocking device 3000.Can also according to blocking device 3000 deal with, manufacture smaller length 3620 and larger diameter 3618 that blocking device 3000 material therefor or other factors change blocking device 3000.Such as, smaller length 3620 may diminish to is enough to allow process aneurysm or the comparatively macrolattice density needed for other diseases.In certain embodiments, smaller length 3620 is about 30% to about 50% of drift 3616.In certain embodiments, smaller length 3620 is about 50% to about 75% of drift 3616.In certain embodiments, smaller length 3620 is less than or equal to about 30% of drift 3616 or be greater than about 75% of drift 3616.In certain embodiments, larger diameter 3618 is identical with free diameter 3618.In certain embodiments, larger diameter 3618 is 110% of free diameter 3618.In certain embodiments, larger diameter 3618 is about 101% to 115% of free diameter 3618.In certain embodiments, larger diameter 3618 is less than or equal to about 101% of free diameter 3618 or is greater than about 115% of free diameter 3618.

Figure 36 B shows the example of relation between the length 3624 (as shown in length 3624a and 3624b) of blocking device 3000 (as shown in blocking device 3000a and 3000b) and diameter 3626.Blocking device 3000a can be in the first structure, comprises the first length 3624a, diameter 3626 and the first mesh-density 3622a.Apply axial expansion power can to blocking device 3000a.In certain embodiments, apply axial expansion power mesh-density is reduced and length is increased.Such as, by applying axial expansion power to the blocking device 3000a being in the first structure, blocking device 3000a can be expanded to second structure of blocking device 3000b.Therefore, the second mesh-density 3622b can be less than the first mesh-density 3622a, and the second length 3624b can be greater than the first length 3624a.

Similarly, in certain embodiments, apply axial compressive force mesh-density is increased and length is reduced.Such as, by applying axial compressive force to the blocking device 3000b being in the second structure, blocking device 3000b can be compressed into first structure of blocking device 3000a.Therefore, the first mesh-density 3622a can be greater than the second mesh-density 3622b, and the first length 3624a can be less than the second length 3624b.In certain embodiments, applying axial compressive force or expansive force can not change the diameter 3626 of blocking device 3000.Such as, diameter 3626 keeps identical substantially being between the blocking device 3000a of the first structure and the blocking device 3000b being in the second structure.

Figure 36 C shows the example of relation between the length 3630 of blocking device 3000 (as shown in blocking device 3000a and 3000b) and diameter 3632 (as shown in diameter 3632a and 3632b).Blocking device 3000a can be in the first structure, comprises length 3630, first diameter 3632a and the first mesh-density 3628a.Apply expanding radial force can to blocking device 3000a.In certain embodiments, apply expanding radial force mesh-density is reduced and diameter is increased.Such as, by applying expanding radial force to the blocking device 3000a being in the first structure, blocking device 3000a can be expanded to second structure of blocking device 3000b.Therefore, the second mesh-density 3628b can be less than the first mesh-density 3628a, and Second bobbin diameter 3632b can be greater than the first diameter 3632a.

Similarly, in certain embodiments, applying radial compression force makes mesh-density increase and diameter is reduced.Such as, by applying radial compression force to the blocking device 3000b being in the second structure, blocking device 3000b can be compressed into first structure of blocking device 3000a.Therefore, the first mesh-density 3628a can be greater than the second mesh-density 3628b, and the first diameter 3632a can be less than Second bobbin diameter 3632b.In certain embodiments, applying radial compression force or expansive force can not change the length 3630 of blocking device 3000.Such as, length 3630 keeps identical substantially being between the blocking device 3000a of the first structure and the blocking device 3000b being in the second structure.

Figure 11-13 shows the example of blocking device 60, and wherein, the network 63 of blocking device 60 is not uniform in the length of blocking device 60.At the middle part 65 of blocking device 60, it is the part can opened at aneurysmal cervical region place, and mesh-density 63a has a mind to the numerical value of the mesh-density being increased to other position in blocking device 60.Such as, as shown in Figure 11 A, mesh-density 63a is obviously greater than the mesh-density 63 of adjacent part 64.Figure 11 B-11G shows other example that mesh-density changes in the length of blocking device.In some instances, blocking device 60 has and can be positioned at the end of blocking device 60, centre or other position compared with the part of macrolattice density 63a.Blocking device 60 can also have different mesh-densities in the length of blocking device 60.Such as, as shown in Figure 11 F and 11G, blocking device 60 can have mesh-density 63b higher than mesh-density 63 and lower than the part of mesh-density 63a.In one extreme case, mesh-density can be 100%, that is, blocking device 60 is completely impervious.In another embodiment, the mesh-density 63A at middle part 65 can be about 50%, and the mesh-density of another part 64 of blocking device is about 25%.Figure 12 shows the blocking device 60, Figure 13 being in curved configuration and shows the blocking device 60 opened in vessel lumen.What Figure 13 also show that blocking device 60 locates along the cervical region of aneurysm 10 has the part increasing mesh-density 63A.Just as the blocking device disclosed in any one, the mesh-density of at least one part of blocking device 60 can be about 20% to about 30%.In certain embodiments, the mesh-density of at least one part of blocking device 60 can be about 30% to 65%.In certain embodiments, the mesh-density of at least one part of blocking device 60 can be about 65% to 95%.In certain embodiments, the mesh-density of at least one part of blocking device 60 can be less than or equal to about 20% or be greater than about 95%.

In certain embodiments, the mesh-density increasing a part for support makes the porosity of holder part reduce.On the contrary, the mesh-density reducing holder part makes the porosity of holder part increase.In certain embodiments, the change of mesh-density or porosity is called encapsulation or dynamic encapsulation.

Blocking device 60 can also be described with porosity.According to an embodiment, the porosity of blocking device 60 can equal the ratio of the open surface area of blocking device 60 and the total surface area of blocking device 60.Blocking device 60 can comprise multiple braiding strand, forms hole in its open area between strand.

In certain embodiments, hole has average pore length.Average pore length can be any pore length of applicable aneurysm process or other type of process.In certain embodiments, average pore length is about 0.43mm.In certain embodiments, average pore length is that about 0.15mm is to about 0.40mm.In certain embodiments, average pore length is that about 0.4mm is to about 0.65mm.In certain embodiments, average pore length is less than or equal to about 0.15mm or is greater than about 0.65mm.

The size of hole can increase according to the structure of blocking device 60 or reduce.Such as, the porosity of a part for blocking device 60 can reduce by making this part axial compression of blocking device 60.By making this part axial compression of blocking device 60, open surface area is close to along with the compression of braiding strand and reduces, and causing hole porosity reduces.

When the axial compression part of blocking device 60 is unrestricted, blocking device 60 can expand, and causing hole porosity increases.In certain embodiments, the porosity of blocking device 60 can be about 70% to about 80%.In certain embodiments, the porosity of blocking device 60 can be about 35% to 70%.In certain embodiments, the porosity of blocking device 60 can be about 5% to 35%.In certain embodiments, the porosity of blocking device 60 can be less than or equal to about 5% or be greater than about 80%.

In certain embodiments, porosity is relevant to pore length.Such as, in certain embodiments, porosity is multiplied by average pore length is about 0.3mm.In certain embodiments, porosity is multiplied by average pore length is that about 0.15mm is to about 0.3mm.In certain embodiments, porosity is multiplied by average pore length is that about 0.3mm is to about 0.45mm.In certain embodiments, porosity is multiplied by average pore length and is less than or equal to about 0.15mm or is greater than about 0.45mm.In an example, the porosity of 70% is multiplied by the average pore length of 0.43mm is 0.3mm.

In certain embodiments, porosity is relevant to the thickness of braiding strand.Braiding strand can have average strand thickness.In certain embodiments, average strand thickness is about 0.003in (roughly 0.076mm).In certain embodiments, average strand thickness is about 0.001in (roughly 0.025mm) to about 0.003in (roughly 0.076mm).In certain embodiments, average strand thickness is about 0.003in (roughly 0.076mm) to about 0.005in (roughly 0.13mm).In certain embodiments, average strand thickness is less than or equal to about 0.001in (roughly 0.025mm) or is greater than about 0.005in (roughly 0.13mm).Braiding strand can comprise the band that width is greater than thickness.In other example, band can have the width being less than or equal to its thickness.In certain embodiments, porosity is multiplied by average strand thickness is about 0.002in (roughly 0.05mm).In certain embodiments, porosity is multiplied by average strand thickness is about 0.001in (roughly 0.025mm) to about 0.002in (roughly 0.05mm).In certain embodiments, porosity is multiplied by average strand thickness is about 0.002in (roughly 0.05mm) to about 0.004in (roughly 0.1mm).In certain embodiments, porosity is multiplied by average strand thickness and is less than or equal to about 0.001in (roughly 0.025mm) or is greater than about 0.004in (roughly 0.01mm).Such as, the porosity of 70% is multiplied by the average strand thickness of 0.003in (roughly 0.076mm) is 0.002in (roughly 0.05mm).

In certain embodiments, pore-size is relevant to the thickness of braiding strand.In certain embodiments, average pore length is multiplied by average strand thickness is about 9.4 × 10 ^-5in ²(roughly 0.06mm ²).In certain embodiments, average pore length is multiplied by average strand thickness is about 4 × 10 ^-5in ²(roughly 0.026mm ²) to about 14 × 10 ^-5in ²(roughly 0.09mm ²).In certain embodiments, average pore length is multiplied by average strand thickness and is less than or equal to about 4 × 10 ^-5in ²(roughly 0.026mm ²) or be greater than about 14 × 10 ^-5in ²(roughly 0.09mm ²).Such as, the average pore length of 0.6mm is multiplied by the average strand thickness of 0.004in (roughly 0.1mm) is 9.4 × 10 ^-5in ²(roughly 0.06mm ²).

In certain embodiments, the porosity of blocking device 60 is relevant to pore volume and be configured to the corium (endotheliazation) contributing to blood vessel dilating.In such embodiments, pore area can be multiplied by average or actual bracket thickness to determine the spatial volume limited by each brace aperture.By selecting the brace aperture volume of wishing, the corium of blood vessel dilating can be strengthened.In certain embodiments, other parameter can be used to optimize or to strengthen the function of support, such as average pore length, average strand thickness, average pore size or other size.

Figure 14 and 15 shows another embodiment of blocking device 300.In the present embodiment, blocking device 300 opens having in aneurysmal vessel lumen.Blocking device 300 comprises the surface 310 in the face of aneurysm tube chamber.With diametrically compared with in the of surperficial 320, surface 310 has obviously higher mesh-density (less and/or less space).Due to the higher mesh-density on surface 310, less blood is had to flow in aneurysmal tube chamber.But, because the mesh-density on the surface 320 towards side branch does not reduce, can not the blood flowing to side branch be had a negative impact.

As described in example above, the different piece of blocking device can have different mesh-densities, and fluid or blood stream can be controlled according to the position in blocking device.The input that mesh-density can be received by blocking device controls further.Input for controlling the mesh-density of the different piece of blocking device can comprise pressure or the power of the part being such as applied to blocking device.Blocking device in this example can comprise the material of spiral winding, such as, strand in network described here or band.The strand of spiral wound can relative to each other move.Such as, the first strand and the second strand can spiral winding to form network, what it opening comprised between strand was alternately arranged intersect strand (the first strand and the second strand can be intersected with each other).

In another example, the network formed by the hair cross bar of blocking device can regulate according to input as above (such as, motion, pressure or active force input).When blocking device receives input, strand can relative to each other move.Such as, a part for the first strand can move the appropriate section near the second strand, and the Part II of the first strand also can move away from the corresponding Part I of the second strand.Therefore, in this example, formed blocking device network spiral winding material the first and second strands between interval can change to form different mesh-densities.Strand in a part of blocking device moves close to each other, and when the strand in another part of simultaneously blocking device is mobile away from each other, the different piece of blocking device can have different mesh-densities.

Equally, the input that the relative motion of strand can receive according to blocking device controls.As mentioned above, input can comprise for mobile or regulate the input of any type of blocking device, such as, comprise pressure, active force, motion, rotation or other similar input.

Blocking device or support can put into blood vessel, and certain part of blocking device can comprise high mesh-density, keep low mesh-density in the different piece of blocking device simultaneously.Receive position and/or mesh-density that input can control blocking device, thus obtain the mesh-density of wishing in the selection section office of blocking device.Therefore, the input that blocking device place receives can make the Part I of blocking device have the first mesh-density, and the Part II of blocking device has the second mesh-density, and wherein, the first mesh-density is different from the second mesh-density.

In an example, blocking device can to insert in blood vessel and can apply pressure to regulate the mesh-density of blocking device to blocking device by user.In another example, motoricity can be applied to blocking device, the strand of the blocking device forming network can be moved relative to another strand at least one part of blocking device.Strand differently can also rearrange the different piece place at blocking device, makes the mesh-density of blocking device part different from another part of blocking device.

Such as, blocking device can comprise mesh-density adjustment means, makes the pressure be applied in a part for blocking device by mesh-density adjustment means that the mesh-density of this part of blocking device can be made to be subject to the work of mesh-density adjustment means in order to obtain the mesh-density of wishing.Figure 31 shows the example of blocking device 3101, and it comprises the mesh-density adjustment means 3102 of the mesh-density at any hope part place for regulating blocking device 3101.User can apply active force to the near-end of mesh-density adjustment means 3102, thus makes the far-end of mesh-density adjustment means regulate grid material to change mesh-density.In addition, the motion of mesh-density adjustment means 3102 can allow user regulate the mesh-density of any hope part of blocking device.In certain embodiments, mesh-density adjustment means 3102 is not needed to regulate mesh-density.

Blocking device can be carried further by transporter and locate in the blood vessel.Such as, transporter can comprise the tubular structure of such as conduit, and blocking device can put into blood vessel through it.Transporter can also comprise the mesh-density adjustment means 3102 of the mesh-density for regulating blocking device.If desired, mesh-density adjustment means 3102 only can also regulate the mesh-density at a part place of blocking device, does not affect the other parts of blocking device simultaneously.Alternatively, mesh-density adjustment means 3102 can be used to increase the mesh-density at a part place of blocking device, reduce the mesh-density at another part place of blocking device simultaneously.Mesh-density adjustment means 3102 can be utilized and be controlled by transporter applied pressure or motoricity.

In an example, mesh-density adjustment means 3102 can be connected on the tinsel of the proximal end being positioned at transporter.User can apply active force to the near-end wiry of the proximal end being positioned at transporter.The active force (can be pressure or motoricity) applied such as can cause the corresponding sports of mesh-density adjustment means 3102.The strand that the motion of mesh-density adjustment means 3102 can contact blocking device further moves to make strand.The motion of the strand of blocking device can make the mesh-density of at least one part of blocking device change.Therefore, user input can change with the mesh-density of the selected part making blocking device by control mesh density adjusting implement 3102.

In another example, can according to the mesh-density of the motor adjustment blocking device of the blocking device in blood vessel or its part.Such as, blocking device can be put in the blood vessel and move.When blocking device moves in the blood vessel, thus the mesh-density of the selected part of blocking device can be regulated.The mesh-density of a part of blocking device can increase, and the mesh-density of another part of blocking device can increase, reduces or remain unchanged simultaneously.In an example, occluding device contacts blood vessel wall and active force are applied to the near-end of blocking device.Such as, user applies active force can to the near-end of blocking device.The active force of such as pressure or motoricity can be applied to the near-end of transporter, and blocking device can be put into blood vessel through described transporter and can regulate in the blood vessel.The active force applied regulates the strand of blocking device or band, and the mesh-density of blocking device is changed according to the part of blocking device.

As an example, blocking device comprises the entanglement band being formed and have the network of mesh-density.Blocking device introduces the position in aneurysm blood vessel.Blocking device can also be applied to and be positioned at the part that blood vessel is positioned at aneurysm place or surrounding, as shown in Figure 7.The outside of blocking device can with the contacting of blood vessel be arranged in around aneurysmal region at least partially, but, the outside being positioned at the blocking device at aneurysm site place not with vessel wall contact.This is because aneurysm is positioned to make aneurysm wall portion from the outwardly directed cause of Peripheral blood tube wall, and the outside of blocking device or surface are not directly contacted with the inner surface of aneurysm wall portion.

Pressure such as can be applied to the near-end of blocking device.In this example, the network of blocking device can free adjustment, makes pressure cause the network of blocking device to move along distal direction.Because of the outside of blood vessel wall inner surface and blocking device or surface contact and the frictional force acted on blocking device can prevent the network in blocking device and vessel wall contact region to be moved.But blocking device motion gradually in the blood vessel can by applying pressure or active force realization to the near-end of blocking device.

In certain embodiments, blocking device cover aneurysm neck part not with vessel wall contact.Because stand comparatively less friction compared with the part that this part of blocking device and blocking device directly contact blood vessel, the network covering aneurysmal blocking device can make blocking device distad move near aneurysmal part and change along with applied active force, thus makes to be applied to the active force increase that blocking device covers aneurysmal part.Equally, the part that blocking device covers away from aneurysmal blood vessel wall can be subject to covering the larger frictional force of aneurysmal part than being applied to blocking device.Therefore, in certain embodiments, the mesh-density covering aneurysmal blocking device increases.In certain embodiments, the mesh-density of blocking device can not cover than blocking device the degree that aneurysmal part increases or increase is very little.

In another example, aneurysm can be positioned at vessel branch place, as shown in figure 32.Blocking device is placed to the Part I 3201 making blocking device can near vessel branch and aneurysm location.The Part II 3202 of blocking device can be positioned to cover vessel branch 3208, the Part III of blocking device can be positioned to cover blood vessel away from vessel branch 3208 also near the part of the first aneurysm 3209, the Part IV of blocking device can be positioned to covering first aneurysm 3209, and the Part V of blocking device can cover blood vessel away from the first aneurysm 3209 also near the part of the second aneurysm 3210.The Part VI of blocking device can cover the second aneurysm 3210.But people wish that block blood flows to aneurysm, do not wish that block blood flows to branch vessel.

In this example, user applies pressure or active force can to the near-end of blocking device, thus causes a part for blocking device to move along distal direction in the blood vessel.Active force can be sent to the more distal part of blocking device by the Part I 3201 (near vessel branch 3208 and aneurysm 3209 and 3210) of blocking device, comprises the Part II 3202 that blocking device covers vessel branch 3208 location.The frictional force preventing blocking device from advancing in the Part II 3202 of blocking device is little, because the Part II of blocking device 3202 does not directly contact blood vessel wall (or fewer than Part I contact).On the contrary, the Part II 3202 of blocking device covers vessel branch 3208, as shown in figure 32.Therefore, because active force to be sent to the Part II 3202 of blocking device by the Part I 3201 of blocking device, the mesh-density of the Part II 3202 of blocking device increases.Equally, the counteracting force being applied to blocking device can make the mesh-density of the Part II 3202 of blocking device reduce, thus allows blood to flow into vessel branch 3208.

Active force is also sent to the Part III 3203 of blocking device covering away from the vasculature part of vessel branch 3208 by the Part II 3202 of blocking device.But because the Part III of blocking device 3203 and vessel wall contact, the frictional force acted on the Part III 3203 of blocking device is greater than the frictional force acted on Part II 3202.Therefore, the mesh-density of the Part III 3203 of blocking device is at first lower than the mesh-density of the Part II 3202 of blocking device.

The active force being applied to the Part III 3203 (cover and contact the vasculature part away from vessel branch 3208 and the first aneurysm 3209) of blocking device sends the Part IV 3204 of blocking device to, and it is the part that blocking device covers the first aneurysm 3209.Because the Part IV of blocking device 3204 does not directly contact with blood vessel, the frictional force acted on the Part IV 3204 of blocking device is less than the active force acted on the Part III 3203 of blocking device.Therefore, the pressure be applied on the Part IV 3204 of blocking device causes the mesh-density of the Part IV 3204 of blocking device to increase.

Equally, the active force be applied on the Part IV 3204 of blocking device can send the Part V 3205 of blocking device to, itself and the part contact of blood vessel between the first aneurysm 3209 and the second aneurysm 3210.Because contacting with blood vessel at least partially of the Part V of blocking device 3205, the frictional force acted on the Part V 3205 of blocking device is greater than the frictional force acted on the Part IV 3204 of blocking device.But, the Part IV 3204 of blocking device cover the second aneurysm 3209 and not with vessel wall contact.Therefore, in this example, the difference being applied to the frictional force of blocking device each several part causes the mesh-density of blocking device different piece to produce the change be controlled.

Equally as shown in figure 32, the Part VI 3206 that blocking device covers the second aneurysm 3210 is shown.Because the Part VI of blocking device 3206 does not directly contact with blood vessel wall, the frictional force acted on the Part VI 3206 of blocking device is less than the frictional force acted on the Part V 3205 of blocking device.Therefore, the active force sending the Part VI 3206 of blocking device from the Part V 3205 of blocking device to can cause the mesh-density of Part VI 3206 to increase.Therefore, the Part IV of blocking device and the mesh-density of Part VI can by increasing at blocking device place applying pressure or motoricity.Equally, such as blocking device near-end is pulled to make blocking device retraction that the mesh-density of the Part II of blocking device can be caused to reduce by proximad.This flow that blood and/or fluid can be caused to flow into vessel branch 3208 increases, and stops blood and/or fluid to flow into the first or second aneurysm (3209,3210) simultaneously.

Figure 37 shows another embodiment of blocking device 3700.Blocking device 3700 can be used to process multi-form aneurysm.Such as, blocking device 3700 can be used to process aneurysm 3702 (as shown in aneurysm part 3702a, 3702b and 3702c), and it is netraneurysm.Blocking device 3700 can open, and makes the extremity 3710 of blocking device 3700 arrive target location to process aneurysm 3702.Blocking device 3700 can utilize various method to open.Such as, conduit can store the blocking device 3700 that is in compressed configuration and make blocking device 3700 be advanced to target location, and the extremity 3710 of blocking device 3700 opens thereon.When blocking device 3700 opens from conduit, blocking device 3700 can be expanded to expanded configuration.At extremity 3710 place, blocking device 3700 and the vessel wall contact away from aneurysm 3702.Conduit can retract the remainder of blocking device 3700 is opened further, such as, allows pars intermedia 3714 (as shown in 3714a and 3714b) and proximal portion 3712 (as shown in 3712a and 3712b) to expand.Pars intermedia 3714 contacts with aneurysm wall 3716 because the larger diameter of blocking device 3700 can not expand into always.After being expanded to expanded configuration from compressed configuration, the proximal portion 3712 of blocking device 3700 can contact the blood vessel wall near aneurysm 3702.

The porosity of pars intermedia 3714 can be regulated to reduce to flow into the blood flow 3704 of aneurysm 3702.Such as, the porosity of pars intermedia 3714 can by applying the axial compressive force in the direction in distally portion 3710 to the proximal portion 3712 of blocking device 3700 and reducing.Axial compressive force can be greater than the frictional force caused by the Contact of proximal portion 3712 and blood vessel wall.Axial compressive force can apply continuously, until the porosity of pars intermedia 3714 has suitably been reduced to process aneurysm 3702.The porosity of pars intermedia 3714 can by applying axial compressive force or applying axial expansion power (such as, pulling proximal portion 3712 by edge in the opposite direction with blood flow 3704 side) to proximal portion 3712 and regulate to proximal portion 3712.Similar method is also applicable to extremity 3710.

Particularly, the porosity of pars intermedia 3714b can be regulated to make it higher than the porosity of pars intermedia 3714a, thus allow enough blood flows 3706 to enter branch vessel 3708, reduce the blood flow flowing to aneurysm part 3702a simultaneously.This can realize by applying less axial compressive force to the proximal portion 3712b relevant to proximal portion 3712a.Alternatively, axial compressive force can be applied or apply the porosity of axial expansion power to pars intermedia 3714b to proximal portion 3712b to regulate by means of only giving proximal portion 3712b.Such as, if the porosity of pars intermedia 3714b is too small so that blood flow 3706 can not be allowed to enter branch vessel 3708, apply axial expansion power (such as, pulling proximal portion 3712b) can to proximal portion 3712b.This can cause pars intermedia 3714b to expand with the porosity increasing pars intermedia 3714b, allows more blood to flow into branch vessel 3708.In addition, the porosity that adjustment in use instrument (such as, the adjustment means 3102 shown in Figure 31) regulates pars intermedia 3714b can be passed through, as mentioned above.

The porosity of pars intermedia 3714b can be regulated, thus a large amount of thrombosis can be formed in aneurysm 3702, allow blood flow 3706 to enter branch vessel 3708 simultaneously.In certain embodiments, the porosity of pars intermedia 3714b can be regulated, thus can occur to show the corium of blood flow 3706 by the profile of aneurysm 3702.Such as, the porosity of pars intermedia 3714b can be regulated, make in aneurysm 3702 inner, particularly form a large amount of thrombosis in aneurysm part 3702a, 3702b and 3702c inside, allow endothelium 3718 to open around aneurysm part 3702b and 3702c, the profile of display blood flow 3706 simultaneously.In certain embodiments, the porosity that can reach the pars intermedia 3714b of this corium effect is about 5% to 35%.In certain embodiments, the porosity that can reach the pars intermedia 3714b of this effect is about 35% to 70 corium %.In certain embodiments, the porosity that can reach the pars intermedia 3714b of this corium effect is about 70% to 80%.In certain embodiments, the porosity that can reach the pars intermedia 3714b of this corium effect is less than or equal to about 5% or be greater than about 80%.

This corium effect can obtain according to above-mentioned factor or other factors.Such as, in certain embodiments, the obstruction that postpones as above is used can to produce this corium effect.In certain embodiments, the wall thickness of pars intermedia 3714b as above can produce this corium effect.In certain embodiments, the pore-size of the hole of pars intermedia 3714b as above can produce this corium effect.In certain embodiments, the strand width of pars intermedia 3714b as above or strand thickness can produce this corium effect.In certain embodiments, strand shape as above can produce this corium effect.In certain embodiments, corium effect can only obtain according to above-mentioned any factor or in conjunction with any other factors.

Any blocking device disclosed herein can use the bifurcated blocking device 400 formed shown in Figure 16 together with the second blocking device.This device can be formed in vivo.When forming blocking device 400, the first blocking device 410 has low-density part and can have low-density part equally with the second blocking device 410 and combine.Blocking device 410,420 can be any type discussed here.Combine with after forming woven areas 425 with interleaving mode in these parts of two blocking devices 410,420, remainder 414,424 can diverge to along different directions, thus extends along the Liang Ge branch of bifurcated.Region outside woven areas 425 can have for the treatment of aneurysmal compared with macrolattice density or for allowing the comparatively small grid density of direction of flow vessel branch 15,16.

Figure 38-42 shows the additional of blocking device and/or other embodiment.Multiple blocking device can be used, wherein, overlapping each other at least partially of each blocking device.Such as, Figure 38 shows the first blocking device 3800.Second blocking device 3900 can open in the first blocking device 3800.In certain embodiments, the first blocking device 3800 and the second blocking device 3900 are identical blocking devices.Therefore, the first blocking device 3800 can be identical when two devices are unrestricted with the porosity of the second blocking device 3900.The lap 3850 of the first blocking device 3800 and the second blocking device 3900 can provide combination bore porosity, and it is less than the porosity of the same section of single first blocking device 3800 or the second blocking device 3900.Second blocking device 3800 can open completely in the inside of the first blocking device 3900, or a part for blocking device 3800 can be opened, as shown in Figure 39 and 41 in the first blocking device 3800.Although show two blocking devices, more blocking device can combination with one another use to provide different combination bore porosity, its porosity that can provide much smaller than single blocking device.

In certain embodiments, the first blocking device 3800 can open in blood vessel 3806, as shown in the viewgraph of cross-section in Figure 40.Such as, the first blocking device 3800 can be in compressed configuration before opening.When the first blocking device 3800 opens in blood vessel 3806, the first blocking device 3800 is expanded to the expanded configuration with the first diameter 3804, thus produces contact between the first blocking device 3800 and the wall portion of blood vessel 3806.Second blocking device 3900 can open similarly, wherein, the second blocking device 3900 be arranged in the first blocking device 3800 at least partially.Such as, the second blocking device 3900 can be in compressed configuration before opening.When the second blocking device 3900 opens in the first blocking device 3800 (it is in expanded configuration), second blocking device 3900 is expanded to expanded configuration, thus contacts in the second blocking device 3900 and the inwall 3802 of the first blocking device 3800 or the wall portion of blood vessel 3806 or produce between the two.This process repeats for more blocking device, thus provides suitable combination bore porosity for the process of aneurysm process or other type.

Multiple blocking device process aneurysm can be used, as shown in figure 42.Such as, the first blocking device 3800 can open to utilize similar approach process aneurysm 4202 as above.First blocking device 3800 comprises extremity 3810 and proximal portion 3812, and extends to make proximal portion 3812 near aneurysm 4202, and extremity 3810 is away from aneurysm 4202.Second blocking device 3900 can open in the first blocking device 3800.Second blocking device 3900 comprises extremity 3910 and proximal portion 3912.Second blocking device 3900 can be positioned to make the second blocking device 3900 contiguous aneurysm 4202 substantially.Such as, the proximal portion 3912 of the second blocking device 3900 is located away from the proximal portion 3812 of the first blocking device 3800, and the extremity 3910 of the second blocking device 3900 is located near the extremity 3810 of the first blocking device 3800.

First blocking device 3800 can have porosity identical substantially or different porositys with the second blocking device 3900 when unrestricted.Lap 3850 can produce combination bore porosity, and it is less than the porosity of the first blocking device 3800 or the porosity of the second blocking device 3900, causes the blood flow 4204 flowing into aneurysm 4202 to reduce.Combination bore porosity can regulate according to various mode, such as, by regulating separately the porosity of the first blocking device 3800, second blocking device 3900, or by increasing more blocking device to reduce combination bore porosity.In one extreme case, combination bore porosity can be adjusted to substantially 0%, or causes, seldom to other porosity any not having blood flow 4204 to flow into aneurysm 4202, reducing a large amount of thrombosis be formed in time in aneurysm 4202.

In an example, the porosity of the first blocking device 3800 can use similar approach as above to regulate before the second blocking device 3900 opens.Subsequently, the porosity of the second blocking device 3900 can regulate when the second blocking device 3900 opens.Such as, the extremity 3910 of the second blocking device 3900 can be in compressed configuration and be advanced to the region of the extremity 3810 near the first blocking device 3800.The extremity 3910 of the second blocking device 3900 may be expanded to and contacts with the first blocking device 3800.The remainder of the second blocking device 3900 can open, thus is expanded by the more parts of permission second blocking device 3900 and reduce the porosity of the second blocking device 3900 close to the extremity 3910 of the second blocking device 3900.Alternatively, the porosity of the second blocking device 3900 can be increased away from the extremity 3910 of the second blocking device 3900 by the more parts expansion of permission second blocking device 3900.Therefore, by first regulating the porosity of the first blocking device 3800, the porosity of the second blocking device 3900 can be regulated subsequently when opening and combination bore porosity regulated.

In certain embodiments, combination bore porosity can be regulated after the first blocking device 3800 and the second blocking device 3900 have opened.Such as, apply the axial compressive force in the direction in distally portion 3810 can to the proximal portion 3812 of the first blocking device 3800.Axial compressive force can be greater than the frictional force caused by the Contact of proximal portion 3712 and blood vessel wall.Axial compressive force can apply continuously, until the combination bore porosity of lap 3850 has suitably been reduced to process aneurysm 4202.In certain embodiments, second blocking device 3900 can expand and contact with the first blocking device 3800, makes the axial compressive force being applied to the first blocking device 3800 be less than or equal to the frictional force caused by the Contact of the first blocking device 3800 and the second blocking device 3900.Therefore, apply the Partial shrinkage that axial compressive force also causes the second blocking device 3900 to contact with the first blocking device 3800 to the first blocking device 3800, cause combination bore porosity to reduce.The combination bore porosity of lap 3850 can by applying axial compressive force or applying axial expansion power (such as, pulling proximal portion 3812 by edge in the opposite direction with blood flow 4204 side) to proximal portion 3812 and regulate to proximal portion 3812.Use similar approach can obtain similar result by giving the proximal portion 3912 of the second blocking device 3900.In addition, use similar method can also to extremity 3810 and 3910.

In certain embodiments, second blocking device 3900 can expand and contact with the first blocking device 3800, makes the axial compressive force being applied to the first blocking device 3800 be greater than the frictional force caused by the Contact of the first blocking device 3800 and the second blocking device 3900.In this case, the porosity of the first blocking device 3800 or the porosity of the second blocking device 3900 can regulate independently of one another.Such as, the porosity of any part of the first blocking device 3800 can by applying axial compressive force or apply axial expansion power to proximal portion 3812 to regulate to proximal portion 3812.Similarly, the porosity of any part of the second blocking device 3900 can by applying axial compressive force or apply axial expansion power to proximal portion 3912 to regulate to proximal portion 3912.By regulating separately the porosity of the first blocking device 3800 or the second blocking device 3900, can also regulate the combination bore porosity of lap 3850.In addition, by adjustment in use instrument (adjustment means 3102 of such as Figure 31) and apply axial compressive force to the part of the first blocking device 3800 or the second blocking device 3900 or expansive force can regulate the porosity of lap 3850.

Mesh-density for each disclosed blocking device can be about 20% to about 80% of the surface area of blocking device.In an embodiment, mesh-density can be about 20% to about 50% of the surface area of blocking device.In another embodiment, mesh-density can be about 20% to about 30% of the surface area of blocking device.

In another example, the mesh-density that (such as, user input motion) regulates or change blocking device can be inputted by user.Input motion can longitudinally carry out.Such as, a part for blocking device can receive Input Forces along the longitudinal axis effect of blocking device or pressure.The part of described blocking device can have mesh-density before applying active force, pressure or described blocking device to receive the strand motion of the blocking device in the part of Input Forces.The mesh-density of the part of described blocking device can change according to the input received.Such as, the strand of blocking device can along the lengthwise movement of blocking device.Equally, the lengthwise movement of the strand of blocking device can occur at the part place of blocking device or can occur on whole blocking device.Carry out in a part for blocking device in the example of lengthwise movement at the strand of blocking device, the strand at the part place of described blocking device can move according to the input received, and the mesh-density making blocking device receive the blocking device at the part place of input can increase.Alternatively, the grid of a part for blocking device also can reduce according to input action power, pressure or motion.Equally, according to input action power, pressure or motion, the mesh-density of the Part I of blocking device can increase, and the mesh-density of the Part II of blocking device can reduce or remain unchanged simultaneously.Therefore, the input that the different piece of blocking device can receive according to blocking device has different motions, make blocking device part can have the mesh-density increasing or reduce, and any other parts of blocking device can have the mesh-density reducing or increase.Alternatively, the mesh-density of any part of blocking device can remain unchanged.

The typical blocking device with 16 strand fabrics has the mesh-density of about 30% (surface covered by band), wherein, described fabric has the wide band of about 0.005in (roughly 0.13mm), 30 number of latitude per inch (PPI) (per inch intersection/contact point quantity) and about 0.09in (roughly 2.3mm) external diameter.Here in disclosed embodiment, band can have the thickness of about 0.001in (roughly 0.025mm), and its width is about 0.002in (roughly 0.05mm) to about 0.005in (roughly 0.13mm).In an embodiment, band has the thickness of about 0.004in (roughly 0.1mm).For thickness be about 0.001in (roughly 0.025mm), width is for the 16 strand bands of about 0.004in (roughly 0.1mm), the coverage for 50PPI, 40PPI and 30PPI is respectively the surface coverage of roughly 40%, 32% and 24%.For thickness be about 0.001in (roughly 0.1mm), width is for the 16 strand bands of about 0.005in (roughly 0.13mm), the coverage for 50PPI, 40PPI and 30PPI is respectively the surface coverage of roughly 50%, 40% and 30%.

When selecting the size being used for band, people can consider when band is tied up whether they slide through delivery catheter.Such as, be that can not to slide through internal diameter be about 0.027in (roughly 0.69mm) or less conduit and the support with less contracted configurations for 16 strands that 0.006in (roughly 0.15mm) band is made by width.

Although can use other strand geometry, the gauge due to them makes device be restricted by these other geometries (such as circular).Such as, diameter be the round line of about 0.002in (roughly 0.05mm) can occupy Ink vessel transfusing cross-sectional space up to about 0.008in (roughly 0.2mm).This space can affect and disturb the blood flow flowing through blood vessel.Endovascular fluid can be interfered because of diameter change.

Transmit blocking device in the blood vessel and make it open

There has been described blocking device transfer assembly, it has the part of little cross section and high flexibility.Figure 43 shows guide sheath 4 according to an aspect of the present invention, and it receives, hold blocking device 100 and the flexible conduit 1 sent it to for being positioned in human vasculature.

Size and the structure installation of the far-end 7 of guide sheath 4 become to be received in 2 of conduit 1, as shown in Figure 43 and 44.The near-end that socket 2 can be positioned at conduit 1 or the another location separated along the length of conduit 1.Conduit 1 can be any known conduit, and it can be introduced through the vascular system of patient and advance.In an embodiment, conduit has about 0.047in (roughly 1.2mm) or less internal diameter.In another embodiment, conduit has the internal diameter of about 0.027in (roughly 0.69mm) to about 0.021in (roughly 0.53mm).In alternative embodiments, conduit can have the internal diameter of about 0.025in (roughly 0.64mm).But can expect, conduit 1 can have the internal diameter being greater than about 0.047in (roughly 1.2mm) or being less than about 0.021in (roughly 0.53mm).After guide sheath 4 is positioned in conduit socket 2, blocking device 100 can be advanced to conduit 1 from guide sheath 4, prepares for blocking device 100 opens in patient's vascular system.

Conduit 1 can have at least one fluid introduction port 6 that contiguous socket 2 is located or is positioned at the another position along its length.Intake 6 is preferably communicated with the distal fluid of conduit 1, makes the fluid of such as saline can flow through conduit to rinse air or the chip of any apparatus (such as seal wire) being trapped in conduit 1 and being arranged in conduit 1 before conduit 1 inserts in vascular system.As required, intake 6 can also be used for transmitting the medicine in vascular system or fluid.

Figure 45 show guide sheath 4, can the transmission Yarn guide component 20 of elongated flexible of movement in guide sheath 4 and blocking device 100.As shown in the figure, Yarn guide component 20 and the blocking device 100 that carried by Yarn guide component 20 are not introduced in conduit 1.As an alternative, as shown in the figure, they are positioned at guide sheath 4.Guide sheath 4 can by different thermoplastics, and such as PTFE, FEP, HDPE, PEEK etc. make, and they can selectively as the lining on guide sheath inner surface or the adjoining course of water wetted material or other plastic coating with such as PVP.In addition, result desirably, surface can be coated with the various combination of different materials.

Guide sheath 4 can comprise the outlet or Purge holes (not shown) that are formed in the wall portion in the region covering blocking device 100.Can exist and be formed in single hole in guide sheath 4 or multiple hole, such as three holes.Before the guide sheath 4 making to contact with conduit socket 2 is located, purify guide sheath, such as, when removing the air or chip that retain, these Purge holes allow the fluid of such as saline easily to flow out between guide sheath 4 and Yarn guide component 20.

As shown in figure 46, Yarn guide component 20 comprises elongated flexible guidewire 41.According to the needs of blocking device 100 at vascular system intrinsic displacement, the flexibility of seal wire 41 allows Yarn guide component 20 bend and adapt to the curvature of vascular system.Seal wire 41 can be made up of traditional guidewire material and have solid cross-section.Alternatively, seal wire 41 can be formed by hypodermic tube (hypotube).In an embodiment, seal wire 41 has the diameter D5 of about 0.010in (roughly 0.25mm) to about 0.020in (roughly 0.5mm).In an embodiment, the maximum gauge of seal wire 41 is about 0.016in (roughly 0.4mm).Material for seal wire 41 can be any known guidewire material, comprises superelastic metal, such as Nitinol.Alternatively, seal wire 41 can be made up of such as stainless metal.The length L4 of seal wire can be about 125 to about 190 centimetres.In an embodiment, length L4 is about 175 centimetres.

Yarn guide component 20 can have along the identical flexibility of its whole length.In alternative embodiments, Yarn guide component 20 can have longitudinal section, and each have different flexion/stiffness.The differently curved degree of Yarn guide component 20 can utilize the different materials in the different longitudinal sections of seal wire 41 and/or thickness to be formed.In another embodiment, bending can being subject to of seal wire 41 transmits the control separating otch (not shown) formed in seal wire 41.These otch can longitudinal direction and/or circumferentially spaced each other.Otch accurately can be formed in transmission seal wire 41.Transmit the different piece of seal wire 41 can comprise be formed with different interval and different depth otch to provide bending and rigidity in various degree to these different parts.In above-mentioned any embodiment, Yarn guide component 20 and seal wire 41 react to the torque being applied to Yarn guide component 20 by operator.As described below, the torque being applied to Yarn guide component 20 by seal wire 41 can be used for blocking device 100 is separated with Yarn guide component 20.

The size and dimension being formed in the otch transmitted in seal wire 41 can be controlled, thus greater or lesser flexibility is provided.Because otch can change width when not changing the degree of depth or the overall shape of otch, the flexibility transmitting seal wire 41 can change selectively when not affecting the torsional strength transmitting seal wire 41.Therefore, the flexibility and the torsional strength that transmit seal wire 41 can change selectively and independently.

Advantageously, longitudinally adjacent pair of notches can rotate about 90 degree each other and laterally and vertically bend to provide around the circumference transmitting seal wire 41.But otch can be positioned at precalculated position to provide preferential bending along one or more desired directions.Certainly, otch can be randomly formed to allow comparably, non-preferential to become curved (bending) along all directions or plane.In one embodiment, this can realize by making otch circumferentially spaced.

The flexible seal wire 41 that transmits can comprise many parts with identical or different flexibility.Such as, the flexible seal wire 41 that transmits can comprise two or more parts.In Figure 46 illustrated embodiment, the flexible seal wire 41 that transmits comprises three parts, and each have different diameters.Each part can have the diameter of about 0.003in (roughly 0.076mm) to about 0.025in (roughly 0.64mm).In an embodiment, the diameter of one or more part can be about 0.010in (roughly 0.25mm) to about 0.020in (roughly 0.5mm).Part I 42 comprises the near-end 47 with the position relative localization of blocking device 100.Part I 42 can have constant thickness along its length.Alternatively, Part I 42 can have along its whole length or only along the thickness (diameter) that one partial-length is tapered.In tapered embodiment, the thickness (diameter) of Part I 42 reduces along the direction of the second transition portion 44.For those embodiments that seal wire 41 has circular cross section, thickness is diameter of section.

Second transition portion 44 extends between Part I 42 and the 3rd distal part 46.The thickness of Part II 44 reduces gradually from the major diameter of Part I 42 to the small diameter of Part III 46.Just as Part I 42, Part II 44 can along its whole length or only tapered along one partial-length.

Part III 46 has thickness thinner compared with the other parts 42,44 of transmission seal wire 41.Part III 46 extends the tapered second part 44 away from carrying blocking device 100.Part III 46 can be distally 27 tapered from the Part II 44 transmitting seal wire 41 along its whole length.Alternatively, Part III 46 can have constant diameter or only tapered along one partial-length.In such an embodiment, the tapered portion of Part III 46 can be stretched out from Part II 44 or extend to from the point separated with Part II 44 point separated with the far-end 27 transmitting seal wire 41.Although discuss and show three parts transmitting seal wire 41, transmit the part that seal wire 41 can comprise more than three.In addition, the thickness of each (diameter) in these parts is along its whole length or only tapered along one partial-length.In any one disclosed embodiment, transmitting seal wire 41 can be made up of the marmem of such as Nitinol.

Tip 28 and flexible tip turn 29 are fixed on the far-end 27 of transmission seal wire 41, as shown in Figure 46 and 47.Most advanced and sophisticated 28 can comprise continuous print end cap or end cap, and as shown in the figure, it firmly receives the far-end of most advanced and sophisticated turn 29.Most advanced and sophisticated turn 29 provides bending to the distal portion transmitting seal wire 41 and controls.But in an embodiment, most advanced and sophisticated 28 can not have turn 29.Most advanced and sophisticated 28 have the anti-of non-percutaneous hinders end face.In the embodiment shown, most advanced and sophisticated 28 have circular surface.In alternative embodiments, most advanced and sophisticated 28 can have other non-percutaneous shape, and it can not damage the blood vessel making it introduce.As shown in figure 46, most advanced and sophisticated 28 comprise shell 49, and the far-end of seal wire 41 is received in the opening 48 on the inner surface of shell 49 by securely.Seal wire 41 can be fixing in the opening by any any means known.

As shown in figure 46, most advanced and sophisticated turn 29 is around a part for seal wire 41.

Most advanced and sophisticated turn 29 be flexible, makes its blood flow paths when most advanced and sophisticated 28 advance along blood vessel in adaptation patient body and moves along it, and seal wire 41 bends and moves with the crooked route along vascular system.Most advanced and sophisticated turn 29 extends back from tip 28 towards the direction of near-end 47, as shown in the figure.

Tip 28 and turn 29 have the outer diameter D 1 of about 0.010in (roughly 0.25mm) to about 0.018in (roughly 0.46mm).In an embodiment, their outer diameter D 1 is about 0.014in (roughly 0.36mm).Tip 28 and turn 29 also have the length L1 of about 0.1 centimetre to about 3.0 centimetres.In an embodiment, they have the total length L 1 of about 1.5 centimetres.

The near-end 80 of most advanced and sophisticated turn 29 is received in the shell 82 at far-end 44 place being positioned at protection turn 85, as shown in Figure 43 and 46.Shell 82 and protection turn 85 have the outer diameter D 2 of about 0.018in (roughly 0.46mm) to about 0.038in (roughly 0.97mm).In an embodiment, their outer diameter D 2 is about 0.024in (roughly 0.61mm).Shell 82 and protection turn 85 have the length L2 of about 0.05 centimetre to about 0.2 centimetre.In an embodiment, their total length L 2 is about 0.15 centimetre.

Shell 82 has the anti-impairment of the configuration shape of non-percutaneous.Such as, as shown in figure 47, shell 82 has obtuse profile substantially.Equally, the size of shell 82 can be arranged in it through open/support blood vessel in blood vessel.In addition, shell 82 can comprise angled sides, and it is sized to the inner surface only separating guide sheath 4.

Shell 82 and protection turn 85 form distally retaining member, it keeps the position of blocking device 100 on flexible guidewire assembly 20, and before opening, contribute to blocking device 100 to remain on compressive state in the Ink vessel transfusing transmission of vascular system at blocking device.Protection turn 85 extends from shell 82 towards the direction of the near-end 47 transmitting seal wire 41, as shown in figure 46.Protection turn 85 is fixed on shell 82 with various known way.In a first embodiment, protect turn 85 can be fixed on the outer surface of shell 82.In alternative embodiments, protection turn 85 can be fixed in the opening of shell 82, make shell 82 around and internal receipt protection turn 85 far-end 51 (Figure 46).As shown in Figure 45 and 46, the far-end 102 of blocking device 100 remains in near-end 52, and blocking device 100 can not be opened while being arranged in guide sheath 4 or conduit 1.

At the near-end of blocking device 100, buffering elastic spring coil 86 and cap 88 prevent or limit blocking device 100 along the length of seal wire 41 towards the transverse movement in the direction of near-end 47, as shown in figure 45.Buffering elastic spring coil 86 and cap 88 have the outer diameter D 4 of about 0.018in (roughly 0.046mm) to about 0.038in (roughly 0.97mm).In an embodiment, their outer diameter D 4 is about 0.024in (roughly 0.61mm).Cap 88 contacts the near-end 107 of blocking device 100 and prevents from or limit it moving away from protection turn 85 along the length of seal wire 41.Buffering elastic spring coil 86 can have the spring shape along the direction contact and clamping cap 88 of protecting turn 85, thus produces the bias force acted on blocking device 100.This bias force (pressure) contributes to keeping firm, the covering relation between the far-end 102 of blocking device 100 and protection turn 85.Just as any turn of locating along transmission seal wire 41, buffering elastic spring coil 86 can be fixed to by soft soldering, welding, RF welding, bonding and/or other known binding agent and transmit on seal wire 41.

In the alternative embodiment shown in Figure 52, do not use buffering elastic spring coil 86.As an alternative, the near-end 107 of blocking device 100 remains on appropriate location by one group of spring-loaded support arm (jaw) 104, is arranged in guide sheath 4 or conduit 1 simultaneously.The expanded radially of the inner surface restriction support arm 104 of conduit 1 and guide sheath 4.When the near-end of blocking device passes from conduit 1, support arm 104 flicks and unclamps blocking device, as shown in Figure 53.

In another example, the blocking device 100 in guide sheath 4 or conduit 1 can expand under stress in the blood vessel.Figure 54 shows the example of the expansion blocking device 100 in response to pressure expansion.When blocking device 100 passes from conduit 1, pressure can be applied by conduit 1 or guide sheath 4.Pressure can apply by using air, fluid or various material, thus improves the internal pressure of blocking device.When blocking device 100 passes from conduit 1, in blocking device 100, the increase of pressure can cause blocking device to expand in the blood vessel.On the contrary, apply negative pressure can to blocking device 100.Figure 55 shows blocking device 100 shown in Figure 54 that negative pressure is applied to after blocking device 100.Negative pressure can be applied by conduit 1 or guide sheath 4 and the contraction of blocking device 100 or size can be caused to reduce.In an example, after blocking device 100 passes conduit 1 and expands in the blood vessel, negative pressure is applied to blocking device 100.Negative pressure causes blocking device 100 to shrink.When shrinking, the size of blocking device 100 reduces.In another example, blocking device 100 returns in conduit 1 after contractions.Negative pressure can apply according to various mode.Such as, negative pressure can by from conduit 1 sucking-off air or by removing or sucking-off fluid and applying from conduit 1.

Equally, in another example, blocking device 100 such as can expand by applying the pressure of increase in blocking device.Can by such as air or fluid being injected the pressure of blocking device 100 via transporter control increase via transporter.Therefore, blocking device 100 can expand in the blood vessel, makes blocking device 100 can contact the inner surface of blood vessel wall.Like this, blocking device 100 can contact blood vessel wall when being in swelling state at least partially.

When being in swelling state, blocking device 100 can be repositioned at Ink vessel transfusing.Figure 60 shows the example of expansion blocking device 100.Figure 61 shows example shown in the Figure 60 after blocking device is reorientated in the blood vessel.In this example, blocking device 100 can longitudinally along vascular dilation, make blocking device 100 can move at Ink vessel transfusing while expansion by axis.Pressure can be applied to the near-end of blocking device 100 by user, near-end is distad moved in vessel lumen.Meanwhile, blood vessel wall and the blocking device frictional force more between extremity can prevent or limit the immediate movement of the more extremity of blocking device.When the pressure or active force that are applied to near-end exceed critical level, the more extremity that active force can pass to blocking device moves to farther side in vessel lumen to cause the more extremity of blocking device.Like this, blocking device distad can move and can reorientate desired location in the blood vessel by user in vessel lumen.Figure 61 shows blocking device and distad reorientates in the blood vessel.

Similarly, blocking device can be repositioned in vessel lumen to more nearside by user.Such as, user can apply active force or pressure along the direction towards nearside to the extremity of blocking device.While the frictional force more between proximal portion of blocking device prevents or limits the initial movable of more proximal portion of blocking device, the extremity of blocking device can move by proximad.Therefore, in this example, blocking device is being positioned at the extremity of blocking device and the position compression more in the middle of proximal portion.When the pressure of extremity or active force that are applied to blocking device by user exceed critical level (it exceedes the frictional force of the motion of the more proximal portion preventing or limit blocking device), the more proximal portion of blocking device can move along proximal direction in response to institute's applied pressure or active force.Like this, blocking device can be reorientated in the blood vessel by proximad.

In another example, blocking device 100 can be reorientated in the blood vessel while it is in retracted mode.Figure 62 shows the example of the blocking device 100 being in retracted mode.Such as, apply negative pressure can to blocking device 100 shown in Figure 54 and reduce to cause the size of blocking device 100, as shown in Figure 62.Blocking device 100 is as shown in Figure 62 retracted and close to transporter.Figure 63 shows the example while blocking device is retracted, blocking device 100 being reorientated.As shown in Figure 63, blocking device moves along distal direction.Similarly, blocking device can also be reorientated along proximal direction (not shown).

Equally, opening of blocking device can partially be performed.Such as, blocking device 100 can have far-end and near-end.Blocking device open the near-end that can be included in and unclamp blocking device after unclamp far-end.Alternatively, blocking device open can be included in unclamp far-end after unclamp near-end.Equally, blocking device open the near-end and far-end that can comprise and unclamp blocking device 100 roughly simultaneously.

Figure 56 shows the example of the far-end of release blocking device 100 while the near-end of blocking device keeps being attached on transporter.As shown by the circuit diagram of figure 56, the far-end of blocking device 100 opens and against blood vessel wall.The near-end of blocking device 100 is still attached on transporter.The unclamping of near-end of blocking device can be realized by various mode as described herein.

In addition, the blocking device 100 that part is as shown by the circuit diagram of figure 56 opened can be reorientated in the blood vessel.Figure 57 shows the example of blocking device 100 that part is opened, and wherein, the far-end of blocking device 100 is separated with transporter, and the near-end of blocking device 100 to keep being attached on transporter and do not open simultaneously.In addition, Figure 57 show blocking device part open while reorientate.As shown in Figure 57, transporter and blocking device 100 in the blood vessel proximad move.Equally, Figure 57 shows blocking device and partly opens in the blood vessel, and blocking device far-end is separated with transporter, and the near-end of blocking device 100 keeps being attached on transporter simultaneously.

As shown in Figure 56 and 57, the near-end of blocking device 100 keeps compressed configuration, and the remainder of blocking device 100 is expanded configuration simultaneously.Except making except blocking device 100 reorientates, axial compressive force is applied by giving blocking device 100, such as by making the near-end of blocking device 100 advance towards the far-end of blocking device 100 with the pars intermedia axial compression making blocking device 100, the porosity of any portion of blocking device 100 can be made to reduce.In an example, apply axial compressive force can to the near-end of blocking device 100, wherein, axial compressive force is greater than the frictional force of the Part I 111 of blocking device 100 and the Contact generation of blood vessel wall.Axial compressive force applies continuously, makes Part II 112 axial compression of blocking device 100, and causing hole porosity reduces.It should be noted that Part II 112 contiguous aneurysm A substantially, make the frictional force contacting generation between the Part II 112 of blocking device 100 and Peripheral blood tube wall less.

In addition, axial expansion power is applied by giving blocking device 100, such as by making the near-end of blocking device 100 return to make the pars intermedia axial expansion of blocking device 100 away from the far-end of blocking device 100, the porosity of any portion of blocking device 100 can be made to increase.Such as, apply axial expansion power can to the near-end of blocking device 100, wherein, axial expansion power is greater than the frictional force of the Part I 111 of blocking device 100 and the Contact generation of blood vessel wall.Axial expansion power can apply continuously, makes Part II 112 axial expansion of blocking device 100, and causing hole porosity increases.Therefore, by making the near-end of blocking device 100 exit away from the far-end of blocking device 100 and increase the porosity of the Part II 112 of blocking device 100.Similarly, by making blocking device 100 advance or returning the porosity of any portion that can regulate blocking device 100.

Blocking device 100 can also retract by making the near-end of blocking device 100 (its maintenance is attached on transporter) be withdrawn in conduit 1 or be separated with blood vessel, constantly return in conduit 1 by making the near-end of blocking device 100, any dilation of blocking device 100 can be drawn in conduit 1 and to compress, and blocking device 100 can be loaded in conduit 1.

Alternatively, while the far-end of blocking device keeps being attached on transporter, the near-end of blocking device can be separated with transporter.The far-end of blocking device can open in the follow-up time or be separated with transporter subsequently.Figure 58 shows the blocking device 100 that the part that is arranged in blood vessel is opened, and wherein, the near-end of blocking device 100 is separated with transporter, and the far-end of blocking device keeps being attached on transporter simultaneously.Therefore, the near-end of blocking device 100 is near blood vessel wall.

Figure 59 shows blocking device 100 example shown in Figure 58 of reorientating of proximad in the blood vessel.In this example, blocking device partly opens, and the near-end of blocking device 100 is separated with transporter, is attached the far-end of blocking device 100 simultaneously.Subsequently, blocking device moves or is repositioned onto the position of more proximad in blood vessel.Alternatively, blocking device can also move in Ink vessel transfusing (not shown) or be repositioned onto the position in more distally.

As shown in Figure 58 and 59, the far-end of blocking device 100 keeps compressed configuration, and the remainder of blocking device 100 is in expanded configuration simultaneously.Except making except blocking device 100 reorientates, applying axial compressive force by giving blocking device 100 can make the porosity of any portion of blocking device 100 reduce, such as by making the far-end of blocking device 100 return towards the near-end of blocking device 100, make the pars intermedia axial compression of blocking device 100.In an example, apply axial compressive force can to the far-end of blocking device 100, wherein, axial compressive force is greater than the frictional force of the Part I 115 of blocking device 100 and the Contact generation of blood vessel wall.Axial compressive force can apply continuously, makes Part II 116 axial compression of blocking device 100, and causing hole porosity reduces.It should be noted that Part II 116 contiguous aneurysm A substantially, make the frictional force contacting generation between the Part II 116 of blocking device 100 and Peripheral blood tube wall less.

In addition, axial expansion power is applied by giving blocking device 100, such as by making the far-end of blocking device 100 advance away from the near-end of blocking device 100 with the pars intermedia axial expansion making blocking device 100, the porosity of any portion of blocking device 100 can be made to increase.Such as, apply axial expansion power can to the far-end of blocking device 100, wherein, axial expansion power is greater than the frictional force of the Part I 115 of blocking device 100 and the Contact generation of blood vessel wall.Axial expansion power can apply continuously, makes Part II 116 axial expansion of blocking device 100, and causing hole porosity increases.Therefore, the porosity of the Part II 116 of blocking device 100 is increased by making the far-end of blocking device 100 advance away from the near-end of blocking device 100.Similarly, by making blocking device 100 relative to the near-end propelling of blocking device 100 or the porosity returning any portion that can regulate blocking device 100.

In alternative embodiments, can cancel buffering elastic spring coil 86 and cap 88, the near-end of blocking device 100 can remain on appropriate location relative to protection turn 85 by the conical section of seal wire 41.In this embodiment, the expansion cross section of this conical section can be used blocking device 100 to be remained on the appropriate position of the length along transmission seal wire 41, and prevent or limit the motion of blocking device 100 towards near-end 47.

As shown in figure 46, Yarn guide component 20 comprises the support 70 for blocking device 100.In a first embodiment, support 70 can comprise the outer surface transmitting seal wire 41, and it is sized to contact with the inner surface of blocking device 100 when blocking device 100 is contained on Yarn guide component 20.In the present embodiment, the outer surface transmitting seal wire 41 supports blocking device 100 and makes it remain on preparation open configuration.In another embodiment, as shown in the figure, support 70 comprises middle springs circle 70, and it stretches out from the position near protection turn 85 backward towards buffering elastic spring coil 86.Middle springs circle 70 is below blocking device 100 and transmit extension above seal wire 41, as shown in figure 43.Middle springs circle 70 can extend jointly with one or more part transmitting seal wire 41.Such as, middle springs circle 70 can only extend with the Part II 44 transmitting seal wire 41 or it can extend along the Part III 46 and Part II 44 transmitting seal wire 41 jointly.

Middle springs circle 70 provides the surface that stretches out to Yarn guide component 20, and it is sized to contact with the inner surface of blocking device 100, thus contributes to supporting blocking device and blocking device 100 being remained on preparation open configuration.The same with other turn discussed here and accompanying drawing shows, the coil shape of middle springs circle 70 allows when transmitting the vascular system of seal wire 41 through patient and advancing, and middle springs circle 70 bends together with transmission seal wire 41.Middle springs circle 70 along transmit seal wire 41 get clogged device 100 cover length constant diameter is provided, the tapering effect of the transmission seal wire 41 be positioned at below blocking device 100 can not be subject to.It is tapered that middle springs circle 70 allows to transmit seal wire 41, makes it can obtain necessary flexibility and move with the path along vascular system, and can not damage the support of blocking device 100.Middle springs circle 70 provides stable support to before blocking device 100 opens blocking device 100, can not be subject to the impact of the tapering transmitting seal wire 41.The minimum diameter of blocking device 100 when it is in compressive state is also subject to the size Control of middle springs circle 70.In addition, the diameter of middle springs circle 70 can be selected, to form suitable interval (do not comprise continuously every) before blocking device 100 opens between blocking device 100 and the inwall of conduit 1.Middle springs circle 70 can also be used to open period by blocking device 100 bias voltage away from transmission seal wire 41 at blocking device.

In an embodiment, support 70 can have the outer diameter D 3 of about 0.010in (roughly 0.25mm) to about 0.018in (roughly 0.46mm).In an embodiment, outer diameter D 3 is about 0.014in (roughly 0.36mm).Support 70 can also have the length L3 of about 2.0 centimetres to about 30 centimetres.In an embodiment, the length L3 of support 70 is about 7 centimetres.

Blocking device 100 can also be held in place on the middle springs circle 70 between a pair selectable radiopaque reference lamina that the length along Yarn guide component 20 locates.Alternatively, protect turn 85, buffering elastic spring coil 86 and/or middle springs circle 70 and can comprise radiopaque marker.In alternative embodiments, Yarn guide component 20 can only include single radiopaque marker.Radiopaque marker is used to allow to estimate Yarn guide component 20 and blocking device 100 during being put in vascular system.This visual method can comprise conventional method, such as fluoroscopy, radiography, ultrasound investigation, nuclear magnetic resonance etc.

Blocking device 100 can be sent to aneurysmal position according to following method and distortion thereof and open at this.The transmission of blocking device 100 comprises to be introduced conduit 1 in vascular system, until it arrives need position to be processed.Conduit 1 utilizes traditional method, such as, advance in conventional vascular seal wire (not shown) or advance with it simultaneously and introduce in vascular system.The location of conduit 1 can occur before it receives Yarn guide component 20 or while it comprises Yarn guide component 20.Be positioned on conduit 1 or the radiopaque marker of conduit 1 can determine the position of conduit 1 in vascular system by identifying.

After conduit 1 is positioned at desired location, seal wire takes out and the far-end of guide sheath 4 inserts in the near-end of conduit 1, as shown in figure 43.In an embodiment, the far-end of guide sheath 4 is introduced through the socket 2 of the proximal end being positioned at conduit 1.Guide sheath 4 advances in conduit 1, until in the distal tip wedging conduit 1 of guide sheath 4.In this position, guide sheath 4 can not advance further in conduit 1.Guide sheath 4 firmly fixes subsequently, and the transmission Yarn guide component 20 simultaneously carrying blocking device 100 advances, until blocking device 100 leaves from guide sheath 4 and pushes conduit 1 through guide sheath 4.

Yarn guide component 20 and blocking device 100 advance, until most advanced and sophisticated turn 29 is near the far-end of conduit 1 through conduit 1.Now, the position of conduit 1 and Yarn guide component 20 can be determined.Yarn guide component 20 leaves conduit 1 subsequently and pushes in the vascular system of patient, outside the far-end making the near-end 107 of blocking device 100 be positioned at conduit 1 and contiguous region to be processed.Any point during these steps, can detect the position of blocking device 100 to determine that it will correctly open and be positioned at desired location.This can realize by using radiopaque marker as above.

When the far-end 102 of blocking device 100 is positioned at the outside of conduit 1, near-end 107 starts to expand in vascular system along the direction of arrow shown in Figure 49, and far-end 102 is still covered by protection turn 85 simultaneously.When blocking device 100 is in tram, transmits seal wire 41 and rotate (see Figure 50), until the far-end 102 of blocking device 100 moves away from protection turn 85 and expand in desired location place in vascular system.Transmit seal wire 41 can rotate to make blocking device 100 open along clockwise direction or counterclockwise as required.In an embodiment, transmit seal wire 41 such as can along both direction or one of rotate about two circle to ten circle.In another example, be less than about five circles by making transmission seal wire 41 be rotated in a clockwise direction, such as three to five enclose and blocking device are opened.After blocking device 100 has opened, transmit seal wire 41 and to have can be withdrawn in conduit 100 and to take out in body.

In an interchangeable or extra deployment method, the far-end 102 of blocking device 100 can move to the outside of conduit 1.Blocking device 100 can advance further, makes the near-end 107 of blocking device 100 move to the outside of conduit.But in this example, the near-end 107 of blocking device 100 expands in response to pressure is applied to the inner surface of blocking device 100.Institute's applied pressure can come from any source.In blocking device 100, applied pressure example includes but not limited in the tube chamber of fluid or air input blocking device.

In blocking device, the increase of pressure can cause blocking device 100 to expand.The expansion of blocking device 100 can cause the separation of the near-end 107 of blocking device 100 and/or the far-end 102 of blocking device 100, makes blocking device can be full of vessel lumen substantially.Alternatively, in blocking device, the increase of pressure can make blocking device 100 expand under the near-end 107 or the unseparated situation of far-end 102 of blocking device 100.In this example, blocking device 100 can expand when not pulled down from above by blocking device 100.Expansion blocking device 100 can regulate, and moves at Ink vessel transfusing in the expanded state while being connected in induction system.When being in the desired location in blood vessel when blocking device 100, blocking device 100 can be separated with induction system.Blocking device 100 can realize according to various mode as described herein with being separated of induction system.

In addition, the coverage of blocking device 100 can be regulated while blocking device expands and is connected on transfer system.Such as, blocking device 100 is extracted out and is expanded under pressure (such as, being caused by fluid or air) from conduit 1, and blocking device 100 is expanded in the blood vessel.The position of blocking device 100 can regulate further.Equally, can regulate and be applied to pressure in blocking device 100 to increase the size of the expansion blocking device 100 in blood vessel.The corresponding adjustment of the size (that is, by regulating the force value being applied to blocking device 100) of expansion blocking device 100 and the position of blocking device 100 allows to control the coverage of blocking device when putting into blood vessel.

Equally, negative pressure (such as, sucking-off air or removing fluids from blocking device 100) can be applied to cause blocking device to be retracted.The blocking device 100 of retracting can be put back in conduit 1 further.In an example, blocking device 100 can carry out expanding and retracting as required, to make blocking device 100 move in the blood vessel or locate.

At replaceable shown in Figure 51 or additionally open in step, the friction between the inner surface of blocking device 100 and conduit 1 causes the far-end of blocking device 100 to be separated with protection turn 85.Friction can by blocking device 100 open and/or middle springs circle 70 towards conduit 1 inner surface bias voltage blocking device 100 and produce.Friction between conduit 1 and blocking device 100 contributes to opening of blocking device 100.In these cases, when blocking device 100 is not opened and is separated with protection turn 85 during opening, the friction between the inner surface of blocking device 100 and conduit 1 will cause blocking device 100 to move away from protection turn 85 when transmitting seal wire 41 and conduit 1 relative to each other moves.Transmit seal wire 41 can rotate subsequently, and blocking device 100 opens in the blood vessel.

The radial automatic expansion of blocking device 100 be soft but securely with the cervical region of vessel wall contact so that obstructing arterial tumor A after, conduit 1 can take out completely in patient body.Alternatively, conduit 1 can stay the appropriate position in vascular system, thus allows auxiliary tools to insert or apply medicine near process position.

Known materials can be used in the present invention.A kind of common materials that can use together with seal wire 41 with blocking device 100 is Nitinol, a kind of niti-shaped memorial alloy, it can be formed at low temperatures, heat treatment, distortion, and utilize heating, such as return to its original-shape when opening under body temperature.Radiopaque marker can by radiopaque material, and the metal comprising such as platinum or the doped plastics comprising bismuth or tungsten are made with auxiliary range estimation.

The process of tube chamber in body

Provided below is the system and method for the treatment of tube chamber in patient body.Although be described in one or more embodiment, should be appreciated that such system and method can use in different body lumens and in the various modes that those of ordinary skill in the art recognize.Such as, according to present embodiments describing for the treatment of the atherosclerosis in blood vessel and the system and method that provides thromboembolism to protect during processing.

Atheroscleroticly be characterised in that speckle gathers in blood vessel (such as, carotid artery).Speckle can be made up of cholesterol, cell and other fatty material.Along with passage of time, speckle can limit or block the blood flow flowing through influenced blood vessel.If untreated words, a part of speckle can come off becomes speckle chip, and it flows in less blood vessel downstream through blood vessel.Speckle chip can stop blood to flow to less blood vessel, thus causes receiving the tissue die from the more blood of thin vessels.Such as, block to heart or brain provide the blood vessel of blood can cause heart attack or apoplexy.

Have developed the atherosclerosis in the intrusive mood measure process blood vessel of many minimum levels.In a kind of measure, the conduit with balloon-expandable is advanced in blood vessel because of closed position that Plaques form causes through blood vessel.Sacculus expands to make speckle be pressed against blood vessel subsequently, thus opens the blood vessel got clogged.In another measure, the conduit with cutting tool is advanced to closed position through blood vessel.Use cutting tool excision speckle to open the blood vessel got clogged subsequently.Conduit can comprise the speckle chip that the suction pump near cutting tool location causes because of cutting speckle with removal.After blood vessel is opened, support or other device can open to reinforce blood vessel wall and prevent or reduce the probability again closed in process position in the blood vessel.

During atherosclerosis process, speckle chip can be discharged in blood flow and to cause thromboembolism.When the speckle chip discharged is from process position flow further downstream and choked flow, to during the blood flow of more thin vessels, thromboembolism occurs.Thromboembolism can cause heart attack, apoplexy or Other diseases according to the tissue by the vascularity blood that gets clogged.

In order to prevent or limit the thromboembolism during atherosclerosis process, in certain embodiments, support opens at least in part in the blood vessel in process downstream, position.The effect of the filter of the speckle chip that the support that opens of part discharges during playing and being captured in process, prevents from or limits speckle chip swimming downwards and moving to less blood vessel.In certain embodiments, after the treatment, support in the blood vessel (comprise process position) open completely, thus reinforce blood vessel wall and prevent or reduce the probability again closed.

Figure 64 shows according to the embodiments described herein for the treatment of atherosclerosis and the system 5 providing thromboembolism to protect.System 5 comprises conduit 8, is positioned at the Yarn guide component 57 of conduit 8 and is contained in the support 66 on Yarn guide component 57.Figure 64 shows the sectional view of conduit 8, and wherein, Yarn guide component 57 is arranged in the tube chamber 9 of conduit 8.The Yarn guide component 57 opened in the blood vessel for making support 66 is slidably received in the tube chamber 9 of conduit 8.

Conduit 8 comprises balloon-expandable 40 and fluid and is connected to one or more tube chamber 56 on sacculus 40.Tube chamber 56 extends to the proximal portion (not shown) of conduit 8 from sacculus 40, and wherein, expansion fluid can be injected in tube chamber 56 by fluid-infusing port to make sacculus 40 expand into swelling state from deflation status.Figure 64 shows the sacculus 40 being in deflation status.In certain embodiments, sacculus 40 has the tubular in shape of the expanded radially when expanding.In these embodiments, the tube chamber 9 carrying Yarn guide component 57 extends through sacculus 40.

Conduit 8 has distal openings 18, and the far-end 19 that Yarn guide component 57 can be advanced beyond conduit 8 through described distal openings opens in the blood vessel to make support.Tube chamber 56 distally opening 18 extends to proximal open (not shown), and Yarn guide component 57 can insert in conduit 8 through described proximal open, as shown in figure 43.

Yarn guide component 57 can have structure same or similar with Yarn guide component as above.Yarn guide component 57 comprises the transmission seal wire 59 with flexible distal tip portion 61.Transmit seal wire 59 to be configured to, while bending, torque is passed to extremity from the proximal portion transmitting seal wire 59, making to transmit seal wire 59 can bend along the crooked route of blood vessel.Yarn guide component 57 also comprise one of distally retaining member 62 and nearside retaining member 26 or both, it is configured to remained on therebetween by support 66 and support 66 is fixed on the appropriate location on Yarn guide component 57.Distally and nearside retaining member 62 and 26 can utilize distally as shown in figure 49 and nearside retaining member to realize.Such as, distally retaining member 62 can utilize the retaining member of distally shown in Figure 50 to realize, and the far-end of support 66 can be unclamped by making distally retaining member 62 rotate via transmission seal wire 59.Yarn guide component 57 can also comprise support spring circle 70 (shown in Figure 47) and transmits seal wire 59 to be supported on by transmission seal wire 59 and to make support 66 keep preparing open configuration.

In certain embodiments, support 66 is automatic expansion supports, and it comprises the tubular reticulum lattice structure with compressive state and swelling state.Support 66 comprises extremity 67 and proximal portion 68.The support 66 being in compressive state is contained on Yarn guide component 57, as shown in Figure 64.Support 66 can keep compressive state by the inner surface 17 of tube chamber 9 and retaining member 62 and 26 in conduit 8.When support 66 is configured to open in the blood vessel from the automatic expanded radially of compressive state be swelling state, as described in greater detail below.

Hereinafter with reference Figure 65-69 describe according to the embodiment of the present invention for the treatment of atherosclerosis and the measure of thromboembolism that prevents, reduce or limit because of process generation.This measure can utilize system 5 shown in Figure 64 to implement.

With reference to Figure 65, conduit 8 percutaneous introduces in the blood vessel 69 and process position 53 be advanced in blood vessel 69.The feature of process position 53 is narrow (narrow) being caused the blood vessel 53 caused by Plaques form by atherosclerosis.Blood vessel 69 can be carotid artery or other tremulous pulse.In one embodiment, the narrow zone 54 processing position 53 place utilizes balloon angioplasty and placing rack to process.The angioplasty of other form can also be used.

Conduit 8 can utilize fluorescence imaging to guide to process position 53, wherein, to show the position of conduit 8 on fluoroscopic image on the extremity that one or more radiopaque marker (not shown) is positioned at conduit 8.Conduit 8 can also utilize and comprise ultrasonic and other formation method that is nuclear magnetic resonance and guide.In one embodiment, conduit 8 is positioned to make the sacculus 40 of conduit 8 to be positioned at narrow zone 54.During this, sacculus 40 is in deflation status, as shown in Figure 65.

After conduit 8 is positioned at process position 53 place, Yarn guide component 57 is advanced by the distal openings 18 of conduit 8.The extremity 67 of support 66 is advanced beyond the far-end 19 of conduit 8, and the proximal portion of support 66 remains in the tube chamber 9 of conduit 8 simultaneously.The distal location of support 66 is in the downstream of narrow zone 54 or distally.Arrow in Figure 65 shows the direction that blood flow flows through blood vessel.

With reference to Figure 66, the far-end of support 66 unclamps, and allows extremity 67 automatic expansion of support 66.This can such as by making distally retaining member 62 or other means realize.A part for the extremity 67 of support 66 contacts with blood vessel wall 55 in the expanded state.The proximal portion 68 being positioned at the support 66 of conduit 8 keeps compressive state.Under such a configuration, the extremity 67 of support 66 forms filter between blood vessel wall 55 and the far-end 19 of conduit 8 to catch speckle chip.

Hole in the network of support 66 allows blood to flow through the extremity 67 of support 66 while catching speckle chip.Therefore, support 66 partly opens the effect playing filter in blood vessel 69, for preventing while permission blood flow or limiting thromboembolism.In certain embodiments, the porosity of the filter formed by the extremity 67 of support 66 can regulate after extremity 67 opens.Such as, the extremity 67 of support 66 can axial compression to increase mesh-density, thus reduce the porosity of the extremity 67 of support 66.This can filter less speckle chip.In another example, the extremity 67 of support 66 can axial expansion to reduce mesh-density, thus increase the porosity of the extremity 67 of support 66.This can allow more blood to flow through filter.Figure 36 B shows support axial compression and axial expansion to regulate the example of bracket holes porosity.

The extremity 67 of conduit 8 can by making the far-end 18 of conduit 8 advance and axial compression after extremity 67 opens in blood vessel 69.The propelling of conduit 8 causes the far-end 19 of conduit 8 to engage with extremity 67 and in axial direction applies compression stress to extremity 67.Alternatively, the extremity 67 of support 66 can advance and axial compression after extremity 67 opens in blood vessel 67 by making Yarn guide component 57.The propelling of Yarn guide component 57 causes nearside retaining member 26 in axial direction to apply compression stress to support 66.In two kinds of embodiments, support 66 is remained on appropriate location by the contact between the extremity 67 of support 66 and blood vessel wall 55 during axial compression.

Support 66 partly can open to utilize additive method to form filter in blood vessel 69.Such as, the far-end 19 of conduit 8 may be advanced into the position being positioned at narrow zone 54 distally in blood vessel 69.Conduit 8 can retract relative to Yarn guide component 57 extremity 67 exposing support 66 subsequently.In this example, support 66 can remain on compressive state by conduit cavity 9, makes the extremity 67 of support 66 automatic expansion when conduit 8 is retracted.In another example, the pusher 50 (shown in Fig. 5) engaged with the near-end of support 66 can be used by being released from the distal openings 18 of conduit 8 by the extremity 67 of support 66 and making support 66 partly open.

With reference to Figure 67, sacculus 40 is by injecting sacculus 40 by fluid via tube chamber 56 (shown in Figure 64) and be radially expanded to swelling state.The expansion of sacculus 40 causes sacculus 40 that the speckle in narrow zone 54 is pressed against blood vessel wall 55, thus increases the diameter of the blood vessel 69 in narrow zone 54.During processing, the extremity 67 of support 66 catches the speckle chip 58 because of process release.The restriction speckle chip of catching of speckle chip 58 is swum downwards and is moved to more thin vessels block blood flows to more thin vessels.

With reference to Figure 68, sacculus 40 is deflated to deflation status after blood vessel diameter increases.Because the speckle chip 58 of process release is trapped in the extremity 67 of support 66.

With reference to Figure 69, conduit 8 retracts support 66 is opened completely in the blood vessel 69 comprising narrow zone 54 relative to support 66.The remainder expanded radially of support 66 is to contact blood vessel wall 55.As shown in Figure 69, the proximal extension of support 66 is to the position near narrow zone 54.After support 66 opens completely in blood vessel 69, conduit 8 and Yarn guide component 57 exit from blood vessel 69.Residue speckle in speckle chip 58 and narrow zone 54 is trapped in and is between the support 66 of swelling state and blood vessel wall 55.Support 66 provides support structure to reinforce blood vessel 69 and prevent or reduce the probability again closed to blood vessel wall.

Atherosclerosis can utilize other method to process, and wherein, the extremity of support 66 opens to provide thromboembolism to protect.Such as, the laser beam that the speckle in narrow zone 54 can utilize the cutting tool be arranged on conduit 8, send from the extremity of conduit 8, the high energy signal sent from one or more transducer be arranged in conduit 8 or electrode or other method are removed.For laser beam example, conduit can comprise the optical fiber for laser beam to be transferred to catheter distal portion from lasing light emitter.These method examples each in, the extremity 67 of support 66 can open to catch the speckle chip because process produces as shown in Figure 66 like that.

Figure 70 shows the conduit 8 for the treatment of atherosclerotic cutting tool 73, replaces the angioplasty sacculus according to some embodiments.In these embodiments, cutting tool 73 is arranged on the outer surface of conduit 8.Figure 71 shows the cutting tool comprising cutting blade, and described cutting blade is directed at a certain angle on the outer surface of conduit 8.In these embodiments, cutting tool 73 can be used while being advanced through narrow zone 54 by conduit 8 to excise speckle by making cutting tool 73 rotate.Cutting tool 73 can rotate by making conduit 8 rotate.Cutting tool 73 can have any shape can excising speckle.In addition, cutting tool can have wear surface.

In certain embodiments, cutting tool 73 comprises the blade be hinged on conduit 8.This allows blade folding to make conduit 8 more readily pass through blood vessel propelling along the periphery of conduit 8 downwards.Blade can open by making conduit 8 rotate along a direction, makes rotary centrifugal force cause blade to launch.In addition, the fluid resistance that blade rotates wherein can cause blade to open.Hinge arrangement becomes to make blade directed from the outer periphery of conduit 8 when opening.After speckle is removed, conduit 8 can stop the rotation or rotate in opposite direction, and blade is folded back along the periphery of conduit 8.

Conduit 8 can also comprise one or more for removing suction lumen 71 and the pump orifice 74 of the speckle chip of discharging during processing.In these embodiments, the extremity 67 of support 66 can open to catch the speckle chip do not removed by pump orifice 74.

Describing below with reference to Figure 72 uses conduit 8 shown in Figure 70 and 71 to process atherosclerosis and prevent or limit the measure of thromboembolism.

Conduit 8 percutaneous introduces in the blood vessel 69 and process position 53 be advanced in blood vessel 69, and wherein, cutting tool 73 is located near narrow zone 54.In one embodiment, conduit 8 is through outer catheter or sheath 72 is advanced to the process position 53 in blood vessel 69 in case hemostatic tube 69 is subject to the impact of cutting tool 73.

After conduit 8 is positioned at process position 53 place, Yarn guide component 57 is advanced by the distal openings 18 of conduit 8.The extremity 67 being arranged in the support 66 on Yarn guide component 57 is advanced beyond the far-end 19 of conduit 8 and such as opens at blood vessel 69 by making distally retaining member 62 rotate.Support extremity 67 forms filter to catch speckle chip between blood vessel wall 55 and conduit 8, as shown in Figure 72.Final filter bits is in the downstream of narrow zone 54 or distally.

After the extremity of support 66 opens, cutting tool 73 can be used to excise speckle in narrow zone 54.In one embodiment, cutting tool 73 can rotate and be advanced through narrow zone 54 to excise speckle.In the present embodiment, support 66 can open, and wherein, the enough large part of extremity 67 contacts with blood vessel wall 55, makes after cutting tool 73 has been advanced through narrow zone 54, and a part for extremity 67 still contacts with blood vessel wall 55.After excising the speckle in narrow zone 54, conduit 8 can exit support 66 is opened completely, as shown in Figure 69 in blood vessel 69 relative to support 66.

Figure 73 shows the conduit 8 according to some embodiments, and wherein, cutter sweep 132 is slidably received in the work tube chamber 129 of conduit 8.In these embodiments, cutter sweep 132 comprises the cutting tool 135 be arranged in the distal tip 133 of flexible drive shaft 131.Cutting tool 135 can comprise blade, wear surface and/or both combinations.In order to excise the speckle in blood vessel, cutter sweep 132 is released from conduit 8 by opening 137.Opening 137 is located near the far-end 19 of conduit 8.

Figure 74 shows utilizing cutter sweep 132 to process atherosclerosis and preventing or limit the measure of thromboembolism according to some embodiments.Conduit 8 is arranged in narrow zone 54 and the extremity 67 of support 66 opens the filter that formed for trapping speckle chip at blood vessel 69.Cutter sweep 132 advances towards the speckle of narrow zone 54 through the opening 137 of conduit 8 subsequently.In order to excise speckle, driving shaft 131 makes cutting tool 135 rotate and makes cutting tool 135 rotate along with cutting tool 135 and advance through narrow zone 54.The all right slow circumvolve of conduit 8, makes cutting tool 135 can excise speckle along the periphery of blood vessel 69.What rotate as making cutting tool 135 substitutes, and driving shaft 131 can make cutting tool 135 move back and forth to excise speckle.In this example, multiple blades that the periphery that cutting tool 135 can comprise distally top 133 and/or wear surface is arranged.

After excising the speckle in narrow zone 54, cutting tool 135 can return in conduit 8.Conduit 8 can exit support 66 is opened completely, as shown in Figure 69 in blood vessel 69 relative to support 66 subsequently.

Cutter sweep 132 can also be advanced in blood vessel 69 respectively with conduit 8, replaces the work tube chamber 129 through conduit 8.Figure 75 shows cutting tool 132 and conduit 8 is advanced to the example of the narrow zone 54 in blood vessel 69 separately by outer catheter or sheath 72.In order to excise speckle, driving shaft 131 can make cutting tool 135 rotate, and makes cutting tool 135 be advanced through narrow zone 54 simultaneously and/or cutting tool 135 is moved back and forth in narrow zone 54.Cutting tool 135 can move around conduit 8 with the periphery excision speckle along blood vessel 69.

Figure 76 shows the cutting tool 140 be arranged on conduit or sheath 142 according to some embodiments, and described conduit or sheath are separated with the conduit 8 for making support 66 open.In these embodiments, conduit 142 is advanced to narrow zone 54 on conduit 8.Conduit 142 comprises tube chamber (not shown), receives conduit 8 for advancing on conduit 8 along with conduit 142.

Figure 76 shows utilizing cutter sweep 132 to process atherosclerosis and preventing or limit the measure of thromboembolism according to some embodiments.Conduit 8 is arranged in narrow zone 54 and the extremity 67 of support 66 opens the filter that formed for trapping speckle chip at blood vessel 69.Conduit 142 advances towards the speckle of narrow zone 54 on conduit 8.In order to excise speckle, cutting tool 140 can rotate by making conduit 142 rotate on conduit 8.Rotary cutting tool 104 is subsequently by making conduit 142 move through narrow zone 54 along with being rotated in propelling on conduit 8 of conduit 142.Alternatively, cutting tool 140 can move back and forth to excise speckle by making conduit 142 move back and forth in narrow zone 54.

After excising the speckle in narrow zone 54, conduit 142 can exit through outer catheter 72.Conduit 8 can exit support 66 is opened completely, as shown in Figure 69 in blood vessel 69 relative to support 66 subsequently.

In certain embodiments, the periphery that cutting tool 140 comprises along conduit 142 reels and has the blade of the sharp edges towards distally.In these embodiments, blade can be advanced through narrow zone 54 and excision around the speckle of the periphery of conduit 142 by making conduit 142.

With reference to Figure 77, in certain embodiments, support 66 opens to prevent or limit thromboembolism in the region away from narrow zone 54 at narrow zone 54 and blood vessel 69, as described below.Support 66 can utilize Yarn guide component 57 or other mechanism to open in blood vessel 69.Figure 77 shows the viewgraph of cross-section of support 66 so that display is arranged in the device of the interior lumen of support 66.Open support 66 to contact with the speckle being arranged in narrow zone 54 with the blood vessel wall 55 that blood vessel 69 is arranged in away from the region of narrow zone 54.In these embodiments, conduit 8 shown in Figure 64 or other conduit process atherosclerosis can be utilized.

In certain embodiments, after support 66 opens, the sacculus 40 of conduit 8 is positioned at the support 66 (shown in Figure 78) being arranged in narrow zone 54.Sacculus 40 is radially expanded to swelling state (shown in Figure 79) subsequently by fluid is injected sacculus 40 via tube chamber 56.The expansion of sacculus 40 causes sacculus 40 radial direction to be pressed against the inner surface of support 66.This causes support 66 that the speckle in narrow zone 54 is pressed against blood vessel wall 55 then, thus increases the diameter of the blood vessel 69 in narrow zone 54.Support 66 contributes to the speckle chip of catching between blood vessel wall 55 and support 66 from the part that narrow zone 54 distad opens, thus prevents or limit thromboembolism.

After narrow zone 54 is opened, sacculus 40 is deflated to deflation status and conduit 8 exits from blood vessel 69.Speckle is still trapped between blood vessel wall 55 and support 66.

Sacculus 40 can be arranged on Yarn guide component 57, replaces being arranged on conduit 8.Figure 80 shows the sacculus 40 be arranged on Yarn guide component 57 according to some embodiments.Sacculus 40 is located near nearside retaining member 26.Yarn guide component 57 comprises fluid and is connected to one or more tube chamber (not shown) on sacculus 40, thus expansion fluid is injected sacculus 40 and be radially expanded to deflation status (shown in Figure 80) to swelling state to make sacculus 40.

In order to process atherosclerosis, support 66 opens to prevent or limit thromboembolism in the region away from narrow zone 54 at narrow zone 54 and blood vessel 69, as described below.Support 66 can utilize Yarn guide component 57 (shown in Figure 81) or other mechanism to open in blood vessel 69.Figure 81 shows the viewgraph of cross-section of support 66 so that display is arranged in the device of the interior lumen of support 66.

In certain embodiments, after support 66 opens, the sacculus 40 of Yarn guide component 57 is positioned at the support 66 (shown in Figure 81) being arranged in narrow zone 54.Sacculus 40 is radially expanded to swelling state (shown in Figure 82) subsequently by fluid is injected sacculus 40.The expansion of sacculus 40 causes sacculus 40 radial direction to be pressed against the inner surface of support 66.This causes support 66 that the speckle in narrow zone 54 is pressed against blood vessel wall 55 then, thus increases the diameter of the blood vessel 69 in narrow zone 54.Support 66 contributes to the speckle chip of catching between blood vessel wall 55 and support 66 from the part that narrow zone 54 distad opens, thus prevents or limit thromboembolism.

After narrow zone 54 is opened, sacculus 40 is deflated to deflation status and Yarn guide component 57 and conduit 8 exit from blood vessel.Speckle keeps being trapped between blood vessel wall 55 and support 66.

In certain embodiments, when opening in narrow zone 54, the expansive force of support 66 is enough to narrow zone 54 is opened.In these embodiments, the extremity 67 of support 66 can open in the region of blood vessel 69 away from narrow zone 64.Support 66 can open subsequently near the part of extremity 67 in narrow zone 54.When support 66 is opening period in narrow zone 54 during expanded radially, the speckle in narrow zone 54 is pressed against blood vessel wall 55 by the expansive force of support 66, thus increases the diameter of the blood vessel in narrow zone.Speckle is trapped between blood vessel wall 55 and support 66.Support 66 contributes to the speckle chip of catching between blood vessel wall 55 and support 66 from the part that narrow zone 54 distad opens, thus prevents or limit thromboembolism.

After support 66 opens in blood vessel 69, the speckle in narrow zone 54 and speckle chip keep being trapped between blood vessel wall 55 and support 66.Along with time lapse, new intima can accumulate on the inner surface of support 66.Therefore, the inner surface of support 66 forms the new inner liner of blood vessel 69, this contributes to speckle and speckle chip to remain between the old inner liner of blood vessel 69 and support 66.

In certain embodiments, " blocking device " and " support " uses interchangeably.In certain embodiments, " micropore " and " hole " uses interchangeably.In certain embodiments, porosity refers to the numerical value be inversely proportional to mesh-density.

Equipment described herein and method are not limited to blocking device opening and using in any particular blood vessel, but can comprise many dissimilar blood vessels.Such as, in some respects, blood vessel can comprise tremulous pulse or vein.In some respects, blood vessel can be breast cardiovascular (such as, the blood vessel of cervical region or more), intrathoracic blood vessel (such as, blood vessel in chest), blood vessel is (such as under breast, abdominal part or following blood vessel), breast vascellum laterale (such as, the blood vessel of thorax side, such as shoulder regions or outside blood vessel) or the blood vessel of other type and/or its branch.

In some respects, breast cardiovascular can comprise at least one in intracranial vessel, cerebral arteries and/or its any branch.Such as, breast cardiovascular can comprise common carotid artery, internal carotid artery, external carotid artery, middle meningeal artery, superficial temporal artery, occipital artery, lachrymal gland (eye) tremulous pulse, middle meningeal artery, anterior ethmoidal artery, posterior ethmoidal artery, maxillary artery, posterior auricular artery, ascending pharyngeal artery, vertebral artery, left middle meningeal artery, posterior cerebral artery, superior cerebellar artery, basilar artery, left inner ear (getting lost) tremulous pulse, anterior inferior cerebellar artery, left ascending pharyngeal artery, posterior inferior cerebellar artery, deep cervical artery, supreme intercostal artery, costocervical trunk, subclavian artery, middle cerebral artery, anterior cerebral artery, the anterior communicating artery, ophthalmic artery, posterior communicating artery, facial artery, lingual artery, superior laryngeal artery, superior thyroid artery, ascending cervical artery, inferior thyroid artery, thyrocervical trunk, at least one in internal thoracic artery and/or its any branch.Breast cardiovascular can also comprise at least one in tremulous pulse inside socket of the eye, (HeubnerShi) arteria centralis longa, inner side and outer side artery of cerebral hemorrhage, lateral frontobasal artery, upper volume (candlestick) tremulous pulse, anterior choroidal artery, pontine arteries, internal ear (getting lost) tremulous pulse, anterior spinal artery, posterior spinal artery, medial posterior choroidal artery, lateral posterior choroidal artery and/or its branch.Breast cardiovascular can also comprise at least one in perforating arteries, hypothalamus tremulous pulse, artery of cerebral hemorrhage, superior hypophysial artery, inferior hypophysial artery, mound stricture of vagina prerolandic artery Rolando, mound stricture of vagina artery and/or its branch.Breast cardiovascular can also comprise at least one in tremulous pulse under tremulous pulse before and after precentral sulcus (before central authorities) and center (central authorities) tremulous pulse, top, arteria angularis, Temporal Artery (front, neutralization after), paracentral artery, pericallosal artery, callosomarginal artery, frontopolar artery, precuneal artery, parietooccipital artery, calcarine artery, earthworm and/or its branch.

In some respects, breast cardiovascular can also comprise at least one in diploic veins, emissary vein, cerebral veins, venae cerebri, middle meningeal veins, surperficial temporo vein, frontal diploic vein, front temporal diploic veins, parietal emissary vein, rear temporal diploic veins, occipital emissary vein, occipital diploic vein, mastoid emissary vein, superior cerebral veins, nervus centrifugalis hypophysis vein, funnel (hypophysis) and long hypophyseal portal vessel and/or its branch.

Intrathoracic blood vessel can comprise aorta or its branch.Such as, intrathoracic blood vessel can comprise at least one in ascending aorta, descending aorta, aortic arch and/or its branch.Descending aorta can comprise at least one in thoracic aorta, ventral aorta and/or its any branch.Intrathoracic blood vessel can also comprise at least one in tremulous pulse between subclavian artery, internal thoracic artery, pericardiacophrenic artery, right pulmonary artery, right coronary artery, brachiocephalic trunk, pulmonary trunk, left pulmonary artery, cup and/or its branch.Intrathoracic blood vessel can also comprise at least one in inferior thyroid artery, thyrocervical trunk, vertebral artery, right arteriae bronchiales, upper left arteriae bronchiales, lower-left arteriae bronchiales, main arteriae oesophageae and/or its branch.

In some respects, intrathoracic blood vessel can also comprise at least one in right internal jugular vein, right brachiocephalic vein, subclavian vein, vena thoracica interna, pericardiacophrenic veins, superior vena cava, superior right pulmonary vein, left brachiocephalic vein, left internal jugular vein, left superior pul monary vein, inferior thyroid vein, external jugular vein, vertebral vein, right highest intercostal vein, the 6th right intercostal vein, azygos vein, postcava, left highest intercostal vein, accessory hemiazygos vein, hemiazygos vein and/or its branch.

In some respects, under breast, blood vessel can comprise renal artery, tremulous pulse under diaphragm, there is the coeliac trunk of common hepatic artery, left gastric artery and splenic artery, superior suprarenal arteries, middle suprarenal artery, inferior suprarenal artery, the right tremulous pulse of kidney, subcostal artery, the right tremulous pulse of the first to the four waist, internal iliac artery, iliolumbar artery, internal iliac artery, lateral sacral arteries, external iliac artery, testis (ovary) tremulous pulse, ramus ascendens arteriae circumflexae ilium profundae, superficial iliac circumflex artery, inferior epigastric artery, superficial epigastric artery, femoral artery, deferent duct and testicular artery, superficial external pudendal artery, at least one in deep external pudendal artery and/or its branch.Under breast, blood vessel can also comprise superior mesenteric artery, kidney left artery, ventral aorta, inferior mesenteric artery, arteria colica, sigmoid arteries, superior rectal artery, 5th lumbar arteries, rumpbone medium-sized artery, superior gluteal artery, umbilical cord and superior vesical arteries, obturator artery, towards deferential inferior vesical artery, arteria haemorrhoidalis media, internal pudendal artery, inferior gluteal artery, testis elevator, pubis (obturator artery coincide) branch of inferior epigastric artery, arteria colica sinistra, at least one in arteria haemorrhoidalis and/or its branch.

In some respects, breast vascellum laterale can comprise at least one in brachial artery, transverse cervical artery, suprascapular artery, dorsal scapular artery and/or its branch.Breast vascellum laterale can also comprise at least one in anterior humeral circumflex artery, posterior humeral circumflex artery, subscapular artery, circumflex scapular artery, brachial artery, thoracodorsal artery, lateral thoracic artery, inferior thyroid artery, thyrocervical trunk, subclavian artery, superior thoracic artery, thoracoacromial artery and/or its branch.

Equipment described herein and method are not limited to blocking device and open in vascular system and use, but can comprise many further process application.Other process position can comprise body region or position, such as organ.It will be apparent to one skilled in the art that modification and change of the present invention to implementing each the said equipment of the present invention and method fall within the protection domain of claim.In addition, key element, parts or method step is not had to be proprietary for the public, unless described key element, parts or method step clearly indicate in the claims.

Although detailed description of the present invention comprises many illustrating, these should not regard limitation of the present invention as, and only show different instances of the present invention and aspect.Will be appreciated that, other embodiment do not discussed in detail above scope of the present invention comprises.When not departing from the spirit and scope of the invention limited by claims, other modification various that can it will be apparent to those skilled in the art that the layout of method and apparatus of the present invention disclosed herein, operation and details, change and change.Therefore, scope of the present invention should be stated by claims and legal equivalents thereof and determine.In addition, key element, parts or method step is not had to be proprietary for the public, unless described key element, parts or method step clearly indicate in the claims.Underline and/or the title of italic and subtitle only object for convenience, be not used in and limit the scope of the invention, and have nothing to do with explanation of the invention.In claims and description, except as otherwise noted, odd number key element does not refer to " have and only have one ", unless expressly stated, otherwise refers to " one or more ".In addition, each problem that can be solved by different embodiments of the invention need not be solved for device or method, thus contained by claim.

Claims (20)

1. can stride across the expandable device that the aneurysm in patient vessel is implanted, described device comprises:

Length between the near-end and the far-end of device of described device;

Along the tube chamber of described length extension at least partially; With

The multiple strands be woven together, at least some in described strand comprises cobalt-nickel alloy and at least some in described strand comprises platinum-tungsten alloys,

Wherein, described device has porosity, and described porosity is arranged so that, when described device is placed in blood vessel, guide blood flow is left aneurysm and allowed blood to flow to branch vessel, and

Wherein, described device can be expanded to the swell diameter being greater than described compression diameter in swelling state from the compression diameter compressive state.

2. device as claimed in claim 1, wherein, in swelling state, described porosity is between 70% and 80%.

3. device as claimed in claim 1, wherein, in swelling state, described porosity is between 35% and 70%.

4. device as claimed in claim 1, wherein, in swelling state, described device has the mesh-density between 20% and 50%.

5. device as claimed in claim 1, wherein, in swelling state, described device has the mesh-density between 35% and 50%.

6. device as claimed in claim 1, wherein, in swelling state, described device has the coverage of 33%.

7. device as claimed in claim 1, wherein, described multiple strand comprises 48 rhizoid bars.

8. device as claimed in claim 1, wherein, described device has the diameter between 2.75mm and 4.25mm.

9. device as claimed in claim 1, wherein, described cobalt-nickel alloy comprises 35NLT.

10. device as claimed in claim 1, wherein, described platinum-tungsten alloys comprises the tungsten of 8%.

11. devices as claimed in claim 1, wherein, each described strand has circular cross section.

12. devices as claimed in claim 11, wherein, each described strand has the diameter between 0.0005 inch and 0.0020 inch.

13. devices as claimed in claim 11, wherein, each described strand has the diameter between 0.001 inch and 0.0003 inch.

14. devices as claimed in claim 11, wherein, each described strand has the diameter between 0.003 inch and 0.0005 inch.

15. devices as claimed in claim 11, wherein, each described strand has the diameter between 0.001 inch and 0.0014 inch.

16. devices as claimed in claim 1, wherein, each described strand has oval cross-section.

17. devices as claimed in claim 1, wherein, each described strand has rectangular cross section.

18. devices as claimed in claim 1, wherein, described multiple strand weaves according to " on 11 time 1 " pattern.

19. devices as claimed in claim 1, wherein, described multiple strand weaves according to " on 12 times 2 " pattern.

20. 1 kinds of aneurysm treatment equipment, comprising:

Device as claimed in claim 1; With

Conduit, described conduits configurations is placed for described device being striden across aneurysm.