Flow reducing implant

• US 20050055082A1
• Filed: 10/03/2002
• Published: 03/10/2005
• Est. Priority Date: 10/04/2001
• Status: Abandoned Application

• Current Assignee: Shockwave Medical, Incorporated (Johnson & Johnson)
• Original Assignee: Shockwave Medical, Incorporated (Johnson & Johnson)
• Inventors: Tsehori, Jonathan, Ben Muvhar, Shmuel, Shalev, Ilan, Darvish, Nissim
• Application Number:
  US10/491,976
• Publication Number:
  US 20050055082A1
• Time in Patent Office: Days
• US Class Current: 623/1.150
• CPC Class Codes: A61B 17/12036 partial occlusion
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61F 2/848 having means for fixation to the vessel wall, e.g. barbs
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/91 made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
• CPC Class Codes: A61F 2/915 with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/068 Modifying the blood flow model, e.g. by diffuser or deflector
• CPC Class Codes: A61F 2002/91525 within the whole structure different bands showing different meander characteristics, e.g. frequency or amplitude
• CPC Class Codes: A61F 2002/91533 characterised by the phase between adjacent bands
• CPC Class Codes: A61F 2002/9155 Adjacent bands being connected to each other
• CPC Class Codes: A61F 2002/91575 connected peak to trough
• CPC Class Codes: A61F 2210/0076 multilayered, e.g. laminated structures
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0078 hyperboloidal
• CPC Class Codes: A61F 2230/008 paraboloidal
• CPC Class Codes: A61F 2250/0018 differing in elasticity, stiffness or compressibility

Abstract

A flow reducing implant for reducing blood flow in a blood vessel having a cross sectional dimension, the flow reducing implant comprising a hollow element adapted for placement in the blood vessel defining a flow passage therethrough, said flow passage comprising at least two sections, one with a larger diameter and one with a smaller diameter, wherein said smaller diameter is smaller than a cross section of the blood vessel. A plurality of tabs anchor, generally parallel to the blood vessel wall, are provided in some embodiments of the invention.

Claims

1. A flow reducing implant, comprising:

a flared section adapted to contact a blood vessel wall;

at least one narrowed section continuous with said flared section; and

at least one anchor tab that lies generally in a plane of said flared section.

2. An implant according to claim 1, wherein said implant is formed of a sheet material and wherein said tab is attached to a portion of said flared section that is generally parallel to a wall of said blood vessel.

3. An implant according to claim 2, wherein said anchor tab points axially.

4. An implant according to claim 1, wherein said anchor tab points towards said narrowed section.

5. An implant according to claim 1, comprising at least two opposing anchor tabs.

6. An implant according to claim 1, comprising at least two flared sections, each one with at least one anchor tab.

7. An implant according to claim 1, wherein said implant is plastically deformed to said configuration.

8. An implant according to claim 1, wherein said implant self-deforms to said configuration.

9. An implant according to claim 1, wherein said anchor tabs are blunt enough to generally prevent damage to said blood vessel.

10. A flow reducing implant, comprising:

a flared section adapted to contact a blood vessel wall; and

at least one narrowed section continuous with said flared section and adapted to be narrowed after implantation.

11. An implant according to claim 10, comprising an external ribbon adapted to selectively increasingly constrain said narrowing.

12. An implant according to claim 11, comprising an impulser adapted to receive signals from outside the body and constrain said ribbon in response.

13. An implant according to claim 11, wherein said ribbon is expandable.

14. An implant according to claim 11, wherein said ribbon is inflatable.

15. An implant according to claim 13, wherein said ribbon is self-expands by absorption.

16. An implant according to claim 11, wherein said ribbon is tearable.

17. An implant according to claim 10, wherein said narrowed section comprises a plurality of engagement points adapted to be engaged, for radial constriction, by a catheter with matching engagers.

18. An implant according to claim 10, wherein said narrowed section is adapted to be selectively widened after implantation.

19. An implant according to claim 10, wherein said narrowed section is inflatable.

20. An implant according to claim 10, wherein said narrowed section is expandable in thickness.

21. A flow reducing implant, comprising:

a flared section adapted to contact a blood vessel wall;

at least one narrowed section continuous with said flared section; and

at least ribbon coupled to said narrowed section and adapted to define at least two discrete expansion states of said narrowed section.

22. An implant according to claim 21, wherein said at least one ribbon comprises a tearable ribbon.

23. An implant according to claim 21, wherein said at least one ribbon comprises a ribbon with a sliding clasp and a plurality of stop positions defined thereon.

24. An implant according to claim 21, wherein said at least one ribbon comprises a plurality of ribbons, being different in at least one of initial diameter, tear strength and final diameter.

25. An implant according to claim 21, wherein said at least one ribbon comprises a slitted ribbon having a first diameter and a second diameter set by said slits being closed or expanded.

26. An implant according to claim 21, wherein said at least one ribbon comprises a cord woven into said narrowed section.

27. An implant according to claim 21, wherein said at least one ribbon lies outside of said narrowed section.

28. An implant according to claim 21, wherein said at least one ribbon is biodegradable.

29. An implant according to claim 21, wherein said at least one ribbon blocks flow through a wall of said narrowed section.

30. A flow reducing implant, comprising:

a flared section adapted to contact a blood vessel wall;

at least one narrowed section continuous with said flared section,

wherein said implant comprises at least one overlapping section, whose overlap changes when said narrowed section is expanded.

31. An implant according to claim 30, wherein said overlap comprises a plurality of overlapping cut-outs of said implant.

32. An implant according to claim 30, wherein said overlap comprises an overlap of substantially an entire length of said implant.

33. A flow reducing implant, comprising:

a stent-like element adapted to anchor in a tubular blood vessel; and

a flexible cone-shaped nozzle mounted on said stent, said cone shaped nozzle defining a narrowing that substantially reduces a cross-section of blood flow through said sent-like element.

34. An implant according to claim 33, wherein said nozzle comprises at least one stiffener.

35. A flow reducing implant, comprising:

an open weave mesh that does not substantially impede blood flow, therethrough; and

a layer of graft material mounted on said mesh and defining a narrowed lumen for blood flow therethrough.

36. An implant according to claim 35, wherein said open weave mesh forms an hourglass shape when expanded in said graft material layer.

37. A flow reducing implant, comprising:

a flared section adapted to contact a blood vessel wall; and

at least one narrowed section continuous with said flared section,

wherein said implant is defined by a sheet material with slots and wherein a width of said slots varies over the implant to control an expanded geometry of said implant.

38. A flow reducing implant, comprising:

a flared section adapted to contact a blood vessel wall; and

at least one narrowed section continuous with said flared section,

wherein said implant is defined by a sheet material with slots and wherein said slots are arranged in axial lines and wherein said alternating lines have different lengths of slots at a same axial position.

39. A flow reducing implant for reducing blood flow in a blood vessel, comprising:

a body having a cross sectional dimension; and

a restricting element that at least partially encircles a blood vessel.

40. A flow reducing implant according to claim 39, wherein said element pierces said blood vessel.

41. A flow reducing implant according to claim 40, wherein said element comprises a tack or a suture.

42. A flow reducing implant according to claim 39, wherein said element comprises a band.

43. A flow reducing implant according to claim 42, wherein said band comprises a ratchet mechanism that maintains it in position in respect to said vessel.

44. A flow reducing implant according to claim 42, wherein said band comprises a plurality of expandable slits.

45. A flow reducing implant according to claim 39, wherein said element comprises one of a clip, clasp and vise.

46. A flow reducing implant according to claim 39, wherein said element comprises a spiral.

47. A flow reducing implant according to claim 39, wherein said element comprises an expandable material.

48. A flow reducing implant according to claim 47, wherein said element is adapted to expand by expansion pressure from the interior of said blood vessel.

49. A flow reducing implant according to claim 48, wherein said implant is adapted to expand in response to expansion pressure of a balloon catheter.

50. A method of treating abnormal growth in the body, comprising:

determining a source artery for the growth; and

inserting a flow reducing implant with an adjustable configuration into the determined artery, such that flow to the growth is reduced.

51. A method according to claim 50, wherein said growth is extant in an organ that is fed from multiple source arteries.

52. A method according to claim 50, wherein said growth is fed by a single source artery.

53. A method according to claim 50, wherein said growth comprises a leiomyoma.

54. A method according to claim 50, wherein said growth comprises a malignant tumor.

55. A method according to claim 54, wherein said tumor is a liver tumor.

56. A method according to claim 54, wherein said tumor is an encapsulated tumor.

57. A method of treating blood flow problems in a limb, comprising:

identifying at least one vein that if flow in the vein is reduced is expected to reduce the blood flow problem; and

inserting a flow reducing implant into the determined vein.

58. A method according to claim 57, wherein said vein is a deep vein.

59. A method according to claim 57, wherein said vein is a surface vein.

60. A flow reducing implant comprising:

an outer generally tubular section adapted to be inserted in a blood vessel; and

an insert adapted to lodge in said tubular section, said insert designed to reduce blood flow passing through the blood vessel.

61. A flow reducing implant according to claim 60, wherein said generally tubular section is designed to reduce blood flow passing therethrough.

62. A flow reducing implant according to claim 60, wherein said insert comprises a funnel shaped insert.

63. A flow reducing implant according to claim 60, wherein said generally tubular section is designed to not reduce blood flow passing therethrough.

64. A flow reducing implant according to claim 60, wherein said generally tubular section comprises a plurality of opening in its wall and wherein said insert comprises a plurality of opening in its wall.

65. An implant according to claim 64, wherein said insert and said tubular section are rotationally alignable to modify an alignment of said pluralities of openings with each other.

66. A method of reducing flow in a blood vessel, comprising:

selecting a location in the vessel to narrow;

inserting a flow reducing implant into the blood vessel at the location; and

mounting a restricting element on said vessel at the location and over said flow reducing implant.

67. A method according to claim 66, wherein said restricting element reduces an inner diameter of said flow reducing implant.

68. A method according to claim 67, comprising removing said restricting element.