Method for treating aneurysms

• US 20070191924A1
• Filed: 10/15/2004
• Published: 08/16/2007
• Est. Priority Date: 03/31/2004
• Status: Active Grant

• Current Assignee: Merlin MD Pte. Ltd.
• Original Assignee: Merlin MD Pte. Ltd.
• Inventors: Rudakov, Leon
• Granted Patent: US 8,915,952 B2
• Time in Patent Office: Days
• US Class Current: 623/1.11
• 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 17/12118 for positioning in conjunction with a stent
• CPC Class Codes: A61B 17/1214 Coils or wires
• CPC Class Codes: A61B 17/12186 liquid materials adapted to be injected
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/89 the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
• 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 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/3008 radio-opaque, e.g. radio-opaque markers
• CPC Class Codes: A61F 2002/823 Stents, different from stent-grafts, adapted to cover an aneurysm
• 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 2002/91541 Adjacent bands are arranged out of phase
• CPC Class Codes: A61F 2002/91558 connected peak to peak
• CPC Class Codes: A61F 2002/91566 connected trough to trough
• CPC Class Codes: A61F 2210/0076 multilayered, e.g. laminated structures
• CPC Class Codes: A61F 2220/0008 Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2220/005 using adhesives
• 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 2230/005 : Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61F 2230/0054 : V-shaped
• CPC Class Codes: A61F 2230/0067 : conical
• CPC Class Codes: A61F 2250/0037 : differing in height or in length
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers

Abstract

A method for treating a bifurcation aneurysm, the aneurysm having an aneurysm neck, by positioning a first mechanically expandable device in a first bifurcation branch proximate to the aneurysm neck; positioning a second mechanically expandable device in a second bifurcation branch proximate to the aneurysm neck; and expanding the mechanically expandable devices to constrict the aneurysm neck such that blood circulation to the bifurcation aneurysm is reduced.

Claims

1. A method for treating a bifurcation aneurysm, the aneurysm having an aneurysm neck, the method comprising:

positioning a first mechanically expandable device in a first bifurcation branch proximate to the aneurysm neck;

positioning a second mechanically expandable device in a second bifurcation branch proximate to the aneurysm neck; and

expanding the mechanically expandable devices to constrict the aneurysm neck such that blood circulation to the bifurcation aneurysm is reduced.

2. The method according to claim 1, wherein the aneurysm neck is constricted such that blood circulation to the aneurysm is completely interrupted.

3. The method according to claim 1, wherein the mechanically expandable devices are stents.

4. The method according to claim 3, wherein the stents are mechanically expanded such that blood circulation to the bifurcation aneurysm via the aneurysm neck may be occluded.

5. The method according to claim 1, wherein the aneurysm is reduced further in size by deploying gels or using coils.

6. The method according to claim 1, wherein if the aneurysm neck is wide, coils or securing glues are deployed inside the aneurysm to reduce blood circulation inside the aneurysm.

7. The method according to claim 6, wherein an aneurysm neck is wide if the ratio of the diameter of the aneurysm dome to the width of the aneurysm neck is less than two.

8. The method according to claim 3, wherein the stents are balloon expandable or self-expandable.

9. The method according to claim 3, wherein the stents have markers to facilitate precise positioning in the branches.

10. The method according to claim 9, wherein the markers are placed at the distal and proximal ends of the stents.

11. The method according to claim 9, wherein the markers are radiopaque.

12. The method according to claim 9, wherein the markers are made from gold or platinum.

13. The method according to claim 3, wherein the stents are positioned in the branches sequentially.

14. The method according to claim 3, wherein the stents are expanded at the same time.

15. The method according to claim 3, wherein the stents are expanded sequentially.

16. The method according to claim 3, wherein the stent is tapered towards the distal end of the stent.

17. The method according to claim 3, wherein the stent has a trapezoidal longitudinal cross-section.

18. The method according to claim 16 or 17, wherein the stent has proximal end struts that are elongated relative to the remaining struts.

19. The method according to claim 3, wherein the first stent is positioned partially within the first bifurcation branch such that a portion of the proximal end of the first stent is not introduced within the first bifurcation branch.

20. The method according to claim 3, wherein the second stent is positioned partially within the second bifurcation branch such that a portion of the proximal end of the second stent is not introduced within the second bifurcation branch.

21. The method according to claim 3, wherein a balloon of a balloon catheter expands the stent during deployment.

22. The method according to claim 21, wherein the balloon is tapered such that the proximal end of the stent is expanded first during deployment.

23. The method according to claim 21, wherein the balloon is made of soft durometer thin nylon or silicon.

24. The method according to claim 3, wherein the first stent is expanded by a first balloon and the second stent is expanded by a second balloon.

25. The method according to claim 24, wherein the first and second balloons are on a single shaft of a balloon catheter.

26. The method according to claim 24, wherein the stents are expanded at the same time during deployment.

27. The method according to claim 24, wherein additional angioplasty balloon expansion is used to secure the deployment of the stents.

28. The method according to claim 3, wherein the stents are connected by a membrane for obstructing blood circulation to the bifurcation aneurysm.

29. The method according to claim 28, wherein the membrane comprises at least one layer of an elastomeric polymer.

30. The method according to claim 29, wherein the membrane comprises receptacles for carrying drugs or reagents for subsequent release after the stents are deployed.

31. The method according to claim 30, wherein the drugs or reagents include substances that reduce the thrombogenic, inflammatory or smooth muscle cell proliferative response of the vessel to the implantable medical devices.

32. The method according to claim 31, wherein the substances include cell inhibitors to inhibit smooth muscle cells proliferation.

33. The method according to claim 31, wherein the substances include fibrin sealants to seal aneurysm neck and provide fibroblasts and endothelial cells growth.

34. The method according to claim 30, wherein the drugs or reagents include heparin, phosporylcholine, albumin, dexamethasone, paclitaxel and vascular endothelial growth factor (VEGF).

35. A method for treating a trifurcation aneurysm, the aneurysm having an aneurysm neck, the method comprising:

positioning a first mechanically expandable device in a first trifurcation branch proximate to the aneurysm neck;

positioning a second mechanically expandable device in a second trifurcation branch proximate to the aneurysm neck;

positioning a third mechanically expandable device in a third trifurcation branch proximate to the aneurysm neck; and

expanding the mechanically expandable devices to constrict the aneurysm neck such that blood circulation to the trifurcation aneurysm is reduced.

36. The method according to claim 35, wherein the first mechanically expandable device is positioned partially within the first trifurcation branch such that a portion of the proximal end of the first mechanically expandable device is not introduced within the first trifurcation branch.

37. The method according to claim 35, wherein the second mechanically expandable device is positioned partially within the second trifurcation branch such that a portion of the proximal end of the second mechanically expandable device is not introduced within the second trifurcation branch.

38. The method according to claim 35, wherein the third mechanically expandable device is positioned partially within the third trifurcation branch such that a portion of the proximal end of the third mechanically expandable device is not introduced within the third trifurcation branch.

39. A system for treating a bifurcation aneurysm, the aneurysm having an aneurysm neck, the system comprising:

a first mechanically expandable device positioned in a first bifurcation branch proximate to the aneurysm neck;

a second mechanically expandable device positioned in a second bifurcation branch proximate to the aneurysm neck; and

wherein the mechanically expandable devices are expanded to constrict the aneurysm neck such that blood circulation to the bifurcation aneurysm is reduced.

40. A system for treating a trifurcation aneurysm, the aneurysm having an aneurysm neck, the system comprising:

a first mechanically expandable device positioned in a first trifurcation branch proximate to the aneurysm neck;

a second mechanically expandable device positioned in a second trifurcation branch proximate to the aneurysm neck;

a third mechanically expandable device positioned in a third trifurcation branch proximate to the aneurysm neck; and

wherein the mechanically expandable devices are expanded to constrict the aneurysm neck such that blood circulation to the trifurcation aneurysm is reduced.

41. A mechanically expandable device for treating a bifurcation or trifurcation aneurysm, the aneurysm having an aneurysm neck, the device comprising:

a generally tubular structure having an exterior surface defined by a plurality of interconnected struts having interstitial spaces therebetween, said generally tubular structure expandable from a first position to a second position, and said tubular structure is expanded radially outwardly to the second position such that the exterior surface of said structure engages with the inner surface of a bifurcation or trifurcation branch so as to maintain a fluid pathway through said branch and to constrict the aneurysm neck such that blood circulation to the aneurysm is reduced;

wherein a proximal portion of the struts are elongated relative to the remaining struts such that the device is tapered towards its distal end after deployment in the branch.

42. A balloon for expanding a mechanically expandable device for treating a bifurcation or trifurcation aneurysm, the balloon being connected to a balloon catheter for inflation, and the device comprising a interconnected struts at its proximal end that are elongated relative to the remaining struts of the device such that the device is tapered towards its distal end after deployment in a bifurcation or trifurcation branch;

wherein the balloon is tapered towards its distal end after inflation, and the inflation of the balloon causes the elongated struts of the device to expand at a greater rate than the remaining struts for constricting the aneurysm neck such that blood circulation to the aneurysm is reduced.

43. The balloon according to claim 42, wherein the balloon is a first balloon used in combination with a second balloon to expand a second mechanically expandable device in another bifurcation or trifurcation branch.

44. The balloon according to claim 43, wherein the first balloon and second balloon are inflated together via a single balloon catheter.