VASCULAR STENTING FOR ANEURYSMS

• US 20140172071A1
• Filed: 09/13/2013
• Published: 06/19/2014
• Est. Priority Date: 05/25/2004
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Berez, Aaron Lee, Tran, Quang Quoc
• Granted Patent: US 9,161,851 B2
• Time in Patent Office: Days
• US Class Current: 623/1.15
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• 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 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12118 for positioning in conjunction with a stent
• CPC Class Codes: A61B 17/12168 having a mesh structure A61B17/1214 takes precedence
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• 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 2017/22001 Angioplasty, e.g. PCTA
• CPC Class Codes: A61F 2/01 Filters implantable into blood vessels
• 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 2/07 Stent-grafts
• 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 2/844 folded prior to deployment
• CPC Class Codes: A61F 2/852 Two or more distinct overlapping stents
• CPC Class Codes: A61F 2/86 Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/90 characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/915 with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9522 : Means for mounting a stent or stent-graft onto or into a placement instrument
• CPC Class Codes: A61F 2/958 : Inflatable balloons for placing 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 2002/016 : made from wire-like elements
• CPC Class Codes: A61F 2002/018 : made from tubes or sheets of material, e.g. by etching or laser-cutting
• 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 2002/91558 : connected peak to peak
• CPC Class Codes: A61F 2002/9505 : having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
• CPC Class Codes: A61F 2002/9528 : for retrieval of stents
• CPC Class Codes: A61F 2002/9534 : for repositioning of stents
• CPC Class Codes: A61F 2002/9665 : with additional retaining means
• CPC Class Codes: A61F 2230/001 : Figure-8-shaped, e.g. hourglass-shaped
• CPC Class Codes: A61F 2230/0069 : cylindrical
• CPC Class Codes: A61F 2230/0078 : hyperboloidal
• CPC Class Codes: A61F 2230/008 : paraboloidal
• 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 2250/0015 : differing in density or specific weight
• CPC Class Codes: A61F 2250/0063 : Nested prosthetic parts

Abstract

Described herein are flexible implantable occluding devices that can, for example, navigate the tortuous vessels of the neurovasculature. The occluding devices can also conform to the shape of the tortuous vessels of the vasculature. In some embodiments, the occluding devices can direct blood flow within a vessel away from an aneurysm or limit blood flow to the aneurysm. Some embodiments describe methods and apparatus for adjusting, along a length of the device, the porosity of the occluding device. In some embodiments, the occluding devices allows adequate blood flow to be provided to adjacent structures such that those structures, whether they are branch vessels or oxygen-demanding tissues, are not deprived of the necessary blood flow.

Claims

1-18. -18. (canceled)

19. A method of implanting a stein at an aneurysm in a blood vessel, the method comprising:

advancing, within the blood vessel, an elongate body comprising a proximal portion, a distal portion, and a lumen extending between the proximal portion and the distal portion, until the distal portion is proximate to the aneurysm;

advancing, relative to the elongate body and from within the lumen of the elongate body, a stent in a compressed configuration;

expanding the stent within the vessel, such that the stent extends from a first location distal to the aneurysm to a second location proximal to the aneurysm; and

following the expanding the stent and upon confirming that a body of the aneurysm has more than about 30% occlusion formation, wherein said occlusion formation is indicative of a correlated level of thrombosis, withdrawing the elongate body from the vessel.

20. The method of claim 19, wherein the confirming comprises imaging the aneurysm.

21. The method of claim 19, wherein the withdrawing occurs upon confirming that the body of the aneurysm has not more than about 50% occlusion formation.

22. The method of claim 19, wherein the stent, when expanded, has a porosity that is configured to result in a delayed occlusion of the aneurysm, such that between about 50% and 99% of blood within the aneurysm is thrombosed within a time frame after the expanding the stent within the vessel.

23. The method of claim 22, wherein the time frame is between about 1 month and about 5 months.

24. The method of claim 22, wherein the time frame is greater than about 5 months.

25. The method of claim 22, wherein the porosity is between about 60% and about 85%

26. A method of at least partially causing thrombosis in an aneurysm, the method comprising:

advancing a delivery device within a blood vessel until a distal portion of the delivery device is adjacent the aneurysm;

expanding a stent across the aneurysm;

determining a degree of thrombosis of blood in the aneurysm after expanding the stent; and

after determining that the expanding results in formation of occlusion material, comprising a thrombus, in the aneurysm corresponding to more than about 30% of a fluid in a body of the aneurysm, withdrawing the delivery device from the vessel.

27. The method of claim 26, wherein the determining comprises imaging the aneurysm.

28. The method of claim 26, wherein the withdrawing occurs after determining that the expanding results in formation of the occlusion material corresponding to not more than about 50% of the fluid in the body of the aneurysm.

29. The method of claim 26, wherein the stent, when expanded, has a porosity that is configured to result in a delayed occlusion of the aneurysm, such that between about 50% and 99% of the blood within the aneurysm is thrombosed within a time frame after the expanding the stent across the aneurysm.

30. The method of claim 29, wherein the time frame is between about 1 month and about 5 months.

31. The method of claim 29, wherein the time frame is greater than about 5 months.

32. The method of claim 29, wherein the porosity is between about 60% and about 85%

33. A method of treating an aneurysm, the method comprising:

advancing a delivery device within a blood vessel until a distal portion of the device is adjacent the aneurysm;

expanding a first stent within the vessel, such that the first stent extends from a first side of the aneurysm to a second side of the aneurysm; and

withdrawing the delivery device from the vessel upon determining that more than about 30% of a fluid in a body of the aneurysm has formed occlusive material, comprising a thrombus.

34. The method of claim 33, wherein the determining comprises imaging the aneurysm.

35. The method of claim 33, wherein the withdrawing occurs upon determining that not more than about 50% of the fluid in the body of the aneurysm has formed the occlusive material.

36. The method of claim 33, wherein the stent, when expanded, has a porosity that is configured to result in a delayed occlusion of the aneurysm, such that between about 50% and 99% of blood within the aneurysm is thrombosed within a time frame after the expanding the first stent within the vessel.

37. The method of claim 36, wherein the time frame is between about 1 month and about 5 months.

38. The method of claim 36, wherein the time frame is greater than about 5 months.

39. The method of claim 36, wherein the porosity is between about 60% and about 85%