JPWO2020190639A5 - - Google Patents

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JPWO2020190639A5
JPWO2020190639A5 JP2021555224A JP2021555224A JPWO2020190639A5 JP WO2020190639 A5 JPWO2020190639 A5 JP WO2020190639A5 JP 2021555224 A JP2021555224 A JP 2021555224A JP 2021555224 A JP2021555224 A JP 2021555224A JP WO2020190639 A5 JPWO2020190639 A5 JP WO2020190639A5
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permeable shell
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JP2022525745A (en
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前述の発明は、明確性および理解の目的のために、ある程度詳細に、例証および実施例として、説明されているが、依然として、添付の請求項の範囲内に該当するであろう、ある変更および修正が、実践されてもよいことが明白となるであろう。
（付記）
（付記１）
患者の脳動脈瘤の治療のためのデバイスであって、
第１の浸透性シェルであって、前記第１の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記拡張状態は、近位部分、遠位部分、および内部空洞を有し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有し、前記複数のフィラメントのそれぞれの近位端は、近位ハブによって集められ、前記複数のフィラメントのそれぞれの遠位端は、遠位ハブによって集められる、第１の浸透性シェルと、
第２の浸透性シェルであって、前記第２の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記第２の浸透性シェルの少なくとも一部は、前記第１の浸透性シェルの近位部分と接触し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有する、第２の浸透性シェルと
を備え、
前記第２の浸透性シェルの複数のフィラメントのそれぞれの近位端は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの近位端とともに、前記近位ハブ内に集められ、
前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さより小さい、デバイス。
（付記２）
前記第２の浸透性シェルは、前記第１の浸透性シェルより堅い、付記１に記載のデバイス。
（付記３）
前記第２の浸透性シェルの外面は、前記第１の浸透性シェルの内面と接触する、付記１に記載のデバイス。
（付記４）
前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さの約１０％～約４０％である、付記１に記載のデバイス。
（付記５）
前記第２の浸透性シェルは、溶接、接着剤、または機械的結着によって、前記第１の浸透性シェルに取り付けられる、付記１に記載のデバイス。
（付記６）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの遠位端は、ともに接合されない、付記１に記載のデバイス。
（付記７）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの直径は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの直径より大きい、付記１に記載のデバイス。
（付記８）
患者の脳動脈瘤の治療のためのデバイスであって、
第１の自己拡張メッシュであって、前記第１の自己拡張メッシュは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記拡張状態は、近位部分、遠位部分、および内部空洞を有し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有し、前記複数のフィラメントのそれぞれの近位端は、近位ハブによって集められ、前記複数のフィラメントのそれぞれの遠位端は、遠位ハブによって集められる、第１の自己拡張メッシュと、
第２の自己拡張メッシュであって、前記第２の自己拡張メッシュは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記第２の自己拡張メッシュの少なくとも一部は、前記第１の自己拡張メッシュの近位部分と接触し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有する、第２の自己拡張メッシュと
を備え、
前記第２の自己拡張メッシュの複数のフィラメントのそれぞれの近位端は、前記第１の自己拡張メッシュの複数のフィラメントのそれぞれの近位端とともに、前記近位ハブ内に集められ、
前記第２の自己拡張メッシュの拡張状態の長さは、前記第１の自己拡張メッシュの拡張状態の長さより小さい、デバイス。
（付記９）
前記第２の自己拡張メッシュは、前記第１の自己拡張メッシュより堅い、付記８に記載のデバイス。
（付記１０）
前記第２の自己拡張メッシュの外面は、前記第１の自己拡張メッシュの内面と接触する、付記８に記載のデバイス。
（付記１１）
前記第２の自己拡張メッシュの拡張状態の長さは、前記第１の自己拡張メッシュの拡張状態の長さの約１０％～約４０％である、付記８に記載のデバイス。
（付記１２）
前記第２の自己拡張メッシュは、溶接、接着剤、または機械的結着によって、前記第１の自己拡張メッシュに取り付けられる、付記８に記載のデバイス。
（付記１３）
前記第２の自己拡張メッシュの複数のフィラメントのそれぞれの遠位端は、ともに接合されない、付記８に記載のデバイス。
（付記１４）
前記第２の自己拡張メッシュの複数のフィラメントのそれぞれの直径は、前記第１の自己拡張メッシュの複数のフィラメントのそれぞれの直径より大きい、付記８に記載のデバイス。
（付記１５）
患者の脳動脈瘤の治療のためのデバイスであって、
第１の浸透性シェルであって、前記第１の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記拡張状態は、近位部分、遠位部分、および内部空洞を有し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有し、前記複数のフィラメントのそれぞれの近位端は、近位ハブによって集められ、前記複数のフィラメントのそれぞれの遠位端は、遠位ハブによって集められる、第１の浸透性シェルと、
第２の浸透性シェルであって、前記第２の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記第２の浸透性シェルの少なくとも一部は、前記第１の浸透性シェルの近位部分と接触し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有する、第２の浸透性シェルと
を備え、
前記第２の浸透性シェルは、開放遠位端を有し、前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さより小さい、デバイス。
（付記１６）
前記第２の浸透性シェルは、前記第１の浸透性シェルより堅い、付記１５に記載のデバイス。
（付記１７）
前記第２の浸透性シェルは、溶接、接着剤、または機械的結着によって、前記第１の浸透性シェルに取り付けられる、付記１５に記載のデバイス。
（付記１８）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの遠位端は、前記第１の浸透性シェルに取り付けられない、付記１５に記載のデバイス。
（付記１９）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの近位端は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの近位端とともに、前記近位ハブ内に集められる、付記１５に記載のデバイス。
（付記２０）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの直径は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの直径より大きい、付記１５に記載のデバイス。
（付記２１）
内部空洞と、頸部とを有する脳動脈瘤を治療するための方法であって、
マイクロカテーテル内のインプラントを脳動脈内の着目領域まで前進させるステップであって、前記インプラントは、
第１の浸透性シェルであって、前記第１の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記拡張状態は、近位部分、遠位部分、および内部空洞を有し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有し、前記複数のフィラメントのそれぞれの近位端は、近位ハブによって集められ、前記複数のフィラメントのそれぞれの遠位端は、遠位ハブによって集められる、第１の浸透性シェルと、
第２の浸透性シェルであって、前記第２の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記第２の浸透性シェルの少なくとも一部は、前記第１の浸透性シェルの近位部分と接触し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有する、第２の浸透性シェルと
を備え、
前記第２の浸透性シェルの複数のフィラメントのそれぞれの近位端は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの近位端とともに、前記近位ハブ内に集められ、
前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さより小さい、ステップと、
前記インプラントを前記脳動脈瘤内で展開するステップであって、前記第１および第２の浸透性シェルはそれぞれ、その拡張状態に、前記動脈瘤の内部空洞内で拡張する、ステップと、
前記インプラントを展開後、前記マイクロカテーテルを前記着目領域から抜去するステップと
を含む、方法。
（付記２２）
前記第２の浸透性シェルは、前記第１の浸透性シェルより堅い、付記２１に記載の方法。
（付記２３）
前記第２の浸透性シェルの外面は、前記第１の浸透性シェルの内面と接触する、付記２１に記載の方法。
（付記２４）
前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さより小さい、付記２１に記載の方法。
（付記２５）
前記第２の浸透性シェルは、溶接、接着剤、または機械的結着によって、前記第１の浸透性シェルに取り付けられる、付記２１に記載の方法。
（付記２６）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの遠位端は、ともに接合されない、付記２１に記載の方法。
（付記２７）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの直径は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの直径より大きい、付記２１に記載の方法。
（付記２８）
内部空洞と、頸部とを有する脳動脈瘤を治療するための方法であって、
マイクロカテーテル内のインプラントを脳動脈内の着目領域まで前進させるステップであって、前記インプラントは、
第１の自己拡張メッシュであって、前記第１の自己拡張メッシュは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記拡張状態は、近位部分、遠位部分、および内部空洞を有し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有し、前記複数のフィラメントのそれぞれの近位端は、近位ハブによって集められ、前記複数のフィラメントのそれぞれの遠位端は、遠位ハブによって集められる、第１の自己拡張メッシュと、
第２の自己拡張メッシュであって、前記第２の自己拡張メッシュは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記第２の自己拡張メッシュの少なくとも一部は、前記第１の自己拡張メッシュの近位部分と接触し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有する、第２の自己拡張メッシュと
を備え、
前記第２の自己拡張メッシュの複数のフィラメントのそれぞれの近位端は、前記第１の自己拡張メッシュの複数のフィラメントのそれぞれの近位端とともに、前記近位ハブ内に集められ、
前記第２の自己拡張メッシュの拡張状態の長さは、前記第１の自己拡張メッシュの拡張状態の長さより小さい、ステップと、
前記インプラントを前記脳動脈瘤内で展開するステップであって、前記第１および第２の自己拡張メッシュはそれぞれ、その拡張状態に、前記動脈瘤の内部空洞内で拡張する、ステップと、
前記インプラントを展開後、前記マイクロカテーテルを前記着目領域から抜去するステップと
を含む、方法。
（付記２９）
前記第２の浸透性シェルは、前記第１の浸透性シェルより堅い、付記２８に記載の方法。
（付記３０）
前記第２の浸透性シェルの外面は、前記第１の浸透性シェルの内面と接触する、付記２８に記載の方法。
（付記３１）
前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さより小さい、付記２８に記載の方法。
（付記３２）
前記第２の浸透性シェルは、溶接、接着剤、または機械的結着によって、前記第１の浸透性シェルに取り付けられる、付記２８に記載の方法。
（付記３３）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの遠位端は、ともに接合されない、付記２８に記載の方法。
（付記３４）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの直径は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの直径より大きい、付記２８に記載の方法。
（付記３５）
内部空洞と、頸部とを有する脳動脈瘤を治療するための方法であって、
マイクロカテーテル内のインプラントを脳動脈内の着目領域まで前進させるステップであって、前記インプラントは、
第１の浸透性シェルであって、前記第１の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記拡張状態は、近位部分、遠位部分、および内部空洞を有し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有し、前記複数のフィラメントのそれぞれの近位端は、近位ハブによって集められ、前記複数のフィラメントのそれぞれの遠位端は、遠位ハブによって集められる、第１の浸透性シェルと、
第２の浸透性シェルであって、前記第２の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記第２の浸透性シェルの少なくとも一部は、前記第１の浸透性シェルの近位部分と接触し、前記複数のフィラメントはそれぞれ、近位端および遠位端を有する、第２の浸透性シェルと
を備え、
前記第２の浸透性シェルは、開放遠位端を有し、前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さより小さい、ステップと、
前記インプラントを前記脳動脈瘤内で展開するステップであって、前記第１および第２の浸透性シェルはそれぞれ、その拡張状態に、前記動脈瘤の内部空洞内で拡張する、ステップと、
前記インプラントを展開後、前記マイクロカテーテルを前記着目領域から抜去するステップと
を含む、方法。
（付記３６）
前記第２の浸透性シェルは、前記第１の浸透性シェルより堅い、付記３５に記載の方法。
（付記３７）
前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さより小さい、付記３５に記載の方法。
（付記３８）
前記第２の浸透性シェルは、溶接、接着剤、または機械的結着によって、前記第１の浸透性シェルに取り付けられる、付記３５に記載の方法。
（付記３９）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの近位端は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの近位端とともに、前記近位ハブ内に集められる、付記３５に記載の方法。
（付記４０）
前記第２の浸透性シェルの複数のフィラメントのそれぞれの直径は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの直径より大きい、付記３５に記載の方法。 Although the foregoing invention has been described in some detail, by way of illustration and example, for purposes of clarity and understanding, certain modifications and It will be apparent that modifications may be practiced.
(Appendix)
(Appendix 1)
A device for treatment of a brain aneurysm in a patient, comprising:
a first permeable shell, said first permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, said expanded state having a proximal portion, a distal portion, and an internal cavity. and each of said plurality of filaments has a proximal end and a distal end, a proximal end of each of said plurality of filaments being gathered by a proximal hub, a distal end of each of said plurality of filaments being , a first permeable shell collected by a distal hub;
a second permeable shell, said second permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, wherein at least a portion of said second permeable shell comprises at least a portion of said first permeable shell. a second permeable shell in contact with the proximal portion of the permeable shell, each of said plurality of filaments having a proximal end and a distal end;
with
a proximal end of each of the plurality of filaments of the second permeable shell, together with a proximal end of each of the plurality of filaments of the first permeable shell, are gathered within the proximal hub;
The device, wherein the expanded state length of the second permeable shell is less than the expanded state length of the first permeable shell.
(Appendix 2)
Clause 1. The device of Clause 1, wherein the second permeable shell is stiffer than the first permeable shell.
(Appendix 3)
Clause 1. The device of Clause 1, wherein the outer surface of the second permeable shell contacts the inner surface of the first permeable shell.
(Appendix 4)
Clause 1. The device of Clause 1, wherein the expanded state length of the second permeable shell is about 10% to about 40% of the expanded state length of the first permeable shell.
(Appendix 5)
Clause 1. The device of Clause 1, wherein the second permeable shell is attached to the first permeable shell by welding, adhesive, or mechanical bonding.
(Appendix 6)
Clause 1. The device of Clause 1, wherein distal ends of each of the plurality of filaments of the second permeable shell are not joined together.
(Appendix 7)
Clause 1. The device of Clause 1, wherein the diameter of each of the plurality of filaments of the second permeable shell is greater than the diameter of each of the plurality of filaments of the first permeable shell.
(Appendix 8)
A device for treatment of a brain aneurysm in a patient, comprising:
a first self-expanding mesh, said first self-expanding mesh having a radially constrained stretched state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, said expanded state having a proximal portion, a distal portion, and an internal cavity. and each of said plurality of filaments has a proximal end and a distal end, a proximal end of each of said plurality of filaments being gathered by a proximal hub, a distal end of each of said plurality of filaments being , a first self-expanding mesh collected by the distal hub;
a second self-expanding mesh, said second self-expanding mesh having a radially constrained stretched state configured for delivery within a catheter lumen and said radially constrained state and a plurality of elongated filaments woven together to form a mesh, wherein at least a portion of said second self-expanding mesh comprises at least a portion of said first self-expanding mesh. a second self-expanding mesh in contact with the proximal portion of the expanding mesh, wherein each of the plurality of filaments has a proximal end and a distal end;
with
a proximal end of each of the plurality of filaments of the second self-expanding mesh, together with a proximal end of each of the plurality of filaments of the first self-expanding mesh, are gathered within the proximal hub;
The device, wherein the expanded state length of the second self-expanding mesh is less than the expanded state length of the first self-expanding mesh.
(Appendix 9)
9. The device of Clause 8, wherein the second self-expanding mesh is stiffer than the first self-expanding mesh.
(Appendix 10)
9. The device of clause 8, wherein the outer surface of the second self-expanding mesh contacts the inner surface of the first self-expanding mesh.
(Appendix 11)
Clause 8. The device of Clause 8, wherein the expanded state length of the second self-expanding mesh is about 10% to about 40% of the expanded state length of the first self-expanding mesh.
(Appendix 12)
9. The device of Clause 8, wherein the second self-expanding mesh is attached to the first self-expanding mesh by welding, adhesives, or mechanical bonding.
(Appendix 13)
9. The device of clause 8, wherein distal ends of each of the plurality of filaments of the second self-expanding mesh are not joined together.
(Appendix 14)
9. The device of clause 8, wherein the diameter of each of the plurality of filaments of the second self-expanding mesh is greater than the diameter of each of the plurality of filaments of the first self-expanding mesh.
(Appendix 15)
A device for treatment of a brain aneurysm in a patient, comprising:
a first permeable shell, said first permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, said expanded state having a proximal portion, a distal portion, and an internal cavity. and each of said plurality of filaments has a proximal end and a distal end, a proximal end of each of said plurality of filaments being gathered by a proximal hub, a distal end of each of said plurality of filaments being , a first permeable shell collected by a distal hub;
a second permeable shell, said second permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, wherein at least a portion of said second permeable shell comprises at least a portion of said first permeable shell. a second permeable shell in contact with the proximal portion of the permeable shell, each of said plurality of filaments having a proximal end and a distal end;
with
The device, wherein the second permeable shell has an open distal end and the length of the second permeable shell in the expanded state is less than the length of the first permeable shell in the expanded state.
(Appendix 16)
16. The device of Clause 15, wherein the second permeable shell is stiffer than the first permeable shell.
(Appendix 17)
16. The device of Clause 15, wherein the second permeable shell is attached to the first permeable shell by welding, adhesive, or mechanical bonding.
(Appendix 18)
16. The device of Clause 15, wherein distal ends of each of the plurality of filaments of the second permeable shell are not attached to the first permeable shell.
(Appendix 19)
16, wherein a proximal end of each of the plurality of filaments of the second permeable shell is collected within the proximal hub along with a proximal end of each of the plurality of filaments of the first permeable shell; Devices listed.
(Appendix 20)
16. The device of clause 15, wherein the diameter of each of the plurality of filaments of the second permeable shell is greater than the diameter of each of the plurality of filaments of the first permeable shell.
(Appendix 21)
A method for treating a brain aneurysm having an internal cavity and a neck, comprising:
advancing an implant in a microcatheter to a region of interest in a cerebral artery, the implant comprising:
a first permeable shell, said first permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, said expanded state having a proximal portion, a distal portion, and an internal cavity. and each of said plurality of filaments has a proximal end and a distal end, a proximal end of each of said plurality of filaments being gathered by a proximal hub, a distal end of each of said plurality of filaments being , a first permeable shell collected by a distal hub;
a second permeable shell, said second permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, wherein at least a portion of said second permeable shell comprises at least a portion of said first permeable shell. a second permeable shell in contact with the proximal portion of the permeable shell, each of said plurality of filaments having a proximal end and a distal end;
with
a proximal end of each of the plurality of filaments of the second permeable shell, together with a proximal end of each of the plurality of filaments of the first permeable shell, are gathered within the proximal hub;
wherein the expanded state length of the second permeable shell is less than the expanded state length of the first permeable shell;
deploying the implant within the cerebral aneurysm, wherein the first and second permeable shells each expand to their expanded states within the internal cavity of the aneurysm;
withdrawing the microcatheter from the region of interest after deploying the implant;
A method, including
(Appendix 22)
22. The method of clause 21, wherein the second permeable shell is stiffer than the first permeable shell.
(Appendix 23)
22. The method of clause 21, wherein the outer surface of the second permeable shell contacts the inner surface of the first permeable shell.
(Appendix 24)
22. The method of clause 21, wherein the expanded state length of the second permeable shell is less than the expanded state length of the first permeable shell.
(Appendix 25)
22. The method of Clause 21, wherein the second permeable shell is attached to the first permeable shell by welding, adhesive, or mechanical bonding.
(Appendix 26)
22. The method of clause 21, wherein distal ends of each of the plurality of filaments of the second permeable shell are not joined together.
(Appendix 27)
22. The method of clause 21, wherein the diameter of each of the plurality of filaments of the second permeable shell is greater than the diameter of each of the plurality of filaments of the first permeable shell.
(Appendix 28)
A method for treating a brain aneurysm having an internal cavity and a neck, comprising:
advancing an implant in a microcatheter to a region of interest in a cerebral artery, the implant comprising:
a first self-expanding mesh, said first self-expanding mesh having a radially constrained stretched state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, said expanded state having a proximal portion, a distal portion, and an internal cavity. and each of said plurality of filaments has a proximal end and a distal end, a proximal end of each of said plurality of filaments being gathered by a proximal hub, a distal end of each of said plurality of filaments being , a first self-expanding mesh collected by the distal hub;
a second self-expanding mesh, said second self-expanding mesh having a radially constrained stretched state configured for delivery within a catheter lumen and said radially constrained state and a plurality of elongated filaments woven together to form a mesh, wherein at least a portion of said second self-expanding mesh comprises at least a portion of said first self-expanding mesh. a second self-expanding mesh in contact with the proximal portion of the expanding mesh, wherein each of the plurality of filaments has a proximal end and a distal end;
with
a proximal end of each of the plurality of filaments of the second self-expanding mesh, together with a proximal end of each of the plurality of filaments of the first self-expanding mesh, are gathered within the proximal hub;
wherein the length of the expanded state of the second self-expanding mesh is less than the length of the expanded state of the first self-expanding mesh;
deploying the implant within the cerebral aneurysm, wherein the first and second self-expanding meshes each expand to their expanded states within the interior cavity of the aneurysm;
withdrawing the microcatheter from the region of interest after deploying the implant;
A method, including
(Appendix 29)
29. The method of clause 28, wherein the second permeable shell is stiffer than the first permeable shell.
(Appendix 30)
29. The method of clause 28, wherein the outer surface of the second permeable shell contacts the inner surface of the first permeable shell.
(Appendix 31)
29. The method of clause 28, wherein the expanded state length of the second permeable shell is less than the expanded state length of the first permeable shell.
(Appendix 32)
29. The method of clause 28, wherein the second permeable shell is attached to the first permeable shell by welding, adhesive, or mechanical bonding.
(Appendix 33)
29. The method of clause 28, wherein distal ends of each of the plurality of filaments of the second permeable shell are not joined together.
(Appendix 34)
29. The method of clause 28, wherein the diameter of each of the plurality of filaments of the second permeable shell is greater than the diameter of each of the plurality of filaments of the first permeable shell.
(Appendix 35)
A method for treating a brain aneurysm having an internal cavity and a neck, comprising:
advancing an implant in a microcatheter to a region of interest in a cerebral artery, the implant comprising:
a first permeable shell, said first permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, said expanded state having a proximal portion, a distal portion, and an internal cavity. and each of said plurality of filaments has a proximal end and a distal end, a proximal end of each of said plurality of filaments being gathered by a proximal hub, a distal end of each of said plurality of filaments being , a first permeable shell collected by a distal hub;
a second permeable shell, said second permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, wherein at least a portion of said second permeable shell comprises at least a portion of said first permeable shell. a second permeable shell in contact with the proximal portion of the permeable shell, each of said plurality of filaments having a proximal end and a distal end;
with
wherein the second permeable shell has an open distal end and the expanded length of the second permeable shell is less than the expanded length of the first permeable shell;
deploying the implant within the cerebral aneurysm, wherein the first and second permeable shells each expand to their expanded states within the internal cavity of the aneurysm;
withdrawing the microcatheter from the region of interest after deploying the implant;
A method, including
(Appendix 36)
36. The method of clause 35, wherein the second permeable shell is stiffer than the first permeable shell.
(Appendix 37)
36. The method of clause 35, wherein the expanded state length of the second permeable shell is less than the expanded state length of the first permeable shell.
(Appendix 38)
36. The method of Clause 35, wherein the second permeable shell is attached to the first permeable shell by welding, adhesive, or mechanical bonding.
(Appendix 39)
35, wherein a proximal end of each of the plurality of filaments of the second permeable shell is collected within the proximal hub along with a proximal end of each of the plurality of filaments of the first permeable shell; described method.
(Appendix 40)
36. The method of clause 35, wherein the diameter of each of the plurality of filaments of the second permeable shell is greater than the diameter of each of the plurality of filaments of the first permeable shell.

Claims (20)

患者の脳動脈瘤の治療のためのデバイスであって、
第１の浸透性シェルであって、前記第１の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記拡張状態は、近位部分、遠位部分、および内部空洞を有し、前記複数の伸長フィラメントはそれぞれ、近位端および遠位端を有し、前記複数の伸長フィラメントのそれぞれの近位端は、近位ハブによって集められ、前記複数の伸長フィラメントのそれぞれの遠位端は、遠位ハブによって集められる、第１の浸透性シェルと、
第２の浸透性シェルであって、前記第２の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記第２の浸透性シェルの少なくとも一部は、前記第１の浸透性シェルの近位部分と接触し、前記複数の伸長フィラメントはそれぞれ、近位端および遠位端を有する、第２の浸透性シェルと、
を備え、
前記第２の浸透性シェルの複数のフィラメントのそれぞれの近位端は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの近位端とともに、前記近位ハブ内に集められ、
前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さより小さい、デバイス。 A device for treatment of a brain aneurysm in a patient, comprising:
a first permeable shell, said first permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, said expanded state having a proximal portion, a distal portion, and an internal cavity. and each of said plurality of elongated filaments has a proximal end and a distal end, a proximal end of each of said plurality of elongated filaments being gathered by a proximal hub and a distal end of each of said plurality of elongated filaments. a first permeable shell collected by a distal hub;
a second permeable shell, said second permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, wherein at least a portion of said second permeable shell comprises at least a portion of said first permeable shell. a second permeable shell in contact with the proximal portion of the permeable shell, the plurality of elongated filaments each having a proximal end and a distal end ;
with
a proximal end of each of the plurality of filaments of the second permeable shell, together with a proximal end of each of the plurality of filaments of the first permeable shell, are gathered within the proximal hub;
The device, wherein the expanded state length of the second permeable shell is less than the expanded state length of the first permeable shell. 前記第２の浸透性シェルは、前記第１の浸透性シェルより堅い、請求項１に記載のデバイス。 2. The device of Claim 1, wherein the second permeable shell is stiffer than the first permeable shell. 前記第２の浸透性シェルの外面は、前記第１の浸透性シェルの内面と接触する、請求項１に記載のデバイス。 2. The device of claim 1, wherein the outer surface of the second permeable shell contacts the inner surface of the first permeable shell. 前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さの約１０％～約４０％である、請求項１に記載のデバイス。 2. The device of claim 1, wherein the expanded state length of the second permeable shell is about 10% to about 40% of the expanded state length of the first permeable shell. 前記第２の浸透性シェルは、溶接、接着剤、または機械的結着によって、前記第１の浸透性シェルに取り付けられる、請求項１に記載のデバイス。 2. The device of claim 1, wherein the second permeable shell is attached to the first permeable shell by welding, adhesives, or mechanical bonding. 前記第２の浸透性シェルの複数のフィラメントのそれぞれの遠位端は、ともに接合されない、請求項１に記載のデバイス。 2. The device of claim 1, wherein distal ends of each of the plurality of filaments of the second permeable shell are not joined together. 前記第２の浸透性シェルの複数のフィラメントのそれぞれの直径は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの直径より大きい、請求項１に記載のデバイス。 2. The device of claim 1, wherein the diameter of each of the plurality of filaments of the second permeable shell is greater than the diameter of each of the plurality of filaments of the first permeable shell. 患者の脳動脈瘤の治療のためのデバイスであって、
第１の自己拡張メッシュであって、前記第１の自己拡張メッシュは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記拡張状態は、近位部分、遠位部分、および内部空洞を有し、前記複数の伸長フィラメントはそれぞれ、近位端および遠位端を有し、前記複数の伸長フィラメントのそれぞれの近位端は、近位ハブによって集められ、前記複数の伸長フィラメントのそれぞれの遠位端は、遠位ハブによって集められる、第１の自己拡張メッシュと、
第２の自己拡張メッシュであって、前記第２の自己拡張メッシュは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記第２の自己拡張メッシュの少なくとも一部は、前記第１の自己拡張メッシュの近位部分と接触し、前記複数の伸長フィラメントはそれぞれ、近位端および遠位端を有する、第２の自己拡張メッシュと、
を備え、
前記第２の自己拡張メッシュの複数のフィラメントのそれぞれの近位端は、前記第１の自己拡張メッシュの複数のフィラメントのそれぞれの近位端とともに、前記近位ハブ内に集められ、
前記第２の自己拡張メッシュの拡張状態の長さは、前記第１の自己拡張メッシュの拡張状態の長さより小さい、デバイス。 A device for treatment of a brain aneurysm in a patient, comprising:
a first self-expanding mesh, said first self-expanding mesh having a radially constrained stretched state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, said expanded state having a proximal portion, a distal portion, and an internal cavity. and each of said plurality of elongated filaments has a proximal end and a distal end, a proximal end of each of said plurality of elongated filaments being gathered by a proximal hub and a distal end of each of said plurality of elongated filaments. a first self-expanding mesh gathered by a distal hub;
a second self-expanding mesh, said second self-expanding mesh having a radially constrained stretched state configured for delivery within a catheter lumen and said radially constrained state and a plurality of elongated filaments woven together to form a mesh, wherein at least a portion of said second self-expanding mesh comprises at least a portion of said first self-expanding mesh. a second self-expanding mesh in contact with the proximal portion of the expanding mesh, wherein each of the plurality of elongated filaments has a proximal end and a distal end ;
with
a proximal end of each of the plurality of filaments of the second self-expanding mesh, together with a proximal end of each of the plurality of filaments of the first self-expanding mesh, are gathered within the proximal hub;
The device, wherein the expanded state length of the second self-expanding mesh is less than the expanded state length of the first self-expanding mesh. 前記第２の自己拡張メッシュは、前記第１の自己拡張メッシュより堅い、請求項８に記載のデバイス。 9. The device of Claim 8, wherein the second self-expanding mesh is stiffer than the first self-expanding mesh. 前記第２の自己拡張メッシュの外面は、前記第１の自己拡張メッシュの内面と接触する、請求項８に記載のデバイス。 9. The device of claim 8, wherein an outer surface of said second self-expanding mesh contacts an inner surface of said first self-expanding mesh. 前記第２の自己拡張メッシュの拡張状態の長さは、前記第１の自己拡張メッシュの拡張状態の長さの約１０％～約４０％である、請求項８に記載のデバイス。 9. The device of claim 8, wherein the expanded state length of the second self-expanding mesh is about 10% to about 40% of the expanded state length of the first self-expanding mesh. 前記第２の自己拡張メッシュは、溶接、接着剤、または機械的結着によって、前記第１の自己拡張メッシュに取り付けられる、請求項８に記載のデバイス。 9. The device of claim 8, wherein the second self-expanding mesh is attached to the first self-expanding mesh by welding, adhesives, or mechanical bonding. 前記第２の自己拡張メッシュの複数のフィラメントのそれぞれの遠位端は、ともに接合されない、請求項８に記載のデバイス。 9. The device of claim 8, wherein distal ends of each of the plurality of filaments of the second self-expanding mesh are not bonded together. 前記第２の自己拡張メッシュの複数のフィラメントのそれぞれの直径は、前記第１の自己拡張メッシュの複数のフィラメントのそれぞれの直径より大きい、請求項８に記載のデバイス。 9. The device of claim 8, wherein the diameter of each of the plurality of filaments of the second self-expanding mesh is greater than the diameter of each of the plurality of filaments of the first self-expanding mesh. 患者の脳動脈瘤の治療のためのデバイスであって、
第１の浸透性シェルであって、前記第１の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記拡張状態は、近位部分、遠位部分、および内部空洞を有し、前記複数の伸長フィラメントはそれぞれ、近位端および遠位端を有し、前記複数の伸長フィラメントのそれぞれの近位端は、近位ハブによって集められ、前記複数の伸長フィラメントのそれぞれの遠位端は、遠位ハブによって集められる、第１の浸透性シェルと、
第２の浸透性シェルであって、前記第２の浸透性シェルは、カテーテル管腔内での送達のために構成される半径方向に拘束された伸長状態と、前記半径方向に拘束された状態に対して縦方向に短縮された構成を伴う拡張状態と、ともに織り合わされ、メッシュを形成する複数の伸長フィラメントとを含み、前記第２の浸透性シェルの少なくとも一部は、前記第１の浸透性シェルの近位部分と接触し、前記複数の伸長フィラメントはそれぞれ、近位端および遠位端を有する、第２の浸透性シェルと、
を備え、
前記第２の浸透性シェルは、開放遠位端を有し、前記第２の浸透性シェルの拡張状態の長さは、前記第１の浸透性シェルの拡張状態の長さより小さい、デバイス。 A device for treatment of a brain aneurysm in a patient, comprising:
a first permeable shell, said first permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, said expanded state having a proximal portion, a distal portion, and an internal cavity. and each of said plurality of elongated filaments has a proximal end and a distal end, a proximal end of each of said plurality of elongated filaments being gathered by a proximal hub and a distal end of each of said plurality of elongated filaments. a first permeable shell collected by a distal hub;
a second permeable shell, said second permeable shell having a radially constrained extended state configured for delivery within a catheter lumen; and said radially constrained state. and a plurality of elongated filaments woven together to form a mesh, wherein at least a portion of said second permeable shell comprises at least a portion of said first permeable shell. a second permeable shell in contact with the proximal portion of the permeable shell, the plurality of elongated filaments each having a proximal end and a distal end ;
with
The device, wherein the second permeable shell has an open distal end and the length of the second permeable shell in the expanded state is less than the length of the first permeable shell in the expanded state. 前記第２の浸透性シェルは、前記第１の浸透性シェルより堅い、請求項１５に記載のデバイス。 16. The device of Claim 15, wherein the second permeable shell is stiffer than the first permeable shell. 前記第２の浸透性シェルは、溶接、接着剤、または機械的結着によって、前記第１の浸透性シェルに取り付けられる、請求項１５に記載のデバイス。 16. The device of Claim 15, wherein the second permeable shell is attached to the first permeable shell by welding, adhesives, or mechanical bonding. 前記第２の浸透性シェルの複数のフィラメントのそれぞれの遠位端は、前記第１の浸透性シェルに取り付けられない、請求項１５に記載のデバイス。 16. The device of claim 15, wherein distal ends of each of the plurality of filaments of the second permeable shell are not attached to the first permeable shell. 前記第２の浸透性シェルの複数のフィラメントのそれぞれの近位端は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの近位端とともに、前記近位ハブ内に集められる、請求項１５に記載のデバイス。 16. A proximal end of each of the plurality of filaments of the second permeable shell is gathered within the proximal hub with a proximal end of each of the plurality of filaments of the first permeable shell. device described in . 前記第２の浸透性シェルの複数のフィラメントのそれぞれの直径は、前記第１の浸透性シェルの複数のフィラメントのそれぞれの直径より大きい、請求項１５に記載のデバイス。 16. The device of claim 15, wherein the diameter of each of the plurality of filaments of the second permeable shell is greater than the diameter of each of the plurality of filaments of the first permeable shell.
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