Procedures for vascular occlusion

• US 10,548,748 B2
• Filed: 12/13/2017
• Issued: 02/04/2020
• Est. Priority Date: 06/23/2009
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Berez, Aaron Lee, Tran, Quang Quoc
• Primary Examiner(s): Fishback, Ashley L
• Application Number:
  US15/840,954
• Publication Number:
  US 20180147075A1
• Time in Patent Office: 783 Days
• CPC Class Codes: A61B 17/12036 partial occlusion
• 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 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/12177 comprising additional materials, e.g. thrombogenic, having filaments, having fibers or being coated
• 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 2017/00336 with a protective sleeve, e.g. retractable or slidable
• 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 2017/22079 with suction of debris
• CPC Class Codes: A61B 2017/320716 comprising means for preventing embolism by dislodged material
• CPC Class Codes: A61B 2017/320766 eccentric
• CPC Class Codes: A61B 2017/320791 with cutter extending outside the cutting window
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61F 2/01 Filters implantable into blood vessels
• CPC Class Codes: A61F 2/011 Instruments for their placement or removal
• 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 2/82 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 2/852 Two or more distinct overlapping stents
• CPC Class Codes: A61F 2/90 : characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/95 : Instruments specially adapted for placement or removal of 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 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 2002/9528 : for retrieval of stents
• CPC Class Codes: A61F 2230/0078 : hyperboloidal
• 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 2250/0018 : differing in elasticity, stiffness or compressibility
• CPC Class Codes: A61F 2250/0026 : differing in surface structures
• CPC Class Codes: A61F 2250/0065 : telescopic
• CPC Class Codes: A61M 25/00 : Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00
• CPC Class Codes: A61M 29/00 : Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00
• CPC Class Codes: A61M 5/007 : for contrast media

Abstract

A method of reducing blood flow within an aneurysm includes: injecting a contrast agent into a blood vessel including an aneurysm; expanding a stent, from a delivery device, across the aneurysm; and confirming that a stagnated area forms in the aneurysm. The stagnated area can form a crescent shape, a mushroom shape, a hemispherical shape, and/or a flat side. Upon confirming that the stagnated area forms in the aneurysm, the delivery device can be withdrawn from the blood vessel. The stagnated area can include the contrast agent. If the stagnated area does not form in the aneurysm, a second occluding device may be deployed. After withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

Claims

1. A method of reducing blood flow within an aneurysm comprising:

injecting a contrast agent into a blood vessel comprising an aneurysm;

deploying an occlusion device from a delivery device in the blood vessel next to the aneurysm;

producing an image of the aneurysm including the contrast agent;

confirming that the contrast agent forms a shape after deploying the occlusion device; and

while the contrast agent has formed the shape, withdrawing the delivery device from the blood vessel.

2. The method of claim 1, wherein the shape comprises a crescent shape, a mushroom shape, a hemispherical shape, and/or a flat side.

3. The method of claim 1, wherein the shape formed by the contrast agent comprises a stagnated area in the aneurysm.

4. The method of claim 1, wherein after withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

5. The method of claim 1, wherein the confirming is sufficient to determine that the deploying the occlusion device is sufficient to lead to thrombosis of the aneurysm.

6. The method of claim 1, wherein the confirming comprises comparing a first image of the aneurysm before deploying the occlusion device to a second image of the aneurysm after deploying the occlusion device.

7. The method of claim 1, wherein deploying the occlusion device comprises expanding a stent across a neck of the aneurysm.

8. The method of claim 1, wherein confirming that the contrast agent forms a shape comprises confirming that the contrast agent forms a persistent shape.

9. The method of claim 1, further comprising observing stagnation within the aneurysm caused by the occlusion device.

10. A method of implanting a stent at an aneurysm comprising:

providing an elongate body comprising a proximal portion, a distal portion, and a lumen extending between the proximal portion and the distal portion;

advancing the elongate body into a patient until the distal portion is adjacent to the aneurysm;

delivering a stent across the aneurysm from within the lumen at the distal portion of the elongate body, wherein delivering the stent comprises expanding the stent from a compressed configuration to an expanded configuration with a first location distal to the aneurysm and a second location proximal to the aneurysm;

observing stagnation within the aneurysm caused by delivering the stent across the aneurysm; and

withdrawing the elongate body from the patient with the expanded stent remaining across the aneurysm once the observed stagnation produces a persistent shape in the aneurysm.

11. The method of claim 10, wherein the persistent shape comprises a crescent shape, a mushroom shape, a hemispherical shape, and/or a flat side.

12. The method of claim 10, wherein after withdrawing the elongate body, substantially all of the aneurysm progressively thromboses.

13. The method of claim 10, wherein observing stagnation within the aneurysm comprises injecting a contrast agent into a blood vessel comprising the aneurysm.

14. The method of claim 13, wherein observing stagnation within the aneurysm comprises producing an image of the aneurysm including the contrast agent.

15. A method of reducing blood flow within an aneurysm comprising:

injecting a contrast agent into a blood vessel comprising an aneurysm, at least a portion of the contrast agent flowing into the aneurysm;

deploying an occlusion device from a delivery device in the blood vessel next to the aneurysm;

stagnating the portion of the contrast agent in the aneurysm;

producing an image of the aneurysm including the portion of the contrast agent;

observing a shape formed by the portion of the contrast agent in the aneurysm after deploying the occlusion device; and

withdrawing the delivery device from the blood vessel after observing the shape.

16. The method of claim 15, wherein the shape comprises a crescent shape, a mushroom shape, a hemispherical shape, and/or a flat side.

17. The method of claim 15, wherein the shape formed by the contrast agent comprises a stagnated area in the aneurysm.

18. The method of claim 15, wherein after withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

19. The method of claim 15, wherein the delivery device comprises a catheter.

20. The method of claim 15, wherein the observing is sufficient to determine that the deploying the occlusion device is sufficient to lead to thrombosis of the aneurysm.

21. The method of claim 15, wherein the observing comprises comparing a first image of the aneurysm before deploying the occlusion device to a second image of the aneurysm after deploying the occlusion device.

22. The method of claim 15, wherein deploying the occlusion device comprises expanding a stent across a neck of the aneurysm.

23. The method of claim 15, wherein observing a shape formed by the portion of the contrast agent in the aneurysm comprises confirming that the contrast agent forms a persistent shape.