Embolic deflection device
First Claim
1. A method of reducing the risk of emboli entering the cerebral circulation as a consequence of an index procedure in the heart or the aorta, comprising the steps of:
- placing a wire through a first side branch vessel and into the aortic arch;
advancing an elongated introducer sheath over the wire and along the first side branch vessel until a distal end of the sheath is positioned in the aortic arch, wherein the elongated introducer sheath houses an expandable emboli deflection device attached to a distal end of an elongate shaft, the emboli deflection device having an elongated periphery in plan view when expanded, the periphery defined by a Nitinol skeleton in a modified rectangle with straight longitudinal sides terminating in opposite rounded ends, the periphery having a concave depth profile with a concave side facing toward the shaft, the emboli deflection device having a porous material stretched over the skeleton, the material having pores to allow the flow of blood but deflect or trap emboli;
retracting the sheath to expose and permit the emboli deflection device to expand;
manipulating the emboli deflection device such that the concave side covers the ostia of each of the first side branch vessel and a second side branch vessel, wherein manipulating the deflection device comprises pulling the shaft to create a seal between the periphery of the emboli deflection device and a wall of the aortic arch around the ostia of the first and second side branch vessels;
wherein the emboli deflection device permits blood flow from the main vessel into each of the first and second side branch vessels, but deflects emboli from entering the first and second side branch vessels;
performing an index procedure in the heart selected from the group consisting of a balloon aortic or mitral valvuloplasty, a mitral or aortic valve replacement, and a coronary angioplasty; and
retracting the emboli deflection device into the sheath and withdrawing the sheath from the body.
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Accused Products
Abstract
There is disclosed a porous emboli deflector for preventing cerebral emboli while maintaining cerebral blood flow during an endovascular or open surgical procedure. The device prevents the entrance of emboli of a size able to cause stroke (such as greater than 100 microns) from entering either the right or left common carotid arteries, and/or the right or left vertebral arteries by deflecting emboli downstream of these vessels. The device can be placed prior to any manipulation of the heart or aorta allowing maximal protection of the brain during the index procedure. The deflector has a low profile within the aorta which allows sheaths, catheters, or wires used in the index procedure to pass. Also disclosed are methods for insertion and removal of the deflector.
126 Citations
17 Claims
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1. A method of reducing the risk of emboli entering the cerebral circulation as a consequence of an index procedure in the heart or the aorta, comprising the steps of:
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placing a wire through a first side branch vessel and into the aortic arch; advancing an elongated introducer sheath over the wire and along the first side branch vessel until a distal end of the sheath is positioned in the aortic arch, wherein the elongated introducer sheath houses an expandable emboli deflection device attached to a distal end of an elongate shaft, the emboli deflection device having an elongated periphery in plan view when expanded, the periphery defined by a Nitinol skeleton in a modified rectangle with straight longitudinal sides terminating in opposite rounded ends, the periphery having a concave depth profile with a concave side facing toward the shaft, the emboli deflection device having a porous material stretched over the skeleton, the material having pores to allow the flow of blood but deflect or trap emboli; retracting the sheath to expose and permit the emboli deflection device to expand; manipulating the emboli deflection device such that the concave side covers the ostia of each of the first side branch vessel and a second side branch vessel, wherein manipulating the deflection device comprises pulling the shaft to create a seal between the periphery of the emboli deflection device and a wall of the aortic arch around the ostia of the first and second side branch vessels; wherein the emboli deflection device permits blood flow from the main vessel into each of the first and second side branch vessels, but deflects emboli from entering the first and second side branch vessels; performing an index procedure in the heart selected from the group consisting of a balloon aortic or mitral valvuloplasty, a mitral or aortic valve replacement, and a coronary angioplasty; and retracting the emboli deflection device into the sheath and withdrawing the sheath from the body. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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Specification