Embolic deflection device
First Claim
1. A temporary emboli diversion device for use during an endovascular procedure to prevent emboli from entering a carotid artery from the aortic arch, comprising:
- an elongated introducer sheath comprising a proximal end, a distal end, and a lumen extending therethrough, the introducer sheath being dimensioned for accessing the aortic arch through a connecting artery;
an elongate, flexible shaft, having a proximal end and a distal end, the flexible shaft dimensioned to extend from the proximal end to the distal end of the introducer sheath, and through the lumen thereof;
an embolic deflector connected to the distal end of the flexible shaft configured to be transformed from a first, reduced size configuration constrained during delivery within the introducer sheath lumen to a second, unconstrained expanded configuration when the flexible shaft is advanced relative to the introducer sheath, the embolic deflector comprising a flexible frame of nitinol and consisting of, in its unconstrained expanded configuration;
first and second struts extending from a common junction connected to the distal end of the flexible shaft, each of the first and second struts extending distally from the junction and curving away so as to diverge from the other strut and define a mid-plane of the deflector;
first and second lobes each formed of a thin curved nitinol member having opposite medial ends each of which is connected to one of the first and second struts on the mid-plane and extend in opposite lateral directions from the mid-plane so as to form a complete loop with lateral ends farthest away from the mid-plane, wherein each of the divergent first and second struts further laterally diverge in opposite lateral directions and are contiguous with the loops defined by the first and second lobes, wherein the deflector is concave in a proximal direction and convex in a distal direction, the combination of the first and second lobes defining a periphery of an oval shape having a minor axis on the midplane and a major axis perpendicular thereto; and
a single membrane secured around the first and second lobes and having a shape that generally matches the oval shape of the combination of the first and second lobes and extends on both sides of the mid-plane, the membrane having a pore size configured to permit passage of blood but deflect emboli greater than a selected size, whereinthe oval shape of the embolic deflector is adapted to be deployed from the connecting artery into the aortic arch into its second, unconstrained expanded configuration having a sufficient length along the major axis and width along the minor axis to cover and prevent emboli from entering the ostia of both the connecting artery and a carotid artery while at the same time the reduced width relative to the length permits the embolic deflector to be oriented along one side wall of the aortic arch.
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Accused Products
Abstract
There is disclosed a porous emboli deflector for preventing cerebral emboli while maintaining cerebral blood flow during an endovascular or open surgical procedure. The device prevents the entrance of emboli of a size able to cause stroke (such as greater than 100 microns) from entering either the right or left common carotid arteries, and/or the right or left vertebral arteries by deflecting emboli downstream of these vessels. The device can be placed prior to any manipulation of the heart or aorta allowing maximal protection of the brain during the index procedure. The deflector has a low profile within the aorta which allows sheaths, catheters, or wires used in the index procedure to pass. Also disclosed are methods for insertion and removal of the deflector.
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Citations
24 Claims
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1. A temporary emboli diversion device for use during an endovascular procedure to prevent emboli from entering a carotid artery from the aortic arch, comprising:
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an elongated introducer sheath comprising a proximal end, a distal end, and a lumen extending therethrough, the introducer sheath being dimensioned for accessing the aortic arch through a connecting artery; an elongate, flexible shaft, having a proximal end and a distal end, the flexible shaft dimensioned to extend from the proximal end to the distal end of the introducer sheath, and through the lumen thereof; an embolic deflector connected to the distal end of the flexible shaft configured to be transformed from a first, reduced size configuration constrained during delivery within the introducer sheath lumen to a second, unconstrained expanded configuration when the flexible shaft is advanced relative to the introducer sheath, the embolic deflector comprising a flexible frame of nitinol and consisting of, in its unconstrained expanded configuration; first and second struts extending from a common junction connected to the distal end of the flexible shaft, each of the first and second struts extending distally from the junction and curving away so as to diverge from the other strut and define a mid-plane of the deflector; first and second lobes each formed of a thin curved nitinol member having opposite medial ends each of which is connected to one of the first and second struts on the mid-plane and extend in opposite lateral directions from the mid-plane so as to form a complete loop with lateral ends farthest away from the mid-plane, wherein each of the divergent first and second struts further laterally diverge in opposite lateral directions and are contiguous with the loops defined by the first and second lobes, wherein the deflector is concave in a proximal direction and convex in a distal direction, the combination of the first and second lobes defining a periphery of an oval shape having a minor axis on the midplane and a major axis perpendicular thereto; and a single membrane secured around the first and second lobes and having a shape that generally matches the oval shape of the combination of the first and second lobes and extends on both sides of the mid-plane, the membrane having a pore size configured to permit passage of blood but deflect emboli greater than a selected size, wherein the oval shape of the embolic deflector is adapted to be deployed from the connecting artery into the aortic arch into its second, unconstrained expanded configuration having a sufficient length along the major axis and width along the minor axis to cover and prevent emboli from entering the ostia of both the connecting artery and a carotid artery while at the same time the reduced width relative to the length permits the embolic deflector to be oriented along one side wall of the aortic arch. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A temporary emboli diversion device for use during an endovascular procedure to prevent emboli from entering a carotid artery from the aortic arch, comprising:
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an elongated introducer sheath comprising a proximal end, a distal end, and a lumen extending therethrough, the introducer sheath being dimensioned for accessing the aortic arch through a connecting artery; an elongate, flexible shaft, having a proximal end and a distal end, the flexible shaft dimensioned to extend from the proximal end to the distal end of the introducer sheath, and through the lumen thereof; an embolic deflector connected to the distal end of the flexible shaft configured to be transformed from a first, reduced size configuration constrained during delivery within the introducer sheath lumen to a second, unconstrained expanded configuration when the flexible shaft is advanced relative to the introducer sheath, the embolic deflector comprising a flexible frame of nitinol and consisting of, in its unconstrained expanded configuration; first and second struts extending distally from a common junction connected to the distal end of the flexible shaft, each of the first and second struts extending distally from the junction; first and second lobes each formed of a thin curved nitinol member having opposite medial ends each of which are connected to one of the first and second struts so as to form a complete loop with lateral ends farthest away from each other, the combination of the first and second lobes defining a periphery of an elongated atraumatic shape having a minor axis and a larger major axis perpendicular thereto, and the periphery is concave in a proximal direction with a first curvature along the major axis and a second smaller curvature along the minor axis; and a single membrane secured around the first and second lobes and having a peripheral shape that generally matches the atraumatic shape of the combination of the first and second lobes, the membrane having a pore size configured to permit passage of blood but deflect emboli greater than a selected size, wherein the atraumatic shape of the embolic deflector is adapted to be deployed from the connecting artery into the aortic arch into its second, unconstrained expanded configuration having a sufficient length along the major axis and width along the minor axis to cover and prevent emboli from entering the ostia of both the connecting artery and a carotid artery, and the flexible frame being capable of flattening when pulled proximally against the aortic arch wall and forming a seal therewith around the atraumatic shape. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24)
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Specification