Protuberant Aneurysm Bridging Device and Method of Use

• US 20130116774A1
• Filed: 10/08/2012
• Published: 05/09/2013
• Est. Priority Date: 11/04/2011
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Reverse Medical Corporation (Medtronic Plc)
• Inventors: Strauss, Brian M., Henson, Michael R., Pecor, Robert A., Valko, Jeffrey J.
• Granted Patent: US 8,771,341 B2
• Time in Patent Office: Days
• US Class Current: 623/1.35
• 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 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• 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 2002/823 Stents, different from stent-grafts, adapted to cover an aneurysm
• CPC Class Codes: A61F 2002/91575 connected peak to trough
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2230/0076 ellipsoidal or ovoid
• CPC Class Codes: A61F 2250/0037 differing in height or in length
• CPC Class Codes: A61F 2250/0039 differing in diameter

Abstract

A bridging device for supporting occlusive masses within an aneurysm located at a vascular bifurcation.

Claims

1. An aneurysm bridging device for use in a bifurcation of a blood vessel, wherein the bifurcation comprises an inlet vessel with a first diameter, a first outlet vessel with a second diameter, and a second outlet vessel, said bridging device comprising:

a substantially tubular wire-frame structure (1) characterized by a distal region (21), a central region (23) and a proximal region (22), said wire frame structure having small diameter configuration for delivery through a delivery catheter (2) and an expanded, large diameter configuration,

wherein said distal region (21) and proximal region (22) establish a cylindrical structure with a first diameter, in the expanded, large diameter configuration, that matches or slightly exceeds the diameter of the blood vessel in which they are to be placed, and wherein the central region has a bulbous outline with a second diameter, in the expanded, large diameter configuration, which exceeds the first diameter of the distal region and proximal region;

the proximal region comprising a first proximal zigzag segment (29), and

the distal region comprising a first distal zigzag segment (25), and

said central region comprising a first central zigzag segment (34), and a plurality of spirally oriented struts (39, 42) joining the zigzag segment (34) of the central region (23) to the zigzag segments of the distal region and the proximal region (25 29).

2. The device of claim 1, wherein:

said central region comprises a second central zigzag segment (35), said second central zigzag segment opposing the first central zigzag segment (34) such that centrally pointing vertices of the first central zigzag segment are aligned with centrally pointing vertices of the second central zigzag segment.

3. The device of claim 1, wherein:

said distal region comprises a second distal zigzag segment (24), said second distal zigzag segment opposing the first distal zigzag segment (25) such that vertices (26) of the first distal zigzag segment are aligned with vertices (27) of the second distal zigzag segment.

4. The device of claim 1, wherein:

the proximal region comprises a second proximal zigzag segment (50), said second proximal zigzag segment opposing the first proximal zigzag segment (29) such that vertices (51) of the first proximal zigzag segment (29) are aligned with vertices (51) of the second proximal zigzag segment.

5. The device of claim 4, wherein first central zigzag segment (34) is characterized by distally pointing vertices, and the second central zigzag segment (35) is characterized by proximally pointing vertices, and distally pointing vertices of the first central zigzag segment are joined by a spirally oriented strut extending from an originating distally pointing vertex of the first central zigzag segment to a vertex of the distal zigzag segment which is circumferentially displaced from the originating vertex.

6. The device of claim 4, wherein the first central zigzag segment (34) is characterized by distally pointing vertices, and the second central zigzag segment (35) is characterized by proximally pointing vertices (37), and proximally pointing vertices of the second central zigzag segment are joined by a spirally oriented strut (39) extending from an originating proximally pointing vertex (37) of the second central zigzag segment to a vertex (38) of the proximal zigzag segment (29) which is circumferentially displaced from the originating proximally pointing vertex.

7. The device of claim 1, wherein:

said central region comprises a second central zigzag segment (35, 67p), said second central zigzag segment opposing the first central zigzag segment (34, 67d), and a plurality of spirally oriented struts (69), each of said spirally oriented struts joining a vertex of the first central zigzag segment to a vertex of the second central zigzag segment.

8. The device of claim 7, wherein the first central zigzag segment (34, 67d) and the second central zigzag segment (35, 67p) are radially aligned such that vertices of the first central zigzag segment are aligned with vertices of the second central zigzag segment.

9. The device of claim 8, wherein a first vertex of the first central zigzag segment (34, 67d) is joined by a spirally oriented strut (69) to a second vertex of the second central zigzag segment (35, 67p) which is circumferentially displaced from the first vertex.

10. The device of claim 8, wherein each vertex of the first central zigzag segment (34, 67d) is joined by a spirally oriented strut (69) extending from an originating vertex of the first central zigzag segment to a vertex of the second central zigzag segment (35, 67p) which is circumferentially displaced from the originating vertex.

11. A method of placing an endoluminal support, said method comprising the steps of:

placing the endoluminal support within the vasculature of a patient;

securing the distal end of the endoluminal support within the vasculature;

manipulating the proximal end of the endoluminal support to deform a central region of the endoluminal support;

securing the proximal end of the endoluminal support within the vasculature to maintain the central region of the endoluminal support in a deformed state.

12. A method of claim 11, further comprising the step of:

delivering the endoluminal support to into the vasculature while secured to a delivery wire; and

detaching the endoluminal support from the delivery wire and withdrawing the delivery wire from the vasculature.

13. A method of treating a wide-necked aneurysm proximate a bifurcation in the vasculature of a patient, said bifurcation characterized by an inlet vessel providing blood flow to a first outlet vessel and a second outlet vessel, said method comprising:

providing a bridging device for bridging the aneurysm, said bridging device comprising an inlet anchoring portion at a first end of the bridging device and an outlet anchoring portion at a second end of the bridging device, and one or more struts extending from the inlet anchoring portion to the outlet anchoring portion and protruding arcuately and outwardly from a center portion of the bridging device;

installing the bridging device in the vasculature of the patient, proximate the aneurysm, such that the inlet anchoring portion is disposed within the inlet vessel and the outlet anchoring portion is disposed within the first outlet vessel, and the struts protrude toward the aneurysm and the second outlet; and

implanting an embolizing mass into the aneurysm, such that the struts of the bridging device retain the embolizing mass within the wide-necked aneurysm and maintain a flow path from the inlet vessel to the second outlet vessel which is substantially unoccluded by the embolizing mass.

14. The method of claim 13, wherein aneurysm is a wide-necked basilar tip aneurysm, the inlet vessel is the basilar artery, the first outlet vessel is a first posterior cerebral artery, and the second outlet vessel is a second posterior cerebral artery.

15. The method of claim 13, wherein the bifurcation is a bifurcation of a middle cerebral artery, an internal carotid artery, the anterior communicating artery, a superior cerebellar artery, a pericallosal artery, the basilar artery or a posterior inferior cerebellar artery

16. A method of treating a wide-necked aneurysm at a bifurcation of a parent artery into a first and second branch artery, said wide-necked aneurysm characterized by a neck opening into the bifurcation, said method comprising:

providing a bridging device in a first catheter and delivering said bridging device to the neck of the aneurysm;

placing a distal segment of first catheter across the neck of the aneurysm;

deploying a distal portion of the bridging device from the distal segment of the first catheter while maintaining the bridging device in secure connection to a delivery wire;

adjusting the position of the bridging device, so that a proximal edge of a distal segment of substantially cylindrical cross-section is aligned with the junction of the aneurysm neck and the first branch artery;

deploying a bridging portion of the bridging device from the distal segment of the catheter so that the bridging portion is disposed adjacent the aneurysm neck, spanning the aneurysm neck;

pushing a proximal segment of the bridging device to longitudinally compress the bridging portion and force the bridging portion to assume a radially expanded configuration proximate the aneurysm neck;

removing a proximal segment of substantially cylindrical cross-section from the distal segment of the catheter so that the proximal segment is disposed within the parent artery;

delivering an occlusive device or substance from a second catheter into the aneurysm sac; and

releasing the bridging device from the first catheter.

17. The method of claim 16 further comprising the step of:

detaching the bridging device from the first catheter and removing the first catheter from the bifurcation, leaving the bridging device within the bifurcation, spanning the neck of the aneurysm.

18. The method of claim 16 further comprising the steps of

withdrawing the bridging device into the distal segment of first catheter and removing the bridging device from the bifurcation after delivering the occlusive device or substance.