CN108618822A - 栓子医疗设备 - Google Patents
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Abstract
一种用于闭塞目标区域的闭塞设备,可包括:细长构件,其具有沿所述构件纵向延伸的相对的第一和第二侧边缘,以及构件宽度。所述构件可具有收缩构型,其中第一和第二侧边缘绕所述构件的纵向轴线朝向彼此卷曲。此外,所述构件可具有膨胀构型,其中所述构件形成一系列环,并且第一和第二侧边缘伸展以彼此间隔开。
Description
本申请是名称为“栓子医疗设备”、申请日为2015年4月17日、国家申请号为201510282448.1的发明申请的分案申请。
技术领域
本发明涉及可植入设备。更具体地,本发明涉及能够植入血管内的闭塞设备,并且在一些实施方式中用于动脉瘤治疗的闭塞设备。
背景技术
许多栓子设备已被用于动脉瘤治疗。通常,编制球栓子设备、线圈和其它类型的栓塞术通过中断血流和后续的血栓形成来操作。目前,利用栓子线圈来治疗血管瘤,例如Covidien AxiumTM或Stryker 10。这些栓子设备是具有从0.0090英寸至0.0145英寸范围外径的小线圈。这些设备在芯轴上被加热处理,以赋予有利于动脉瘤几何形状的二维或三维形状。
发明内容
本发明的至少一方面提供了用于在体内输送一个或多个闭塞设备(例如,一个或多个支架)的方法和装置。闭塞设备能够易于遵从脉管系统的弯曲血管的形状。闭塞设备能够用于多种用途。例如,在一些实施方式中,通过基本或完全阻塞动脉瘤的颈部或者基本或完全中断动脉瘤内的血流,闭塞设备能够引导血管内的血流远离动脉瘤。此外,本文披露的闭塞设备的实施方式在单个设备中提供了多种优势,这些优势以前仅通过使用不同医疗设备的组合才能得到。
根据一些实施方式,所披露的设备能够具有平面轮廓,并且由管状材料或扁平片构成。该设备能够进行热处理以赋予二维或三维形状。
所述设备能够由聚合物、金属或聚合物和金属的组合制成。所述设备能够用多条细丝在单个缝线器或载体内进行编织、针织或交织。能够加入不透射线的细丝以增强在输送至目标脉管系统期间和之后的能见度。所述设备的各实施方式可具有比线圈更宽的轮廓,并且因此,与线圈相比需要更少的设备来获得足够的动脉瘤颈部覆盖范围和动脉瘤囊郁积(sac stasis)。所述设备还能提供优秀的动脉瘤囊的框式支架。
根据一些实施方式,一种输送一个或多个设备的方法包括使设备形成为圆柱形或“螺旋形”形状并通过导管输送该设备。使设备形成为圆柱形或螺旋形形状,这能够使横截面轮廓最小化并允许进入远侧的解剖结构。因而,一些实施方式能够用在对于传统支架或其它这些可展开结构来说可能较小的脉管系统中。此外,能够减小设备的推动阻力,从而改善设备的推动能力。
示意了例如根据下述各个方面的本发明。为了方便起见,本发明的各方面的不同实例描述为数字标记的项或实施方式(1、2、3、等)。这些提供为实例而并不限制本发明。应当指出,任意从属项可以以与彼此或者一个或多个其它独立项的任意结合来进行结合,来形成独立项。其它项能够以类似方式来呈现。下面是本文呈现的一些实施方式的非限制性概述:
项1.一种用于闭塞目标区域的闭塞设备,所述闭塞设备包括:细长构件,所述细长构件具有沿细长构件纵向延伸的相对的第一侧边缘和第二侧边缘、以及构件宽度,细长构件具有(ⅰ)收缩构型,在收缩构型中,第一侧边缘和第二侧边缘绕细长构件的纵向轴线朝向彼此卷曲,以及(ⅱ)膨胀构型,在膨胀构型中,细长构件形成一系列环,并且第一侧边缘和第二侧边缘伸展以彼此间隔开。
项2.项1的闭塞设备,其中,第一侧边缘和第二侧边缘伸展,从而彼此以不超过两倍构件宽度的距离间隔开。
项3.项2的闭塞设备,其中,第一侧边缘和第二侧边缘伸展,从而彼此以接近构件宽度的距离间隔开。
项4.前述所述项中任一项的闭塞设备,其中,细长构件包括形状记忆材料。
项5.项4的闭塞设备,其中,细长构件包括在膨胀构型时处于奥氏体状态的材料。
项6.前述所述项中任一项的闭塞设备,其中,细长构件包括扁平的管状件。
项7.前述所述项中任一项的闭塞设备,其中,细长构件包括多条细丝。
项8.项7的闭塞设备,其中,细丝的间隔沿细长构件的长度变化。
项9.项7的闭塞设备,其中,多条细丝编织在一起。
项10.项7的闭塞设备,其中,多条细丝交织在一起。
项11.项7的闭塞设备,其中,细长构件构造为使细丝形成扁平管状构件。
项12.项11的闭塞设备,其中,管状构件的细丝具有可变节距。
项13.前述所述项中任一项的闭塞设备,其中,细长构件包括至少一个狭缝。
项14.项13的闭塞设备,其中,所述至少一个狭缝沿细长构件的纵向轴线延伸。
项15.项13的闭塞设备,其中,细长构件包括多个狭缝,所述多个狭缝沿细长构件的纵向轴线延伸并且以大体上线性的构型间隔开。
项16.前述所述项中任一项的闭塞设备,其中,第一侧边缘和第二侧边缘包括从其侧向延伸的多个翼元件。
项17.项16的闭塞设备,其中,翼元件从细长构件的相对的侧部延伸。
项18.项17的闭塞设备,其中,一对翼元件在沿细长构件的第一纵向位置处从相对的侧部延伸。
项19.项17的闭塞设备,其中,翼元件包括第一组翼元件和第二组翼元件,第一组翼元件从细长构件的第一侧部延伸,而第二组翼元件在与第一组翼元件不同的纵向位置处从细长构件的第二侧部延伸。
项20.一种用于闭塞目标区域的闭塞设备,所述闭塞设备包括:细长构件,所述细长构件包括多条细丝,细长构件具有中央支柱以及从支柱延伸的多个翼元件,细长构件具有(ⅰ)收缩构型,在收缩构型中,翼绕细长构件的纵向轴线朝向支柱卷曲,以及(ⅱ)膨胀构型,在膨胀构型中,支柱形成一系列环。
项21.项20的闭塞设备,其中,翼元件从细长构件的相对的侧部延伸。
项22.项20-21中任意一项的闭塞设备,其中,翼元件包括第一组翼元件和第二组翼元件,第一组翼元件从细长构件的第一侧部延伸,而第二组翼元件在与第一组翼元件不同的纵向位置处从细长构件的第二侧部延伸。
项23.项20-22中任意一项的闭塞设备,其中,细长构件包括扁平的编织管状构件。
项24.项20-23中任意一项的闭塞设备,其中,在膨胀构型中,翼远离支柱伸展。
项25.一种操作闭塞设备组件的方法,其包括:将处于收缩构型的细长构件在导管内推进,细长构件具有沿细长构件纵向延伸的相对的第一侧边缘和第二侧边缘,在收缩构型中,第一和第二侧边缘绕细长构件的纵向轴线朝向彼此卷曲;以及驱使细长构件的远端越过导管远端,以将细长构件释放至膨胀构型,在膨胀构型中,第一和第二侧边缘远离彼此移动并且细长构件卷成一系列环。
项26.项25的方法,还包括将导管远端定位在动脉瘤的口处,其中所述驱使步骤包括驱使细长构件进入动脉瘤的底部。
本发明的另外特征和优势将在下面的描述中阐明,并且在某种程度上将从描述中而显而易见,或者可从本发明的实现中学到。本发明的优势将通过所写成的说明书中具体指明的结构及其实施方式以及附图来实现和获得。
应当理解的是,前面的一般说明和下面的详细描述是示例性和解释性的,并且目的在于提供本发明的进一步解释。
附图简述
所包含的附图提供了本发明的进一步理解,并且并入本说明书并构成本说明书的一部分,示意了本发明的各方面并与说明书一起用于解释本发明的原理。
图1是示意根据一些实施方式的将闭塞设备在动脉瘤中展开的侧面横截面图。
图2A是根据一些实施方式的闭塞设备的透视图,其能够释放进入体腔的目标区域内。
图2B是根据一些实施方式的闭塞设备沿其纵向轴线的透视横截面图,其中闭塞设备处于在目标去取内膨胀时能够实现的第一、膨胀构型。
图2C是根据一些实施方式的闭塞设备沿其纵向轴线的透视横截面图,其中闭塞设备处于在推进到目标区域过程中能够保持的第二、收缩构型。
图3A-3I示意了根据一些实施方式的、能够包含在闭塞设备中的各个方面和可选特征。
图4示意了根据一些实施方式的、在导管内处于收缩构型的闭塞设备。
图5A-6B示意了根据一些实施方式的、布置在导管内的闭塞设备的横截面图。
图7A-7F示意了根据一些实施方式的、在将闭塞设备在动脉瘤中展开中的渐进步骤。
图8示意了根据一些实施方式的、利用一个或多个闭塞设备覆盖动脉瘤颈部。
图9A-9B示意了根据一些实施方式的、处于膨胀构型的闭塞设备的其它形状。
具体实施方式
在下面的详细描述中,阐明了许多具体细节以提供对于本发明的全面理解。应当理解的是,本发明可以在没有这些具体细节中的一些的情况下来实现。在其它情形中,未详细示出公知结构和技术以免使本发明变得晦涩。
此外,尽管本说明书阐明了各实施方式的具体细节,但是应当理解的是,本说明书仅仅是示例性的而不应以任何方式解释为限制。另外,能够预期的是,虽然在动脉瘤治疗的上下文中披露或示出本发明的具体实施方式,但是这些实施方式能够用于脉管系统内的其它闭塞治疗中。此外,本文描述的一般概念也包含这些实施方式以及对本领域技术人员来说显而易见的变体的各个应用。
根据本文披露的一些实施方式的一个方面,提供了闭塞设备和使用方法,其例如相比于在闭塞动脉瘤中使用的传统线圈、支架、或编织结构,不论是以单独的方式还是以组合的方式都提供了优势。一些实施方式能够提供比传统线圈更大的动脉瘤表面接触,这能够允许展开较少的设备材料,同时倾向于增大植入闭塞设备的表面积,这会增强凝血活性。通过能提供良好的贴壁性和颈部覆盖的一些实施方式,能够极大地减小动脉瘤再通的可能性。此外,一些实施方式还能更易于在动脉瘤圆顶(dome)或腔内操纵。例如,闭塞设备更易于遵从动脉瘤腔的内部形状。此外,当动脉瘤尺寸开始减小时,一些实施方式的方案允许闭塞设备变形,从而闭塞设备尺寸能够压缩或折叠以促进动脉瘤治愈,这通常利用传统线圈或其他设备是不可能的。
例如,图1是示意根据一些实施方式将闭塞设备在动脉瘤中展开的侧视横截面图。如图所示,闭塞设备10能够利用设备组件20推进至目标动脉瘤40。闭塞设备10能够从组件20的导管22推进并穿过动脉瘤40的颈部42到达动脉瘤40的底部44。
闭塞设备10可包括具有细长形状的本体12。在一些实施方式中,本体12在位于导管22内时可处于第一构型,而在从导管22释放进入动脉瘤40时膨胀至第二构型。例如,在一些实施方式中,当本体12被约束在导管22中并且主要以横向于本体12纵向轴线的方向卷曲或卷绕时,能够实现第一构型。在一些实施方式中,当本体12从导管22中释放并且主要以沿本体12纵向轴线的方向卷曲或卷绕时,能够实现第二构型。因而,随着闭塞设备10的本体12从导管22释放,闭塞设备10的主要卷曲部或卷绕部能够从沿纵向轴线的一个方向转换为另一个方向,从而闭塞设备从细长大体上管状的构型变为动脉瘤40中的捆束圆形。随着闭塞设备10被释放,本体12能够渐进地接触更多的动脉瘤壁并覆盖更多的动脉瘤40颈部42,直到颈部42基本被覆盖或阻塞为止。最后,不论是单个还是多个闭塞设备插入到动脉瘤40中,动脉瘤的壁都会更完全地接触闭塞设备,并且能够基本塞满或填充动脉瘤40的容积,从而动脉瘤40内的循环或流体运动变缓或停止,并且通过颈部42进入动脉瘤40的循环或流体运动显著变缓或停止。
图2A描绘了能够释放进入身体的目标组织以闭塞目标区域的闭塞设备100的实施方式。目标区域可以是体腔或空间,例如动脉瘤(包括神经血管动脉瘤或颅内动脉瘤)、血管、或其他中空解剖结构。根据一些实施方式,闭塞设备100能够提供相比其他闭塞设备(例如线圈和可膨胀细丝结构,包括支架、金属丝笼、以及其它公知的闭塞设备)更多的显著优势。
例如,在动脉瘤治疗的情形中,闭塞设备100能够塞满或填充目标容积,并适应目标容积的形状、执行支架或编织结构无法独立充分执行的功能。此外,闭塞设备100能够接触动脉瘤的不规则侧壁形状。此外,闭塞设备100还能使动脉瘤颈部的覆盖最大化,充分抓握动脉瘤的侧壁以防止闭塞设备脱出或滑移,促进沿动脉瘤颈部的治愈响应,提供至期望膨胀形状的可预测膨胀,并且无需其它支架或颈部阻塞设备而达到目的、执行线圈结构无法独立地充分执行的功能。
参照图3A,闭塞设备100示意为包括本体,即由具有多股线(例如金属丝或聚合物细丝)的编织物形成的带状物或细长构件150。例如,本体150可包括镍钛合金或其它合适(超弹)材料。例如,根据一些实施方式,构成本体150的材料可允许本体150当处于室温或接近室温时大体上是直的(并且相对细长,例如,在用于输送的第二构型中),而当处于人体体温或接近人体体温时盘绕(并且相对缩短或打环,例如,在用于在目标区域空间装满或填充的第一构型中)。然而,在一些实施方式中,闭塞设备100还可包括其他类型的材料或材料构型。例如,闭塞设备100可包括生物可吸收材料或聚合物。此外,所述材料还可包括钴铬。
此外,闭塞设备100可包括机织、针织、编织的或者非编织、非针织、非织物的单个连续材料件、或模压件,不论其处于扁平片状构型或管状构型。闭塞设备100可包括单层或多层片状或管状结构。在一些实施方式中,闭塞设备100可包括激光切割或光蚀刻材料。闭塞设备100还可包括由一种或多种非织造纤维(例如长纤维)形成的材料,所述非织造纤维形成的材料被一起压缩或者结合到管状或扁平片状构型中。
在一些实施方式中,闭塞设备100可构造为管状结构,所述管状结构能够变平以提供大体上扁平的横截面轮廓。因而,管状结构的变平能够提供多层片或结构,顺便说一下,所述多层片或结构的层沿闭塞设备的侧向纵向边缘连接。
在一些实施方式中,闭塞设备100可包括扁平片,所述扁平片可沿闭塞设备100的纵向轴线自身折叠一次或多次。因而,材料的折叠可提供多层片或结构。这种材料片的使用能够提供制造便利性、并且能够更好地控制闭塞设备100的端部。
在一些实施方式中,不管闭塞设备100的材料或构型如何,闭塞设备100都可包括具有网纹表面或光滑表面的本体。例如,在一些实施方式中,闭塞设备可包括具有不规则、多孔、凹陷、编织、交织、或针织表面的本体。因而,闭塞设备100的一些实施方式可构造为提供给予血流所需水平的凝血活性和/或阻力的孔眼、孔洞、凹口、或孔隙空间。此外,这些孔眼、孔洞、凹口、或孔隙空间当释放进入动脉瘤时,能够有益地接合动脉瘤的侧壁。正是如此,在展开闭塞设备100期间,网纹表面倾向于增强贴壁性、并确保闭塞设备100与动脉瘤壁接合且不会在动脉瘤内移动或从动脉瘤脱出。
此外,替代这种网纹表面或者除了这种网纹表面之外,血栓形成材料可用作闭塞设备100中的涂层、添加剂或者其它,例如,金、铂、铂铱合金、或纤维蛋白。在使用编织物的情形中,可选择编织线金属以使电流(以及任何产生的凝血活性)最大化。
在使用中,图2A中示出的闭塞设备100可装载在输送系统(例如导管)中,并输送至体内的目标区域。根据一些实施方式,闭塞设备100当从输送系统释放在目标区域中时,可呈现膨胀构型、第一构型或初级构型110,如图2A-2B所示。而闭塞设备100在正被输送到目标区域期间,还可具有收缩构型、第二构型或次级构型120,例如图2C的实施方式所示。因而,为了促进闭塞设备100的输送,本体150当处于输送导管中时可以以诸如收缩构型120的构型定位。在从输送导管释放后,本体150可优先地采取膨胀构型110。因此,本体150当无约束时倾向于自调节或移动至膨胀构型110(与停留在收缩构型120或移动至收缩构型120相反)。
在图2A-2B所示的膨胀构型110中,闭塞设备100的本体150可以绕横向于本体150的纵向轴线160的轴线成环、弯曲、卷曲或卷绕。此外,在图2C所示的收缩构型120(例如,当闭塞设备100处于导管中时实现)中,闭塞设备100的本体150可以绕与本体150的纵向轴线160对齐的轴线成环、弯曲、卷曲或卷绕。
在一些实施方式中,本体150可包括“卷曲向量”162,所述卷曲向量能够利用“右手定则”几何限定为当手的手指沿本体150的相同弧度或方向卷曲时拇指所指的向量或方向。如图2B所示,当处于膨胀构型110时,卷曲向量162定向为基本横向于本体的纵向轴线160。在一些实施方式中,当本体150处于膨胀构型110时,卷曲向量162可以以相对于纵向轴线160基本垂直的方向延伸。
例如,本体150可包括相对的第一和第二侧边缘172、174。在膨胀构型110中,在沿纵向轴线160的给定点处,第一和第二侧边缘172、174以第一距离间隔开。此外,如图2B所示,闭塞设备100可包括前边缘176(其表示闭塞设备基本垂直于纵向轴线160的横截面),当闭塞设备100处于膨胀构型110时,前边缘176可具有基本扁平的横截面形状。
闭塞设备100在从输送系统释放后,基本上装满或填充体腔(例如动脉瘤)的内部容积。例如,如下面进一步讨论,当闭塞设备100处于膨胀构型110时,闭塞设备100可包括各种三维形状,包括球形或非球形形状,包括半球、面条状、线圈、长球、扁球、滚球、非球面旋转曲面(例如,环面、锥体、圆柱体、或者绕中点或共面轴旋转的其它形状),和/或它们的组合。例如,图2A示意了具有球形或基本球形构型的闭塞设备的实施方式,而图9A-9B示意了具有半圆柱形、3-D、或圆柱形构型的闭塞设备100的实施方式。
然而,如图2C所示,在收缩构型120中,本体150可具有基本圆柱形构型。例如,本体150可环绕或围绕相对于纵向轴线160基本平行的直线弯曲、卷曲或卷绕。如图2C所示,当处于收缩构型120时,本体150可卷曲,从而卷曲向量162定向为相对于本体的纵向轴线160基本平行。当本体150处于收缩构型120时,即使卷曲向量162不相对于纵向轴线160基本平行,卷曲向量162也可以相对于纵向轴线160在约30度内、约20度内、或者约10度内平行,此外,在收缩构型120中,第一和第二侧边缘172、174可朝向彼此卷曲。
例如,如上所指出的,在膨胀构型110中,在沿纵向轴线160的给定点处,第一和第二侧边缘172、174以第一距离间隔开。当移动至收缩构型120时,在沿纵向轴线160的给定点,第一和第二侧边缘172、174以第二距离间隔开,第二距离小于第一距离。此外,如图2C所示,当闭塞设备100处于收缩构型110时,闭塞设备100的前边缘176(其可代表闭塞设备基本垂直于纵向轴线160的横截面)可具有曲线形状或横截面。
在一些实施方式中,第一和第二侧边缘172、174在收缩构型120中相对于彼此基本平行。例如,第一和第二侧边缘172、174相对于纵向轴线160基本平行地延伸。在一些实施方式中,第一和第二侧边缘172、174在收缩构型120中至少部分地绕纵向轴线160螺旋延伸。
在闭塞设备100输送期间,第一和第二侧边缘172、174虽然在收缩构型120中绕纵向轴线160卷曲或卷绕,但在穿过脉管系统的迂曲部时可略微偏转、弯折、或弯曲到纵向轴线160上。为了本发明的目的,在将闭塞设备100推进至目标区域期间,这些动作被认为是典型的动作,并且当闭塞设备100被定位为导管内折叠的第二构型120时,不管闭塞设备100弯曲或成环在纵向轴线160上的程度或数量,闭塞设备100都被认为处于收缩构型120。
然后,有益的是,一些实施方式能够提供在通过脉管系统的迂曲部推进时具有足够柔性来弯曲或弯折、而不会扭结或破坏闭塞设备的纤维或细丝的闭塞设备。此外,一些实施方式还允许闭塞设备100承受相当大的推力而不会收缩或屈曲。例如,一些实施方式允许闭塞设备定位成基本管状或卷绕的形状,从而有益地增强闭塞设备处于收缩构型的轴向压缩时的强度。
如上所指出,根据一些实施方式,闭塞设备100的本体150可构造为具有至少一种预设构型。例如,能够偏压闭塞设备100的本体150,从而闭塞设备100在膨胀构型110中呈现第一预设的二维或三维构型。然而,在一些实施方式中,闭塞设备100的本体150还包括闭塞设备100呈现收缩构型120的第二预设构型。
在一些实施方式中,能够将闭塞设备100的本体150朝向第一或第二预设构型其中之一或二者偏压。闭塞设备100还能够预设为呈现第一构型作为初级构型,而呈现第二构型作为次级构型。例如,闭塞设备100的本体150可具有两个稳定位置。可选地,当没有外力施加在本体150上时可以优选第一构型。
此外,能够提供其中闭塞设备仅具有这些预设构型中的一个或全部两个的一些实施方式。例如,在一些实施方式中,虽然闭塞设备100的本体150可仅具有一个预设膨胀构型110,但是闭塞设备100能够充分卷绕或卷曲以允许将闭塞设备100装载在导管内并在其内推进。此外,在一些实施方式中,虽然闭塞设备100的本体150可仅具有一个预设收缩构型120,但是闭塞设备100可结合另一结构(例如下面讨论的张紧构件),以赋予闭塞设备100二维或三维形状。
为示意起见,图3A-3I示出了闭塞设备处于平面或扁平构型的各个实施方式的俯视图。图3A-3I中示意的任意闭塞设备能够利用管状网眼材料变平为两层片来形成。然而,图3A-3I中示意的任意闭塞设备还可构造为网眼材料的单层片,其能够折叠一次、两次、或多次,或者根本不折叠而形成所述闭塞设备。一些实施方式的横截面轮廓示意在图5A-6B中。此外,根据一些实施方式,闭塞设备不论由扁平管状网眼还是由单层片(折叠或者不折叠)构成,都能够可选地包括促进进入通过闭塞设备或增加闭塞设备在其膨胀构型中的覆盖面积的一个或多个结构,例如狭缝或突出。其他特征还能够可选地结合在闭塞设备中,以为闭塞设备提供不透射线性、药物输送机构、可膨胀材料、或例如本文所披露的或者本领域公知的其它结构。
例如,图3A示意了闭塞设备100的截面,其中本体150构造为使得第一和第二侧边缘172、174基本是直的或者相对于闭塞设备100的纵向轴线160基本平行地延伸。
图3B示意了闭塞设备100能够可选地包括至少一个纵向狭缝。如图所示,闭塞设备100可包括沿闭塞设备100的纵向轴线160延伸的至少一个狭缝190。在一些实施方式中,闭塞设备100可包括多个狭缝190,例如图3B中所示。狭缝190能够允许临床医生将另一栓子设备(例如一个或多个线圈或栓子材料或液体)推进或注入到动脉瘤中。例如,合适的液体栓子剂是由加州Irvine的Covidien LP制造的OnyxTM液体栓子系统。OnyxTM液体栓子系统是在治疗脑动静脉畸形中使用的非粘性液体。OnyxTM液体栓子系统包含溶解在二甲基亚砜(“DMSO”)中的乙烯乙烯醇共聚物(“EVOH”)以及悬浮微粉化钽粉,以提供用于荧光镜检查下可视化的对比度。还能预想到其它液体栓子溶液。
图3C示意了在一些实施方式中,闭塞设备100可选地包括赋形的、结构性的或张紧构件194。本体150可与张紧构件194分开形成,从而张紧构件194作为影响本体150形状的单独的、独立组件。如图3C所示,张紧构件194可交织到编织物中。
张紧构件194可联接至闭塞设备100的一个或多个部分,从而为闭塞设备100提供拉伸阻力或抗拉伸特性。因而,在一些实施方式中,虽然闭塞设备100可由弹性或可变形材料构成,但是张紧构件194的加入能够确保闭塞设备100的长度在推进闭塞设备100通过输送系统期间以及在目标区域内展开闭塞设备100期间仅略微变化或者基本不变化。此外,在一些实施方式中,张紧构件194弹性地提供拉伸阻力。因而,能够增大闭塞设备100的长度,并且张紧构件194能够抗拉伸并促使闭塞设备100朝向其未拉伸的原始长度。
在一些实施方式中,张紧构件194不仅提供了抗拉伸能力,还能赋予闭塞设备100处于膨胀构型110时的二维或三维构型。可以利用张紧构件194来赋予本文讨论的二维或三维构型、或者其它合适的这种构型中的任意一种。
可以将期望的无约束构型热定型或以其它方式处理到张紧构件194中。张紧构件194可以与自身没有特定的热定型或其它预设无约束构型的闭塞设备100一起使用,或者与不具有预设的二维或三维构型的闭塞设备100一起使用。在仅张紧构件194具有预设的无约束构型的情形中,张紧构件194能够促使闭塞设备100在从输送导管释放或者进入目标区域时进入二维或三维无约束或半约束构型。因而,通过闭塞设备100实现的无约束构型可基本类似于张紧构件194中预设的无约束构型。
张紧构件194可包括第一和第二端,其中至少一端联接至闭塞设备100的本体150。在一些实施方式中,张紧构件194可包括都分别联接至闭塞设备100的第一和第二部分的第一和第二端。闭塞设备100的第一和第二部分可包括第一和第二端部。
张紧构件194通过在推进闭塞设备100时提供牵拉或推动功能而促进闭塞设备100的输送。例如,在一些实施方式中,张紧构件194在一端仅联接至闭塞设备100的一部分或一端。在这些实施方式中,张紧构件194的另一端能够被抓紧或联接至输送系统的一部分以提供抗拉伸特性。正是如此,闭塞设备100能够利用远端处包括垫或接合件的芯线或组件在导管内输送。芯线的接合件能够在远离闭塞设备100近端的一点处接合闭塞设备100。在一些实施方式中,接合件能够在靠近闭塞设备100远端的一点处接合闭塞设备100,例如在沿闭塞设备100纵向轴线的中点处,或者在中点与闭塞设备100的远端之间。张紧构件194能够联接至闭塞设备100的近端并向远侧延伸,从而张紧构件194的远端与芯线的一部分接合,例如接合件。在一些实施方式中,张紧构件194的远端能够有摩擦地接合在接合件和闭塞设备100之间或者可释放地与芯线接合。此外,在一些实施方式中,张紧构件194能够附接至芯线或接合件的远端和闭塞设备100的近端,并构造为在将闭塞设备100释放在目标区域内时分解。
可替代地,根据一些实施方式,张紧构件194能够为闭塞设备100提供裂断强度。因而,在输送闭塞设备100期间通过向远侧方向上手动推动张紧构件194的近侧延伸部,张紧构件194可用于通过导管向远侧推进闭塞设备100。例如,张紧构件194能够联接至闭塞设备100的本体150的远端部,并且能够接触张紧构件194的近端(以及一些实施方式,连同本体150的近端一起)以向远侧推动闭塞设备100通过导管管腔。正是如此,输送系统的一些实施方式能够构造为邻接或联接至张紧构件194的近端以推动闭塞设备100通过导管。
此外,类似于闭塞设备100的本体150,可与本体150分开立形成的张紧构件194可包括能够如上讨论那样预成形的一根或多根镍钛合金丝。例如,可以使用镍钛合金或奥氏体镍钛合金(或其它材料),所述镍钛合金或奥氏体镍钛合金(或其它材料)在处于或接近室温时基本是直的(并且相对细长),而在处于或接近人的体温时盘绕(并且相对变短)。这种张紧构件能够如上文讨论的那样使用,以在通过导管管腔输送时保持闭塞设备100的轴向长度,但是允许或促进从收缩构型120到膨胀构型110的运动。此外,如上文所述,能够提供一些实施方式,其中在从导管释放时,张紧构件194赋予闭塞设备100二维或三维形状。
现参照图3D-3E,闭塞设备100的本体150能够构造为使得侧边缘172、174相对于彼此汇聚或分叉。例如,如图3D所示,本体150可包括从本体150的纵向轴线160横向向外延伸的一个或多个扩大部分(可包括翼、凸起)。
图3D示意了从闭塞设备100的相对侧基本对称延伸的多个扩大部分200。此外,图3E示意了闭塞设备100的另一实施方式,其中扩大部分200从闭塞设备100的相对侧以交错构型延伸。此外,图3G示意了另一实施方式,其中扩大部分200具有不同的宽度或尺寸。
如所示意,扩大部分200的形状和大小为扩大部分200提供了圆形、半圆形边缘。然而,扩大部分或翼200还能够构造为使得侧边缘172、174具有正弦曲线的形状。扩大部分可包括任意形状、尺寸、或者沿闭塞设备的长度占据任意位置,及其任意组合。
扩大部分200可由单一的连续材料件与本体150一起形成。本体150能够被切割或成形为包括扩大部分200。例如,本体150可由编织片或管形成,所述编织片或管的细丝横向伸展并且热成型以形成扩大部分200。然而,在一些实施方式中,扩大部分200可与本体150独立形成并随后联接至本体150。
此外,扩大部分200能够构造为绕纵向轴线160卷绕或卷曲,或从压缩构型横向自扩张。图3D-3E所示意的实施方式示意了可卷绕或可卷曲的扩大部分200。此外,图3F-3G示意了闭塞设备100的实施方式,其中扩大部分200分别处于压缩和展开位置210、212。扩大部分200在压缩时或者与流体或热量接触之前,能够使得沿本体150的扩大部分200的交织数(pic count)(即,细丝每英寸交叉数量或每英寸交织数(PPI))或纤维密度更高。扩大部分200当被释放或暴露至流体或热量时,能从压缩位置210移动至展开位置212,如图3F-3G所示。例如,在一些实施方式中,扩大部分200是超弹性的。
例如,当(例如,通过从收缩位置伸直、展开、或扩展而)释放扩大部分200时,沿扩大部分200的侧边缘172、174的间隔大于沿本体150的侧边缘172、174的间隔。侧边缘172、174可具有最大宽度(例如,在图3G的距离220处测得)和最小宽度(例如,在图3G的距离222处测得)。最大宽度220可大于最小宽度222。在一些实施方式中,最大宽度220是最小宽度222的约1.1至约4倍、约1.5倍至约3.5倍、约2至约3倍、或者约2.2至约2.8倍。在一些实施方式中,最大宽度220不超过最小宽度222的多于三倍或四倍。
此外,在一些实施方式中,如图3G所示,扩大部分或翼200可包括约等于最小宽度222的宽度224。此外,以及一些实施方式中,扩大部分或翼200的宽度224是最小宽度222的约0.25至约2倍之间、约0.5至约1.5倍、约1至约1.25倍。
根据一些实施方式,扩大部分200可构造为具有沿闭塞设备100长度的不同宽度、尺寸(例如,纵向长度)、或形状。因而,当释放时,侧边缘172、174能够限定基本不规则的图案。最大和最小宽度220、222可处于如上所述的那些范围内。
此外,扩大部分200当被释放时能够构造为提供基本等于或同于本体150的纤维密度或图案的纤维密度或图案。然而,扩大部分200还能够构造为提供与本体150的布置为邻近各个扩大部分或翼200的部分相比较低的纤维密度或不同图案。在这些实施方式中,扩大部分200能够以这种构型热定型或者预定型。
如上所指出的,能够通过拉伸本体150以使本体在沿其长度的离散位置变宽、或者通过将独立组件联接至本体150,来形成扩大部分200。在扩大部分200在压缩位置和膨胀位置之间移动的实施方式中,通过施加压缩力或者通过使用闭塞设备100上的涂层,扩大部分200能够保持在压缩位置,所述涂层能够帮助保持压缩位置直到在释放之后涂层溶解在所存在的流体中为止。
现参照图3H,根据一些实施方式,本体150可包括具有不同特性的第一和第二节段240、242。例如,本体150能够构造为使得编织、纺织或机织图案变化至少一次或多次、或者沿本体150的长度而变化。在一些实施方式中,本体150可包括具有第一和第二节段240、242的编织结构。第一和第二节段240、242可具有不同孔隙率、交织数、细丝节距、细丝尺寸或编织/纺织/机织密度。因而,第一和第二节段240、242可具有不同特性,其能够有益地影响闭塞设备100在目标区域内以及在输送至目标区域期间的功能。
例如,较高交织数或编织密度倾向于减少或阻塞通过闭塞设备100的流量,而较低的交织数或编织密度能够允许栓子材料或线圈通过闭塞设备100流动或注入。此外,交织数或编织密度还能够影响与目标区域壁的摩擦接合以及当释放时在例如动脉瘤颈部处的内皮化。此外,细丝的节距或对准还能够影响当在导管内朝着目标区域向远侧驱动闭塞设备100时的纵向压缩能力或推动能力。例如,纤维能够与闭塞设备100的纵向轴线紧密轴向对准,从而增强或增大闭塞设备100的推动能力。此外,较低的交织数也倾向于增大闭塞设备100的推动能力。
现参照图3I,闭塞设备100还能够构造为使得闭塞设备100的近端和远端250、252中的至少一个包括无创伤结构或组件。例如,闭塞设备100能够构造为使得近端和/或远端250、252包括一个或多个点或拐角(不论是圆角还是尖角),所述点或拐角具有从其延伸的细丝260。细丝260能够允许近端和/或远端250、252缓慢且无创伤地接触目标区域壁(例如动脉瘤壁)。在一些实施方式中,细丝260可包括圆形或球形尖端262。
图4-6B示意了闭塞设备组件300的视图,其中闭塞设备100布置在导管302中。如图所示,闭塞设备100处于收缩构型120中。在所示意的实施方式中,闭塞设备100包括围绕闭塞设备100的纵向轴线折叠或卷曲的扩大部分200。此外,闭塞设备100还包括无创伤部分或细丝260。因而,闭塞设备100能够向远侧地推出导管302并进入目标动脉瘤中,在目标动脉瘤处,闭塞设备100能够从收缩构型120展开为膨胀构型。
此外,根据一些实施方式,闭塞设备100在它的一端或两端处、在沿其长度的各位置处、或者沿其整个长度包括不透射线标记。这些标记能够以类似于细丝260和/或圆形或球形尖端262的方式进行构造。例如,细丝260和/或其圆形或球形尖端262可以是不透射线的。
闭塞设备100的长度可以是从约5mm至约250mm。在一些实施方式中,长度可以是从约7mm至约180mm。此外,长度可以是从约9mm至约100mm。此外,长度可以是从约10mm至约50mm。闭塞设备100的长度还可以是约25mm。如下文所述,还可以使用具有多个长度的多个闭塞设备和/或构型。
在一些实施方式中,闭塞设备能够构造为使得闭塞设备100的壁包括流动转向孔径。“流动转向孔径”可以指代(在闭塞设备的至少一个节段中的)各孔的平均孔径,所述平均孔径足够小以阻碍或抑制通过这一节段的各孔的流体交换。
在管状构件定位在血管中并邻近动脉瘤时,当闭塞设备的近侧节段的各孔尺寸设定为抑制血液通过侧壁流动进入动脉瘤以达到足以导致血栓形成和动脉瘤治愈的程度时,闭塞设备100(例如,至少闭塞设备的近侧节段)可包括具有流动转向孔径的有效节段或流动转向节段。
例如,在闭塞设备(例如支架)处于展开状态时,当流动转向或有效节段中的孔具有小于约500微米的平均孔径时,能够实现流动转向孔径。在一些实施方式中,平均孔径可以小于约320微米。此外,平均孔径可以从约25微米至约350微米。平均孔径还可以从约40微米至约200微米。此外,在一些实施方式中,平均孔径可以是从约60微米至约150微米。此外,平均孔径可以是约120微米。
大约处于这些范围内的平均孔径能够操控为使流体流动转向并引起由壁封闭的管腔或内部容积内的血栓形成。各孔可具有基本不变的孔径。各孔可具有利用内切圆直径来测量的平均孔径。
此外,在一些实施方式中,能够在展开的编织物中利用设有10%-95%范围孔隙率的闭塞设备100以达到这些效果。在一些实施方式中,可以利用约30%至约90%范围内的孔隙率来达到这些效果。此外,可以利用约50%至约85%范围内的孔隙率来达到这些效果。闭塞设备100能够包含其它各种特征,例如2013年3月22日提交的共同未决国际申请No.PCT/US13/33419中所披露的那些,其全部内容通过引用合并于此。
图5A-5B示意了闭塞设备100和导管302沿图4的剖面线5A-5A和5B-5B取的横截面图。类似于图2C中所示意的视图,图5A-5B示意了闭塞设备100的横截面图,其中闭塞设备围绕或环绕相对于闭塞设备100纵向轴线160基本平行的线304弯曲、卷曲、或卷绕。
图6A-6B还示意了闭塞设备的其它实施方式,其中闭塞设备从管状或片状构型折叠或压缩。例如,图6A示意了闭塞设备100可包括管状形状,所述管状形状变平并且围绕或环绕相对于纵向轴线160基本平行的线304弯曲、卷曲、或卷绕。此外,图6B示意了闭塞设备100可包括片,所述片折叠至少一次并且围绕或环绕相对于纵向轴线160基本平行的线304弯曲、卷曲、或卷绕。
根据一些实施方式,闭塞设备100凭借它的收缩构型120展示出相对于可比较的闭塞设备或结构改进的或更高的推动能力。收缩构型120能够通过减小与导管内壁接触的暴露材料的数量、和/或通过使收缩设备接触小于导管内壁的整个周长来改善推动能力。
例如,由于闭塞设备100在收缩构型120中处于弯曲、卷曲或卷绕形状,因此至少部分闭塞设备100不会与导管302的内表面或壁310接触。在一些实施方式中,内壁310能够沿着小于它的全部周长进行接触。闭塞设备100在它的收缩构型120中将需要比可比较的结构小得多的推力,而对于支架和诸如编织球的其它编织结构来说是典型的是,可比较的结构仅仅是从展开直径径向收缩或压缩至压缩直径(从而,增大了处于收缩状态下的闭塞设备的编织密度或轴向长度)。
例如,参照图5B,闭塞设备100能够卷绕在它自身上,从而闭塞设备的横截面内部径向地处于闭塞设备的横截面外部中。为了本发明的目的,闭塞设备的横截面内部可视为被闭塞设备的另一部分径向重叠的闭塞设备卷绕部。正是如此,仅仅闭塞设备的横截面外部接触导管302的内壁310。
此外,如图5A和6A-6B所示意,在一些实施方式中,卷曲闭塞设备100能够沿小于导管302内壁310的整个周长延伸。如图所示,在其折叠或压缩、扁平横截面构型(其可以假定为处于膨胀构型,如图2B所示意)中,闭塞设备100的横截面宽度可以小于内壁310的周长。
因此,根据所用的导管尺寸(可从约3Fr至约8Fr变化),闭塞设备100能够变平或折叠,并且在一些实施方式中卷绕在其自身上。当闭塞设备不卷绕在其自身上时(例如,在插入导管之前),扁平横截面的宽度可以为约3mm至约7mm之间、约4mm至约6mm之间、或者约5mm。这些尺寸能够用于单层或多层扁平横截面。
闭塞设备可由扁平片形成。例如,扁平片如果在卷绕并插入导管之前折叠为两个基本相同的节段的话,可具有约6mm至约14mm之间、约8mm至约12mm、或者约10mm的宽度。当利用具有三次折叠横截面的折叠片形成闭塞设备时,可以采用类似的度量值。
当闭塞设备卷绕在其自身上时,卷绕扁平材料的横截面直径可以为约1mm至约4mm、约1.5mm至约3.5mm、或者约2mm至约3mm。当闭塞设备卷绕在其自身上时,闭塞设备的横截面直径还常常取决于材料在输送管或导管内卷起的能力(例如,它的弯曲强度)。
因而,闭塞设备100的收缩构型120能够允许更大数量的材料或闭塞设备推进通过导管302,同时使闭塞设备100和导管壁310之间的摩擦阻力最小化。因此,能够有益地改善闭塞设备100的推动能力。
根据一些实施方式,还能够提供各种输送方法和系统。例如,能够利用本文披露的系统结合导管来输送一个或多个闭塞设备。闭塞设备输送系统可包括细长管或导管,所述细长管或导管可滑动地接收构造为运送闭塞设备通过导管的芯部组件。导管可具有能够定位在患者体内治疗部位处的近端和相对的远端、从近端向远端延伸的内部管腔、以及面向管腔的内表面或壁。在远端处,导管具有远侧开口,芯部组件和/或闭塞设备可通过远侧开口推进而越过远端,从而在诸如血管或动脉瘤的目标区域内展开、释放、或部署闭塞设备。近端可包括导管毂。导管能够限定在近端和远端之间延伸的基本纵向的轴线A-A。当使用输送系统时,纵向轴线不需要沿其长度的一部分或任意长度是直的。
导管可选地包括微导管。例如,导管可选地包括可向美国加利福尼亚州Irvine的Covidien LP购买的、任意不同长度的MARKSMANTM导管。导管可选地包括具有约0.030英寸或更小内径、和/或在远端附近3Fr或更小外径的微导管。替代这些规格或除了这些规格以外,导管可包括构造为经皮进入颈内动脉、或者远离颈内动脉的神经脉管系统内位置的微导管,所述微导管具有远侧开口。
能够在2011年9月29日公开的名称为“Variable Flexibility Catheter”的美国专利申请公开No.US2011/0238041A1中找到关于本文描述的导管的各实施方式中可选地使用或实施的导管的其它实施方式、以及其它细节和组件的信息。上述公开的全部内容通过引用合并于此并且构成本说明书的一部分。
图7A-7F示意了输送组件300和已推进至目标动脉瘤400的闭塞设备100的各个方面。如图7A-7B中所示意,闭塞设备100能够通过动脉瘤400的颈部402朝向动脉瘤400的底部404推进。随着闭塞设备100推进到动脉瘤400中,闭塞设备100倾向于从它的收缩构型伸直、展开、或膨胀,从而闭塞设备的相对侧边缘远离彼此移动,并且闭塞设备100的释放部分开始呈现基本扁平的横截面构型。
随着闭塞设备100继续推进到动脉瘤400中,如图7C-7D所示,闭塞设备100的扩大部分200和闭塞设备100的本体150能够接触动脉瘤400的内壁或底部404。随着扩大部分200和本体150接触动脉瘤400的内壁,闭塞设备100倾向于摩擦接触或接合动脉瘤400的内壁,从而减小或消除在动脉瘤400内壁上的滑动或滑移,同时在最初扩张以及闭塞设备100进入动脉瘤400期间保持闭塞设备100在动脉瘤400内顺应且自动移动的能力。因此,一段闭塞设备100(其可以是从约1/4至约3/4,或者从约1/3至约2/3,或者约1/2的闭塞设备100的长度)释放进入动脉瘤400,闭塞设备100倾向于接合动脉瘤400的内壁。这种接合能够允许临床医生更好地预测闭塞设备100在动脉瘤400内的部署特性或释放位置。此外,这种接合还能够使闭塞设备100更牢固地保持在动脉瘤400中,从而避免闭塞设备100从动脉瘤400中突出。
此外,如图7E-7F所示意,随着闭塞设备100继续推进到动脉瘤400中,颈部402倾向于被完全覆盖或阻塞。例如,随着本体150和额外的扩大部分200继续推进到动脉瘤400中,翼200和本体150倾向于接合动脉瘤400在颈部402上延伸的内壁。最终,不论是单个还是多个闭塞设备插入在动脉瘤400中,动脉瘤400的容积都能够基本上被装满或填充,从而动脉瘤400内的循环或流体运动减缓或停止,并且通过颈部402进入动脉瘤400的循环或流体运动基本上减缓或停止。图8示意了在闭塞设备100或多个闭塞设备释放进入动脉瘤400后,从低于动脉瘤颈部402的位置进入动脉瘤400的视图。具有扩大部分200(可选)的闭塞设备的使用还能进一步改善颈部402的覆盖以及与动脉瘤400侧壁的接合。
再次参照图8,利用具有网纹表面(诸如上面提到的那些,包括编织或涂层表面)的闭塞设备基本覆盖动脉瘤颈部402,这能够有利地促进和引发治愈反应。因而,优秀的颈部覆盖范围能够允许内皮化更易于发生在颈部402处。因此,与需要线圈和放置支架或其它框架结构以防止线圈从宽颈部动脉瘤中突出的传统治疗形成对比,能够提供单个闭塞设备治疗宽颈部动脉瘤的一些实施方式。
根据一些实施方式,能够通过输送仅输送单个闭塞设备或多个闭塞设备来实现一个或多个闭塞设备的输送。例如,第一闭塞设备能够释放进入动脉瘤,其能够用作部署在动脉瘤中的这一组闭塞设备的最外层。此后,随后的闭塞设备能够插入在动脉瘤中的第一框架设备中。这些其它设备可包括精加工线圈或其它设备,例如本文披露的那些。随后释放进入动脉瘤的线圈或设备的尺寸和/或形状可逐渐减小或者具有基本相同或不同的尺寸和/或形状。
根据本文披露的一些实施方式的有益特征中的一个,一个或多个闭塞设备能够输送到动脉瘤中,而不需要使用框架结构来将闭塞设备保持在动脉瘤中,而在使用线圈时框架结构是需要的。此外,比线圈更好的是,本文披露的闭塞设备能够提供优异的颈部覆盖范围。另外,比线圈更好的是,本文披露的闭塞设备能够可靠地且可预见地扩张至预设形状或构型。此外,与支架或诸如编织球的可扩张编织结构相比,本文披露的闭塞设备能够装满或填充目标空间的容积,例如动脉瘤,和线圈能够实现的一样。因此,能够利用本文披露的闭塞设备的各实施方式来实现本文披露的这些和其它这样的优势,而在传统上这仅能够通过多个分开的组件来实现。
当输送多个闭塞设备进入动脉瘤时,闭塞设备的长度、以及在一些实施方式中线圈的长度可以是约1cm至约10cm之间。输送这些闭塞设备的顺序可以是以尺寸逐渐减小的顺序。例如,临床医生可从8mm闭塞设备开始,接下来是一个或多个7mm闭塞设备,接下来是一个或多个6mm闭塞设备,等等。
如上所提及,闭塞设备100可包括当处于松弛或释放位置时倾向于具有高度可预测形状的镍钛合金或其它材料。因而,与难以达到高度可预测形状(因而在它们的松弛状态更为随机)的线圈相比,闭塞设备100的各实施方式能够有益地允许临床医生提供特定成形的闭塞设备到达特定形状或尺寸的目标区域。这一定制疗法能够改善针对患者的结果。
本文讨论的装置和方法并不限于医疗设备在血管系统内的部署和使用,而是可包括任意数量的其它治疗应用。其它治疗部位可包括包含任意中空解剖结构的身体区域或部分。
虽然详细描述包含了许多具体细节,但是这些不应当解释为限制本发明的范围,而仅仅作为示意本发明的不同的实例和方面。应当理解的是,本发明的范围包括上文未详细讨论的其他实施方式。能够在不背离本发明范围的情况下,针对本文披露的本发明的方法和装置的布置、操作和细节做出各种其他修改、改变和变体。除非另外表达,以单数提到元件并不旨在意味着“一个且仅有一个”,除非明确陈述,而是意味着指代“一个或多个”。此外,为了包含在本发明的范围内,一个设备和方法无需解决通过本发明不同实施方式可以解决的每个问题(或者具有可以实现的每个优势)。与肯定语的能力相反,本文所使用的“能够”及其派生词应当从“可能”或“可选地”意义上来理解。
Claims (18)
1.一种用于闭塞动脉瘤的闭塞设备,所述闭塞设备包括:
细长构件,其由网眼材料的单层片形成,具有纵向轴线、沿细长构件纵向延伸的相对的第一侧边缘和第二侧边缘、以及在第一侧边缘和第二侧边缘之间横向延伸的本体,其中细长构件具有:(a)用于通过导管输送至动脉瘤的收缩构型,其中在收缩构型中,细长构件围绕平行于细长构件的纵向轴线的直线卷曲,使得第一侧边缘位于细长构件的内部中,第二侧边缘位于细长构件的与内部径向重叠的外部处,并且本体径向位于第一侧边缘和第二侧边缘之间,使得第二侧边缘位于本体和导管内表面之间;以及(b)用于定位在动脉瘤中的膨胀构型,在膨胀构型中细长构件形成预定的三维形状。
2.权利要求1所述的闭塞设备,其中,第一侧边缘和第二侧边缘包括从其侧向延伸的多个翼元件。
3.权利要求1所述的闭塞设备,其中,翼元件从细长构件的相对的侧部延伸。
4.权利要求3所述的闭塞设备,其中,一对翼元件在沿细长构件的第一纵向位置处从相对的侧部延伸。
5.权利要求3所述的闭塞设备,其中,翼元件包括第一组翼元件和第二组翼元件,第一组翼元件从细长构件的第一侧部延伸,而第二组翼元件在与第一组翼元件不同的纵向位置处从细长构件的第二侧部延伸。
6.权利要求1所述的闭塞设备,其中,当细长构件定位在导管内时,仅细长构件的截面外部与导管的内壁接触。
7.权利要求1所述的闭塞设备,其中,细长构件包括超弹性材料。
8.权利要求1所述的闭塞设备,其中,网眼材料包括多个交织细丝。
9.权利要求1所述的闭塞设备,其中,细长构件包括激光切割片。
10.权利要求1所述的闭塞设备,其中,细长构件包括光蚀刻片。
11.权利要求1所述的闭塞设备,其中,细长构件构造为当细长构件从导管释放时从收缩构型自膨胀至膨胀构型。
12.权利要求1所述的闭塞设备,其中,细长构件包括沿细长构件的纵向轴线延伸的至少一个狭缝。
13.权利要求1所述的闭塞设备,其中,细长构件包括多个狭缝,所述多个狭缝沿细长构件的纵向轴线延伸并且以线性的构型间隔开。
14.权利要求1所述的闭塞设备,其中,细长构件在卷曲并定位在导管中之前被折叠。
15.权利要求14所述的闭塞设备,其中,细长构件被折叠两次。
16.权利要求14所述的闭塞设备,其中,细长构件被折叠三次。
17.权利要求1所述的闭塞设备,还包括从其远端向远侧延伸的无创伤部分。
18.权利要求1所述的闭塞设备,还包括不透射线标记。
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US10433853B2 (en) | 2019-10-08 |
KR102230004B1 (ko) | 2021-03-19 |
US20150297240A1 (en) | 2015-10-22 |
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