aneurysm device and delivery system

专利摘要:
the present disclosure relates to a self-expanding tubular braided element for the treatment of an aneurysm. the braid can include a distal implant end opposite a proximal implant end. translating the braid distally from within a tubular distribution element can cause the distal end of the implant to invert and bend, thus forming an occlusive sac for the occlusion of an aneurysm.
公开号:BR112019017548A2
申请号:R112019017548
申请日:2018-02-23
公开日:2020-04-07
发明作者:Lorenzo Juan
申请人:Depuy Synthes Products Inc；
IPC主号:

专利说明:

Descriptive Report of the Invention Patent for ANEURISM DEVICE AND DISTRIBUTION SYSTEM. CROSS REFERENCE TO RELATED APPLICATIONS [0001] This application claims priority over provisional patent application No. 62 / 462,685 entitled ANEURYSM DEVICE AND DELIVERY SYSTEM, filed on February 23, 2017, the content of which is incorporated by reference into the present invention as if it were presented verbatim.
FIELD OF THE INVENTION [0002] This description refers to medical instruments and, more particularly, to delivery systems for an aneurysm treatment device.
BACKGROUND OF THE INVENTION [0003] Aneurysms can be complicated and difficult to treat. For example, access to treatment may be limited or unavailable when an aneurysm is located close to critical tissues. These factors refer particularly to cranial aneurysms due to the presence of brain tissue that surrounds cranial vessels.
[0004] Previous solutions included access to endovascular treatment, so that an internal volume of the aneurysm sac is removed or excluded from the flow and arterial blood pressure.
[0005] Alternatives to endovascular or other approaches may include occlusion devices. These devices typically incorporate multiple embolization coils that are applied to the vasculature using microcatheter delivery systems. For example, when treating cranial aneurysms, an application catheter with embolization spirals is typically inserted first into the non-cranial vasculature through a femoral artery in the hip or groin area. After that, the catheter is guided to a place of interest
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2/39 inside the skull. The aneurysm sac can then be filled with embolic material to create a thrombotic mass that protects the arterial walls from blood flow and related pressure. A specific type of occlusive approach strives to apply and treat the entrance or neck of the aneurysm as opposed to the volume of the aneurysm. In such cervical approaches, by minimizing blood flow through the cervix, venostasis in the aneurysm can be achieved. In turn, a thrombotic mass can form naturally without having to supply embolic materials, as previously described. This is preferable to masses formed from embolic material, since a natural mass can improve healing by reducing possible distension of the arterial walls and allowing reintegration into the original shape of the vessel along the plane of the aneurysm neck. It is understood that the neck plane is an imaginary surface where the innermost layer of the original wall would be if the aneurysm did not exist. However, occlusive neck approaches are not without drawbacks. It is typical for occlusive cervical approaches to fail to prevent flow into blood vessels during aneurysm neck block in the original vessel. This can cause unintentionally serious damage if the vessel openings are blocked. In addition, embolization spirals do not always effectively treat aneurysms, as recanalization of the aneurysm and / or the compaction of the spiral can occur over time.
[0006] Various embodiments of an occlusion device are described in US Patent No. 8,998,947. However, this approach is based on the use of embolization coils or imitates the spiral approach to obtain a safe buffer density and, therefore, unnecessarily risks rupture of the aneurysm. Additionally, this approach does not show a distribution system by which a
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3/39 occlusion device can be repositioned after the initial positioning of its aneurysm occlusion structure to ensure patient safety associated with precise positioning.
[0007] Thus, it is desirable to have a device that easily, accurately and securely occludes a neck of an aneurysm or other arteriovenous malformation in a main vessel without blocking the flow to the perforating vessels that communicate with the original vessel.
SUMMARY OF THE INVENTION [0008] In some respects, the present description relates to a medical device for treating an aneurysm. The device may include a self-expanding tubular braided implant (hereinafter braided) with a lumen that has a distal implant end and a proximal implant end. The distal implant end can be opposite the proximal implant end. The distal translation of the braid within a tubular implantation member can cause the distal implant tip to be inverted and fold over itself, thus forming an occlusive sac to occlude an aneurysm.
[0009] In certain embodiments, the tubular implant member may be arranged around the implant and have a distal end that is releasably connected to the distal implant end of the strand. The braid may have a longitudinal geometric axis between the distal implant end and the proximal implant end. The braid can be invertible around the longitudinal axis, translating the braid distally around the geometric axis.
[0010] In certain embodiments, the lumen of the braid may include a prefabricated break that is disposed between the distal and implant ends. The break can be formed by a localized heat treatment zone that is anti-warping and configured to induce bending and / or gradual inversion of the braid. The break can
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4/39 be arranged between the distal and implant ends. The break can be configured so that the occlusive sac is formed when the distal implant tip is moved towards or comes into contact with an aneurysm dome. In some embodiments, one or more regions or areas of the distal end of the distal implant end are substantially atraumatic or rounded and configured to minimize folding of the strand during inversion. In certain modalities, continuing to transfer the braid after the formation of the occlusive bag can lead to the formation of a second bag in the occlusive bag. Additional bags can be formed in the first and second bags as needed or required (for example, to obtain a desired buffer density or to better support the first and second bags). It is understood that each bag can be formed from a respective portion of the braid that is inverted and folded over itself.
[0011] In certain embodiments, the implant tip is intended to be mechanically attached to an application system. The implantation system can include a catheter and a pushing mechanism disposed in the catheter and / or it can include a hypotube, the pushing mechanism being operable to transfer the braid towards the aneurysm. In certain embodiments, the occlusive sac may be substantially spherical, ellipsoidal, or otherwise conforming to an asymmetric aneurysm, for example an aneurysm with multiple sacs and dome or irregular walls. The proximal implant end may also be less malleable and / or may have less material strength than the distal implant end. An outer surface of the braid may also include a plurality of interstices (for example, a mesh surface).
[0012] The inversibility, elasticity and / or porosity of the
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5/39 braid can be selectively designed to treat an aneurysm that has a specific shape, by varying the properties of the interstices between different portions of the braid.
[0013] In other embodiments, a method is disclosed to deliver an occlusion device to an aneurysm in a blood vessel to a patient. The method may include positioning an occlusion device in an application tube (for example, a tube that can be pushed or that can move the occlusion device), the occlusion device comprising any self-expanding braid of this description; slide the braid distally towards the aneurysm from inside the implantation tube; expanding a distal implant end of the strand from a retracted condition to an implanted condition; and inverting the distal implant end of the braid to form a sac to occlude the aneurysm.
[0014] In certain embodiments, the distal implant end of the strand begins to expand immediately as the strand exits a distal end of the implantation tube. In certain embodiments, when the bag is formed, it can include an agglomeration density or a predetermined density range. In certain embodiments, the method may include placing a microcatheter in the vasculature and then positioning the occlusion device mounted with the delivery tube inside the microcatheter; and distribute the occlusion device and the application tube mounted with the microcatheter on the aneurysm. In certain modalities, the method may also include: imaging the sac in relation to the aneurysm; determine whether the aneurysm is occluded by the sac; and slide the braid distally or proximally to adjust the sac and occlude the aneurysm.
[0015] In certain modalities, imaging the sac in relation to the aneurysm includes determining whether an agglomeration configuration
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6/39 necessary for the sac occludes the aneurysm and moves the braid (for example, sliding distally or proximally the braid) to adjust the sac.
[0016] In other embodiments, a method is revealed to deliver an occlusion device to an aneurysm in a blood vessel to a patient. The method may include: positioning the occlusion device in an application tube, the occlusion device comprising a self-expanding braid; slide a braid distally towards the aneurysm; expand (for example, expand radially) a distal implant end of the strand from a retracted condition to an implanted condition as the strand approaches an aneurysm dome; and inverting the distal implant end of the strand to form an occlusive sac that buffers the aneurysm to a predetermined buffer density and occludes the aneurysm.
[0017] In certain modalities, the braid includes a first break that is defined by a size of the sac to occlude the aneurysm. The braid can also include a second break proximal to the first break. In this regard, the method may also include sliding the braid distally towards the aneurysm after the formation of the first sac; and inverting the braid on the second break to form a second inner bag in the first bag.
[0018] In certain modalities, the method may also include: sliding the braid distally towards the aneurysm after the formation of the first sac; and inverting the braid to form a second inner bag in the first bag.
[0019] In certain modalities, the method may also include: continue to slide the braid distally towards the aneurysm after the formation of the first sac, thereby buffering the sac with one or more unexpanded portions of the braid.
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7/39 [0020] In certain modalities, the method may also include: determining a position of the bag in relation to the aneurysm and, if the position does not fit or conform to the bag, then the braid can be proximally translated, in this way , causing the bag to retract back to the braid; and remove the braid from the aneurysm.
[0021] In other embodiments, this description refers to an application system for an occlusive device to treat an aneurysm. In some embodiments, the delivery system may include an delivery tube that includes a distal end and a proximal end. The application tube can be slidably arranged in a microcatheter. A pressing mechanism can be slidably arranged on the application tube. The occlusive device can be slidably arranged on the application tube and mechanically attached to the pressing mechanism. The occlusive device may include a braid that has a lumen with a distal implant end opposite to a proximal implant end. The pressing mechanism can be operable to move the occlusive device distally to a condition implanted in the aneurysm, in which moving the braid distally to the implanted condition causes the distal implant tip to invert and bend over itself, thereby forming way, an occlusive bag for the aneurysm.
[0022] In certain embodiments, the implant end proximal to the braid may be capable of mechanical attachment, removable or otherwise, to the distal end of the pressing mechanism.
[0023] In other modalities, at least a portion of the braid defines a plurality of interstices with openings for occlusion of the aneurysm. In other modalities, the end of
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8/39 Proximal braid implant can be attached to an internal portion of the pressing mechanism and foldable over it.
[0024] In other modalities, the braid can be fixed to an internal portion of the pressing mechanism and foldable over it. The braid can also be loaded as the braid is folded. In certain embodiments, the braid can be invertible as the braid slides distally and leaves the application tube. The bag can also be a retractable cage-type vessel-occlusive structure.
[0025] In other embodiments, the distal end of the application member may include opposite gripping arms (for example, upper and lower). One or both of the gripping arms can be pivoted towards the other gripping arm to release the strand from the application tube when the strand forms a bag over the aneurysm. In other embodiments, the pressing mechanism may also include an internal passage through which at least one embolization spiral is inserted into the braid when the braid forms a sac in the aneurysm.
[0026] In other embodiments, the pressing mechanism may include radiopaque material (for example, the distal end, the proximal end, etc.).
[0027] In other embodiments, a method is revealed to deliver an occlusion device to an aneurysm in a blood vessel to a patient. The method includes: placing an occlusion device delivery system on a microcatheter in the vasculature, where the delivery system includes an application tube that has a distal end and a proximal end. The delivery system may also include a pressing mechanism that is slidably arranged in the delivery tube, the pressing mechanism comprising a distal end and
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9/39 a proximal end. The method may include sliding a self-expanding strand of the occlusion device into the application tube, the strand comprising a distal end and a proximal end; removably fix the proximal end of the braid to the distal end of the pressing mechanism; selectively insert the microcatheter with the delivery system and the occlusion device into the patient's vasculature to reach the aneurysm; slide the braid distally, by the pressing mechanism, in the application tube towards the aneurysm, which causes the braid to expand and move radially from a retracted condition in the application tube to a condition implanted in the aneurysm, as the distal end of the strand moves out and away from the distal end of the application tube; and release the occlusion device and remove the microcatheter and the application system from the patient.
[0028] In other modalities, the method may also include: forming, through the braid, a sac in the aneurysm, sliding distally the braid in the implanted condition; slide the pressing mechanism distally to the distal end of the application tube until the braid folds; and folding the braid, thereby filling the bag, attaching the occlusion device to the aneurysm to occlude the flow in the aneurysm.
[0029] In other modalities, the method may also include: forming the sac in the aneurysm by inverting the braid as the braid slides distally and leaves the application tube and / or protrudes against an aneurysm wall.
[0030] In other modalities, the method may also include: bypassing the pressing mechanism as the braid is inverted and reaching a dome of the aneurysm; fill the bag as the braid is inverted; and / or continue to move distally,
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10/39 by the pressing mechanism, the braid in the aneurysm until the proximal end of the braid reaches the tip of the distal end of the pressing mechanism.
[0031] In other modalities, the method may also include: fixing the proximal end of the braid to an internal portion of the pressing mechanism; and / or carry the bag by folding the braid until the braid is at least level with an aneurysm neck.
[0032] In other modalities, the method may also include: forming, through the braid, a bag in the aneurysm, sliding distally the braid in the implanted condition; form a gripping mechanism to separate the bag from the delivery system, wherein the gripping mechanism is formed by a pair of opposing gripping arms formed at a distal end of the application tube, one or both gripping arms being pivoting towards the other gripping arm; and / or remove, by the gripping mechanism of the application system, the application system bag by pivoting one or both arms in the opposite direction of the other.
[0033] In other modalities, the method may also include: inserting at least one embolization spiral through an internal passage of the pressing mechanism and into the bag to adjust the buffer density.
[0034] In other modalities, the method may include the formation, inverting the braid, of a first occlusive sac in the aneurysm by sliding the braid of the application tube distally towards the aneurysm; sliding the braid distally towards the aneurysm after the formation of the first sac; and inverting the braid to form a second bag in the first bag. The formation of the first and / or the second sac can cause the flow in the aneurysm to be deflected, deflected and / or delayed.
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11/39 [0035] In other modalities, the method may include the formation, inverting the braid, of a first occlusive sac in the aneurysm by sliding the braid of the application tube distally towards the aneurysm; sliding the braid distally towards the aneurysm after the formation of the first sac; inverting the braid to form a second bag in the first bag; sliding the braid distally towards the aneurysm after the formation of the second sac; and inverting the braid to form a third bag in the first and second bags; The formation of the first, second and / or third sac can cause the flow in the aneurysm to be deflected, deflected and / or delayed. It is contemplated that only one bag can be used or more than three bags could be formed and used for the purposes of deflecting, deflecting and / or slowing the flow in the aneurysm.
[0036] Other aspects and characteristics of this description will be evident to those versed in the technique, through the analysis of the detailed description below, together with the attached figures. BRIEF DESCRIPTION OF THE DRAWINGS [0037] Reference will now be made to the associated drawings, which are not necessarily drawn to scale.
[0038] Figure 1 shows an occlusion device exemplifying this description implanted in an aneurysm.
[0039] Figure 2 is a schematic side view of an exemplary application system with an occlusion device retained in a retracted condition on a microcatheter;
[0040] Figure 3 is an enlarged schematic side view of the application system of Figure 2 along section A-A;
[0041] Figures 4A to 4B are a flow chart for a method of delivering an occlusion device to the vasculature using the application system disclosed in the present invention;
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12/39 [0042] Figure 5A is an enlarged schematic side view of the application system of Figure 2 along section B-B of Figure 4;
[0043] Figure 5B is an enlarged schematic side view of the application system of Figure 2 along section C-C of Figure 4;
[0044] Figure 5C is an enlarged schematic side view of the application system of Figure 2 along the section D-D of Figure 4;
[0045] Figure 5D is an enlarged schematic side view of the application system of Figure 2 along the section E-E of Figure 4;
[0046] Figure 6A is a schematic view in enlarged perspective of the section F-F through its central line showing an end of proximal implant exemplifying the braid in communication with an exemplary pressing mechanism;
[0047] Figure 6B is an enlarged schematic overview showing an exemplary fixation system such as between an application tube, pressing mechanism and catheter in an application system modality;
[0048] Figure 6C is an enlarged schematic view showing an exemplary fixation system such as between an application tube, pressing mechanism and catheter in an application system modality.
[0049] Figure 6D is an enlarged schematic view showing an exemplary fixation system such as between an application tube, pressing mechanism and catheter in an application system modality.
[0050] Figure 6E is an enlarged schematic view showing an exemplary fixation system such as between an application tube, a pressing mechanism with the catheter removed in an application system mode.
[0051] Figure 6F is an enlarged schematic view showing an exemplary fixation system as between an application tube,
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13/39 pressing mechanism with the catheter removed in an application system modality.
[0052] Figure 7 is an enlarged schematic side view of the fixation system of Figure 6E along the section G-G;
[0053] Figure 8 is a schematic side view of an exemplifying application system, in which an occlusion device is implanted with an embolization spiral.
[0054] Figure 9 is a flow diagram for a method of applying an occlusion device.
[0055] Figures 10A and 10B are a flow chart for an application method an occlusion device using the application system disclosed in the present invention.
[0056] Figure 11A shows a braided example of this description.
[0057] Figure 11B shows a braided example of this description implanted.
[0058] Figure 11C shows a braided example with an embolization spiral of this description.
[0059] Figure 12A is an enlarged view of a step of an exemplifying application system device that is implanted in an aneurysm according to this description, the system being shown as moving from a retracted condition to an implanted condition;
[0060] Figure 12B is an enlarged view of a step of an exemplifying application system device that is implanted in an aneurysm according to this description, the system being shown as moving from a retracted condition to an implanted condition;
[0061] Figure 12C is an enlarged view of a step of an example application system device being implanted
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14/39 in an aneurysm according to this description, the system being shown as moving from a retracted condition to an implanted condition;
[0062] Figure 12D is an enlarged view of a step of an exemplary application system device being implanted in an aneurysm according to this description, the system being shown as moving from a retracted condition to an implanted condition;
[0063] Figure 12E is an enlarged view of a step of an exemplary application system device being implanted in an aneurysm according to this description, the system being shown as moving from a retracted condition to an implanted condition;
[0064] Figure 12F is an enlarged view of a step of an exemplary application system device being implanted in an aneurysm according to this description, the system being shown as moving from a retracted condition to an implanted condition;
[0065] Figure 12G is an enlarged view of a step of an exemplary application system device being implanted in an aneurysm according to this description, the system being shown as moving from a retracted condition to an implanted condition;
[0066] Figure 12H is an enlarged view of a step of an exemplifying application system device being implanted in an aneurysm according to this description, the system being shown as moving from a retracted condition to an implanted condition;
[0067] Figure 121 is an enlarged view of a step of an exemplary application system device being implanted
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15/39 in an aneurysm according to this description, the system being shown as moving from a retracted condition to an implanted condition.
DETAILED DESCRIPTION [0068] Although exemplary modalities of the disclosed technology are explained in detail in the present invention, it should be understood that other modalities are contemplated. Therefore, it is not intended that the disclosed technology be limited in scope to the details of construction and arrangement of the components set out in the following description or illustrated in the drawings. The technology revealed is capable of other modalities and can be practiced or performed in several ways.
[0069] It should also be noted that, as used here and in the appended claims, the singular forms one, one, o and a include the respective plural forms, unless the context clearly determines otherwise. By comprising or containing or including it is understood that at least the mentioned compound, element, particle or method step is present in the composition, article or method, but does not exclude the presence of other compounds, materials, particles or steps method, even if the other such compounds, materials, particles or steps of the method have the same function as the named one.
[0070] In the description of the exemplifying modalities, the terminology will be used for the sake of clarity. It should be understood that each term encompasses its broadest meaning, as understood by those skilled in the art, and includes all technical equivalents that operate in a similar way to accomplish a similar purpose. It should also be understood that mentioning one or more steps in a method does not exclude the presence of additional steps in the method or intermediate steps in the method between those steps
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16/39 expressly identified. The steps of a method can be performed in an order different from that described here without departing from the scope of the technology presented. Similarly, it should also be understood that the mention of one or more components in a device or system does not exclude the presence of additional components or intermediate components between those components expressly identified.
[0071] As discussed in this document, the vasculature of an individual or patient can be the vasculature of a human or an animal. It should be noted that an animal can be a variety of any applicable type, including, but not limited to, mammals, veterinary animals, pets or livestock, etc. For example, the animal may be a laboratory animal specifically selected to have certain characteristics similar to those of a human (for example, rat, dog, pig, monkey or the like). It should be noted that the individual can be, for example, any suitable human patient.
[0072] As discussed in this document, an operator may include a doctor, surgeon or any other individual or application instrument associated with the application of a braided body to an individual's vasculature.
[0073] It is known that cerebrovascular aneurysms are treated using embolization spirals, which are applied to the aneurysmal sac through a microcatheter and separated locally. It is understood that compaction density is the volume of the aneurysmal sac occupied by the mass of the spiral. In anterior spiral approaches, multiple spirals (for example, five spirals) were used to buffer aneurysms, and the buffer density can typically vary between 15 and 25%, depending on the size of the aneurysm. The device disclosed in the present invention
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17/39 improves with the use of embolization coils through the use of a single device without the need for even a single coil to plug the device. Instead, the disclosed device is operable to seal the neck of the aneurysm and to buffer the aneurysm at a higher buffer density than with the use of spirals. In practice, the buffer density can be increased by 25 to 50% depending on the length of the braid in the aneurysm, or twice as much as can be obtained with conventional coils. However, the multiple layers of braid formed as the braid closes the aneurysm may indicate that a lower buffer density can cause = change in blood flow and coagulation so that a lower buffer density can reach the same level of occlusion. This allows the neck of the aneurysm to be healed.
[0074] On the other hand, in previous embolization approaches, aneurysm buffering required the implantation of spirals in the aneurysm sac until the aneurysm reached the desired buffer density to occlude the aneurysm. However, obtaining such a buffer density was difficult and time-consuming and the morphology of the aneurysm (eg, wide neck, bifurcation etc.) and the like required auxiliary devices such as stents or balloons to support the mass of the spiral and obtain the desired buffer density . In addition, aneurysms treated with multiple coils are often reanalyzed or compressed as a result of inadequate wrapping, lack of coverage through the aneurysm neck, as a result of the flow, or even by the size of the aneurysm.
[0075] The occlusion device 1 and the corresponding implantation system 30 disclosed in the present invention eliminate the disadvantages of the previous approaches, including the low packing density, compaction and recanalization of aneurysms.
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18/39 [0076] Returning to Figure 1, an occlusion device 1 exemplifying this description is shown implanted in an aneurysm of the VS blood vessel, but not yet released from its delivery system 40. Catheter 20 was delivered to aneurysm A and as shown and discussed more particularly below, the occlusive bag 12 of the braided tubular implant 10 (hereinafter called braided or braided 10) of device 1 formed a predetermined shape and structure that contours and supports the walls of aneurysm A in order to close an aneurysm THE.
[0077] Figure 2 represents a schematic side view of the strand 10 and the delivery system 30 before being positioned at a location of interest in the vasculature for occlusion of the aneurysm A. Strand 10 may include a lumen with a distal implant tip. 16 opposite a proximal implant end 14, as shown more particularly in Figure 3. Specifically, Figure 3 is an enlarged schematic side view of the application system of Figure 2 along section AA prior to implantation. System 30 may include a pressure application tube 34 with an internal lumen and a braid pressing mechanism 38. System 30 may apply an occlusive device, which includes braid 10, to a location of interest (for example, to a location injury) using a microcatheter 20. System 30 can be pre-placed on the microcatheter
20. In certain modalities, the microcatheter 20 can be pre-placed, with or without the system 30, at a level of the neck of the aneurysm and used to track device 1 in the lesion. The mechanism 38 can be tubular, solid, elongated and / or malleable to be able to pass through tortuous pathways of the vasculature in the application tube 34 and / or microcatheter 20. The mechanism 38 can include an internal lumen and be disposable or have ability to operate with a hypotube. For example, a hypotube can be fixed or be in communication with the
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19/39 mechanism 38 to slide mechanism 38 distally towards aneurysm A.
[0078] In this regard, the mechanism 38 can be slidably arranged on the application tube 34, the mechanism 38 being mechanically connected to the braid 10 in the attachment 36. When the braid 10 is mechanically fixed to the mechanism pressing 38 on fixation 36, moving distally, sliding or otherwise moving the mechanism 38 towards the aneurysm can cause an implant end distal 16 of the braid 10 to start moving from a retracted condition to an implanted condition, as discussed below. Both the tube 34 and the delivery mechanism 38 can extend from the proximal end 24 to the distal end 26 of the microcatheter 20.
[0079] It is understood that braid 10 can include a self-expanding braid to treat an aneurysm. The inner lumen of the braid 10 can form a self-expanding multiple filament outer surface that can include a mesh. It can be seen that the mechanism 38 is arranged in a proximal position of the strand 10 and the strand 10 is in communication with the mechanism 38 through fixation 36 at the end of a proximal implant 14. The strand 10 can be fixed at the fixture 36 when crimped on it or by a removable connection. In certain embodiments, the proximal implant end 14 can be inserted into the distal end of the mechanism 38 in the attachment 36, where the mechanism 38 can then be attached to or on it. However, the fixture 36 is not thus limited and, instead, the braid 10 can be slidably and removably inserted over or, in another way, the fixture 36.
[0080] Prior to implantation in an A aneurysm, the distal implant end 16 of strand 10 is adjacent to or in contact with the distal end 46 of the application tube 34. The
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The application 34 may also include one or more clamps 32 operable to securely hold the strand 10 in place prior to implantation. The strand area 10 of the distal end of implant 16 adjacent or in communication with fastener 32 can be substantially non-traumatic and / or rounded, thereby minimizing torsion or other damage to the adjacent area of strand 10. Fastener 32 may include a means crimping, welding, arresting, adhesive, pressure-locking, welding or other fastening means, which includes clamps, or the like, so that the application tube 34 is attached to it, however, the translation of the mechanism 38 and braiding 10 still allowed when performance is desired.
[0081] Braid 10 can be operable to expand over the neck of aneurysm A during delivery which can substantially reduce and / or prevent additional blood flow from the original vessel into the aneurysm bag. The strand portions 10 at or near the end 16 may be more malleable than the strand portions 10 at the adjacent end 14 in order to induce self-expansion during distribution and inversion as the strand 10 forms its predetermined bag-like shape in the aneurysm A (see, for example, Figure 1). Braid 10, including its outer surface, can be self-expanding and made of nitinol with interwoven platinum filaments for radiopacity. Braid 10 is not limited to this, however, and any material or combination of materials can be used to form an outer surface of braid 10 can be used as needed or required.
[0082] Returning to Figure 4, a flowchart for a method 400 is shown to safely and accurately distribute an exemplary strand 10 in the vasculature. As can be seen, in step 405 of method 400, the occlusion device 1 is mounted with a microcatheter 20. The assembly between microcatheter 20 and device 1
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21/39 can occur before introduction into the vasculature. In step 410, ο device 1, which includes system 30, may now have been selectively positioned at the injury site and mechanism 38 may begin its distal translation of strand 10. As can be seen in step 410, strand 10 begins to expand and / or invert as its distal implant end 16 moves in the opposite direction to the distal end 26 of catheter 20 and / or delivery end 46 (not identified in this Figure) of the delivery tube 34 to form the bag 12 in aneurysm A being treated (see, for example, the formed bag 12 of device 1 that occludes aneurysm A of Figure 1).
[0083] In certain modalities, the bag 12 begins to form as the braid 10 is advanced in the vicinity of the neck or bell of the aneurysm so that the mechanism 38, the fixation 36 and / or the portions of the application tube 34 are in the neck level, as seen under fluoroscopy. However, device 1 is not limited to this, and instead the braid 10 can begin to invert and fold to form the bag 12 as the distal end of the implant 16 simply slides distally away from the delivery tube 34 and / or catheter 20. As shown in step 415, bag 12 now takes on a generally spherical shape as braid 10 is moved distally deeper into aneurysm A and / or more in the opposite direction of catheter 20 and tube 34. Moving between steps 405 and 415, the outer diameter of the braid 10 expands radially to a larger diameter than the microcatheter 20 as bag 12 is formed. The count of interstitial stranded strand 10 that can form the outer surface can vary depending on the diameter of the bag 12 or bags needed to occlude the aneurysm. For example, in order to induce the formation of the predetermined shape and strength of the bag 12, the distal implant end 16 of the braid 10 may be more malleable than the proximal implant end 14 and
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22/39 portions of strand 10 can vary from more pliable at or over the end 16 and less pliable at or over the end 14. The interstices of the strand 10 can also form openings for occlusion of the aneurysm.
[0084] Such distal movement of the mechanism 38 and initial bag formation 12 of the strand 10 is more clearly shown in Figure 5A which is an enlarged view of the BB section of Figure 4. As the distal implant end 16 of the strand 10 moves distally into towards aneurysm A and in the opposite direction to the end 26 of the microcatheter 20, the distal implant end 16 of the braid 10 can begin to invert and fold over itself, thereby beginning to form an occlusive sac 12 to occlude an aneurysm . This is most clearly shown in Figure 5B, which is an enlarged view of the section C-C of Figure 4.0. Mechanism 38 can be driven by a hypotube from its proximal end by an operator or the like. It is understood that the braid 10 can also be fixed in and / or foldable over an internal portion of the mechanism 38, for example, in the attachment 36.
[0085] In step 420, the mechanism 38 can continue to be distally translated while the distal implant end 16 of strand 10 continues to invert as it approaches or comes into contact with the dome of aneurysm A. The strand 10 it can also begin to reverse immediately as catheter 20 leaves (see, for example, step 410 in Figure 5A). It can be seen that the bag 12 has now fully expanded into its predetermined spherical shape designed to conform to the shape of the aneurysm A. This is most clearly shown in Figure 5C which is an enlarged view of the DD section, where the bag 12 can be seen in spherical format. More specifically, moving between steps 405 and 420, as shown between Figures 5A and 5C, the mechanism
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23/39 moves the braid 10 distally until the braid folds over its distal implant end 16 to form the bag 12. The bag 12 can take any shape necessary to occlude the respective aneurysm A.
[0086] Between steps 420 and 425, mechanism 38 continues to slide distally until the portion (or portions) of unexpanded braid 17 next to bag 12 folds and randomly loads bag 12, as shown more particularly in Figure 5D , which is an enlarged view of the EE section. The bag 12 can have the spherical shape shown and be formed to transmit a predetermined buffer density and the portion 17 which is formed with the braid 10 which loaded the bag 12 to further reinforce the bag
12. In other words, as braid 10 reaches the dome of the aneurysm, the portion (or portions) of braid 17 next to bag 12 from mechanism 38 can be forced to bypass and start loading bag 12, as shown at the beginning from step 415.
[0087] In step 430, with the bag 12 completely formed in a sufficient manner to occlude aneurysm A, the braid 10 can be removed from fixation 36. However, if the bag 12 is not precisely positioned or if it needs to be redefined in aneurysm A for safe occlusion without risk of rupture, braid 10, which includes bag 12, can be retracted back to application tube 34 by moving mechanism 38 proximally. It is understood that when bag 12 is completely When formed, it has the capacity to buffer aneurysm A with a buffer density of 15 to 25% without the need for any embolization spiral. However, strand 10 can be designed to achieve a buffer density of 40%, 50% or less than 15 to 25%, as needed or required. The change in buffer density can be affected by changing the strand length or diameter 10. One
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24/39 braid 10 more or less long in the same aneurysm A can change the amount of braided implant, which, in turn, can dictate the number of bags 12 formed and the amount of unexpanded braided portion 17 that carries the bag 12 The same may be true for the strand diameter 10, a larger diameter that carries more of aneurysm A in less length, but at a lower density. The operator can then choose between the difference parameters of a strand 10 for each particular aneurysm A.
[0088] In step 435, because bag 12 was properly positioned and formed in aneurysm A, braid 10 was removed from mechanism 38 and mechanism 38 can now be retracted from it. As shown, opposite understanding arms 42a, 42b can be formed with microcatheter 20 or delivery tube 34 and removed proximally, thus arms 42a, 42b can release the bag 12 formed by expanding the braid 10. It is understood that some or all of the arms 42a, 42b may be radiopaque so that positioning and detachment can be monitored and / or triggered under fluoroscopy.
[0089] An example of fastening 36 is shown in Figure 6A which is a schematic view in enlarged perspective of the section EE of step 425 through the central line, in order to show the strand 10 in communication with the mechanism 38. It can be seen that the mechanism 38 may include a pull cable 39 that hooks onto or attaches to the strand 10 and can be released from it in a similar manner, and that the attachment will be secure as long as pull cable 39 is not pulled proximally. If pull cable 39 is pulled back, braid 10 can be released. Figure 6A is merely a way that the mechanism 38 can be attached to the strand 10 through the attachment 36 and any number of attachment means are contemplated, as needed or required.
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25/39 [0090] Another example of how system 30 can release braid 10 is shown in Figure 6B. In a first step 605B of method 600B, the mechanism 38 'is shown in a retracted condition in the delivery tube 34' and catheter 20. The mechanism 38 'includes a substantially elongated portion 37' which generally runs along the internal cavity or lumen of the tube 34 'that leaves a space between the elongated portion 37' and the tube 34 '. The portion 37 'can be axially aligned with the tube 34'. A base portion 33 'of the mechanism 38' can also be included disposed at a proximal end of the mechanism 38 '. The portion 33 'can at least be wider than the portion 37' and can extend on the inner surface of the tube 34 '. During use, the braid 10 can be axially positioned over the space between the 37 'portion and the tube 34', advanced over the 37 'portion and secured to the 33' portion. In step 610B, it can be seen that the mechanism 38 'has been distally translated so that the portion 37' is now distal from the tube 34 'and catheter 20. The base 33' has been translated distally in a similar manner until it comes into contact with the projections 41 'of tube 34'. When the base 33 'comes into contact with the projection 41' in step 610B, the projection 41 'will be distal from the tube 34' so that the proximal implant end 14 of the braid 10 is free to be removed. The projection 41 'may also include a gap or space 43' to which the end 14 of the strand 10 can be attached. When space 43 'is distal from catheter 20 and tube 34', in those embodiments where end 14 has previously been attached to space 43 ', end 14 can now disengage and release freely.
[0091] Protrusions 41 'may be members or extensions of tube 34' that project inwardly to reduce the internal diameter over them so as to be less than a diameter of the base 33 '. In this regard, only a projection 41 'can be provided integrally formed with the tube 34' or connected and removably positioned with
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26/39 him. However, the 600B method is not limited to this and more than one projection 41 'can be provided, as well as a cylindrical projection 41', or any other shaped and designed projection to reduce the inside diameter to prevent the 33 'base from passing .
[0092] Another example of how system 30 can release strand 10 is shown in Figures 6C to 6F. In Figure 6C, a schematic is shown of an example prototype. Figure 6D is a photograph of an exemplary prototype that exemplifies the modality shown in Figure 6C. The braid 10 is shown in both Figures 6C and 6D in an implanted condition in which the bag 12 is formed distally from the catheter 20 and the tube 34. The mechanism 38 in this embodiment is mechanically fixed to the braid 10 by means of fixation 36 , as more clearly shown in Figures 6E and 6F. Specifically, in Figure 6E, catheter 20 has been removed to show braid 10 interconnected with mechanism 38 in fixture 36. In Figure 6F, mechanism 38 has been removed from braid 10. In practice, mechanism 38 and catheter 20 can be now removed from the vasculature and the patient together, which leaves occlusive bag 12 selectively positioned and formed to occlude aneurysm A.
[0093] Fixture 36 is most clearly shown in Figure 7, which is a schematic view in enlarged perspective of the section GG of Figure 6E showing the end 14 of braid 10 in communication with mechanism 38. It can be seen that mechanism 38 it may include a releasable fixing interface formed by an interconnecting member 39 on its distal end 46. The member 39 can be integrally formed with the mechanism 38 and be constructed of a recess or operable channel portion for securely engaging with the portion fastening 11 of the braid 10. The portion 11 may, in turn, be a separate portion secured in, formed with, or otherwise arranged at the end 14 of the
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27/39 braided 10. The portion 11 can include a corresponding channel or recess operable to engage removably and securely with the member 39. In practice, the member 39 can be securely engaged with the portion 11 in the application tube 34 before application to the vasculature. However, the mechanism 38 and the braid 10 are not limited to this and the engagement can occur simultaneously with the application of the system 30 which is applied to the vasculature. When the operator wishes to apply and release the bag 12 with aneurysm A, the braid 10 can be advanced distally from the catheter 20 and / or the application tube 34 by moving the mechanism 38. Since the member 39 is distal from the tube 34, the corresponding portion 11 of the braid 10 can be released from it. The mechanism 38 can then be retracted and the system 30 can be removed from the site of interest in the vasculature. It is understood that Figure 7 is merely a way that a pressing mechanism of the system disclosed in the present invention 30 can be fixed and removed at the end 14 of the braid 10 by means of fixation 36 and any number of fixing means are contemplated, as necessary or required.
[0094] Figure 8 is a schematic side view of another exemplary application system 30 with device 1 in the process of being implanted and bag 12 in the process of being formed. In this embodiment, a spiral 33 is also assembled with the application system 30 to subsequently fill the bag 12 to further facilitate the buffering of the aneurysm A. It is understood that one or more additional spirals can be inserted with the proximal implant end 14, as needed or required. The system 30 is not limited to this, however, and the braid 10 can include portions behind the bag 12 that are not inverted to form a bag. Instead, these rear portions are able to slide distally into the formed bag 12 in a manner similar to adjusting a density of
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28/39 buffer distributed over bag 12 (see, for example, Figures 12A to 121).
[0095] Figure 9 is a flow chart for a 900 method for applying an occlusion device. In step 905, a self-expanding braid is inverted as it is moved distally from a catheter applied to the aneurysm. In step 910, the braid forms an occlusive sac that conforms to the size and / or shape of the aneurysm. The braid can be inverted and / or radially expanded in step 910 to form the occlusive bag. In step 915, the braid continues to move distally and when the braid reaches the top of the aneurysm, the braid portions stop inverting (for example, portions of the braid close to the occlusive sac) and are in an uninverted condition. In some embodiments, the portions of the braid close to the occlusive sac are in an uninverted condition (for example, not expanded) as the braid is moved distally deeper into the aneurysm. In step 920, the strand portions in the non-inverted condition translate distally and fill the occlusive sac in the aneurysm at a predetermined buffer density The density can be increased by at least 25%, between 25 and 50%, or up to 75% more than existing spiral approaches.
[0096] Figure 10 is a flow chart for a method 1000 for applying an occlusion device using the application system disclosed in the present invention. Step 1005 includes selectively positioning a microcatheter in the vasculature. Step 1010 includes slidably positioning an occlusion device delivery system on the microcatheter, the delivery system comprising an application tube comprising a distal end and a proximal end and a pressing mechanism slidably arranged on the tube application, the pressing mechanism comprising a distal end and
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29/39 a proximal end. Step 1015 includes slidingly positioning a self-expanding braid of the occlusion device in the delivery tube, the braid comprising a distal end and a proximal end. Step 1020 includes removably securing the proximal end of the braid to the distal end of the pressing mechanism. Step 1025 includes advancing the application system to the vasculature on the aneurysm Step 1030 includes sliding the strand distally, by the pressing mechanism, into the application tube towards the aneurysm, which causes the strand to be inverted and / or expanded radially as it moves from a retracted condition in the delivery tube to a condition implanted in the aneurysm, as the distal end of the strand moves out and away from the distal end of the delivery tube. Step 1035 includes releasing the occlusion device and removing the delivery system and catheter from the patient.
[0097] Figures 11A and 11B illustrate an example of the braid, or braided mesh 100. The mesh 100 can be self-expanding and can be comprised of a mesh tube. The self-expanding mesh 100 may include multiple threads 102, for example, from 4 to 96 threads. The number of wires 102, and the diameter of the wires can be a factor in controlling the stiffness and pore size. y. For example, the distal end of the braid may be more porous or more flexible than the proximal end, or vice versa. The combination of a braid with just one bag or multiple bags (for example, two or more bags) can be taken into account when determining the number of threads. Fewer wires 102 can be used as a whole and will still result in the desired occlusion. The wires 102 can be made of multiple alloys such as a nickel-titanium alloy, cobaltochrome alloys, platinum, nitinol, stainless steel, tantalum or other alloys, or any other suitable biocompatible materials, or a combination of these materials, which include thin films deposited . Besides that,
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30/39 these materials can be absorbable or non-absorbable by the patient over time.
[0098] The openings 104 in the mesh 100 create a substantially unitary structure or mesh in the wall 106. In this way, the openings 104 can be of any size, shape or porosity, and can be spaced evenly or randomly across the entire wall 106 of the mesh 100 The openings 104 provide flexibility to the tubular element and also assist in transforming the mesh 100 from the retracted state to the expanded state, and vice versa.
[0099] As discussed above, mesh 100 is inverted as it is formed. This means that the interior 108 of the mesh 100, when the mesh is formed, becomes the exterior in the implantation or is in contact with the wall of aneurysm A, as illustrated in Figure 11B. For the sake of clarity, the mesh 100 is initially formed as a hollow cylindrical shape. This shape has an interior 108 and an exterior. In that the interior 108 is similar to the hollow portion of a tube. After implantation, the mesh 100 is turned inside out, so the inside 108 in the formation is now the outside of the bag 112 once implanted in aneurysm A.
[0100] Note that the mesh 100 has a length L and that the length L forms both the bag 112 and the unexpanded mesh 110 (or tail) that forms in the bag 112. Controlling the length L can provide different diameters than bag 112, the number of inner bags and / or the length of the tail 110 that carries the bag 112 and affects the buffer density.
[0101] In one example, the inversion of the mesh 100 can be formed when the proximal end 114 of the mesh 100 is pushed forward while the distal end 116 remains fixed. The proximal end 114 is pushed inward 108, which forces the proximal end 114 to leave the delivery tube first while the end 116 remains attached. Once
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31/39 entire length L is implanted outside the application tube, the distal end 116 is removed and is thus the last end to be implanted. As mentioned above, the proximal end 114 engages the proximal implant end 14 and the distal end 116 engages the distal end of the implant 16. The mesh 100 can be formed similar to a tube sock.
[0102] Another example fixes the distal end 116 as mentioned above, and as the proximal end 114 is pushed, the mesh 110 just behind the distal end 116 is implanted, which still causes the mesh 100 to be implanted inside out. Here, since the mesh 100 is fully implanted, both the proximal and distal ends 114, 116 are close to each other.
[0103] Figure 11C illustrates the mesh 100 after implantation with an embolization spiral 330 at the proximal end 114 that can be opened. With the end 114 open, the embolization spiral 330 can be inserted into it to increase the buffer density of the corresponding occlusive bag or otherwise support the occlusive bag in certain aneurysm morphologies, such as wide-necked aneurysms. Spiral 330 can be made with any biocompatible materials commonly used in the art, such as nickel-titanium alloy, chromium-cobalt alloys, platinum, nitinol, stainless steel, tantalum, or other alloys; or any other suitable biocompatible materials or a combination of those materials. The stiffness of the spiral 330 can be adjusted, for example, by typical spiral parameters of wire diameter of the spiral, coiled diameter of the spiral, pitch of the spiral and material of the spiral. In the example of a spiral, the diameter of the spiral is selected in consideration of the size and shape of the aneurysmal sac A, which can have a variety of shapes and sizes. [0104] Figures 12A to 121 show exemplary modalities of braiding 10 that are distributed in an aneurysm
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The example. Specifically, in Figure 12A, braid 10 can be seen initially advancing towards aneurysm A and bag 12 taking shape. In Figure 12B, it can be seen that braid 10 continues to be distally advanced towards the dome of aneurysm A and folds to form bag 12. However, braid 10 is not limited to this and in certain modalities, as braid 10 leaves catheter 20, braid 10 can begin to invert to form bag 12 without a break 13 and regardless of its position with respect to dome D. The term break is used in the present invention to include a region of the braid which facilitates inversion and / or prevents twisting of the braid during application. The break may include one or more local changes in physical properties with respect to other strand regions (for example, increased, pre-weakened flexibility, etc.). The bag 12 expands radially towards the walls of aneurysm A while the unexpanded portions 17 of the braid 10 continue to be translated. It is understood that the break 13 can be formed in the interstices of the braid 10 so that the inverted fold occurs after the braid 10 has moved distally by a predetermined distance. Break 13 may include localized heat treatment to make braid 10 more ductile, however, anti-twist and induce a gradual bending curve. In this regard, the break 13 which includes localized heat treatment, can make the braid 10 capable of expanding after inversion. The break 13 can also simply be a weak point or pre-adjusted buckling point for a particular bag 12, so that the buckling is induced in order to avoid deformation of the aneurysm A. Alternatively, no break 13 can be included and, in instead, braid 10 can be inverted and folded after contact with the dome of aneurysm A based on the preselected malleability of braid 10.
[0105] In certain embodiments, bag 12 can be sized
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33/39 only for a specific size A aneurysm. However, in other embodiments, the bag 12 can be conformable or adjusted by the operator to sufficiently buffer multiple aneurysms (for example, from approximately 6 mm to approximately 10 mm) by advancing portion 17 so that the bag 12 be adjusted as needed. For example, moving portion 17 distally from the first to the second position can adjust from a first occlusion configuration to a second configuration. This is particularly advantageous in a clinical setting as it means that accurate measurement of aneurysm A is unnecessary and, instead, bag 12 can be precisely and securely adjusted to fit aneurysm A in a way that occludes without risk of rupture.
[0106] In Figure 12C, the bag 12 is almost completely formed and in Figure 12D, the portions 17 have been translated distally so that the bag 12 is completely formed without portions additionally necessary to expand. In Figure 12D, specifically, it can be seen that the formed bag 12 is now adjacent and supports dome D. The braid 10, however, can continue to be translated to form one or more additional internal bags in the bag 12, so superimposing the bag 12 to decrease porosity and / or further delay the flow in the aneurysm. For example, in Figure 12E, a second break can be included in the braid 10, so that, as portion 17 continues to be translated distally, a second bag 15 can begin to form and invert. In Figure 12F, portion 17 has moved further distally, so that the second bag 15 is now completely formed and superimposed within bag 12. In Figures 12G to 121, after the formation of bags 12, 15, portion 17 can continue to be translated distally while other portions of strand 10 are not
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34/39 are more inverted. In this regard, portion 17 can be considered a non-inverted portion of braid 10 close to bags 12, 15. Portion 17 is moved distally to load bag 15 with portions 17, similarly to a spiral approach. However, unlike a spiral approach, portions 17 can both carry bags 12,15 and then retract from them if an operator wishes to reposition or redefine strand 10 with aneurysm A. The buffer density of the bag 12 can be adjusted by advancing the portions 17 distally or proximally between one or more predetermined definitions (for example, a first definition of 15%, a second definition of 20%, a third definition of 25%, etc.). Fluid occlusion rates can also be optimized by varying the porosity along the strand 10, which includes ends 14, 16, portion 17 and / or bags 12, 15. The modalities shown here are merely exemplary approaches to the strand disclosed in the present invention 10. Other embodiments could include just one occlusive bag or more than two exemplary occlusive bags, as shown.
[0107] It is understood that variations of braid 10 can include various materials, such as stainless steel, bioabsorbable materials and polymers. Braid 10, including any specific portions such as any breaks and corresponding bags, can be heat-adjusted for various configurations, such as spherical, oblong, saddle-shaped, etc. with the purpose of formatting the initial sac to better correspond to the morphology of aneurysm. In addition, the braid 10 can be thermally shaped to include weak points to facilitate buckling of the braid when it reaches the aneurysm dome.
[0108] It is also understood that any bag formed by the braids 10 discussed here can have a spherical shape as shown
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35/39 or any other format, as needed or required, such as ellipsoidal, heart-shaped, ovoid, cylindrical, hemispherical or similar. Additionally, the interstices of the braid 10 that form the bag can vary, or be selectively designed, in size or shape along its length, depending on how much of the braid 10 is caused to expand radially as the pressing mechanism 38 is moved distally. .
[0109] The specific configurations, the choice of materials and the size and shape of various elements may vary according to the specifications or restrictions of a specific design that require a system or method built in accordance with the principles of the revealed technology. Such modifications are intended to be included within the scope of the disclosed technology. Therefore, the modalities disclosed herein are considered in all respects to be illustrative and not restrictive. Therefore, it will be evident from the aforementioned that, although specific forms of the description have been illustrated and described, various modifications can be made without deviating from the character and scope of the description, and all changes understood in the meaning and scope of their equivalents are designed to be included in them.
ASPECTS OF THE INVENTION
1. System to treat an aneurysm that comprises:
a braid having a distal implant end opposite a proximal implant end, the braid having a lumen;
the braid being configured so that the distal translation from the proximal implant end towards the distal implant end causes the distal implant end to invert and fold over itself, thus forming an occlusive bag to occlude a aneurysm.
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2. Medical device, according to aspect 1, in which the braid is a self-expanding braid.
3. Medical device, according to aspect 1 or 2, in which the outer surface of the braid is self-expanding.
4. Medical device, according to any previous aspect, in which the braid is configured to assume a predetermined occlusive bag format.
5. Medical device, according to any previous aspect, in which the occlusive bag is configured to be substantially spherical in shape.
6. Medical device, according to any of aspects 1 to 5, in which the occlusive bag is configured to conform in shape to an asymmetric aneurysm or an aneurysm with multiple sacs.
7. Medical device, according to any of aspects 1 to 5, in which the occlusive bag is a retractable cage-type vessel-occlusive structure.
8. Medical device, according to any previous aspect, in which an external surface of the braid is comprised of a plurality of interstices.
9. Medical device, according to aspect 8, in which the dimensions of the interstices vary at the distal implant end against the proximal implant end.
10. Medical device, according to any of aspects 1 to 7, in which at least a portion of the braid defines a plurality of interstices with openings for aneurysm occlusion.
11. Medical device, according to any previous aspect, in which the braid is configured to be of sufficient length so that uninverted portions of the braid do not form the occlusive bag fold in the occlusive bag, according to the distal translation
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37/39 continues, to increase the buffer density of the occlusive bag.
12. Medical device, according to any previous aspect, in which the proximal implant end is less malleable and / or has less material resistance than the distal implant end.
13. Medical device, according to any previous aspect, in which the braid is additionally configured to form, by means of continuous distal translation, a second bag in the occlusive bag, in which each bag is formed from the inversion and fold in itself of the braided.
14. Medical device, according to any previous aspect, in which the braid additionally comprises a break arranged between the distal and proximal implant ends, in which the break is configured to cause the occlusive bag to form when the implant end distal is moved distally towards the aneurysm.
15. Medical device, according to aspect 14, when dependent on aspect 13, in which the braid additionally comprises a second break arranged between the first break and the proximal implant end, in which the second break is configured to cause the second bag is formed by continuous distal translation.
16. Medical device, according to any previous aspect, which additionally comprises an embolization spiral at the end of the proximal implant end.
17. Medical device, according to any previous aspect, which additionally comprises an application system; where the proximal implant end is operable to be mechanically attached to the application system, with the
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38/39 application comprises a microcatheter and a pressing mechanism disposed in the microcatheter, the pressing mechanism being operable to transfer the braid.
18. Application system for an occlusive device to treat an aneurysm characterized by the fact that it comprises:
an application tube comprising a distal end and a proximal end, the application tube being able to be slidably placed in a microcatheter; and a pressing mechanism slidably arranged with or within the application tube, the pressing mechanism comprising a distal end and a proximal end;
the medical device, according to any one of aspects 1 to 16, slidably arranged on the application tube and mechanically fixed on the pressing mechanism, where the pressing mechanism is operable to move the medical device distally to an implanted condition for occlude the aneurysm;
in which the translation is in a distal direction, thus forming the occlusive sac for the aneurysm.
19. System, according to aspect 18, in which the distal implant end of the strand is removably attached adjacent to the distal end of the application tube, so that the strand begins inversion to form the occlusive bag immediately as braided leaves the distal end of the application tube.
20. System, according to any aspect of 18 and 19, which additionally comprises:
an imaging device operatively connected to the occlusive device, where the imaging device has
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39/39 ability to image the sac in relation to the aneurysm; and being that an orientation and / or buffer density of the occlusive bag is adjustable by the braid that is distal or proximally moved.
21. System, according to any of aspects 18 to
20, in which the proximal implant end of the strand is removably attached to the distal end of the pressing mechanism.
22. System, according to any of aspects 18 to
21, in which the proximal implant end of the braid is attached to an internal portion of the pressing mechanism and is foldable over it.
23. System, according to any of the aspects 18 to
22, in which the distal end of the application tube comprises upper and lower gripping arms, with one or both gripping arms pivoting in the opposite direction to the other gripping arm to release the strand of the application tube.
24. System, according to any of aspects 18 to
23, wherein the pressing mechanism additionally comprises an internal passage through which at least one embolization spiral is insertable in the braid when the braid forms a sac in the aneurysm.
25. System, according to any of the aspects 18 to
24, wherein the distal end of the pressing mechanism comprises radiopaque material.

权利要求:
Claims (51)
[1]
1. System to treat an aneurysm, characterized by the fact that it comprises:
a braided tubular implant having a distal implant end and a proximal implant end, the braided tubular implant being invertible around the distal implant end;
a tubular application member around the braided tubular implant, the tubular member having a distal end releasably connected to the distal implant end;
the translation of the braided tubular implant distally from the tubular member causes the braided tubular implant to invert and fold over itself, thus forming an occlusive bag configured to occlude the aneurysm.
[2]
2. System according to claim 1, characterized by the fact that the braided tubular implant additionally comprises a break arranged between the distal implant end and the proximal implant end and configured to cause the occlusive bag to form when the distal implant tip is moved towards the aneurysm.
[3]
3. System, according to claim 1, characterized by the fact that the braided tubular implant additionally comprises a break formed from the localized heat treatment zone that is anti-twist and configured to induce gradual folding of the braided tubular implant, with the The break is arranged between the application and proximal implant ends, and is configured to cause the occlusive sac to form when the distal implant tip is distally transferred towards the aneurysm.
[4]
4. System according to claim 1, characterized
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2/11 by the fact that a distal end of the distal implant end is substantially atraumatic or rounded and configured to minimize twisting of the twisted tubular implant during inversion.
[5]
5. System, according to claim 1, characterized by the fact that the continuous distal translation of the braided tubular implant after the formation of the occlusive sac causes a second sac to form in the occlusive sac, each sac being formed from the twisted tubular implant that reverses and folds over itself.
[6]
6. System, according to claim 1, characterized by the fact that the tubular application member is a microcatheter, the system additionally comprises an application system;
where the proximal implant end is operable to fix mechanically to the application system, the application system comprising the microcatheter and a pressing mechanism disposed in the microcatheter, in which the pressing mechanism is operable to transfer the strand towards aneurysm.
[7]
7. System according to claim 1, characterized by the fact that the occlusive bag is substantially spherical.
[8]
8. System according to claim 1, characterized by the fact that the occlusive bag is conformable to an asymmetric aneurysm or an aneurysm with multiple sacs.
[9]
9. System according to claim 1, characterized by the fact that the proximal implant end is at least one among being less malleable and having less material resistance than the distal implant end.
[10]
10. System according to claim 1, characterized by the fact that the fixation portion is at least one among the less malleable and has less material resistance than the application portion.
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3/11
[11]
11. System according to claim 1, characterized by the fact that an external surface of the braid is comprised of a plurality of interstices.
[12]
12. System according to claim 11, characterized by the fact that the dimensions of the interstices vary at the distal implant end versus the proximal implant end.
[13]
13. Method for applying an occlusion device to an aneurysm characterized by the fact that it comprises:
positioning an occlusion device in an application tube, the occlusion device comprising a self-expanding braid;
sliding the strand distally towards the aneurysm, thereby expanding a distal implant end of the strand from a retracted condition to an implanted condition; and inverting the distal implant end of the braid to form an occlusive bag configured to occlude the aneurysm.
[14]
Method according to claim 13, characterized in that the distal implant end of the strand begins to expand immediately as the strand exits a distal end of the delivery tube.
[15]
15. Method according to claim 13, characterized by the fact that it additionally comprises:
selectively position a microcatheter in the vasculature; and position the occlusion device mounted with the application tube inside the microcatheter.
[16]
16. Method according to claim 13, characterized in that the bag, when formed, comprises a predetermined buffer density range.
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[17]
17. Method, according to claim 13, characterized by the fact that it additionally comprises:
imagine the sac in relation to the aneurysm;
determine whether the aneurysm is occluded by the sac; and slide the braid distally or proximally to adjust the sac and occlude the aneurysm.
[18]
18. Method, according to claim 13, characterized by the fact that the bag is a first bag, additionally comprises: it continues to slide the braid distally towards the aneurysm after the formation of the first bag, thereby changing the density tamponade of the occlusive bag with one or more unexpanded portions of the braid.
[19]
19. Method, according to claim 13, characterized by the fact that the braid additionally comprises:
a first break defined by a size of the sac to plug the aneurysm; and a second break in the braid after the first break;
the method additionally comprising:
slide the braid distally towards the aneurysm after the formation of the first sac; and inverting the braid on the second break to form a second bag in the first bag.
[20]
20. Method according to claim 13, characterized by the fact that it additionally comprises:
slide the braid distally towards the aneurysm after the formation of the first sac; and inverting the braid to form a second bag in the first bag.
[21]
21. Method, according to claim 13, characterized by the fact that it additionally comprises:
Petition 870190098227, of 10/01/2019, p. 47/75
5/11 slide the braid distally towards the aneurysm after the formation of the first sac;
inverting the braid to form a second bag in the first bag;
slide the braid distally towards the aneurysm after the formation of the second sac; and inverting the braid to form a third bag in the first and second bags;
[22]
22. Method, according to claim 13, characterized by the fact that it additionally comprises:
continue to slide the braid distally towards the aneurysm after the formation of the first sac, thereby plugging the sac with one or more unexpanded portions of the braid.
[23]
23. Method according to claim 13, characterized by the fact that it additionally comprises:
determine a position of the sac in relation to the aneurysm; and if the position does not satisfy a fit limit with the aneurysm, then slide the braid proximally, thereby causing the bag to retract back to the braid; and remove the braid from the aneurysm.
[24]
24. Method, according to claim 13, characterized by the fact that the strand additionally comprises a break formed from a localized heat treatment zone that is anti-twist and configured to induce gradual folding of the strand during application, the break is arranged between the application and proximal implant ends, and is configured to cause the occlusive sac to form when the distal implant tip is distally moved towards the aneurysm.
Petition 870190098227, of 10/01/2019, p. 48/75
6/11
[25]
25. Application system for an occlusive device to treat an aneurysm characterized by the fact that it comprises:
an application tube comprising a distal end and a proximal end, the application tube being able to be slidably placed in a microcatheter; and a pressing mechanism slidably arranged with or within the application tube, the pressing mechanism comprising a distal end and a proximal end;
in which the occlusive device is slidably arranged in the application tube and is mechanically attached to the pressing mechanism, the occlusive device comprising a braid that has a distal implant end and a proximal implant end, with distal translation of the braid, through the pressing mechanism, causes the distal implant tip to invert and fold over itself, thus forming an occlusive sac for the aneurysm.
[26]
26. System according to claim 25, characterized in that the distal implant end of the strand begins to invert to form the occlusive bag immediately as the strand exits a distal end of the application tube.
[27]
27. System according to claim 25, characterized by the fact that an imaging device in operational communication with the occlusive device, in which the imaging device is capable of imaging the bag in relation to the aneurysm; and where an orientation and / or buffer density of the occlusive bag is adjustable by the braid that is distal or
Petition 870190098227, of 10/01/2019, p. 49/75
7/11 proximally moved.
[28]
28. System according to claim 25, characterized by the fact that the implant end proximal to the braid is fixed to an internal portion of the pressing mechanism and by being foldable over it.
[29]
29. System according to claim 25, characterized by the fact that the implant end proximal to the braid is removably attached to the distal end of the pressing mechanism.
[30]
30. System according to claim 25, characterized by the fact that at least a portion of the braid defines a plurality of interstices with openings for occlusion of the aneurysm.
[31]
31. System according to claim 25, characterized by the fact that the occlusive bag is a retractable cage-type vaso-occlusive structure.
[32]
32. System according to claim 25, characterized by the fact that the distal end of the application tube comprises upper and lower gripping arms, with one or both gripping arms pivoting towards the other gripping arm for release the braid from the application tube.
[33]
33. System according to claim 25, characterized in that the pressing mechanism additionally comprises an internal passage through which at least one embolization spiral is insertable in the braid when the braid forms a bag around the aneurysm.
[34]
34. System according to claim 25, characterized by the fact that the distal end of the pressing mechanism comprises radiopaque material.
[35]
35. Method for applying an occlusion device to a
Petition 870190098227, of 10/01/2019, p. 50/75
8/11 aneurysm characterized by the fact that it comprises:
position a microcatheter in a patient's vasculature;
positioning an application system of the occlusion device in the microcatheter, the application system comprising an application tube comprising a distal end and a proximal end and a pressing mechanism slidably arranged in the application tube, the compression mechanism comprising a distal end and a proximal end;
slidingly position a self-expanding braid of the occlusion device in the application tube, the braid comprising a distal end and a proximal end;
removably fix the proximal end of the braid to the distal end of the pressing mechanism;
slide the braid distally, by the pressing mechanism, from the application tube towards the aneurysm, which causes the braid to expand and move from a retracted condition in the application tube to a condition implanted in the aneurysm, as that the distal end of the braid moves outwardly and in the opposite direction to the distal end of the application tube; and releasing the occlusion device and removing the catheter and delivery system from the patient.
[36]
36. Method according to claim 35, characterized by the fact that it additionally comprises:
form, by inverting the braid, an occlusive sac in the aneurysm, sliding the braid distally from the application tube;
slide the pressing mechanism distally to the distal end of the application tube until the braid folds; and
Petition 870190098227, of 10/01/2019, p. 51/75
9/11 load the bag, through the braid being folded, in the aneurysm to occlude the flow in the aneurysm.
[37]
37. Method, according to claim 36, characterized by the fact that the bag is formed in the aneurysm by inverting the braid as the braid slides distally and leaves the application tube and protrudes against the aneurysm.
[38]
38. Method according to claim 37, characterized by the fact that it additionally comprises:
deflect the pressing mechanism as the braid is inverted and reaches a dome of the aneurysm.
[39]
39. Method, according to claim 38, characterized by the fact that it additionally comprises: it continues to move distally, through the pressing mechanism, the braid in the aneurysm until the proximal end of the braid reaches the distal end of the pressing mechanism.
[40]
40. Method according to claim 36, characterized in that the braid is folded over the distal end of the pressing mechanism.
[41]
41. Method, according to claim 36, characterized by the fact that it additionally comprises:
fix the proximal end of the braid to an internal portion of the pressing mechanism.
[42]
42. Method according to claim 36, characterized by the fact that it additionally comprises:
load the bag by folding the braid until the braid is at least level with an aneurysm neck.
[43]
43. Method, according to claim 35, characterized by the fact that it additionally comprises:
form, through the braid, a sac around the aneurysm
Petition 870190098227, of 10/01/2019, p. 52/75
10/11 sliding the braid distally to the condition implanted in the aneurysm;
separate the bag from the application system with a gripping mechanism comprising a pair of opposing upper and lower gripping arms formed at one distal end of the application tube, with one or both gripping arms pivoting towards the other arm of grasping.
[44]
44. Method according to claim 43, characterized by the fact that the bag is a retractable cage-type vessel-occlusive structure.
[45]
45. Method according to claim 43, characterized by the fact that it additionally comprises:
insert at least one embolization spiral through an internal passage of the pressing mechanism and into the bag.
[46]
46. Method, according to claim 35, characterized by the fact that it additionally comprises:
form, by inverting the braid, a first occlusive sac in the aneurysm by sliding the braid of the application tube distally towards the aneurysm;
slide the braid distally towards the aneurysm after the formation of the first sac; and inverting the braid to form a second bag in the first bag.
[47]
47. Method according to claim 46, characterized by the fact that the formation of the first and second bags causes the flow in the aneurysm to be deflected, deflected or delayed.
[48]
48. Method, according to claim 35, characterized by the fact that it additionally comprises:
form, by inverting the braid, a first occlusive sac in the aneurysm by sliding the braid of the
Petition 870190098227, of 10/01/2019, p. 53/75
11/11 application towards the aneurysm;
slide the braid distally towards the aneurysm after the formation of the first sac;
inverting the braid to form a second bag in the first bag;
slide the braid distally towards the aneurysm after the formation of the second sac; and inverting the braid to form a third bag in the first and second bags;
[49]
49. Method according to claim 48, characterized by the fact that the formation of the first, second and third sacs causes the flow in the aneurysm to be deflected, deflected or delayed.
[50]
50. Method, according to claim 35, characterized by the fact that the braid additionally comprises a break formed from the localized heat treatment zone which is anti-twist and is configured to induce gradual folding of the braid during application, with the The break is arranged between the proximal and distal ends of the braid and is configured to cause an occlusive sac to form when the distal end is distally transferred towards the aneurysm.
[51]
51. Method according to claim 35, characterized in that the distal end of the braid is substantially atraumatic or rounded and configured to minimize twisting of the braided tubular implant during inversion.

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引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

---

US5334210A|1993-04-09|1994-08-02|Cook Incorporated|Vascular occlusion assembly|

---

US6168622B1|1996-01-24|2001-01-02|Microvena Corporation|Method and apparatus for occluding aneurysms|

---

US7410482B2|1998-09-04|2008-08-12|Boston Scientific-Scimed, Inc.|Detachable aneurysm neck bridge|

---

US6331184B1|1999-12-10|2001-12-18|Scimed Life Systems, Inc.|Detachable covering for an implantable medical device|

---

US6391037B1|2000-03-02|2002-05-21|Prodesco, Inc.|Bag for use in the intravascular treatment of saccular aneurysms|

---

US6346117B1|2000-03-02|2002-02-12|Prodesco, Inc.|Bag for use in the intravascular treatment of saccular aneurysms|

---

US8715312B2|2001-07-20|2014-05-06|Microvention, Inc.|Aneurysm treatment device and method of use|

---

US8252040B2|2001-07-20|2012-08-28|Microvention, Inc.|Aneurysm treatment device and method of use|

---

US20030195553A1|2002-04-12|2003-10-16|Scimed Life Systems, Inc.|System and method for retaining vaso-occlusive devices within an aneurysm|

---

US20040044391A1|2002-08-29|2004-03-04|Stephen Porter|Device for closure of a vascular defect and method of treating the same|

---

US7371228B2|2003-09-19|2008-05-13|Medtronic Vascular, Inc.|Delivery of therapeutics to treat aneurysms|

---

US9308382B2|2004-06-10|2016-04-12|Medtronic Urinary Solutions, Inc.|Implantable pulse generator systems and methods for providing functional and/or therapeutic stimulation of muscles and/or nerves and/or central nervous system tissue|

---

US8777974B2|2004-03-19|2014-07-15|Aga Medical Corporation|Multi-layer braided structures for occluding vascular defects|

---

BE1016067A3|2004-06-03|2006-02-07|Frid Noureddine|Luminal endoprosthesis FOR OBSTRUCTION OF ANEURYSM AND METHOD OF MANUFACTURING SUCH STENT.|

---

CA2595809A1|2004-08-31|2006-03-09|Cook Incorporated|Device for treating an aneurysm|

---

US9655633B2|2004-09-10|2017-05-23|Penumbra, Inc.|System and method for treating ischemic stroke|

---

AU2005305367A1|2004-09-22|2006-05-18|Lee R. Guterman|Cranial aneurysm treatment arrangement|

---

US20060089637A1|2004-10-14|2006-04-27|Werneth Randell L|Ablation catheter|

---

JP2008519613A|2004-11-09|2008-06-12|ボストン サイエンティフィック リミテッド|Vascular occlusion device with composite shaped proximal portion and smaller diameter distal|

---

US8562672B2|2004-11-19|2013-10-22|Medtronic, Inc.|Apparatus for treatment of cardiac valves and method of its manufacture|

---

US8025668B2|2005-04-28|2011-09-27|C. R. Bard, Inc.|Medical device removal system|

---

US9636115B2|2005-06-14|2017-05-02|Stryker Corporation|Vaso-occlusive delivery device with kink resistant, flexible distal end|

---

US7850685B2|2005-06-20|2010-12-14|Medtronic Ablation Frontiers Llc|Ablation catheter|

---

WO2007076179A2|2005-11-17|2007-07-05|Microvention, Inc.|Three-dimensional complex coil|

---

US20070186933A1|2006-01-17|2007-08-16|Pulmonx|Systems and methods for delivering flow restrictive element to airway in lungs|

---

US9757260B2|2006-03-30|2017-09-12|Medtronic Vascular, Inc.|Prosthesis with guide lumen|

---

US9615832B2|2006-04-07|2017-04-11|Penumbra, Inc.|Aneurysm occlusion system and method|

---

US8377091B2|2006-06-15|2013-02-19|Microvention, Inc.|Embolization device constructed from expansile polymer|

---

US20080281350A1|2006-12-13|2008-11-13|Biomerix Corporation|Aneurysm Occlusion Devices|

---

US9414842B2|2007-10-12|2016-08-16|St. Jude Medical, Cardiology Division, Inc.|Multi-component vascular device|

---

BRPI0821070B1|2007-12-21|2018-10-23|Microvention Inc|implantation device and method for preparing a hydrogel filament for implantation in an animal|

---

US8974518B2|2008-03-25|2015-03-10|Medtronic Vascular, Inc.|Eversible branch stent-graft and deployment method|

---

EP2310077A1|2008-04-30|2011-04-20|Medtronic, Inc.|Techniques for placing medical leads for electrical stimulation of nerve tissue|

---

US8070694B2|2008-07-14|2011-12-06|Medtronic Vascular, Inc.|Fiber based medical devices and aspiration catheters|

---

US8333796B2|2008-07-15|2012-12-18|Penumbra, Inc.|Embolic coil implant system and implantation method|

---

US9351715B2|2008-07-24|2016-05-31|St. Jude Medical, Cardiology Division, Inc.|Multi-layered medical device for treating a target site and associated method|

---

US9232992B2|2008-07-24|2016-01-12|Aga Medical Corporation|Multi-layered medical device for treating a target site and associated method|

---

US20100069948A1|2008-09-12|2010-03-18|Micrus Endovascular Corporation|Self-expandable aneurysm filling device, system and method of placement|

---

US8721714B2|2008-09-17|2014-05-13|Medtronic Corevalve Llc|Delivery system for deployment of medical devices|

---

KR101719831B1|2009-04-15|2017-03-24|마이크로벤션, 인코포레이티드|Implant delivery system|

---

US8758423B2|2009-06-18|2014-06-24|Graftcraft I Goteborg Ab|Device and method for treating ruptured aneurysms|

---

US8911487B2|2009-09-22|2014-12-16|Penumbra, Inc.|Manual actuation system for deployment of implant|

---

US20110152993A1|2009-11-05|2011-06-23|Sequent Medical Inc.|Multiple layer filamentary devices or treatment of vascular defects|

---

JP5899200B2|2010-04-14|2016-04-06|マイクロベンション インコーポレイテッド|Implant delivery device|

---

US8764811B2|2010-04-20|2014-07-01|Medtronic Vascular, Inc.|Controlled tip release stent graft delivery system and method|

---

US8876878B2|2010-07-23|2014-11-04|Medtronic, Inc.|Attachment mechanism for stent release|

---

JP6087281B2|2010-09-10|2017-03-01|メディナ メディカル，インコーポレイテッド|Device and method for treating vascular abnormalities|

---

US8616040B2|2010-09-17|2013-12-31|Medtronic Vascular, Inc.|Method of forming a drug-eluting medical device|

---

US8998947B2|2010-09-18|2015-04-07|Medina Medical, Inc.|Devices and methods for the treatment of vascular defects|

---

BR112013015437A2|2010-12-20|2016-09-20|Microvention Inc|polymeric stents and manufacturing methods|

---

US20120283768A1|2011-05-05|2012-11-08|Sequent Medical Inc.|Method and apparatus for the treatment of large and giant vascular defects|

---

US9486604B2|2011-05-12|2016-11-08|Medtronic, Inc.|Packaging and preparation tray for a delivery system|

---

WO2012158668A1|2011-05-17|2012-11-22|Stryker Corporation|Method of fabricating an implantable medical device that includes one or more thin film polymer support layers|

---

EP3741314A1|2011-05-23|2020-11-25|Covidien LP|Retrieval systems|

---

WO2012166467A1|2011-05-27|2012-12-06|Stryker Corporation|Assembly for percutaneously inserting an implantable medical device, steering the device to a target location and deploying the device|

---

US9750565B2|2011-09-30|2017-09-05|Medtronic Advanced Energy Llc|Electrosurgical balloons|

---

US20130204351A1|2012-02-02|2013-08-08|Inceptus Medical LLC|Aneurysm Graft Devices And Methods|

---

CN104487024B|2012-03-16|2017-08-29|微仙美国有限公司|Support and support delivery device|

---

US9717421B2|2012-03-26|2017-08-01|Medtronic, Inc.|Implantable medical device delivery catheter with tether|

---

US9833625B2|2012-03-26|2017-12-05|Medtronic, Inc.|Implantable medical device delivery with inner and outer sheaths|

---

US9242290B2|2012-04-03|2016-01-26|Medtronic Vascular, Inc.|Method and apparatus for creating formed elements used to make wound stents|

---

US9700399B2|2012-04-26|2017-07-11|Medtronic Vascular, Inc.|Stopper to prevent graft material slippage in a closed web stent-graft|

---

US9549832B2|2012-04-26|2017-01-24|Medtronic Vascular, Inc.|Apparatus and methods for filling a drug eluting medical device via capillary action|

---

US9149190B2|2012-07-17|2015-10-06|Stryker Corporation|Notification system of deviation from predefined conditions|

---

JP2015525653A|2012-08-13|2015-09-07|マイクロベンション インコーポレイテッド|Mold removal device|

---

US9504476B2|2012-10-01|2016-11-29|Microvention, Inc.|Catheter markers|

---

KR102275634B1|2012-10-15|2021-07-08|마이크로벤션, 인코포레이티드|Polymeric treatment compositions|

---

US20140135811A1|2012-11-13|2014-05-15|Covidien Lp|Occlusive devices|

---

US9539022B2|2012-11-28|2017-01-10|Microvention, Inc.|Matter conveyance system|

---

US9931107B2|2012-12-07|2018-04-03|Medtronic, Inc.|Minimally invasive implantable neurostimulation system|

---

US10342546B2|2013-01-14|2019-07-09|Microvention, Inc.|Occlusive device|

---

US9681861B2|2013-03-11|2017-06-20|St. Jude Medical, Cardiology Division, Inc.|Percutaneous catheter directed collapsible medical closure device|

---

US9539382B2|2013-03-12|2017-01-10|Medtronic, Inc.|Stepped catheters with flow restrictors and infusion systems using the same|

---

US9539011B2|2013-03-14|2017-01-10|Stryker Corporation|Vaso-occlusive device delivery system|

---

WO2014159584A2|2013-03-14|2014-10-02|Stryker Corporation|Vaso-occlusive device delivery system|

---

EP2967572B1|2013-03-14|2019-04-24|Stryker Corporation|Vaso-occlusive device delivery system|

---

JP2016511126A|2013-03-15|2016-04-14|マイクロベンション インコーポレイテッド|Multi-element obstacle removal system and method|

---

CN105377184B|2013-03-15|2017-06-30|微仙美国有限公司|Embolization protective device|

---

US9398966B2|2013-03-15|2016-07-26|Medtronic Vascular, Inc.|Welded stent and stent delivery system|

---

US9314324B2|2013-07-29|2016-04-19|Insera Therapeutics, Inc.|Vascular treatment devices and methods|

---

WO2014144980A1|2013-03-15|2014-09-18|Covidien Lp|Occlusive device|

---

ES2717678T3|2013-04-22|2019-06-24|Stryker European Holdings I Llc|Procedure for loading drugs onto implant surfaces coated with hydroxyapatite|

---

US9445928B2|2013-05-30|2016-09-20|Medtronic Vascular, Inc.|Delivery system having a single handed deployment handle for a retractable outer sheath|

---

US9955976B2|2013-08-16|2018-05-01|Sequent Medical, Inc.|Filamentary devices for treatment of vascular defects|

---

US9675782B2|2013-10-10|2017-06-13|Medtronic Vascular, Inc.|Catheter pull wire actuation mechanism|

---

US9439827B2|2013-10-25|2016-09-13|Medtronic Vascular, Inc.|Tissue compression device with pressure indicator|

---

WO2015095806A2|2013-12-20|2015-06-25|Microvention, Inc.|Device delivery system|

---

JP6412137B2|2013-12-20|2018-10-24|マイクロベンション インコーポレイテッドＭｉｃｒｏｖｅｎｔｉｏｎ， Ｉｎｃ．|Discharge adapter|

---

US11076860B2|2014-03-31|2021-08-03|DePuy Synthes Products, Inc.|Aneurysm occlusion device|

---

US11154302B2|2014-03-31|2021-10-26|DePuy Synthes Products, Inc.|Aneurysm occlusion device|

---

CN106163459B|2014-04-08|2018-05-29|斯瑞克公司|Implantation material delivery system|

---

WO2015160721A1|2014-04-14|2015-10-22|Sequent Medical Inc.|Devices for therapeutic vascular procedures|

---

US20170049596A1|2014-04-30|2017-02-23|Stryker Corporation|Implant delivery system and method of use|

---

US9060777B1|2014-05-28|2015-06-23|Tw Medical Technologies, Llc|Vaso-occlusive devices and methods of use|

---

US9668898B2|2014-07-24|2017-06-06|Medtronic Vascular, Inc.|Stent delivery system having dynamic deployment and methods of manufacturing same|

---

US9770577B2|2014-09-15|2017-09-26|Medtronic Xomed, Inc.|Pressure relief for a catheter balloon device|

---

US9579484B2|2014-09-19|2017-02-28|Medtronic Vascular, Inc.|Sterile molded dispenser|

---

US9692557B2|2015-02-04|2017-06-27|Stryker European Holdings I, Llc|Apparatus and methods for administering treatment within a bodily duct of a patient|

---

KR20180020125A|2015-03-27|2018-02-27|프레지던트 앤드 펠로우즈 오브 하바드 칼리지|Modified T cells and methods for their manufacture and use|

---

US10307168B2|2015-08-07|2019-06-04|Terumo Corporation|Complex coil and manufacturing techniques|

---

US10154905B2|2015-08-07|2018-12-18|Medtronic Vascular, Inc.|System and method for deflecting a delivery catheter|

---

CN107847243B|2015-08-11|2021-06-01|泰尔茂株式会社|Systems and methods for implant delivery|

---

US10182931B2|2015-09-18|2019-01-22|Microvention, Inc.|Releasable delivery system|

---

JP6938471B2|2015-09-18|2021-09-22|マイクロベンション インコーポレイテッドＭｉｃｒｏｖｅｎｔｉｏｎ， Ｉｎｃ．|Implant retention, separation and pressing system|

---

CN108156803B|2015-09-18|2021-05-04|泰尔茂株式会社|Pushable implant delivery system|

---

US10335299B2|2015-09-18|2019-07-02|Terumo Corporation|Vessel prosthesis|

---

EP3352689B1|2015-09-21|2018-12-26|Stryker Corporation|Embolectomy devices|

---

EP3352688B1|2015-09-21|2020-02-19|Stryker Corporation|Embolectomy devices|

---

US10172632B2|2015-09-22|2019-01-08|Medtronic Vascular, Inc.|Occlusion bypassing apparatus with a re-entry needle and a stabilization tube|

---

US10327791B2|2015-10-07|2019-06-25|Medtronic Vascular, Inc.|Occlusion bypassing apparatus with a re-entry needle and a distal stabilization balloon|

---

WO2017062383A1|2015-10-07|2017-04-13|Stryker Corporation|Multiple barrel clot removal devices|

---

US10786302B2|2015-10-09|2020-09-29|Medtronic, Inc.|Method for closure and ablation of atrial appendage|

---

US10271873B2|2015-10-26|2019-04-30|Medtronic Vascular, Inc.|Sheathless guide catheter assembly|

---

WO2017087816A1|2015-11-19|2017-05-26|Penumbra, Inc.|Systems and methods for treatment of stroke|

---

US10631946B2|2015-11-30|2020-04-28|Penumbra, Inc.|System for endoscopic intracranial procedures|

---

US10369326B2|2015-12-09|2019-08-06|Medtronic Vascular, Inc.|Catheter with a lumen shaped as an identification symbol|

---

US10500046B2|2015-12-14|2019-12-10|Medtronic, Inc.|Delivery system having retractable wires as a coupling mechanism and a deployment mechanism for a self-expanding prosthesis|

---

US10159568B2|2015-12-14|2018-12-25|Medtronic, Inc.|Delivery system having retractable wires as a coupling mechanism and a deployment mechanism for a self-expanding prosthesis|

---

WO2017117284A1|2015-12-30|2017-07-06|Stryker Corporation|Embolic devices and methods of manufacturing same|

---

US20170189033A1|2016-01-06|2017-07-06|Microvention, Inc.|Occlusive Embolic Coil|

---

US10070950B2|2016-02-09|2018-09-11|Medtronic Vascular, Inc.|Endoluminal prosthetic assemblies, and associated systems and methods for percutaneous repair of a vascular tissue defect|

---

AU2017218115B2|2016-02-10|2020-03-05|Microvention, Inc.|Devices for vascular occlusion|

---

CA3014315A1|2016-02-10|2017-08-17|Microvention, Inc.|Intravascular treatment site access|

---

US10188500B2|2016-02-12|2019-01-29|Medtronic Vascular, Inc.|Stent graft with external scaffolding and method|

---

CN108883254A|2016-03-31|2018-11-23|美敦力瓦斯科尔勒公司|Expansible guide sheath with steering mechanism|

---

US20170281331A1|2016-03-31|2017-10-05|Medtronic Vascular, Inc.|Endoluminal prosthetic devices having fluid-absorbable compositions for repair of a vascular tissue defect|

---

US10695542B2|2016-04-04|2020-06-30|Medtronic Vascular, Inc.|Drug coated balloon|

---

US10252024B2|2016-04-05|2019-04-09|Stryker Corporation|Medical devices and methods of manufacturing same|

---

US10441407B2|2016-04-12|2019-10-15|Medtronic Vascular, Inc.|Gutter filling stent-graft and method|

---

US9987122B2|2016-04-13|2018-06-05|Medtronic Vascular, Inc.|Iliac branch device and method|

---

US10010403B2|2016-04-18|2018-07-03|Medtronic Vascular, Inc.|Stent-graft prosthesis and method of manufacture|

---

US20170304097A1|2016-04-21|2017-10-26|Medtronic Vascular, Inc.|Stent-graft delivery system having an inner shaft component with a loading pad or covering on a distal segment thereof for stent retention|

---

US10940294B2|2016-04-25|2021-03-09|Medtronic Vascular, Inc.|Balloon catheter including a drug delivery sheath|

---

CN109414272B|2016-04-25|2021-09-28|斯瑞克公司|Reverse mechanical thrombectomy device and method for use in a vascular system|

---

US10517711B2|2016-04-25|2019-12-31|Medtronic Vascular, Inc.|Dissection prosthesis system and method|

---

JP6873227B2|2016-04-25|2021-05-19|ストライカー コーポレイションＳｔｒｙｋｅｒ Ｃｏｒｐｏｒａｔｉｏｎ|Mechanical thrombectomy device that wraps the clot|

---

EP3590446B1|2016-04-25|2021-01-06|Stryker Corporation|Anti-jamming and macerating thrombectomy apparatuses|

---

US10191615B2|2016-04-28|2019-01-29|Medtronic Navigation, Inc.|Method and apparatus for image-based navigation|

---

US10406011B2|2016-04-28|2019-09-10|Medtronic Vascular, Inc.|Implantable medical device delivery system|

---

US11147952B2|2016-04-28|2021-10-19|Medtronic Vascular, Inc.|Drug coated inflatable balloon having a thermal dependent release layer|

---

US10292844B2|2016-05-17|2019-05-21|Medtronic Vascular, Inc.|Method for compressing a stented prosthesis|

---

WO2017210092A1|2016-06-01|2017-12-07|Microvention, Inc.|Improved reinforced balloon catheter|

---

WO2017210487A1|2016-06-03|2017-12-07|Stryker Corporation|Inverting thrombectomy apparatuses|

---

US10751066B2|2017-02-23|2020-08-25|DePuy Synthes Products, Inc.|Aneurysm device and delivery system|

---

US10751065B2|2017-12-22|2020-08-25|DePuy Synthes Products, Inc.|Aneurysm device and delivery system|

---

US10716574B2|2017-12-22|2020-07-21|DePuy Synthes Products, Inc.|Aneurysm device and delivery method|

---

US10905430B2|2018-01-24|2021-02-02|DePuy Synthes Products, Inc.|Aneurysm device and delivery system|US11154302B2|2014-03-31|2021-10-26|DePuy Synthes Products, Inc.|Aneurysm occlusion device|

---

US11076860B2|2014-03-31|2021-08-03|DePuy Synthes Products, Inc.|Aneurysm occlusion device|

---

US9962146B2|2015-01-20|2018-05-08|Neurogami Medical, Inc.|Micrograft for the treatment of intracranial aneurysms and method for use|

---

US10925611B2|2015-01-20|2021-02-23|Neurogami Medical, Inc.|Packaging for surgical implant|

---

US10857012B2|2015-01-20|2020-12-08|Neurogami Medical, Inc.|Vascular implant|

---

US10751066B2|2017-02-23|2020-08-25|DePuy Synthes Products, Inc.|Aneurysm device and delivery system|

---

US10751065B2|2017-12-22|2020-08-25|DePuy Synthes Products, Inc.|Aneurysm device and delivery system|

---

US10716574B2|2017-12-22|2020-07-21|DePuy Synthes Products, Inc.|Aneurysm device and delivery method|

---

US10905430B2|2018-01-24|2021-02-02|DePuy Synthes Products, Inc.|Aneurysm device and delivery system|

---

US11058430B2|2018-05-25|2021-07-13|DePuy Synthes Products, Inc.|Aneurysm device and delivery system|

---

US10939915B2|2018-05-31|2021-03-09|DePuy Synthes Products, Inc.|Aneurysm device and delivery system|

---

US11123077B2|2018-09-25|2021-09-21|DePuy Synthes Products, Inc.|Intrasaccular device positioning and deployment system|

---

US11076861B2|2018-10-12|2021-08-03|DePuy Synthes Products, Inc.|Folded aneurysm treatment device and delivery method|

---

US11134953B2|2019-02-06|2021-10-05|DePuy Synthes Products, Inc.|Adhesive cover occluding device for aneurysm treatment|

---

EP3941392A1|2019-03-20|2022-01-26|Inqb8 Medical Technologies, LLC|Aortic dissection implant|

---

US20200305885A1|2019-03-27|2020-10-01|DePuy Synthes Products, Inc.|Aneurysm treatment device|

---

US20200305886A1|2019-03-27|2020-10-01|DePuy Synthes Products, Inc.|Aneurysm treatment device|

---

EP3854320A1|2020-01-22|2021-07-28|DePuy Synthes Products, Inc.|Layered braided aneurysm treatment device|

---

JP2020189093A|2019-05-21|2020-11-26|デピュイ・シンセス・プロダクツ・インコーポレイテッド|Layered braided aneurysm treatment device|

---

US10653425B1|2019-05-21|2020-05-19|DePuy Synthes Products, Inc.|Layered braided aneurysm treatment device|

---

US20210169495A1|2019-12-05|2021-06-10|DePuy Synthes Products, Inc.|Intrasaccular inverting braid with highly flexible fill material|

---

US20210186518A1|2019-12-18|2021-06-24|DePuy Synthes Products, Inc.|Implant having an intrasaccular section and intravascular section|

---

US20210338250A1|2020-04-30|2021-11-04|DePuy Synthes Products, Inc.|Intrasaccular Flow Diverter|

法律状态:
2021-10-19| B350| Update of information on the portal [chapter 15.35 patent gazette]|

优先权:

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申请号 | 申请日 | 专利标题

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US201762462685P| true| 2017-02-23|2017-02-23|

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PCT/US2018/019330|WO2018156833A1|2017-02-23|2018-02-23|Aneurysm device and delivery system|

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