US20220361890A1 - Aneurysm occluding device for use with coagulating agents - Google Patents
Aneurysm occluding device for use with coagulating agents Download PDFInfo
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- US20220361890A1 US20220361890A1 US17/865,018 US202217865018A US2022361890A1 US 20220361890 A1 US20220361890 A1 US 20220361890A1 US 202217865018 A US202217865018 A US 202217865018A US 2022361890 A1 US2022361890 A1 US 2022361890A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
- A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12027—Type of occlusion
- A61B17/12031—Type of occlusion complete occlusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/1214—Coils or wires
- A61B17/1215—Coils or wires comprising additional materials, e.g. thrombogenic, having filaments, having fibers, being coated
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12181—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12181—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices
- A61B17/12186—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices liquid materials adapted to be injected
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- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12181—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices
- A61B17/12195—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices comprising a curable material
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- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
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- A61B2017/00743—Type of operation; Specification of treatment sites
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- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/1205—Introduction devices
Definitions
- the present invention generally relates to medical instruments, and more particularly, to treatment devices for aneurysm therapy.
- Aneurysms can be complicated and difficult to treat. For example, treatment access can be limited or unavailable when an aneurysm is located proximate critical tissues. Such factors are of particular concern with cranial aneurysms due to the brain tissue surrounding cranial vessels and the corresponding limited treatment access.
- occlusive devices can include occlusive devices.
- Such devices have typically incorporated multiple embolic coils that are delivered to the vasculature using microcatheter delivery systems.
- embolic coils are delivered to the vasculature using microcatheter delivery systems.
- a delivery catheter with embolic coils is typically first inserted into non-cranial vasculature through a femoral artery in the hip or groin area. Thereafter, the catheter is guided to a location of interest within the cranium. The sac of the aneurysm can then be filled with the embolic material to create a thrombotic mass that protects the arterial walls from blood flow and related pressure.
- embolic coil packing density sufficient to either occlude the aneurysm neck or fill the aneurysm sac is difficult and time consuming.
- aneurysm morphology e.g. wide neck, bifurcation, etc.
- ancillary devices such as stents or balloons to support the coil mass and obtain the desired packing density.
- the coils and accompanying ancillary devices can remain in patients for their entire lives.
- embolic coils do not always effectively treat aneurysms as re-canalization of the aneurysm and/or coil compaction can occur over time. Many people who undergo aneurysm coil procedures also require a long period of dual antiplatelet therapy while the patient recovers post-procedure.
- occlusive approach endeavors to deliver and treat the entrance or “neck” of the aneurysm as opposed to the volume of the aneurysm by implanting a device in the parent vessel of the aneurysm.
- neck approaches, by minimizing blood flow across the neck, a cessation of flow into the aneurysm can be achieved.
- a thrombotic mass can naturally form without having to deliver embolic materials into the aneurysm sac, as previously described.
- this approach also has its drawbacks, as the aneurysm does not undergo thromboses immediately, and there is still a risk of rupture post-surgery. Therefore, there is a need for a device capable of simplified and shortened implantation procedures that can quickly inhibit blood flow in an aneurysm to increase patient safety, reduce the length of the patient recovery period, and reduce the length of antiplatelet therapy administration.
- the devices can generally include a fan portion for occluding an aneurysm neck, a channel orifice opening in the fan portion, and an agent channel for delivering a coagulating agent through the orifice into the aneurysm.
- Devices can be delivered through a catheter to the aneurysm, the fan portion can expand to occlude the aneurysm neck, and the coagulating agent can be injected into the aneurysm.
- the fan portion can create a barrier to inhibit the coagulating agent from exiting the aneurysm.
- the fan portion can collapse and the device can be extracted from the patient.
- An example device for occluding an aneurysm can include a fan portion that is expandable from a collapsed configuration to an occluding configuration, a channel orifice, and an agent channel.
- the fan portion in the occluding configuration can occlude an aneurysm neck to create a barrier between the aneurysm and a blood vessel. This barrier can prevent the coagulating agent from leaking into the blood vessel during and/or after delivery of the agent into the aneurysm sac.
- the fan portion can extend across and occlude at least a portion of the aneurysm neck or can completely occlude the aneurysm neck in the occluding configuration.
- the channel orifice can define an opening in the fan portion through which the coagulating agent can be injected.
- the agent channel can be in communication with the channel orifice and can deliver the coagulating agent through the channel orifice into the aneurysm sac.
- the example device can be delivered to the aneurysm using a microcatheter.
- the fan portion can detach from its position near the aneurysm neck after the coagulating agent has been delivered to the aneurysm sac.
- the fan portion can be collapsed from the occluding configuration to an extraction configuration. This extraction configuration can be sized to fit inside a retrieval catheter.
- the fan portion can consist of at least one elongated support.
- the elongated support can be connected to an occluding element.
- the elongated support can have a first end and a second end. The first end of the elongated support can be positioned near the channel orifice in the fan portion.
- the second end of the elongated support can extend towards a wall of the aneurysm across at least a portion of the aneurysm neck to occlude the neck when the fan portion is expanded to the occluding configuration.
- the fan portion can also be inflated to reach the occluding configuration.
- the device can include an inflation tube to inflate the fan portion to the occluding configuration.
- the inflation tube can have a distal end connected to the fan portion.
- the agent channel can have a proximal end and a distal end.
- the distal end of the agent channel can communicate with the channel orifice to transfer the coagulating agent into the aneurysm sac.
- the proximal end of the agent channel can receive the coagulating agent.
- the channel orifice can also be an opening in the distal end of the agent channel, whereby a single opening functions as both the channel orifice and the distal end of the agent channel.
- the example device can further have a trigger mechanism in communication with the proximal end of the agent channel.
- the trigger mechanism can communicate with the proximal end of the agent channel to receive the coagulating agent or introduce the coagulating agent into the agent channel.
- the trigger mechanism can facilitate delivery of the coagulating agent from the proximal end to the distal end of the agent channel, and then through the channel orifice into the aneurysm sac.
- a delivery apparatus for treating an aneurysm can have an agent channel that can deliver a coagulating agent to an aneurysm sac.
- the agent channel can have a distal end and a proximal end.
- the proximal end of the agent channel can receive the coagulating agent and deliver the coagulating agent from the proximal end to the distal end of the agent channel.
- the distal end of the agent channel can communicate with a channel orifice in a fan portion and deliver the coagulating agent through the channel orifice into the aneurysm.
- the channel orifice can also be an opening in the distal end of the agent channel.
- the fan portion can expand from a collapsed configuration to an occluding configuration.
- the fan portion in the occluding configuration can extend across and occlude a portion of an aneurysm neck to create a barrier between a blood vessel and the aneurysm. This barrier can prevent the delivered coagulating agent from entering the blood vessel and help retain the coagulating agent inside the aneurysm sac.
- the fan portion can detach from its position near the aneurysm neck after the coagulating agent has been delivered to the aneurysm sac.
- the fan portion can collapse from the occluding configuration to an extraction configuration.
- This extraction configuration can be sized to fit inside a retrieval catheter.
- the example apparatus can further comprise a trigger mechanism in communication with the proximal end of the agent channel for receiving the coagulating agent or introducing the coagulating agent into the agent channel.
- An example method for treating an aneurysm can include providing an exemplary treatment device which can include a fan portion, a channel orifice defining an opening in the fan portion, and an agent channel; joining the agent channel to the channel orifice; delivering the exemplary treatment device to an aneurysm treatment site; expanding the fan portion to an occluding configuration approximate a center of an aneurysm neck wherein the expanded fan portion occludes at least a portion of the aneurysm neck; injecting a coagulating agent through the agent channel, through the channel orifice, and into the aneurysm sac to coagulate the blood present in the aneurysm; and collapsing the treatment device from the occluding configuration to an extraction configuration for extraction of the device after the injection of the coagulating agent.
- the method can include the step of creating a barrier with the fan portion between a blood vessel and the aneurysm to prevent the coagulating agent from entering the blood vessel.
- the method can include removing the treatment device through a microcatheter or through a retrieval deployment system.
- the method can include treating an aneurysm with only a single implementation step.
- the method can further include providing a trigger mechanism and triggering the delivery of the agent by activating the trigger mechanism at a proximal end of the agent channel to deliver the agent from the proximal end of the agent channel to a distal end of the agent channel.
- FIG. 1 is an illustration of an exemplary treatment device positioned to occlude an aneurysm neck according to aspects of the present invention
- FIGS. 2 a to 2 f are illustrations of a treatment sequence of an exemplary treatment device and delivery of a coagulating agent to an aneurysm according to aspects of the present invention
- FIGS. 3 a to 3 e are illustrations of a treatment sequence of an exemplary inflatable treatment device and delivery of a coagulating agent to an aneurysm according to aspects of the present invention
- FIGS. 4 a to 4 e are illustrations of a treatment sequence of an exemplary treatment device in connection with a trigger mechanism and delivery of a coagulating agent to an aneurysm according to aspects of the present invention.
- FIG. 5 is a flow diagram outlining example method steps that can be carried out during delivery and use of a treatment device according to aspects of the present invention.
- FIG. 6 is a flow diagram outlining example method steps that can be carried out during delivery and use of a treatment device according to aspects of the present invention.
- FIG. 7 is a flow diagram outlining example method steps that can be carried out during delivery and use of a treatment device according to aspects of the present invention.
- FIG. 8 is a flow diagram outlining example method steps that can be carried out during delivery and use of a treatment device according to aspects of the present invention.
- example devices described herein describe a treatment device that can be placed over the neck of an aneurysm to create a barrier between a vessel and the aneurysm. At least one coagulating agent can then delivered into the aneurysm sac. Delivery can be activated via trigger mechanism on the proximal end of the delivery system. The device can be held approximate the aneurysm neck at least until the coagulating agent is injected, and then can be retracted or detached from the aneurysm. The rapid coagulating agents can coagulate the blood in the aneurysm instantly. In some examples, the device can be removed via a microcatheter or deployed via a retrieval deployment system.
- the example devices can include a fan portion that can expand from a collapsed configuration to an occluding configuration in which the fan portion in the occluding configuration is shaped to occlude an aneurysm neck from within an aneurysm sac.
- the fan portion can generally have a channel orifice working in connection with an agent channel that delivers a coagulating agent through the channel orifice and into the aneurysm sac.
- FIG. 1 an example treatment device 100 is shown with the fan portion 102 in an occluding configuration approximate the neck 12 of an aneurysm 10 .
- the fan portion 102 can occlude the aneurysm 10 from inside the aneurysm sac 16 .
- the fan portion 102 in the occluding configuration can be sized to occlude at least a portion of the aneurysm neck 12 .
- the fan portion 102 in the occluding configuration can completely occlude the aneurysm neck 12 as depicted in FIG. 1 .
- the fan portion 102 in the occluding configuration can occlude the neck 12 to create a barrier between a blood vessel 106 and the aneurysm 10 .
- the fan portion 102 can contain a channel orifice 104 .
- the channel orifice 104 can be located in the fan portion 102 such that the channel orifice 104 opens up to the aneurysm 10 .
- the channel orifice 104 can be centrally located in the fan portion 102 .
- the channel orifice can work in connection with an agent channel 112 .
- FIGS. 2 a through 2 f are illustrations of stages or steps that can occur during a treatment sequence of an exemplary treatment device 100 and delivery of a coagulating agent 114 to an aneurysm 10 .
- the coagulating agent 114 can be a drug based on replacement factors, vitamin K, antiplasmins or any other drugs known to those of skill in the art that can affect blood clotting. In some examples, a rapidly clotting drug can be effective. In addition, the drug needs to be deliverable through a torturous agent channel 112 .
- FIG. 2 a is an illustration of an example treatment device 100 wherein the fan portion 102 is shown in a collapsed delivery configuration inside a delivery catheter 400 , a channel orifice 104 positioned on a proximal end of the collapsed fan portion 102 , and an agent channel 112 attached to the channel orifice 104 .
- the fan portion 102 can be sized to fit within the lumen of a delivery catheter 400 when the fan portion 102 is in the collapsed configuration.
- the treatment device 100 in its entirety can be sized to fit within the lumen of a delivery catheter 400 when the fan portion 102 is in the collapsed configuration.
- the fan portion 102 When the fan portion 102 is in the collapsed configuration, the fan portion 102 can have sufficient flexibility to be delivered through the delivery catheter 400 , navigating torturous anatomical geometries, to be delivered to an aneurysm 10 (not shown).
- the agent channel 112 can have sufficient length to be accessible outside of the patient when the fan portion 102 reaches a treatment site.
- the fan portion 102 in the collapsed configuration can have a substantially tubular shape.
- the fan portion 102 can be comprised of at least one elongated support 108 .
- FIG. 2 a shows three elongated supports 108 comprising the fan portion 102 .
- An occluding element 110 can be attached to the one or more elongated supports 108 .
- the treatment device 100 can be delivered to an aneurysm 10 by sliding the device 100 distally when the fan portion 102 is in a collapsed configuration through a delivery catheter 400 .
- the treatment device 100 can be delivered to a treatment site through a blood vessel 106 .
- FIG. 2 b illustrates the treatment device 100 inside the delivery catheter 400 located near an aneurysm neck 12 .
- FIG. 2 b further shows the fan portion 102 pushed partially out of the delivery catheter 400 for deployment inside the aneurysm sac 16 .
- the fan portion 102 can expand as it exits the delivery catheter 400 .
- the fan portion 102 can include a memory shape material such as Nitinol, a Nitinol alloy, a polymer memory shape material, or other memory shape material having properties for reshaping as described herein.
- the fan portion 102 can be in a deformed shape in the collapsed configuration and reshape based on a predetermined shape after exiting the delivery catheter 400 .
- each elongated support 108 of the fan portion 102 can have a first end 108 a positioned approximate the channel orifice 104 , and a second end 108 b extending from the first end 108 a across at least a portion of the aneurysm neck 12 towards an aneurysm wall 14 .
- the second end 108 b can extend towards the interior wall 14 of the aneurysm 10 upon expansion of the fan portion 102 .
- the elongated support 108 can in turn expand the connected occluding element 110 to occlude at least a portion of the aneurysm neck 12 .
- the occluding element 110 can expand upon discharge from the delivery catheter 400 and cause the second end 108 b of each connected elongated support 108 to move towards the aneurysm wall 14 .
- FIG. 2 c illustrates the example treatment device 100 wherein the fan portion 102 is in an occluding configuration in the aneurysm 10 .
- the fan portion 102 in the occluding configuration can be sized to occlude at least a portion of an aneurysm neck 12 .
- the fan portion 102 in the occluding configuration can completely occlude the aneurysm neck 12 as depicted in FIG. 2 c .
- the fan portion 102 in the occluding configuration can occlude the neck 12 to create a barrier between a blood vessel 106 and the aneurysm 10 . As illustrated in FIG.
- the second end 108 b of the elongated support 108 can be in contact with the aneurysm wall 14 when the fan portion 102 is in the occluding configuration.
- the fan portion 102 can be capable of deflecting a blood flow from the aneurysm 10 , diverting a blood flow from the aneurysm 10 , slowing a blood flow into the aneurysm 10 , or any combination thereof.
- the fan portion 102 can extend to the aneurysm wall 14 , and the fan portion 102 can provide a force against the aneurysm wall 14 to maintain the expanded position of the fan portion 102 such that the treatment device 100 doesn't become dislodged and become ineffective at inhibiting blood flow into the aneurysm.
- the force of the fan portion 102 to the aneurysm wall 14 can be sufficient to maintain the position of the treatment device 100 within the aneurysm 10 .
- the fan portion 102 can be made of a memory shape material having a first, predetermined shape and a second, collapsed shape in the collapsed configuration.
- the fan portion 102 When the fan portion 102 is in an occluding configuration within the aneurysm 10 , the fan portion 102 can move to a third, deployed shape that is based at least in part on the first, predetermined shape and the anatomical geometry of the aneurysm 10 .
- the first, predetermined shape can be sized larger than the wall 14 within the aneurysm sac 16 ; the fan portion 102 can move to extend to the wall 14 ; and the fan portion 102 can provide a force against the wall 14 as the properties of the memory shape material cause the fan portion 102 to attempt to open to the predetermined shape.
- the fan portion 102 in the occluding configuration can take the shape of the aneurysm neck 12 and/or interior walls 14 of the aneurysm near the aneurysm neck 12 .
- FIG. 2 d is an illustration of a cross-sectional view looking distally into the aneurysm 10 of an example treatment device 100 where the fan portion 102 is in the occluding configuration, such as the treatment device 100 depicted in FIG. 2 c.
- FIG. 2 e illustrates the treatment device 100 wherein the fan portion 102 is in the occluding configuration.
- the channel orifice 104 in the fan portion 102 can work in connection with an agent channel 112 .
- the agent channel 112 can allow for the transfer of one or more coagulating agents 114 through the channel 112 to the channel orifice 104 .
- the coagulating agent 114 can include rapid coagulating agents, such as collagen, chitosan, kaolin, zeolite, or other agents having properties for coagulating as described herein.
- the agent channel 112 can have a distal end 112 a a proximal end (not shown). The distal end 112 a of the agent channel 112 can connect to the channel orifice 104 .
- the proximal end can receive the coagulating agent 114 into the agent channel 112 and deliver the coagulating agent 114 from the proximal end to the distal end 112 a connected to the channel orifice 104 .
- the proximal end can be accessible outside of the patient for injection of the coagulating agent 114 into the patient.
- Coagulating agent 114 passing through the lumen of the agent channel 112 to the distal end 112 a can subsequently pass through the channel orifice 104 and into the aneurysm sac 16 upon reaching the distal end 112 a of the agent channel 112 .
- the distal end 112 a of the agent channel 112 can also be the channel orifice 104 of the fan portion 102 .
- the coagulating agent 114 can coagulate the blood inside the aneurysm 10 .
- the coagulating agent 114 can coagulate the blood inside the aneurysm 10 virtually instantaneously upon contacting the blood inside the aneurysm 10 according to the coagulation properties of the coagulating agent 114 .
- the treatment device 100 can be removed from the aneurysm 10 .
- the treatment device 100 can be removed once the coagulating agent 114 has coagulated the blood in the aneurysm 10 .
- the treatment device 100 can detach from its location approximate the aneurysm neck 12 after delivery of the coagulating agent 114 . As in the device shown in FIG.
- the occluding element 110 , the elongated supports 108 , or both the occluding element 110 and the elongated supports 108 can detach from their location approximate the aneurysm neck 12 after delivery of the coagulating agent 114 .
- the treatment device 100 can be removed via a retrieval deployment system.
- the fan portion 102 (not shown) can collapse from the occluding configuration to an extraction configuration after the coagulating agent 114 has been delivered to the aneurysm sac 16 .
- the extraction configuration can be sized to traverse through a lumen of a catheter (not shown).
- the aneurysm 10 , now filled with the coagulating agent 114 can now start to be reabsorbed into the blood vessel 106 through the body's natural healing process. This can avoid the need for permanently implanted elements in the patient.
- FIGS. 3 a to 3 e are illustrations of stages or steps that can occur during another example implementation sequence of an exemplary treatment device 100 .
- FIG. 3 a illustrates an example treatment device 100 comprising a fan portion 102 having a channel orifice 104 , an agent channel 112 connected to the channel orifice 104 at a distal end 112 a of the agent channel 112 , and an inflation tube 118 connected to the fan portion 102 .
- the fan portion 102 is shown in a collapsed delivery configuration inside a delivery catheter 400 .
- the fan portion 102 can be in connection with the inflation tube 118 which can inflate the fan portion 102 .
- the fan portion 102 can include at least one material used in neurovascular balloons, such as polyurethane or silicon.
- the inflation tube 118 can have a distal end 118 a connected to the fan portion 102 .
- FIG. 3 b illustrates the treatment device 100 inside the delivery catheter 400 with the fan portion 102 exiting the delivery catheter 104 for deployment inside a sac 16 of an aneurysm 10 .
- the fan portion 102 can be inflated to expand using the inflation tube 118 as it exits the delivery catheter 400 .
- the fan portion 102 can be completely removed from the delivery catheter 400 before inflation begins.
- inflation of the fan portion 102 can begin while the fan portion 102 is still entirely or partially inside the delivery catheter 400 .
- Inflation of the fan portion 102 can occur using saline or a variety of other elements known in the art with respect to inflating neurovascular balloons.
- the outer surface of the fan portion 102 can expand towards the aneurysm wall 14 .
- FIG. 3 c illustrates the treatment device 100 wherein the fan portion 102 is in an occluding configuration in the aneurysm 10 .
- fan portion 102 can inflate to the extent that the fan portion 102 can be in contact with the aneurysm wall 14 when the fan portion 102 is in the occluding configuration.
- FIG. 3 c illustrates the delivery of a coagulating agent 114 to the aneurysm sac 16 in the same manner as described in FIG. 2 e.
- FIG. 3 d illustrates coagulation agent 114 delivered into the aneurysm sac 16 and a retrieval catheter 500 in place to extract the device 100 .
- the fan portion 102 can collapse from the occluding configuration to an extraction configuration after the coagulating agent 114 has been delivered to the aneurysm sac 16 .
- the extraction configuration can be sized to traverse through a lumen of the retrieval catheter 500 .
- the treatment device 100 can be extracted using the retrieval catheter 500 or a deployment and retrieval device.
- the delivery catheter 400 can also be the retrieval catheter 500 .
- FIG. 3 e illustrates the aneurysm following extraction of the retrieval catheter 500 and the treatment device 100 .
- the fan portion 102 can detach from its location approximate the aneurysm neck 12 .
- the fan portion 102 can deflate from the occluding configuration to an extraction configuration after the coagulating agent 114 has been delivered to the aneurysm sac 16 .
- FIGS. 4 a to 4 e are illustrations of stages or steps that can occur during another example implementation sequence of an exemplary treatment device 100 .
- FIG. 4 a is an illustration of an example treatment device 100 including a fan portion 102 , a channel orifice 104 , an agent channel 112 , and a trigger mechanism 116 .
- the fan portion 102 is shown in a collapsed delivery configuration inside a delivery catheter 400 .
- the fan portion 102 can contain the channel orifice 104 that can be in communication with an agent channel 112 .
- the agent channel 112 can have a proximal end 112 b in communication with the trigger mechanism 116 .
- the proximal end 112 b of the agent channel 112 can receive the coagulating agent 114 into the agent channel 112 for delivery.
- the trigger mechanism 116 can facilitate the delivery of the coagulating agent to an aneurysm sac 16 (not shown).
- FIG. 4 b illustrates the treatment device 100 inside the delivery catheter 400 with the fan portion 102 exiting the delivery catheter 400 for deployment inside the aneurysm sac 16 .
- the treatment site can include an aneurysm 10 positioned adjacent bifurcated blood vessel branches and the treatment device 100 can be delivered to the aneurysm 10 through a stem branch 106 feeding the bifurcated blood vessel branches.
- FIG. 4 c illustrates the treatment device 100 wherein the fan portion 102 is in an occluding configuration in the aneurysm 10 .
- the trigger mechanism 116 can facilitate the delivery of the coagulating agent 114 through the agent channel 112 to the aneurysm sac 16 .
- the trigger mechanism 116 can be operated to release the coagulating agent 114 by a physician, nurse, or other medical professional.
- FIG. 4 d illustrates the delivery of a coagulating agent 114 to the aneurysm sac 16 in the same manner as described in FIG. 2 e .
- FIG. 4 e illustrates the aneurysm following extraction of the retrieval catheter 500 and the treatment device 100 .
- FIG. 5 is a flow diagram outlining example method steps that can be carried out during the administration of a treatment device 100 .
- the method steps can be implemented by any of the example means described herein or by any means that would be known to one of ordinary skill in the art.
- the treatment device having a fan portion, a channel orifice defining an opening in the fan portion, and an agent channel can be provided for administration to a patient.
- the agent channel can be joined to communicate with the channel orifice.
- the treatment device can be delivered to an aneurysm treatment site.
- the fan portion can be expanded to the occluding configuration approximate a center of an aneurysm neck. When the fan portion is expanded to the occluding configuration in step 540 , the fan portion can occlude at least a portion of an aneurysm neck.
- Step 540 can also create a barrier between a blood vessel and the aneurysm to prevent the coagulating agent from entering the blood vessel.
- the coagulating agent can be injected through the agent channel and the channel orifice into the aneurysm sac to coagulate the blood present in the aneurysm.
- the treatment device can be collapsed from the occluding configuration to the extraction configuration for extraction of the device after the injection of the coagulating agent.
- Method 500 can further comprise the step of treating an aneurysm with only a single implementation step.
- FIG. 6 is a flow diagram outlining further steps of method 500 .
- Method 500 can further comprise step 562 of removing the treatment device through a microcatheter.
- FIG. 7 is a flow diagram outlining further steps of method 500 .
- Method 500 can further comprise step 564 of removing the treatment device through a retrieval system.
- FIG. 8 is a flow diagram outlining further steps of method 500 .
- Method 500 can further comprise the steps of providing a trigger mechanism (step 542 ) and triggering the delivery of the agent by activating the trigger mechanism at a proximal end of the agent channel to deliver the agent from the proximal end of the agent channel to a distal end of the agent channel (step 544 ).
- the present teachings apply equally to the delivery apparatus 100 and treatment device 100 claimed herein.
- the descriptions contained herein are examples of the invention and are not intended in any way to limit the scope of the invention.
- the invention contemplates many variations and modifications of the device for occluding an aneurysm, including alternative geometries of elements and components described herein, utilizing any number of known means for braiding, knitting, weaving, or otherwise forming the fan portion as is known in the art, utilizing any of numerous materials for each component or element (e.g.
- radiopaque materials utilizing additional components including components to deliver a treatment device to an aneurysm or eject an treatment device from a delivery catheter, or utilizing additional components to perform functions not described herein, such as coagulating agents and deployment devices, for example.
- additional components including components to deliver a treatment device to an aneurysm or eject an treatment device from a delivery catheter, or utilizing additional components to perform functions not described herein, such as coagulating agents and deployment devices, for example.
Abstract
Devices can generally include a fan portion for occluding an aneurysm neck, a channel orifice opening in the fan portion, and an agent channel for delivering a coagulating agent through the orifice into the aneurysm. Devices can be delivered through a catheter to the aneurysm, the fan portion can expand to occlude the aneurysm neck, and coagulating agent can be injected into the aneurysm. During injection of the coagulating agent, the fan portion can inhibit the coagulating agent from exiting the aneurysm. After injection of the coagulation agent, the fan portion can collapse and the device can be extracted from the patient.
Description
- The present application is a continuation application of U.S. patent application Ser. No. 16/218,129 filed Dec. 12, 2018. The entire contents of which are hereby incorporated by reference.
- The present invention generally relates to medical instruments, and more particularly, to treatment devices for aneurysm therapy.
- Aneurysms can be complicated and difficult to treat. For example, treatment access can be limited or unavailable when an aneurysm is located proximate critical tissues. Such factors are of particular concern with cranial aneurysms due to the brain tissue surrounding cranial vessels and the corresponding limited treatment access.
- Prior solutions have included endovascular treatment access whereby an internal volume of the aneurysm sac is removed or excluded from arterial blood pressure and flow. In this respect, because the interior walls of the aneurysm can continue being subjected to flow of blood and related pressure, aneurysm rupture remains possible.
- Alternatives to endovascular or other surgical approaches can include occlusive devices. Such devices have typically incorporated multiple embolic coils that are delivered to the vasculature using microcatheter delivery systems. For example, when treating cranial aneurysms, a delivery catheter with embolic coils is typically first inserted into non-cranial vasculature through a femoral artery in the hip or groin area. Thereafter, the catheter is guided to a location of interest within the cranium. The sac of the aneurysm can then be filled with the embolic material to create a thrombotic mass that protects the arterial walls from blood flow and related pressure. However, such occlusive devices do have certain shortcomings, including mass effect, which can cause compression on the brain and its nerves. Obtaining an embolic coil packing density sufficient to either occlude the aneurysm neck or fill the aneurysm sac is difficult and time consuming. Further, aneurysm morphology (e.g. wide neck, bifurcation, etc.) can require ancillary devices such as stents or balloons to support the coil mass and obtain the desired packing density. The coils and accompanying ancillary devices can remain in patients for their entire lives. Additionally, embolic coils do not always effectively treat aneurysms as re-canalization of the aneurysm and/or coil compaction can occur over time. Many people who undergo aneurysm coil procedures also require a long period of dual antiplatelet therapy while the patient recovers post-procedure.
- One particular type of occlusive approach endeavors to deliver and treat the entrance or “neck” of the aneurysm as opposed to the volume of the aneurysm by implanting a device in the parent vessel of the aneurysm. In such “neck” approaches, by minimizing blood flow across the neck, a cessation of flow into the aneurysm can be achieved. In turn, a thrombotic mass can naturally form without having to deliver embolic materials into the aneurysm sac, as previously described. However, this approach also has its drawbacks, as the aneurysm does not undergo thromboses immediately, and there is still a risk of rupture post-surgery. Therefore, there is a need for a device capable of simplified and shortened implantation procedures that can quickly inhibit blood flow in an aneurysm to increase patient safety, reduce the length of the patient recovery period, and reduce the length of antiplatelet therapy administration.
- It is an aim of this invention to resolve these and other issues of the art.
- Disclosed herein are various exemplary devices for treating an aneurysm with a coagulating agent. The devices can generally include a fan portion for occluding an aneurysm neck, a channel orifice opening in the fan portion, and an agent channel for delivering a coagulating agent through the orifice into the aneurysm. Devices can be delivered through a catheter to the aneurysm, the fan portion can expand to occlude the aneurysm neck, and the coagulating agent can be injected into the aneurysm. During injection of the coagulating agent, the fan portion can create a barrier to inhibit the coagulating agent from exiting the aneurysm. After injection of the coagulating agent, the fan portion can collapse and the device can be extracted from the patient.
- An example device for occluding an aneurysm can include a fan portion that is expandable from a collapsed configuration to an occluding configuration, a channel orifice, and an agent channel. The fan portion in the occluding configuration can occlude an aneurysm neck to create a barrier between the aneurysm and a blood vessel. This barrier can prevent the coagulating agent from leaking into the blood vessel during and/or after delivery of the agent into the aneurysm sac. The fan portion can extend across and occlude at least a portion of the aneurysm neck or can completely occlude the aneurysm neck in the occluding configuration. The channel orifice can define an opening in the fan portion through which the coagulating agent can be injected. The agent channel can be in communication with the channel orifice and can deliver the coagulating agent through the channel orifice into the aneurysm sac.
- The example device can be delivered to the aneurysm using a microcatheter. The fan portion can detach from its position near the aneurysm neck after the coagulating agent has been delivered to the aneurysm sac. In another example, the fan portion can be collapsed from the occluding configuration to an extraction configuration. This extraction configuration can be sized to fit inside a retrieval catheter.
- The fan portion can consist of at least one elongated support. The elongated support can be connected to an occluding element. In some examples, the elongated support can have a first end and a second end. The first end of the elongated support can be positioned near the channel orifice in the fan portion. The second end of the elongated support can extend towards a wall of the aneurysm across at least a portion of the aneurysm neck to occlude the neck when the fan portion is expanded to the occluding configuration.
- The fan portion can also be inflated to reach the occluding configuration. The device can include an inflation tube to inflate the fan portion to the occluding configuration. The inflation tube can have a distal end connected to the fan portion.
- The agent channel can have a proximal end and a distal end. The distal end of the agent channel can communicate with the channel orifice to transfer the coagulating agent into the aneurysm sac. The proximal end of the agent channel can receive the coagulating agent. The channel orifice can also be an opening in the distal end of the agent channel, whereby a single opening functions as both the channel orifice and the distal end of the agent channel.
- The example device can further have a trigger mechanism in communication with the proximal end of the agent channel. The trigger mechanism can communicate with the proximal end of the agent channel to receive the coagulating agent or introduce the coagulating agent into the agent channel. The trigger mechanism can facilitate delivery of the coagulating agent from the proximal end to the distal end of the agent channel, and then through the channel orifice into the aneurysm sac.
- In another example, a delivery apparatus for treating an aneurysm can have an agent channel that can deliver a coagulating agent to an aneurysm sac. The agent channel can have a distal end and a proximal end. The proximal end of the agent channel can receive the coagulating agent and deliver the coagulating agent from the proximal end to the distal end of the agent channel. The distal end of the agent channel can communicate with a channel orifice in a fan portion and deliver the coagulating agent through the channel orifice into the aneurysm. The channel orifice can also be an opening in the distal end of the agent channel.
- In the example apparatus, the fan portion can expand from a collapsed configuration to an occluding configuration. The fan portion in the occluding configuration can extend across and occlude a portion of an aneurysm neck to create a barrier between a blood vessel and the aneurysm. This barrier can prevent the delivered coagulating agent from entering the blood vessel and help retain the coagulating agent inside the aneurysm sac.
- The fan portion can detach from its position near the aneurysm neck after the coagulating agent has been delivered to the aneurysm sac. The fan portion can collapse from the occluding configuration to an extraction configuration. This extraction configuration can be sized to fit inside a retrieval catheter.
- The example apparatus can further comprise a trigger mechanism in communication with the proximal end of the agent channel for receiving the coagulating agent or introducing the coagulating agent into the agent channel.
- An example method for treating an aneurysm can include providing an exemplary treatment device which can include a fan portion, a channel orifice defining an opening in the fan portion, and an agent channel; joining the agent channel to the channel orifice; delivering the exemplary treatment device to an aneurysm treatment site; expanding the fan portion to an occluding configuration approximate a center of an aneurysm neck wherein the expanded fan portion occludes at least a portion of the aneurysm neck; injecting a coagulating agent through the agent channel, through the channel orifice, and into the aneurysm sac to coagulate the blood present in the aneurysm; and collapsing the treatment device from the occluding configuration to an extraction configuration for extraction of the device after the injection of the coagulating agent.
- The method can include the step of creating a barrier with the fan portion between a blood vessel and the aneurysm to prevent the coagulating agent from entering the blood vessel. The method can include removing the treatment device through a microcatheter or through a retrieval deployment system. The method can include treating an aneurysm with only a single implementation step.
- The method can further include providing a trigger mechanism and triggering the delivery of the agent by activating the trigger mechanism at a proximal end of the agent channel to deliver the agent from the proximal end of the agent channel to a distal end of the agent channel.
- The above and further aspects of this invention are further discussed with reference to the following description in conjunction with the accompanying drawings, in which like numerals indicate like structural elements and features in various figures. The drawings are not necessarily to scale, emphasis instead being placed upon illustrating principles of the invention. The figures depict one or more implementations of the inventive devices, by way of example only, not by way of limitation.
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FIG. 1 is an illustration of an exemplary treatment device positioned to occlude an aneurysm neck according to aspects of the present invention; -
FIGS. 2a to 2f are illustrations of a treatment sequence of an exemplary treatment device and delivery of a coagulating agent to an aneurysm according to aspects of the present invention; -
FIGS. 3a to 3e are illustrations of a treatment sequence of an exemplary inflatable treatment device and delivery of a coagulating agent to an aneurysm according to aspects of the present invention; -
FIGS. 4a to 4e are illustrations of a treatment sequence of an exemplary treatment device in connection with a trigger mechanism and delivery of a coagulating agent to an aneurysm according to aspects of the present invention; and -
FIG. 5 is a flow diagram outlining example method steps that can be carried out during delivery and use of a treatment device according to aspects of the present invention. -
FIG. 6 is a flow diagram outlining example method steps that can be carried out during delivery and use of a treatment device according to aspects of the present invention. -
FIG. 7 is a flow diagram outlining example method steps that can be carried out during delivery and use of a treatment device according to aspects of the present invention. -
FIG. 8 is a flow diagram outlining example method steps that can be carried out during delivery and use of a treatment device according to aspects of the present invention. - The descriptions contained herein are examples of the invention and are not intended in any way to limit the scope of the invention. In general, example devices described herein describe a treatment device that can be placed over the neck of an aneurysm to create a barrier between a vessel and the aneurysm. At least one coagulating agent can then delivered into the aneurysm sac. Delivery can be activated via trigger mechanism on the proximal end of the delivery system. The device can be held approximate the aneurysm neck at least until the coagulating agent is injected, and then can be retracted or detached from the aneurysm. The rapid coagulating agents can coagulate the blood in the aneurysm instantly. In some examples, the device can be removed via a microcatheter or deployed via a retrieval deployment system.
- The example devices can include a fan portion that can expand from a collapsed configuration to an occluding configuration in which the fan portion in the occluding configuration is shaped to occlude an aneurysm neck from within an aneurysm sac. In the occluding configuration, the fan portion can generally have a channel orifice working in connection with an agent channel that delivers a coagulating agent through the channel orifice and into the aneurysm sac.
- It must be noted that, as used in the specification and the appended claims, the singular forms “a,” “an” and “the” include plural referents unless the context clearly dictates otherwise. By “comprising” or “containing” or “including” it is meant that at least the named compound, element, particle, or method step is present in the composition or article or method, but does not exclude the presence of other compounds, materials, particles, method steps, even if the other such compounds, material, particles, method steps have the same function as what is named.
- In describing examples, terminology will be resorted to for the sake of clarity. It is intended that each term contemplates its broadest meaning as understood by those skilled in the art and includes all technical equivalents that operate in a similar manner to accomplish a similar purpose. It is also to be understood that the mention of one or more steps of a method does not preclude the presence of additional method steps or intervening method steps between those steps expressly identified. Steps of a method can be performed in a different order than those described herein without departing from the scope of the disclosed technology. Similarly, it is also to be understood that the mention of one or more components in a device or system does not preclude the presence of additional components or intervening components between those components expressly identified.
- Turning to
FIG. 1 , anexample treatment device 100 is shown with thefan portion 102 in an occluding configuration approximate theneck 12 of ananeurysm 10. Thefan portion 102 can occlude theaneurysm 10 from inside theaneurysm sac 16. Thefan portion 102 in the occluding configuration can be sized to occlude at least a portion of theaneurysm neck 12. Thefan portion 102 in the occluding configuration can completely occlude theaneurysm neck 12 as depicted inFIG. 1 . Thefan portion 102 in the occluding configuration can occlude theneck 12 to create a barrier between ablood vessel 106 and theaneurysm 10. Thefan portion 102 can contain achannel orifice 104. As illustrated, thechannel orifice 104 can be located in thefan portion 102 such that thechannel orifice 104 opens up to theaneurysm 10. Thechannel orifice 104 can be centrally located in thefan portion 102. The channel orifice can work in connection with anagent channel 112. -
FIGS. 2a through 2f are illustrations of stages or steps that can occur during a treatment sequence of anexemplary treatment device 100 and delivery of a coagulatingagent 114 to ananeurysm 10. The coagulatingagent 114 can be a drug based on replacement factors, vitamin K, antiplasmins or any other drugs known to those of skill in the art that can affect blood clotting. In some examples, a rapidly clotting drug can be effective. In addition, the drug needs to be deliverable through atorturous agent channel 112. -
FIG. 2a is an illustration of anexample treatment device 100 wherein thefan portion 102 is shown in a collapsed delivery configuration inside adelivery catheter 400, achannel orifice 104 positioned on a proximal end of thecollapsed fan portion 102, and anagent channel 112 attached to thechannel orifice 104. Thefan portion 102 can be sized to fit within the lumen of adelivery catheter 400 when thefan portion 102 is in the collapsed configuration. Thetreatment device 100 in its entirety can be sized to fit within the lumen of adelivery catheter 400 when thefan portion 102 is in the collapsed configuration. When thefan portion 102 is in the collapsed configuration, thefan portion 102 can have sufficient flexibility to be delivered through thedelivery catheter 400, navigating torturous anatomical geometries, to be delivered to an aneurysm 10 (not shown). Theagent channel 112 can have sufficient length to be accessible outside of the patient when thefan portion 102 reaches a treatment site. Thefan portion 102 in the collapsed configuration can have a substantially tubular shape. Thefan portion 102 can be comprised of at least oneelongated support 108. The example inFIG. 2a shows threeelongated supports 108 comprising thefan portion 102. An occludingelement 110 can be attached to the one or moreelongated supports 108. - Moving on to
FIG. 2b , thetreatment device 100 can be delivered to ananeurysm 10 by sliding thedevice 100 distally when thefan portion 102 is in a collapsed configuration through adelivery catheter 400. Thetreatment device 100 can be delivered to a treatment site through ablood vessel 106.FIG. 2b illustrates thetreatment device 100 inside thedelivery catheter 400 located near ananeurysm neck 12.FIG. 2b further shows thefan portion 102 pushed partially out of thedelivery catheter 400 for deployment inside theaneurysm sac 16. Thefan portion 102 can expand as it exits thedelivery catheter 400. Thefan portion 102 can include a memory shape material such as Nitinol, a Nitinol alloy, a polymer memory shape material, or other memory shape material having properties for reshaping as described herein. Thefan portion 102 can be in a deformed shape in the collapsed configuration and reshape based on a predetermined shape after exiting thedelivery catheter 400. As illustrated inFIG. 2b , eachelongated support 108 of thefan portion 102 can have afirst end 108 a positioned approximate thechannel orifice 104, and asecond end 108 b extending from thefirst end 108 a across at least a portion of theaneurysm neck 12 towards ananeurysm wall 14. Thesecond end 108 b can extend towards theinterior wall 14 of theaneurysm 10 upon expansion of thefan portion 102. When eachelongated support 108 expands, theelongated support 108 can in turn expand the connected occludingelement 110 to occlude at least a portion of theaneurysm neck 12. In another example, the occludingelement 110 can expand upon discharge from thedelivery catheter 400 and cause thesecond end 108 b of each connectedelongated support 108 to move towards theaneurysm wall 14. -
FIG. 2c illustrates theexample treatment device 100 wherein thefan portion 102 is in an occluding configuration in theaneurysm 10. Thefan portion 102 in the occluding configuration can be sized to occlude at least a portion of ananeurysm neck 12. Thefan portion 102 in the occluding configuration can completely occlude theaneurysm neck 12 as depicted inFIG. 2c . Thefan portion 102 in the occluding configuration can occlude theneck 12 to create a barrier between ablood vessel 106 and theaneurysm 10. As illustrated inFIG. 2c , thesecond end 108 b of theelongated support 108 can be in contact with theaneurysm wall 14 when thefan portion 102 is in the occluding configuration. In occluding configuration, thefan portion 102 can be capable of deflecting a blood flow from theaneurysm 10, diverting a blood flow from theaneurysm 10, slowing a blood flow into theaneurysm 10, or any combination thereof. - In the occluding configuration, the
fan portion 102 can extend to theaneurysm wall 14, and thefan portion 102 can provide a force against theaneurysm wall 14 to maintain the expanded position of thefan portion 102 such that thetreatment device 100 doesn't become dislodged and become ineffective at inhibiting blood flow into the aneurysm. The force of thefan portion 102 to theaneurysm wall 14 can be sufficient to maintain the position of thetreatment device 100 within theaneurysm 10. For example, thefan portion 102 can be made of a memory shape material having a first, predetermined shape and a second, collapsed shape in the collapsed configuration. When thefan portion 102 is in an occluding configuration within theaneurysm 10, thefan portion 102 can move to a third, deployed shape that is based at least in part on the first, predetermined shape and the anatomical geometry of theaneurysm 10. In the example, the first, predetermined shape can be sized larger than thewall 14 within theaneurysm sac 16; thefan portion 102 can move to extend to thewall 14; and thefan portion 102 can provide a force against thewall 14 as the properties of the memory shape material cause thefan portion 102 to attempt to open to the predetermined shape. Thefan portion 102 in the occluding configuration can take the shape of theaneurysm neck 12 and/orinterior walls 14 of the aneurysm near theaneurysm neck 12. -
FIG. 2d is an illustration of a cross-sectional view looking distally into theaneurysm 10 of anexample treatment device 100 where thefan portion 102 is in the occluding configuration, such as thetreatment device 100 depicted inFIG. 2 c. -
FIG. 2e illustrates thetreatment device 100 wherein thefan portion 102 is in the occluding configuration. Thechannel orifice 104 in thefan portion 102 can work in connection with anagent channel 112. Theagent channel 112 can allow for the transfer of one ormore coagulating agents 114 through thechannel 112 to thechannel orifice 104. The coagulatingagent 114 can include rapid coagulating agents, such as collagen, chitosan, kaolin, zeolite, or other agents having properties for coagulating as described herein. Theagent channel 112 can have adistal end 112 a a proximal end (not shown). Thedistal end 112 a of theagent channel 112 can connect to thechannel orifice 104. The proximal end can receive the coagulatingagent 114 into theagent channel 112 and deliver the coagulatingagent 114 from the proximal end to thedistal end 112 a connected to thechannel orifice 104. The proximal end can be accessible outside of the patient for injection of the coagulatingagent 114 into the patient.Coagulating agent 114 passing through the lumen of theagent channel 112 to thedistal end 112 a can subsequently pass through thechannel orifice 104 and into theaneurysm sac 16 upon reaching thedistal end 112 a of theagent channel 112. Thedistal end 112 a of theagent channel 112 can also be thechannel orifice 104 of thefan portion 102. The coagulatingagent 114 can coagulate the blood inside theaneurysm 10. The coagulatingagent 114 can coagulate the blood inside theaneurysm 10 virtually instantaneously upon contacting the blood inside theaneurysm 10 according to the coagulation properties of the coagulatingagent 114. - As shown in
FIG. 2f , once the coagulatingagent 114 has been pumped into theaneurysm sac 16, thetreatment device 100 can be removed from theaneurysm 10. Thetreatment device 100 can be removed once the coagulatingagent 114 has coagulated the blood in theaneurysm 10. Thetreatment device 100 can detach from its location approximate theaneurysm neck 12 after delivery of the coagulatingagent 114. As in the device shown inFIG. 2e , the occludingelement 110, theelongated supports 108, or both the occludingelement 110 and theelongated supports 108 can detach from their location approximate theaneurysm neck 12 after delivery of the coagulatingagent 114. In another example, thetreatment device 100 can be removed via a retrieval deployment system. In another example, the fan portion 102 (not shown) can collapse from the occluding configuration to an extraction configuration after the coagulatingagent 114 has been delivered to theaneurysm sac 16. The extraction configuration can be sized to traverse through a lumen of a catheter (not shown). Theaneurysm 10, now filled with the coagulatingagent 114 can now start to be reabsorbed into theblood vessel 106 through the body's natural healing process. This can avoid the need for permanently implanted elements in the patient. -
FIGS. 3a to 3e are illustrations of stages or steps that can occur during another example implementation sequence of anexemplary treatment device 100.FIG. 3a illustrates anexample treatment device 100 comprising afan portion 102 having achannel orifice 104, anagent channel 112 connected to thechannel orifice 104 at adistal end 112 a of theagent channel 112, and aninflation tube 118 connected to thefan portion 102. Thefan portion 102 is shown in a collapsed delivery configuration inside adelivery catheter 400. Thefan portion 102 can be in connection with theinflation tube 118 which can inflate thefan portion 102. Thefan portion 102 can include at least one material used in neurovascular balloons, such as polyurethane or silicon. Theinflation tube 118 can have adistal end 118 a connected to thefan portion 102. -
FIG. 3b illustrates thetreatment device 100 inside thedelivery catheter 400 with thefan portion 102 exiting thedelivery catheter 104 for deployment inside asac 16 of ananeurysm 10. As shown inFIG. 3b , thefan portion 102 can be inflated to expand using theinflation tube 118 as it exits thedelivery catheter 400. Thefan portion 102 can be completely removed from thedelivery catheter 400 before inflation begins. Alternatively, inflation of thefan portion 102 can begin while thefan portion 102 is still entirely or partially inside thedelivery catheter 400. Inflation of thefan portion 102 can occur using saline or a variety of other elements known in the art with respect to inflating neurovascular balloons. As thefan portion 102 inflates, the outer surface of thefan portion 102 can expand towards theaneurysm wall 14. -
FIG. 3c illustrates thetreatment device 100 wherein thefan portion 102 is in an occluding configuration in theaneurysm 10. As illustrated inFIG. 3c ,fan portion 102 can inflate to the extent that thefan portion 102 can be in contact with theaneurysm wall 14 when thefan portion 102 is in the occluding configuration.FIG. 3c illustrates the delivery of a coagulatingagent 114 to theaneurysm sac 16 in the same manner as described inFIG. 2 e. -
FIG. 3d illustratescoagulation agent 114 delivered into theaneurysm sac 16 and aretrieval catheter 500 in place to extract thedevice 100. Thefan portion 102 can collapse from the occluding configuration to an extraction configuration after the coagulatingagent 114 has been delivered to theaneurysm sac 16. The extraction configuration can be sized to traverse through a lumen of theretrieval catheter 500. Thetreatment device 100 can be extracted using theretrieval catheter 500 or a deployment and retrieval device. Thedelivery catheter 400 can also be theretrieval catheter 500.FIG. 3e illustrates the aneurysm following extraction of theretrieval catheter 500 and thetreatment device 100. Once the coagulatingagent 114 has been pumped into theaneurysm sac 16, thefan portion 102 can detach from its location approximate theaneurysm neck 12. Thefan portion 102 can deflate from the occluding configuration to an extraction configuration after the coagulatingagent 114 has been delivered to theaneurysm sac 16. -
FIGS. 4a to 4e are illustrations of stages or steps that can occur during another example implementation sequence of anexemplary treatment device 100.FIG. 4a is an illustration of anexample treatment device 100 including afan portion 102, achannel orifice 104, anagent channel 112, and atrigger mechanism 116. Thefan portion 102 is shown in a collapsed delivery configuration inside adelivery catheter 400. Thefan portion 102 can contain thechannel orifice 104 that can be in communication with anagent channel 112. Theagent channel 112 can have aproximal end 112 b in communication with thetrigger mechanism 116. Theproximal end 112 b of theagent channel 112 can receive the coagulatingagent 114 into theagent channel 112 for delivery. Thetrigger mechanism 116 can facilitate the delivery of the coagulating agent to an aneurysm sac 16 (not shown). -
FIG. 4b illustrates thetreatment device 100 inside thedelivery catheter 400 with thefan portion 102 exiting thedelivery catheter 400 for deployment inside theaneurysm sac 16. As illustrated inFIGS. 4b to 4d , the treatment site can include ananeurysm 10 positioned adjacent bifurcated blood vessel branches and thetreatment device 100 can be delivered to theaneurysm 10 through astem branch 106 feeding the bifurcated blood vessel branches. -
FIG. 4c illustrates thetreatment device 100 wherein thefan portion 102 is in an occluding configuration in theaneurysm 10. Upon the fan portion reaching the occluding configuration, thetrigger mechanism 116 can facilitate the delivery of the coagulatingagent 114 through theagent channel 112 to theaneurysm sac 16. Thetrigger mechanism 116 can be operated to release the coagulatingagent 114 by a physician, nurse, or other medical professional.FIG. 4d illustrates the delivery of a coagulatingagent 114 to theaneurysm sac 16 in the same manner as described inFIG. 2e .FIG. 4e illustrates the aneurysm following extraction of theretrieval catheter 500 and thetreatment device 100. -
FIG. 5 is a flow diagram outlining example method steps that can be carried out during the administration of atreatment device 100. The method steps can be implemented by any of the example means described herein or by any means that would be known to one of ordinary skill in the art. - Referring to a
method 500 outlined inFIG. 5 , instep 510 the treatment device having a fan portion, a channel orifice defining an opening in the fan portion, and an agent channel can be provided for administration to a patient. Instep 520, the agent channel can be joined to communicate with the channel orifice. Instep 530, the treatment device can be delivered to an aneurysm treatment site. Instep 540, the fan portion can be expanded to the occluding configuration approximate a center of an aneurysm neck. When the fan portion is expanded to the occluding configuration instep 540, the fan portion can occlude at least a portion of an aneurysm neck. Step 540 can also create a barrier between a blood vessel and the aneurysm to prevent the coagulating agent from entering the blood vessel. Instep 550, the coagulating agent can be injected through the agent channel and the channel orifice into the aneurysm sac to coagulate the blood present in the aneurysm. Instep 560, the treatment device can be collapsed from the occluding configuration to the extraction configuration for extraction of the device after the injection of the coagulating agent.Method 500 can further comprise the step of treating an aneurysm with only a single implementation step. -
FIG. 6 is a flow diagram outlining further steps ofmethod 500.Method 500 can further comprisestep 562 of removing the treatment device through a microcatheter.FIG. 7 is a flow diagram outlining further steps ofmethod 500.Method 500 can further comprisestep 564 of removing the treatment device through a retrieval system.FIG. 8 is a flow diagram outlining further steps ofmethod 500.Method 500 can further comprise the steps of providing a trigger mechanism (step 542) and triggering the delivery of the agent by activating the trigger mechanism at a proximal end of the agent channel to deliver the agent from the proximal end of the agent channel to a distal end of the agent channel (step 544). - It should be apparent to those skilled in the art that the present teachings apply equally to the
delivery apparatus 100 andtreatment device 100 claimed herein. The descriptions contained herein are examples of the invention and are not intended in any way to limit the scope of the invention. As described herein, the invention contemplates many variations and modifications of the device for occluding an aneurysm, including alternative geometries of elements and components described herein, utilizing any number of known means for braiding, knitting, weaving, or otherwise forming the fan portion as is known in the art, utilizing any of numerous materials for each component or element (e.g. radiopaque materials, memory shape materials, etc.), utilizing additional components including components to deliver a treatment device to an aneurysm or eject an treatment device from a delivery catheter, or utilizing additional components to perform functions not described herein, such as coagulating agents and deployment devices, for example. These modifications would be apparent to those having ordinary skill in the art to which this invention relates and are intended to be within the scope of the claims which follow.
Claims (14)
1. A treatment device for treating an aneurysm, the treatment device comprising:
a fan portion which is inflatable from a collapsed configuration to an occluding configuration, the occluding configuration sized to extend across and occlude at least a portion of a neck of the aneurysm, the fan portion comprising a concave surface facing into a sac of the aneurysm, an outer surface of the fan portion configured to be in contact with an interior wall of the aneurysm proximate to the neck of the aneurysm when the fan portion is in the occluding configuration;
a channel orifice defining an opening in the fan portion, wherein in the occluding configuration the channel orifice is open to the aneurysm; and
an agent channel joined to the channel orifice in the collapsed configuration, the agent channel configured to deliver a coagulating agent to the aneurysm sac through the channel orifice.
2. The treatment device of claim 1 further comprising an inflation tube for inflating the fan portion, the inflation tube comprising a distal end connected to the fan portion.
3. The treatment device of claim 1 further comprising:
a trigger mechanism for introducing the coagulating agent into the agent channel;
wherein the agent channel comprises a proximal end in communication with the trigger mechanism to receive the coagulating agent into the agent channel and a distal end in communication with the channel orifice; and
wherein the agent channel delivers the coagulating agent from the proximal end to the distal end and through the channel orifice into the sac of the aneurysm.
4. The treatment device of claim 1 , wherein the channel orifice is an opening in the distal end of the agent channel.
5. The treatment device of claim 1 , wherein the fan portion is further collapsible from the occluding configuration to an extraction configuration following delivery of the coagulating agent to the aneurysm sac, the extraction configuration sized to traverse through a lumen of a retrieval catheter.
6. The treatment device of claim 1 further comprising a trigger mechanism in communication with a proximal end of the agent channel for introducing the coagulating agent into the agent channel.
7. A method for treating an aneurysm, the method comprising:
providing a treatment device comprising a fan portion inflatable from a collapsed configuration to an occluding configuration, a channel orifice defining an opening in the fan portion, and an agent channel;
joining an inflation tube comprising a distal end to the fan portion for inflating the fan portion;
joining the agent channel to communicate with the channel orifice when the fan portion is in the collapsed configuration;
delivering the treatment device to an aneurysm treatment site;
inflating the fan portion to an occluding configuration approximate a center of an aneurysm neck by the inflation tube, wherein the inflated fan portion configuration is sized to extend across and occlude at least a portion of a neck of the aneurysm, the fan portion comprising a concave surface facing into a sac of the aneurysm, and an outer surface of the fan portion configured to be in contact with an interior wall of the aneurysm proximate to the neck of the aneurysm when the fan portion is in the occluding configuration;
injecting a coagulating agent through the agent channel and the channel orifice into the aneurysm sac to coagulate blood present in the aneurysm; and
collapsing the treatment device from the occluding configuration to an extraction configuration for extraction of the device after the injection of the coagulating agent.
8. The method of claim 7 , wherein the step of inflating the fan portion to an occluding configuration approximate a center of an aneurysm neck further comprises the step of creating a barrier between a blood vessel and the aneurysm to prevent the coagulating agent from entering the blood vessel.
9. The method of claim 7 further comprising the step of removing the treatment device through a retrieval catheter.
10. The method of claim 7 further comprising the step of removing the treatment device through a retrieval deployment system.
11. The method of claim 7 further comprising the steps of:
providing a trigger mechanism; and
triggering the delivery of the agent by activating the trigger mechanism at a proximal end of the agent channel to deliver the agent from the proximal end of the agent channel to a distal end of the agent channel.
12. The method of claim 7 , wherein the fan portion is inflated to expand as it exits the delivery catheter.
13. The method of claim 7 , wherein the fan portion is completely removed from the delivery catheter before inflation begins.
14. The method of claim 7 , wherein inflation of the fan portion begins while the fan portion is still entirely or partially inside the delivery catheter.
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US17/865,018 US20220361890A1 (en) | 2018-12-12 | 2022-07-14 | Aneurysm occluding device for use with coagulating agents |
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2018
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CN111297429A (en) | 2020-06-19 |
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