Methods and apparatus for luminal stenting

• US 10,004,618 B2
• Filed: 03/28/2016
• Issued: 06/26/2018
• Est. Priority Date: 05/25/2004
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Berez, Aaron L., Tran, Quang Q.
• Primary Examiner(s): McEvoy, Thomas
• Application Number:
  US15/082,404
• Publication Number:
  US 20160206452A1
• Time in Patent Office: 820 Days
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12118 for positioning in conjunction with a stent
• CPC Class Codes: A61B 17/12168 having a mesh structure A61B17/1214 takes precedence
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/1205 Introduction devices
• CPC Class Codes: A61B 2017/12054 Details concerning the detachment of the occluding device from the introduction device
• CPC Class Codes: A61B 2017/22001 Angioplasty, e.g. PCTA
• CPC Class Codes: A61B 2017/320766 eccentric
• CPC Class Codes: A61B 2017/320791 with cutter extending outside the cutting window
• CPC Class Codes: A61B 2217/005 with suction drainage system
• CPC Class Codes: A61F 2/01 Filters implantable into blood vessels
• CPC Class Codes: A61F 2/0105 Open ended, i.e. legs gathered only at one side
• CPC Class Codes: A61F 2/013 Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
• CPC Class Codes: A61F 2/06 Blood vessels
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61F 2/844 : folded prior to deployment
• CPC Class Codes: A61F 2/852 : Two or more distinct overlapping stents
• CPC Class Codes: A61F 2/86 : Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/90 : characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/915 : with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/95 : Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9522 : Means for mounting a stent or stent-graft onto or into a placement instrument
• CPC Class Codes: A61F 2/958 : Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2/966 : with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
• CPC Class Codes: A61F 2/9661 : the proximal portion of the stent or stent-graft is released first
• CPC Class Codes: A61F 2/9662 : the middle portion of the stent or stent-graft is released first
• CPC Class Codes: A61F 2002/016 : made from wire-like elements
• CPC Class Codes: A61F 2002/018 : made from tubes or sheets of material, e.g. by etching or laser-cutting
• CPC Class Codes: A61F 2002/823 : Stents, different from stent-grafts, adapted to cover an aneurysm
• CPC Class Codes: A61F 2002/826 : more than one stent being applied sequentially
• CPC Class Codes: A61F 2002/91558 : connected peak to peak
• CPC Class Codes: A61F 2002/9505 : having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
• CPC Class Codes: A61F 2002/9528 : for retrieval of stents
• CPC Class Codes: A61F 2002/9534 : for repositioning of stents
• CPC Class Codes: A61F 2002/9665 : with additional retaining means
• CPC Class Codes: A61F 2230/001 : Figure-8-shaped, e.g. hourglass-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0078 : hyperboloidal
• CPC Class Codes: A61F 2230/008 : paraboloidal
• CPC Class Codes: A61F 2230/0091 : helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
• CPC Class Codes: A61F 2230/0095 : Saddle-shaped
• CPC Class Codes: A61F 2250/0015 : differing in density or specific weight
• CPC Class Codes: A61F 2250/0017 : differing in yarn density
• CPC Class Codes: A61F 2250/0023 : differing in porosity
• CPC Class Codes: A61F 2250/0063 : Nested prosthetic parts
• CPC Class Codes: A61M 2025/09183 : having tools at the distal tip
• CPC Class Codes: A61M 25/09 : Guide wires
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: D04C 1/06 : Braid or lace serving particular purposes
• CPC Class Codes: D10B 2509/06 : Vascular grafts; stents

Abstract

Described herein are flexible implantable occluding devices that can, for example, navigate the tortuous vessels of the neurovasculature. The occluding devices can also conform to the shape of the tortuous vessels of the vasculature. In some embodiments, the occluding devices can direct blood flow within a vessel away from an aneurysm or limit blood flow to the aneurysm. Some embodiments describe methods and apparatus for adjusting, along a length of the device, the porosity of the occluding device. In some embodiments, the occluding devices allows adequate blood flow to be provided to adjacent structures such that those structures, whether they are branch vessels or oxygen-demanding tissues, are not deprived of the necessary blood flow.

Claims

1. A flow-directing device implantable across an aneurysm in a blood vessel of a patient, the flow-directing device comprising:

a proximal end;

a distal end;

a length extending between the proximal end and the distal end;

a lumen extending the length; and

a plurality of strands braided together, a first plurality of the strands formed of first materials comprising a cobalt-nickel alloy, and a second plurality of the strands formed of second materials different from the first materials, the second materials comprising a platinum-tungsten alloy;

wherein the flow-directing device has a porosity between the strands configured to direct blood flow away from an aneurysm and to allow blood flow to branch vessels when placed in a blood vessel;

wherein the flow-directing device is self-expandable from a compressed state to an expanded state;

wherein the length of the flow-directing device in the expanded state is shorter than the length of the flow-directing device in the compressed state;

wherein a diameter of each of the plurality of strands is between about 0.0005 inches and 0.0020 inches;

wherein each of the plurality of strands comprises an inner surface and an outer surface, the outer surfaces comprising between about 20% and about 50% of a total circumferential area of the flow-directing device in the expanded state; and

wherein a linear density of the plurality of strands is at least 74.04 picks per inch along the length of the flow-directing device in the expanded state.

2. The flow-directing device of claim 1, wherein the porosity is between 70% and 80% in the expanded state.

3. The flow-directing device of claim 1, wherein the flow-directing device has a lattice density between 20% and 50% in the expanded state.

4. The flow-directing device of claim 1, wherein the flow-directing device has a coverage of 33% in the expanded state.

5. The flow-directing device of claim 1, wherein the plurality of strands comprises 48 strands.

6. The flow-directing device of claim 1, wherein the flow-directing device has a diameter between 2.75 mm and 4.25 mm.

7. The flow-directing device of claim 1, wherein the cobalt-nickel alloy comprises 35NLT.

8. The flow-directing device of claim 1 wherein the platinum-tungsten alloy comprises 8% tungsten.

9. The flow-directing device of claim 1, wherein each of the plurality of strands has a circular cross-section.

10. The flow-directing device of claim 9, wherein the diameter of each of the plurality of strands is between 0.001 inches and 0.0014 inches.

11. The flow-directing device of claim 1, wherein each of the plurality of strands has an oval cross-section.

12. The flow-directing device of claim 1, wherein each of the plurality of strands has a rectangular cross-section.

13. The flow-directing device of claim 1, wherein the plurality of strands are braided in a 1 over 1 under 1 pattern.

14. The flow-directing device of claim 1, wherein the plurality of strands are braided in a 1 over 2 under 2 pattern.

15. A flow-directing device implantable across an aneurysm in a blood vessel of a patient, the flow-directing device comprising:

a length between a proximal end of the flow-directing device and a distal end of the flow-directing device;

a lumen extending along at least a portion of the length; and

a plurality of strands braided together, a first plurality of the strands formed of first materials comprising a cobalt-nickel alloy, and a second plurality of the strands formed of second materials different from the first materials, the second materials comprising a platinum-tungsten alloy;

wherein the flow-directing device has a porosity between the strands configured to direct blood flow away from an aneurysm and to allow blood flow to branch vessels when placed in a blood vessel;

wherein the flow-directing device is self-expandable from a compressed diameter in a compressed state to an expanded diameter, greater than the compressed diameter, in an expanded state;

wherein a diameter of each of the plurality of strands is between about 0.0005 inches and 0.0020 inches;

wherein each of the plurality of strands comprises an inner surface and an outer surface, the outer surfaces comprising between about 20% and about 50% of a total circumferential area of the flow-directing device in the expanded state; and

wherein a linear density of the plurality of strands is at least 74.04 picks per inch along the length of the flow-directing device in the expanded state.

16. The flow-directing device of claim 15, wherein the porosity is between 70% and 80% in the expanded state.

17. The flow-directing device of claim 15, wherein the flow-directing device has a diameter between 2.75 mm and 4.25 mm.

18. The flow-directing device of claim 15, wherein the cobalt-nickel alloy comprises 35NLT.

19. The flow-directing device of claim 15, wherein the platinum-tungsten alloy comprises 8% tungsten.

20. The flow-directing device of claim 15, wherein the diameter of each of the plurality of strands is between 0.001 inches and 0.0014 inches.