Coil assemblies, components and methods

Information

  • Patent Grant
  • 8007509
  • Patent Number
    8,007,509
  • Date Filed
    Wednesday, October 12, 2005
    19 years ago
  • Date Issued
    Tuesday, August 30, 2011
    13 years ago
Abstract
Coil assemblies and related components and methods are disclosed. The coil assemblies can include two or more embolic coils having one or more different coil parameters.
Description
TECHNICAL FIELD

The invention relates to embolic coil assemblies, as well as related components and methods.


BACKGROUND

Embolic coils can be used to occlude vessels in a variety of medical applications.


SUMMARY

The invention relates to embolic coil assemblies, as well as related components and methods.


In one aspect, the invention features a coil assembly that includes at least first and second embolic coils. The first embolic coil has an engaging member, and the second embolic coil has an engaging member that is engaged with the engaging member of the first embolic coil. The first embolic coil differs from the second embolic coil in at least one coil parameter.


In another aspect, the invention features coil assemblies that include three or more embolic coils. Each of the three embolic coils has an engaging member at each end that is adjacent to another embolic coil. The engaging members of each of the three embolic coils are engaged with an engaging member of an adjacent embolic coil. At least one embolic coil differs from at least one other embolic coil in at least one coil parameter.


In a further aspect, the invention features a method that includes inserting a coil assembly into a body lumen of a subject. The coil assembly includes at least first and second embolic coils. The first embolic coil has an engaging member, and the second embolic coil has an engaging member that is engaged with the engaging member of the first embolic coil. The first embolic coil differs from the second embolic coil in at least one coil parameter.


In an additional aspect, the invention features a method that includes inserting a coil assembly into a body lumen of a subject. The coil assembly includes three or more embolic coils. Each of the three embolic coils has an engaging member at each end that is adjacent to another embolic coil. The engaging members of each of the three embolic coils are engaged with an engaging member of an adjacent embolic coil. At least one embolic coil differs from at least one other embolic coil in at least one coil parameter.


In another aspect, the invention features a method of deploying embolic coils to a site. The methods include placing a distal end of a catheter at the site; pushing a coil assembly including at least two (e.g., at least three) embolic coils to the distal end of the catheter; and deploying at least two embolic coils in the coil assembly out of the catheter to the site. At least one embolic coil differs from at least another embolic coil in at least one coil parameter.


Embodiments can include one or more of the following.


The coil parameter can be selected from length, inner diameter, outer diameter, stiffness, secondary shape, and degree of fiber coverage.


The coil assembly can include additional embolic coils (e.g., a third, a fourth, a fifth, or more embolic coils), one or more of which may include engaging members for engaging with engaging members of adjacent embolic coils.


The coil assembly can include a sleeve at least partially surrounding the first and second embolic coils, and optionally any additional embolic coils. The engaging member of an embolic coil (e.g., the first embolic coil) can remain engaged with the engaging member of an adjacent embolic coil (e.g., the second embolic coil) when constrained by the sleeve, and can be capable of disengaging from the engaging member of the adjacent embolic coil when unconstrained by the sleeve.


The assembly can be configured such that movement of the second embolic coil in a proximal or distal direction results in movement of the first coil in the same direction.


The assembly can include a pusher wire. The pusher wire can include an engaging member (e.g., at the distal end of the pusher wire) that is capable of engaging with an engaging member of an adjacent embolic coil.


The embolic coils can be deployed by pushing the coil assembly distally until the distal-most embolic coil (e.g., the first embolic coil) is pushed fully out of the catheter or sleeve, where it disengages from the adjacent embolic coil (e.g., the second embolic coil), optionally repositioning the catheter or sleeve, and then pushing the coil assembly distally until the adjacent embolic coil is pushed fully out of the catheter, where it disengages and is deployed. Where there are additional embolic coils, the method can include pushing each of the embolic coils distally out of the catheter or sleeve such that they disengage and deploy, optionally with repositioning of the catheter occurring between coil deployments. One or more of the embolic coils can be pushed partially out of the catheter and then at least partially retracted back into the catheter, e.g., for repositioning. The method can include determining appropriate coil parameters for treatment of the particular defect (e.g., a vascular defect) and selecting at least first and second embolic coils that have the appropriate coil parameters.


Embodiments can include one or more of the following advantages.


In some embodiments, multiple embolic coils can be disposed within a subject without removing the pusher wire from the subject. This can reduce the complexity, e.g., by reducing the number of steps, and/or enhance the precision of disposing one or more embolic coils within a subject.


In certain embodiments, multiple embolic coils can be disposed within a subject using a continuous process. This can reduce the complexity, e.g., by reducing the number of steps, and/or enhance the precision of disposing one or more embolic coils within a subject.


In some embodiments, multiple embolic coils can be disposed within a subject with a single push of the pusher wire. This can reduce the complexity, e.g., by reducing the number of steps, and/or enhance the precision of disposing one or more embolic coils within a subject.


In certain embodiments, at least one of the multiple embolic coils can differ from at least one other multiple embolic in a coil parameter, such as, for example, length, outer diameter, stiffness, secondary shape, and degree of fiber coverage. One or more of the embolic coils can be selected based on the desired use of the embolic coil(s). Optionally, the order of the embolic coils can also be selected based on the desired use of the embolic coils. For example, each embolic coil can be selected and/or ordered so that the multiple embolic coils as a collection form a particular configuration when disposed within the subject.


Other features and advantages are apparent from the description, drawings and claims.





DESCRIPTION OF DRAWINGS


FIG. 1 is a cross-sectional view of an embodiment of a coil assembly.



FIG. 2A is a cross-sectional view of an embodiment of a coil assembly illustrating disengagement of the most distal embolic coil.



FIG. 2B is a perspective view of an embodiment of a secondary shape mandrel



FIG. 3A is a perspective view of an embodiment of an embolic coil.



FIG. 3B is a perspective view of an embodiment of an embolic coil.



FIG. 3C is a perspective view of an embodiment of an embolic coil.



FIG. 3D is a perspective view of an embodiment of an embolic coil.



FIG. 3E is a perspective view of an embodiment of an embolic coil.



FIG. 3F is a perspective view of an embodiment of an embolic coil.



FIG. 3G is a perspective view of an embodiment of an embolic coil.



FIG. 3H is a perspective view of an embodiment of an embolic coil.



FIG. 4A is a side view of an embodiment of engaging member.



FIG. 4B is a perspective view of the embodiment of FIG. 4A.



FIG. 4C is a partial cross-sectional view of an embodiment of a coil assembly.



FIG. 5A is a side view of an embodiment of engaging member.



FIG. 5B is a perspective view of the embodiment of FIG. 5A.



FIG. 5C is a partial cross-sectional view of an embodiment of a coil assembly.



FIG. 6 is a partial cross-sectional view of an embodiment of a coil assembly.



FIG. 7A is a partial cross-sectional view of an embodiment of a coil assembly.



FIG. 7B is a side view of an embodiment of engaging member.



FIG. 8 is a cross-sectional side view of an embodiment of a coil assembly, introducer sheath and catheter.



FIG. 9A-C illustrate an embodiment of a method.



FIG. 10 illustrate an embodiment of a method.



FIG. 11 illustrates an embodiment of a method.





Like reference symbols in the various drawings indicate like elements.


DETAILED DESCRIPTION


FIG. 1 shows an embolic coil delivery system 8, which includes a sleeve 10, in this case a catheter. An embolic coil assembly 14 is disposed within a lumen 12 in catheter 10. Embolic coil assembly 14 includes a first embolic coil 16 having a distal end 18, a proximal end 20, and an engaging member 22 at the proximal end 20. Embolic coil assembly 14 further includes a second embolic coil 26 having a distal end 28, a proximal end 30, and engaging members 22 at each end. A pusher wire 46 includes an engaging member 22 at distal end 48.


The engaging member 22 of the first embolic coil 16 is engaged with the adjacent engaging member 22 of the second embolic coil 26. Further, the engaging member 22 at the proximal end 30 of the second embolic coil 26 is engaged with the engaging member 22 of the pusher wire 46. In such an arrangement, the pusher wire 46 can be used to move the embolic coil assembly 14 either proximally or distally within the catheter 10. The catheter 10 prohibits disengagement of the engaged embolic coils 16 and 26 while they are constrained by the catheter 10. As illustrated in FIG. 2A, when embolic coil assembly 14 is moved distally such that the engaging member 22 at the proximal end 20 of the first embolic coil 16 is no longer constrained by the catheter 10, the first embolic coil 16 disengages from the second embolic coil 26 and is deployed. Similarly, the second embolic coil 26 can be so deployed.


The embolic coils 16 and 26 differ from each other in at least one coil parameter. For example, the embolic coils may differ from each other in secondary shape. In general, embolic coils have a primary shape and a secondary shape. The primary shape refers generally to the shape of the coil when constrained within the sleeve. The primary shape of an embolic coil generally depends on a number of coil parameters, including, for example, the composition, shape, size, and stiffness of the wire which forms the coil (or braid, where the embolic coil is a braided coil), the outer diameter of the coil, the inner diameter of the coil, and the length of the coil. The secondary shape of an embolic coil refers to the shape of the coil when it is not constrained by the sleeve. As an embolic coil exits the sleeve it can assume its secondary shape. In general, the secondary shape of an embolic coil depends on the process by which the coil was formed, particularly the shape of the mandrel on which the coil was formed and the heat treatment cycle used to shape the coil. For example, a secondary shape mandrel 34, shown in FIG. 2B, can be used to form a primary coil into a secondary shape. The secondary shape mandrel 34 includes a chuck 35 for connecting the mandrel to a device holds the mandrel steady and optionally rotates the mandrel (e.g., a drill). The mandrel 34 includes three shaping locations 36 that have a substantially diamond-shaped cross section. A groove 38 is disposed about the shaping locations 36 to form a continuous, diamond-shaped helix. A primary coil can be positioned in the groove 38 and wound around the shaping locations 36, and subject to a heat cycle to impart the helical diamond shape into the coil. The heat cycle can include, for example, elevating the coil to a temperature of from about 1025° F. to about 1300° F. (e.g., 1100° F.) for a period of time from about 20 minutes to about 40 minutes (e.g., about 30 minutes) to impart the secondary shape into the coil. An embolic coil shaped by one of the shaping locations 36 would represent the diamond-shaped helical coil 54 illustrated in FIG. 3C, described below. The secondary shape mandrel is typically formed of a material capable of withstanding the heat cycle to which the coil will be subjected without significantly softening or changing shape, e.g., stainless steel. The mandrel 34 can include any number of shaping locations and can simultaneously accommodate multiple embolic coils (e.g., at least 4 coils, at least 8 coils, at least 12 coils, or at least 16 coils). The secondary shape imparted by each of the shaping locations can be the same, or can vary.


Other coil parameters play a role in the secondary shape of an embolic coil. Examples of such parameters include the composition, shape, size and stiffness of the wire which forms the coil, the inner and/or outer diameter and the length of the coil, the uniformity of the windings of the coil, the pitch of the primary coil windings, and/or the spacing of the primary coil windings. Typically, the primary shape is selected for deliverability and the secondary shape is selected for the application, e.g., the embolization of an aneurysm.


The embolic coils can have any number of secondary shapes, the choice of which can depend on the particular application in which the embolic coil is to be used. For example, the secondary shape of a first embolic coil and of a second embolic coil can each be independently selected from the group consisting of helical or spiral dual-spiral, dual-diameter spiral, diamond, cone-shaped, random, basket-shaped, straight, C-shaped and J-shaped. As an example, in some of the embodiments, one coil can be have a secondary shape in the form of a basket, while a different coil has a secondary shape in the form of a J. As another example, in certain embodiments one coil can have a helical secondary shape, while a different coil has a diamond or a conical secondary shape. Exemplary secondary shapes are illustrated in FIGS. 3A-3H. For example, FIG. 3A shows an embolic coil 50 with a spiral secondary shape, which can be used, e.g., to provide a supportive framework along a vessel wall and/or to hold other embolic coils that are subsequently delivered to the target site. FIG. 3B shows an embolic coil 52 with a vortex or conical secondary shape, which can be used, e.g., to close the center of a target site such as a vessel or an aneurysm that is to be occluded, optionally in conjunction with an embolic coil or coils, for example, a coil of a different secondary shape. As shown in FIG. 3C, embolic coil 54 can have a diamond secondary shape which can be utilized in a fashion similar to coil 52. FIG. 3D shows a dual-spiral secondary shape 55 in which two conical shapes 56 and 57 meet at their smaller ends. FIG. 3E shows an embolic coil 58 with secondary shape in the form of a J, which can be used, for example, to fill remaining space in an aneurysm not filled by other coils. Optionally, a curved portion 59 of embolic coil 58 can be hooked by the operator (e.g., a physician) into a coil or coil mass that has already been deployed at the target site, with a straight part 60 of embolic coil 58 optionally extending into open space to fill the target site. FIG. 3F shows an embolic coil 62 with a secondary shape in the form of a spiral having a first section 63 with a first helical diameter and a second section 64 with a second helical diameter. Such a coil can be used, for example, to provide a supportive framework along a vessel wall and simultaneously occlude or partially occlude the vessel and/or hold other embolic coils that are subsequently delivered to the target site. FIG. 3G shows an embolic coil 66 having a basket-shaped secondary shape, which can be used, for example, to frame an aneurysm and/or hold or provide a support for other embolic coils that are subsequently delivered to the target site. Any of the shapes just described can be achieved using a braided embolic coil; for example, FIG. 3H shows a braided embolic coil 68 having a secondary shape in the form of a C, which may be used, e.g., in filling an aneurysm. It should be noted that these secondary shapes are approximations, and that the coils may be, for example, a diamond-shape or substantially a diamond shape. Other secondary shapes include random or tangled, generally spherical or spheroid, generally elliptical, clover-shaped, box-shaped. Also included are three-dimensional shapes such as these in which a single coil frames the shape and fills or partially fills the shape. For example, a spherical-shaped coil could have a generally spherical coil frame and be partially filled by the same coil that forms the frame.


In certain embodiments, the embolic coils may differ in length. Suitable coil lengths generally include lengths of, e.g., at least about 2 cm long (e.g., at least about 8 cm long, at least about 15 cm long, or at least about 20 cm long) and/or at most about 30 cm long (e.g., at most about 20 cm long, at most about 15 cm long, or at most about 8 cm long). A coil can, for example, be from about 2 cm to about 30 cm long (e.g., from about 2 cm to about 8 cm long, from about 8 cm to about 15 cm long, from about 15 cm to about 20 cm long, or from about 20 cm to about 30 cm long). As used here, the length of an embolic coil refers to the length of the embolic coil while restrained in a sleeve (i.e. the length of the coil in its primary configuration or shape).


Thus possible coil configurations include, for example, a total coil length (the combined length of all of the embolic coils) of about 30 cm split into one 10 cm coil and ten 2 cm coils; two 5 cm coils and ten 2 cm coils; two 10 cm coils and two 5 cm coils; two 10 cm coils and five 2 cm coils; and three 5 cm coils and five 3 cm coils. The restrained (primary) coil length of an embolic coil may be related to the secondary shape of the coil. For example, a diamond-shaped coil can have a length of no more than about 80 mm (e.g., no more than about 60 mm or no more than about 40 mm) and/or can have a length of no less than about 20 mm (e.g., no less than about 40 mm or no less than about 60 mm). A diamond shaped coil can in some embodiments have a length of from about 20 mm to about 80 mm (e.g., from about 40 mm to about 60 mm). As another example, a spiral-shaped coil can have a length of no more than about 70 mm (e.g., no more than about 60 mm, no more than about 50 mm, no more than about 40 mm, no more than about 30 mm, or no more than about 20 mm) and/or can have a length of no less than about 10 mm (e.g., no less than about 20 mm, no less than about 30 mm, no less than about 40 mm, no less than about 50 mm, or no less than about 60 mm). A spiral-shaped coil can in some embodiments have a length from about 10 to about 70 mm (e.g., from about 20 mm to about 60 mm or from about 30 mm to about 50 mm). As another example, a straight coil can have a length of no more than about 10 mm (e.g., no more than about 7 mm, no more than about 5 mm, or no more than about 3 mm) and/or can have a length of no less than about 2 mm (e.g., no less than about 3 mm, no less than about 5 mm, or no less than about 7 mm). A straight coil can in some embodiments have a length of from about 2 mm to about 10 mm (e.g., from about 3 mm to about 7 mm). As another example, a C-shaped coil can have a length of no more than about 10 mm (e.g., no more than about 7 mm, no more than about 5 mm, or no more than about 3 mm) and/or can have a length of no less than about 2 mm (e.g., no less than about 3 mm, no less than about 5 mm, or no less than about 7 mm). A C-shaped coil can in some embodiments have a length of from about 2 mm to about 10 mm (e.g., from about 3 mm to about 7 mm). As another example, a J-shaped coil can have a length of no more than about 30 mm (e.g., no more than about 25 mm, no more than about 20 mm, or no more than about 15 mm) and/or can have a length of no less than about 10 mm (e.g., no less than about 15 mm, no less than about 20 mm, or no less than about 25 mm). A J-shaped coil can in some embodiments have a length of from about 10 mm to about 30 mm (e.g., from about 15 mm to about 25 mm). As another example, a vortex-shaped or conical-shaped coil can have a length of no more than about 70 mm (e.g., no more than about 67 mm, no more than about 53 mm, or no more than about 35 mm) and/or can have a length of no less than about 30 mm (e.g., no less than about 35 mm, no less than about 53 mm, or no less than about 67 mm). A vortex-shaped or conical-shaped coil can in some embodiments have a length of from about 30 mm to about 70 mm (e.g., from about 35 mm to about 67 mm or from about 35 mm to about 53 mm).


In general, the length of any one coil can be no more than about 80 mm (e.g., no more than about 70 mm, no more than about 60 mm, no more than about 50 mm, no more than about 40 mm, no more than about 30 mm, no more than about 20 mm, no more than about 10 mm, or no more than about 5 mm) and/or can be no less than about 0.5 mm (e.g., no less than about 5 mm, no less than about 10 mm, no less than about 20 mm, no less than about 30 mm, no less than about 40 mm, no less than about 50 mm, no less than about 60 mm, or no less than about 70 mm). In some embodiments, the length of any one coil can be from about 0.5 mm to about 80 mm (e.g., from about 5 mm to about 70 mm, from about 10 mm to about 60 mm, from about 20 mm to about 50 mm, or from about 30 mm to about 40 mm). In some embodiments, the length of all the coils, in total, can be no more than about 60 cm (e.g., no more than about 50 cm, no more than about 40 cm, no more than about 30 cm, no more than about 20 cm, no more than about 10 cm, or no more than about 8 cm). Generally, the length of the coils, in total, is selected in part to prevent the amount of force used to push the coil assembly from becoming too large.


The coils may differ in the diameter of the wire from which they are formed. For example, the coils may be formed of wire, e.g., platinum, platinum/tungsten alloy or stainless steel wire, having a diameter of between about 0.001 inch to about 0.005 inch in diameter. One coil may be formed of wire having a diameter of between about 0.001 inch to about 0.0025 inch in diameter, while another coil may be between about 0.003 inch to about 0.005 inch in diameter. The difference in wire diameter can result in a difference in the outer diameter of the first coil and second coil (taken in their primary shapes), given a constant inner diameter of the first and second coils. For example, the outer diameter of one of the first coil and second coil may be between about 0.013 inch to about 0.015 inch and the other of the first coil and second coil may be between about 0.010 inch to about 0.012 inch while sharing a constant inner diameter.


The outer diameter of the coils may differ regardless of the inner diameter of the coils. The outer diameter of a coil refers to the outer diameter of the coil when in its secondary configuration. In certain embodiments, the outer diameter of the coils can be no more than about 14 mm (e.g., no more than about 12 mm, no more than about 10 mm, no more than about 8 mm, no more than about 6 mm, no more than about 4 mm, or no more than about 2 mm) and/or can be no less than about 1 mm (e.g., no less than about 2 mm, no less than about 4 mm, no less than about 6 mm, no less than about 8 mm, no less than about 10 mm, or no less than about 12 mm). In some embodiments, the outer diameter of the embolic coils can be from about 1 mm to about 14 mm (e.g., from about 2 mm to about 12 mm, from about 4 mm and to about 10 mm, or from about 6 mm and to about 8 mm). In some embodiments, one embolic coil can have an outer diameter no more than about 6 mm (e.g., no more than about 5 mm, no more than about 4 mm, no more than about 3 mm, or no more than about 2 mm) while another embolic coil can have an outer diameter of not less than about 8 mm (e.g., not less than about 10 mm or not less than about 12 mm).


The stiffness of the coils may be varied. It will be recognized that certain other parameters will affect the stiffness of the coils, for example, the composition and the diameter of the wire from which the coil is formed. The diameter of a mandrel around which the coil is formed (in other words, the inner diameter of the coil) may affect the stiffness. Also, additional treatment of the coil once formed can affect the stiffness. For example, subjecting a coil to heat and then cooling the coil may result in stiffening of the coil. Coil stiffness may vary between about 0.001 lbf and about 0.004 lbf. Coil stiffness can be measured by measuring the force required to compress the outer coil 5% of the main secondary coil diameter. For example, a dynamic testing machine, such as is available from Instron Corp., can be utilized to test coil stiffness. A main outer diameter of a secondary coil is removed from the secondary coil and placed in the gripping mechanism of the testing machine such that only half of the diameter (a semi-circle shape) is exposed. The sample is placed directly below an anvil-like fixture that compresses down on the surface of the outer diameter. The force required to compress the sample by 5% of the overall main outer diameter is measured.


In some embodiments, some or all of the embolic coils may include fibers. Exemplary fiber materials include polyethylene terephthalate (e.g., Dacron®), nylon, collagen and/or cotton fibers, which may promote thrombosis by providing a substrate for clot formation. The degree of fiber coverage may be varied. For example, some of the embolic coils may have fibers while others do not. In some embodiments, the embolic coils may each have fibers but have different amounts of fibers for a given length of coil. The fibers may be, for example, of the same or different length (generally between about 0.5 mm to about 5 mm), stiffness, and/or diameter. The spacing between fiber bundles and the fiber densities (i.e. number of fiber filaments per fiber bundle) are additional factors capable of variation; one coil can have bundles having greater numbers of fibers than a different coil but have the bundles spaced farther apart, resulting in the same number of fibers per length of coil but a different distribution of fiber coverage on each coil.


While embodiments that contain two embolic coils have been described, the embolic coil delivery systems can include more than two embolic coils (e.g., three or more, four or more, five or more, or six or more embolic coils). In such embodiments, at least two of the embolic coils differ from each other in at least one coil parameter. In certain embodiments, three or more, four or more, five or more, or six or more embolic coils can differ from each other in at least one coil parameter; further, the coil parameters that differ may be the same coil parameter or may be two or more different coil parameters (e.g., three or more, four or more, five or more, or six or more different coil parameters).


The embolic coils generally include at least one engaging member for engaging with an adjacent embolic coil, and may optionally include two engaging members for engaging with adjacent embolic coils or pusher wires one either side of the embolic coil. The engaging members generally are configured such that one member reversibly accepts a portion of a corresponding member. Configurations include an engaging member having an open receiving slot generally perpendicular to the longitudinal axis of the coil and corresponding engaging member having a hook adapted to enter and exit an open receiving slot generally perpendicular to the longitudinal axis of the coil, and also include engaging members having an outer portion of a generally cylindrical shape, a middle portion adapted to accept a generally cylindrical outer portion of an adjacent corresponding engaging member, and an inner portion adapted for attaching to the coil (where “outer” refers to the portion of the engaging member distant from the coil to which it is attached and “inner” refers to the portion nearest the coil). The engaging member of one end of a coil may be, but need not be, the same as the engaging member at a different end of the coil, where the coil has two engaging members. Each coil and each engaging member may further include a channel or lumen extending longitudinally, with a control wire extending through the channels to further engage the coils.


Examples of engaging member embodiments are illustrated in FIGS. 4-6. FIGS. 4A and 4B show side and perspective views, respectively, of an embodiment of an engaging member 160. Engaging member 160 is generally cylindrical in shape with a surface 162 which may be cut or milled away to allow the surface to mesh with receiving area 164 on an adjacent engaging member. Connecting end 166 is adapted to be connected to an embolic coil or pusher wire, and may be any suitable shape, e.g., cylindrical. Vertical mating surface 168 is adapted to meet a similar vertical mating face on an adjacent engaging member to allow one engaging member to pull the other when the first engaging member is pulled, while end surface 170 pushes against mating surface 167 when the first engaging member is pushed. FIG. 4C shows a pair of engaging members as described in FIGS. 4A and 4B when engaged, in this case engaging a pusher wire 178 and an embolic coil 180. FIGS. 5A, 5B and 5C show an interlocking member 172 having an end surface 174 that is ramped. This design can, for example, permit assembly ease in placing the coils into a catheter or introducer sheath.


In certain embodiments, the engaging members of adjacent embolic coils that are engaged with one another have different configurations from each other. For example, as shown in FIG. 6, each of the pair of engaging members has a differing configuration. A coil 300 has an engaging member 305 which has a slot 310 located thereon. Slot 310 is configured to receive a hook 322 of an engaging member 320, located at an end of coil 400.


In some embodiments, an embolic coil assembly may also include a control wire. The control wire can permit the coils to remain engaged until the control wire is removed and the coil is not constrained by a catheter or introducer sleeve. For example, FIGS. 7A and 7B show an embolic coil assembly 130 in which a coil 128 is engaged with a pusher wire 130 by engaging members 132 in combination with a control wire 106. Each engaging member 132 includes a ramped face 136 with a slot 138 and a longitudinally-extending passageway 140 for receiving control wire 106. Control wire 106 extends through lumens 131 and 133 in the pusher wire 130 and in coil 128, respectively. Engaging members 132 cannot disengage, even when unconstrained by a sleeve, until control wire 106 is pulled out of opening 141 of channel 140. When engaging members 132 are not constrained by a sleeve and control wire 106 has been pulled out of opening 141 of channel 140, the coil 120 will disengage from the pusher wire 130. Such a control wire may be incorporated into any of the other engaging member embodiments.



FIG. 8 illustrates an embolic coil assembly delivery system in which an embolic coil assembly 202 is contained in an introducer sleeve 204 which is separate from catheter 210. Optionally, the introducer sleeve 204 includes a locking portion 206, e.g., a portion of the introducer sleeve that has been twisted under heat to deform and grip the pusher wire and/or coil assembly, to lock a pusher wire 224 and/or coil assembly 202 in sleeve 204. This may prevent the coil assembly from moving longitudinally in the sleeve and possibly out of the sleeve before such is desired. Such a locking portion can be unlocked, e.g., by untwisting the sheath, to allow the pusher wire/coil assembly to move freely.


Generally, the catheter 210 is first inserted into a body lumen of a subject, for example, through an incision into the femoral artery, and moved through the body until its distal end is at a target location, for example, the opening of an aneurysm. Once in place, a distal tip 206 of sleeve 204 is placed into a hub 216 attached to a proximal end 212 of the catheter and the embolic coil assembly is pushed by means of pusher wire 224 into catheter 210 and to the distal end of the catheter for delivery to the target site. The pusher wire is then used to push the embolic coil assembly out of the distal tip of the catheter such that individual coils disengage from the assembly and deploy into the target area. Alternatively, the pusher wire may be used to hold the coil assembly in place while the catheter is retracted, thus permitting self-disengagement of individual coils. Where a control wire is included, it may be retracted either before or after pushing the coils out of the catheter or retracting the catheter.



FIGS. 9A-C illustrate an embodiment of a method for treatment of an aneurysm. A catheter 510 is inserted into the body and guided through a lumen 502 in a vessel 500 to an opening 506 in an aneurysm 504. An embolic coil assembly 514 is inserted into the catheter for deployment into the aneurysm. Embolic coil assembly 514 includes a long coil 536 with an engaging member 522 at a proximal end 540 and two shorter coils 516 and 526, each having engaging members 522 at each end. The coils are selected to accomplish particular tasks with respect to treating the aneurysm. For example, long coil 536 is selected of a sufficient length and secondary shape to frame the embolism to add strength and prevent the aneurysm from rupturing, to begin sealing off the opening 506, and to provide a framework to which shorter coils 516, 526 can attach themselves. Shorter coils 516, 526 have a secondary shape in the form of a J to enable each to be hooked onto this framework and are sufficiently flexible to enable them to pack together densely to fill the voids in the aneurysm. In certain embodiments, the J-shaped coils will themselves be long (e.g., from about 15 mm to about 30 mm) as well as soft and flexible. This can enable a physician to custom fill vessels or aneurysms as desired to achieve a desired density of packing.


A pusher wire 546 with an engaging member 522 at its distal end 548 is engaged to coil 526. The pusher wire is used to push embolic coil assembly 514 to the distal end 511 of catheter 510 so that the long coil 536 extends partially out of the catheter. The long coil 536 begins to assume its secondary shape as it exits the catheter. At this point, should repositioning be desired, the embolic coil assembly 514 can be retracted into the catheter by pulling back on the pusher wire 546.


Once in the proper position, as illustrated in FIG. 9B, the embolic coil assembly 514 is pushed sufficiently far distally that the long coil 536 passes entirely out of catheter 510, disengages and assumes its secondary basket shape and frames the aneurysm. At this point, the catheter 510 can be left in position and the remaining coils 516, 526 can be deployed. As seen in FIG. 9C, embolic coils 516 and 526 have a secondary shape in the form of a J to hook onto the long coil 536 and extend into and fill voids in the aneurysm. The pusher wire 546 need not be withdrawn to permit insertion of the additional coils. This may provide for shorter times of treatment and/or less movement of materials through the catheter, given the lack of a requirement for removing the pusher wire, inserting a J-shaped coil, reinserting the pusher wire and pushing the coil to the distal tip of the catheter, and may lead to superior results.



FIGS. 10A-C show the occlusion of a vessel 600, with a long coil 636 having a helical secondary shape being first deployed (FIG. 10A, 10B), followed by a first coil 616 having a secondary shape in the form of a C that can, for example, hook itself into the helical coil 636, and followed by second coil 626 having a secondary shape in the form of a J such that, for example, the hooked portion of the J shape can attach itself to the helical coil and the straight portion can extend into the opening to occlude the vessel 600. Additional coils could be added to the embolic coil assembly, such as coils having as secondary shapes diamonds, vortexes or the like to better occlude the central part of the vessel and interweave themselves with the helical coil (see, e.g., FIG. 11).


While certain embodiments have been described, others are possible.


As an example, some or all of the embolic coils in the embolic coil assembly may have secondary shapes other than those disclosed above. For example, other suitable secondary shapes, and methods for creating embolic coils having such shapes, are discussed in U.S. Pat. Nos. 4,994,069, 6,231,586, 6,322,576 and 6,635,069, each of which is hereby incorporated by reference.


As another example, one or more of the embolic coils may include a coating, e.g., a polymer coating, for example, a lubricous coating, that may reduce friction between the coil and the catheter and allow for easier pushing of the coil.


As an additional example, one or more coils may further include a therapeutic substance, e.g., a drug, for delivery to the target site along with the coil.


As a further example, the embolic coils may differ in more than one coil parameter, for example, two, three, four, five or more coil parameters may be different.


As another example, more than two of the embolic coils may differ in one or more coil parameters, for example, three, four, five, or more coils, even each of the coils, may differ from each other in one or more coil parameters.


At least one of the embolic coils may be made in whole or in part of helical wire.


At least one of the coils may be made in whole or in part of braided wire.


At least one of the coils may include a radiopaque marker, which may consist of or be a part of the engaging member.


At least one of the embolic coils may be formed of a polymer, e.g., a biocompatible polymer. Exemplary polymers include polyethylene, polyurethane, and polypropylene.


Moreover, while embodiments of the engaging members have been described as being generally cylindrical in cross-sectional shape, the engaging members may have other configurations, for example, pentagonal or hexagonal. Also, the engaging members may have different engaging configurations than those disclosed above. Other suitable engaging members are described in U.S. Pat. Nos. 5,250,071, 5,304,195, 5,800,453, 5,800,455, 5,891,130, 5,925,059, 6,099,546, RE37,117 E, and in WO 94/06503, each of which is hereby incorporated by reference.


Further, in some embodiments, a saline flush can be used to deliver an embolic coil from the sleeve rather than, or in addition to, the pusher wire.


Still further, in some embodiments, embolic coils can be used in conjunction with other embolic devices. Other embolic devices include, for example, embolic particles such as those described in U.S. Published Patent Application No. 2003/0185896 A1, published on Oct. 2, 2003, and in U.S. Published Patent Application No. US 2004/0096662 A1, published on May 20, 2004, each of which are hereby incorporated by reference. Other embolic devices also include, for example, embolic gels such as described, for example, in U.S. patent application Ser. No. 10/927,868, filed on Aug. 27, 2004, and entitled “Embolization”, which is hereby incorporated by reference.


In general, embolic coils may be used to treat a variety of conditions. For example, embolic coils may be used generally to treat neurological and/or peripheral conditions such as to occlude a vessel or to treat an aneurysm, an arteriovenous malformation (AVM), or a traumatic fistula. Embolic coils can be used to embolize a tumor, for example, a liver tumor. Embolic coils can be used in transarterial chemoembolization (TACE).


Other embodiments are in the claims.

Claims
  • 1. A coil assembly, comprising: a first embolic coil having a proximal end interlocking member;a second embolic coil having a distal end interlocking member engaged with the proximal end interlocking member of the first embolic coil, the second embolic coil having a predetermined secondary shape configured to be received at least partially within and engage a predetermined secondary shape of the first embolic coil when the respective first and second embolic coils are released within an aneurysm sac; anda delivery catheter containing the first embolic coil and the second embolic coil, the first embolic coil disposed farther from a proximal end of the catheter than the second embolic coil, wherein the proximal end interlocking member of the first embolic coil remains engaged with the distal end interlocking member of the second embolic coil when the respective coils are constrained within the delivery catheter, and the interlocking member of the first embolic coil is configured to disengage from the interlocking member of the second embolic coil when the respective coils are released out of a distal end opening of the delivery catheter;wherein the predetermined secondary shape of the first embolic coil is selected from a group consisting of helical, diamond, cone-shaped, basket-shaped, and spiral; andwherein the predetermined secondary shape of the second embolic coil is selected from a group consisting of C-shaped, straight, diamond, and J-shaped.
  • 2. The coil assembly of claim 1, wherein the first embolic coil differs from the second embolic coil in at least one coil parameter selected from the group consisting of length, inner diameter, outer diameter, stiffness, and degree of fiber coverage.
  • 3. The coil assembly of claim 1, wherein movement of the second embolic coil in a proximal or distal direction results in movement of the first embolic coil in the same direction.
  • 4. The coil assembly of claim 1, further comprising a pusher wire including a distal end interlocking member, wherein the second embolic coil further comprises a proximal end interlocking member engaged with the distal end interlocking member of the pusher wire.
  • 5. The coil assembly of claim 1, further comprising a third embolic coil having a distal end interlocking member, wherein the second embolic coil further comprises a proximal end interlocking member engaged with the distal end interlocking member of the third embolic coil.
  • 6. The coil assembly of claim 1, wherein the first and second embolic coils differ in length.
  • 7. The coil assembly of claim 6, wherein the first embolic coil is at least 50 cm long and the second embolic coil is no more than 10 cm long.
  • 8. The coil assembly of claim 1, wherein the secondary shape of the first embolic coil is the basket shape and the secondary shape of the second embolic coil is the J-shape.
  • 9. The coil assembly of claim 1, wherein the secondary shape of the first embolic coil is the helical shape and the secondary shape of the second embolic coil is the diamond.
  • 10. The coil assembly of claim 1, wherein the first embolic coil and the second embolic coil differ in stiffness.
  • 11. The coil assembly of claim 1, wherein the first embolic coil and the second embolic coil differ in outer diameter.
  • 12. The coil assembly of claim 11, wherein the outer diameter of one of the first embolic coil and second embolic coil is at least about 0.013 inch and the other of the first embolic coil and second embolic coil is at most about 0.012 inch.
  • 13. The coil assembly of claim 1, further comprising an introducer sheath configured to contain the first and second embolic coils in an engaged state, the introducer sheath adapted to abut the proximal end of the delivery catheter to permit passage of the first and second embolic coils from the introducer sheath to the delivery catheter without the first and second embolic coils disengaging.
US Referenced Citations (404)
Number Name Date Kind
2609347 Wilson Sep 1952 A
3663470 Nishimura et al. May 1972 A
3737398 Yamaguchi Jun 1973 A
3921632 Bardani Nov 1975 A
3957933 Egli et al. May 1976 A
4025686 Zion May 1977 A
4034759 Haerr Jul 1977 A
4055377 Erickson et al. Oct 1977 A
4076640 Forgensi et al. Feb 1978 A
4094848 Naito Jun 1978 A
4096230 Haerr Jun 1978 A
4098728 Rosenblatt Jul 1978 A
4110529 Stoy Aug 1978 A
4159719 Haerr Jul 1979 A
4191672 Salome et al. Mar 1980 A
4198318 Stowell et al. Apr 1980 A
4243794 White et al. Jan 1981 A
4246208 Dundas Jan 1981 A
4266030 Tschang et al. May 1981 A
4268495 Muxfeldt et al. May 1981 A
4271281 Kelley et al. Jun 1981 A
4402319 Handa et al. Sep 1983 A
4413070 Rembaum Nov 1983 A
4427794 Lange et al. Jan 1984 A
4428869 Munteanu et al. Jan 1984 A
4429062 Pasztor et al. Jan 1984 A
4442843 Rasor et al. Apr 1984 A
4444961 Timm Apr 1984 A
4452773 Molday Jun 1984 A
4456693 Welsh Jun 1984 A
4459145 Elsholz Jul 1984 A
4472552 Blouin Sep 1984 A
4477255 Pasztor et al. Oct 1984 A
4492720 Mosier Jan 1985 A
4522953 Barby et al. Jun 1985 A
4542178 Zimmermann et al. Sep 1985 A
4551132 Pasztor et al. Nov 1985 A
4551436 Johnson et al. Nov 1985 A
4573967 Hargrove et al. Mar 1986 A
4622362 Rembaum Nov 1986 A
4623706 Timm et al. Nov 1986 A
4640807 Afghan et al. Feb 1987 A
4657756 Rasor et al. Apr 1987 A
4661137 Garnier et al. Apr 1987 A
4663358 Hyon et al. May 1987 A
4671954 Goldberg et al. Jun 1987 A
4674480 Lemelson Jun 1987 A
4675113 Graves et al. Jun 1987 A
4678710 Sakimoto et al. Jul 1987 A
4678814 Rembaum Jul 1987 A
4680320 Uku et al. Jul 1987 A
4681119 Rasor et al. Jul 1987 A
4708718 Daniels Nov 1987 A
4742086 Masamizu et al. May 1988 A
4743507 Franses et al. May 1988 A
4772635 Mitschker et al. Sep 1988 A
4782097 Jain et al. Nov 1988 A
4789501 Day et al. Dec 1988 A
4793980 Torobin Dec 1988 A
4795741 Leshchiner et al. Jan 1989 A
4801458 Hidaka et al. Jan 1989 A
4804366 Zdeb et al. Feb 1989 A
4819637 Dormandy, Jr. et al. Apr 1989 A
4822535 Ekman et al. Apr 1989 A
4833237 Kawamura et al. May 1989 A
4850978 Dudar et al. Jul 1989 A
4859711 Jain et al. Aug 1989 A
4863972 Itagaki et al. Sep 1989 A
4897255 Fritzberg et al. Jan 1990 A
4900303 Lemelson Feb 1990 A
4929400 Rembaum et al. May 1990 A
4933372 Feibush et al. Jun 1990 A
4946899 Kennedy et al. Aug 1990 A
4954399 Tani et al. Sep 1990 A
4981625 Rhim et al. Jan 1991 A
4990340 Hidaka et al. Feb 1991 A
4994069 Ritchart et al. Feb 1991 A
4999188 Sloldovnik et al. Mar 1991 A
5007940 Berg Apr 1991 A
5011677 Day et al. Apr 1991 A
H915 Gibbs May 1991 H
5015423 Eguchi et al. May 1991 A
5021059 Kensey et al. Jun 1991 A
5032117 Motta Jul 1991 A
5034324 Shinozaki et al. Jul 1991 A
5047438 Feibush et al. Sep 1991 A
5079274 Schneider et al. Jan 1992 A
5091205 Fan Feb 1992 A
5106903 Vanderhoff et al. Apr 1992 A
5108407 Geremia et al. Apr 1992 A
5114421 Polak May 1992 A
5116387 Berg May 1992 A
5120349 Stewart et al. Jun 1992 A
5125892 Drudik Jun 1992 A
5147631 Glajch et al. Sep 1992 A
5147937 Frazza et al. Sep 1992 A
5149543 Cohen et al. Sep 1992 A
5158573 Berg Oct 1992 A
5167624 Butler et al. Dec 1992 A
5171214 Kolber et al. Dec 1992 A
5171217 March et al. Dec 1992 A
5181921 Makita et al. Jan 1993 A
5190760 Baker Mar 1993 A
5190766 Ishihara Mar 1993 A
5192301 Kamiya et al. Mar 1993 A
5202352 Okada et al. Apr 1993 A
5216096 Hattori et al. Jun 1993 A
5226911 Chee et al. Jul 1993 A
5234437 Sepetka Aug 1993 A
5250071 Palermo Oct 1993 A
5253991 Yokota et al. Oct 1993 A
5256146 Ensminger et al. Oct 1993 A
5260002 Wang Nov 1993 A
5261916 Engelson Nov 1993 A
5262176 Palmacci et al. Nov 1993 A
5263964 Purdy Nov 1993 A
5263992 Guire Nov 1993 A
5288763 Li et al. Feb 1994 A
5290310 Makower et al. Mar 1994 A
5292332 Lee Mar 1994 A
5292814 Bayer et al. Mar 1994 A
5302369 Day et al. Apr 1994 A
5304194 Chee et al. Apr 1994 A
5304195 Twyford, Jr. et al. Apr 1994 A
5312415 Palermo May 1994 A
5314974 Ito et al. May 1994 A
5316774 Eury et al. May 1994 A
RE34640 Kennedy et al. Jun 1994 E
5320639 Rudnick Jun 1994 A
5324306 Makower et al. Jun 1994 A
5328936 Leifholtz et al. Jul 1994 A
5334216 Vidal et al. Aug 1994 A
5336263 Ersek et al. Aug 1994 A
5342394 Matsuno et al. Aug 1994 A
5344452 Lemperle Sep 1994 A
5344867 Morgan et al. Sep 1994 A
5350397 Palermo et al. Sep 1994 A
5354290 Gross Oct 1994 A
5354295 Guglielmi et al. Oct 1994 A
5369133 Ihm et al. Nov 1994 A
5369163 Chiou et al. Nov 1994 A
5382260 Dormandy, Jr. et al. Jan 1995 A
5384124 Courteille et al. Jan 1995 A
5397303 Sancoff et al. Mar 1995 A
5398851 Sancoff et al. Mar 1995 A
5403870 Gross Apr 1995 A
5411520 Nash et al. May 1995 A
5417982 Modi May 1995 A
5431174 Knute Jul 1995 A
5435645 Faccioli et al. Jul 1995 A
5443495 Buscemi et al. Aug 1995 A
5456693 Conston et al. Oct 1995 A
5468801 Antonelli et al. Nov 1995 A
5469854 Unger et al. Nov 1995 A
5476472 Dormandy, Jr. et al. Dec 1995 A
5484584 Wallace et al. Jan 1996 A
5490984 Freed Feb 1996 A
5494682 Cohen et al. Feb 1996 A
5494940 Unger et al. Feb 1996 A
5512604 Demopolis Apr 1996 A
5514090 Kriesel et al. May 1996 A
5525334 Ito et al. Jun 1996 A
5534589 Hager et al. Jul 1996 A
5540680 Guglielmi et al. Jul 1996 A
5541031 Yamashita et al. Jul 1996 A
5542935 Unger et al. Aug 1996 A
5553741 Sancoff et al. Sep 1996 A
5556391 Cercone et al. Sep 1996 A
5556610 Yan et al. Sep 1996 A
5558255 Sancoff et al. Sep 1996 A
5558822 Gitman et al. Sep 1996 A
5558856 Klaveness et al. Sep 1996 A
5559266 Klaveness et al. Sep 1996 A
5567415 Porter Oct 1996 A
5569193 Hofstetter et al. Oct 1996 A
5569449 Klaveness et al. Oct 1996 A
5569468 Modi Oct 1996 A
5571182 Ersek et al. Nov 1996 A
5580575 Unger et al. Dec 1996 A
5583162 Li et al. Dec 1996 A
5585112 Unger et al. Dec 1996 A
5595821 Hager et al. Jan 1997 A
5622657 Takada et al. Apr 1997 A
5624685 Takahashi et al. Apr 1997 A
5635215 Boschetti et al. Jun 1997 A
5637087 O'Neil et al. Jun 1997 A
5639277 Mariant et al. Jun 1997 A
5639710 Lo et al. Jun 1997 A
5648095 Illum et al. Jul 1997 A
5648100 Boschetti et al. Jul 1997 A
5649949 Wallace et al. Jul 1997 A
5650116 Thompson Jul 1997 A
5651990 Takada et al. Jul 1997 A
5653922 Li et al. Aug 1997 A
5657756 Vrba Aug 1997 A
5681576 Henry Oct 1997 A
5695480 Evans et al. Dec 1997 A
5695740 Porter Dec 1997 A
5698271 Liberti et al. Dec 1997 A
5701899 Porter Dec 1997 A
5715824 Unger et al. Feb 1998 A
5716981 Hunter et al. Feb 1998 A
5718884 Klaveness et al. Feb 1998 A
5723269 Akagi et al. Mar 1998 A
5725534 Rasmussen Mar 1998 A
5733925 Kunz et al. Mar 1998 A
5741331 Pinchuk Apr 1998 A
5746734 Dormandy, Jr. et al. May 1998 A
5749891 Ken et al. May 1998 A
5752974 Rhee et al. May 1998 A
5760097 Li et al. Jun 1998 A
5766147 Sancoff et al. Jun 1998 A
5770222 Unger et al. Jun 1998 A
5779668 Grabenkort Jul 1998 A
5785642 Wallace et al. Jul 1998 A
5785682 Grabenkort Jul 1998 A
5792478 Lawin et al. Aug 1998 A
5795562 Klaveness et al. Aug 1998 A
5797953 Tekulve Aug 1998 A
5800453 Gia Sep 1998 A
5800454 Jacobsen et al. Sep 1998 A
5800455 Palermo et al. Sep 1998 A
5807323 Kriesel et al. Sep 1998 A
5813411 Van Bladel et al. Sep 1998 A
5823198 Jones et al. Oct 1998 A
5827502 Klaveness et al. Oct 1998 A
5827531 Morrison et al. Oct 1998 A
5830178 Jones et al. Nov 1998 A
5833361 Funk Nov 1998 A
5840387 Berlowitz-Tarrant et al. Nov 1998 A
5846518 Yan et al. Dec 1998 A
5853752 Unger et al. Dec 1998 A
5855615 Bley et al. Jan 1999 A
5863957 Li et al. Jan 1999 A
5876372 Grabenkort et al. Mar 1999 A
5877224 Brocchini et al. Mar 1999 A
5885216 Evans, III et al. Mar 1999 A
5885547 Gray Mar 1999 A
5888546 Ji et al. Mar 1999 A
5891128 Gia et al. Apr 1999 A
5891130 Palermo et al. Apr 1999 A
5891155 Irie Apr 1999 A
5894022 Ji et al. Apr 1999 A
5895385 Guglielmi et al. Apr 1999 A
5895398 Wensel et al. Apr 1999 A
5895411 Irie Apr 1999 A
5899877 Leibitzki et al. May 1999 A
5902832 Van Bladel et al. May 1999 A
5902834 Porrvik May 1999 A
5922025 Hubbard Jul 1999 A
5922304 Unger Jul 1999 A
5925059 Palermo et al. Jul 1999 A
5928626 Klaveness et al. Jul 1999 A
5935553 Unger et al. Aug 1999 A
5941888 Wallace et al. Aug 1999 A
5951160 Ronk Sep 1999 A
5957848 Sutton et al. Sep 1999 A
5959073 Schlameus et al. Sep 1999 A
6003566 Thibault et al. Dec 1999 A
6013084 Ken et al. Jan 2000 A
6015546 Sutton et al. Jan 2000 A
6024754 Engelson Feb 2000 A
6027472 Kriesel et al. Feb 2000 A
6028066 Unger Feb 2000 A
6033423 Ken et al. Mar 2000 A
6047861 Vidal et al. Apr 2000 A
6048908 Kitagawa Apr 2000 A
6051247 Hench et al. Apr 2000 A
6056721 Shulze May 2000 A
6056844 Guiles et al. May 2000 A
6059766 Greff May 2000 A
6063068 Fowles et al. May 2000 A
6071495 Unger et al. Jun 2000 A
6071497 Steiner et al. Jun 2000 A
6073759 Lamborne et al. Jun 2000 A
6090925 Woiszwillo et al. Jul 2000 A
6096344 Liu et al. Aug 2000 A
6099546 Gia Aug 2000 A
6099864 Morrison et al. Aug 2000 A
6100306 Li et al. Aug 2000 A
6139963 Fujii et al. Oct 2000 A
6149623 Reynolds Nov 2000 A
6159206 Ogawa Dec 2000 A
6160084 Langer et al. Dec 2000 A
6162377 Ghosh et al. Dec 2000 A
6165193 Greene, Jr. et al. Dec 2000 A
6179817 Zhong Jan 2001 B1
6190373 Palermo et al. Feb 2001 B1
6191193 Lee et al. Feb 2001 B1
RE37117 Palermo Mar 2001 E
6214331 Vanderhoff et al. Apr 2001 B1
6224630 Bao et al. May 2001 B1
6224794 Amsden et al. May 2001 B1
6231586 Mariant May 2001 B1
6235224 Mathiowitz et al. May 2001 B1
6238403 Greene, Jr. et al. May 2001 B1
6245090 Gilson et al. Jun 2001 B1
6254592 Samson et al. Jul 2001 B1
6258338 Gray Jul 2001 B1
6261585 Sefton et al. Jul 2001 B1
6264861 Tavernier et al. Jul 2001 B1
6267154 Felicelli et al. Jul 2001 B1
6268053 Woiszwillo et al. Jul 2001 B1
6277392 Klein Aug 2001 B1
6280457 Wallace et al. Aug 2001 B1
6291605 Freeman et al. Sep 2001 B1
6296604 Garibaldi et al. Oct 2001 B1
6296622 Kurz et al. Oct 2001 B1
6296632 Luscher et al. Oct 2001 B1
6306153 Kurz et al. Oct 2001 B1
6306418 Bley Oct 2001 B1
6306419 Vachon et al. Oct 2001 B1
6306427 Annonier et al. Oct 2001 B1
6312407 Zadno-Azizi et al. Nov 2001 B1
6315709 Garibaldi et al. Nov 2001 B1
6322576 Wallace et al. Nov 2001 B1
6335384 Evans et al. Jan 2002 B1
6344041 Kupiecki et al. Feb 2002 B1
6344182 Sutton et al. Feb 2002 B1
6355275 Klein Mar 2002 B1
6368658 Schwarz et al. Apr 2002 B1
6379373 Sawhney et al. Apr 2002 B1
6388043 Langer et al. May 2002 B1
6394965 Klein May 2002 B1
6423332 Huxel et al. Jul 2002 B1
6432437 Hubbard Aug 2002 B1
6436112 Wensel et al. Aug 2002 B2
6443941 Slepian et al. Sep 2002 B1
6476069 Krall et al. Nov 2002 B2
6544503 Vanderhoff et al. Apr 2003 B1
6544544 Hunter et al. Apr 2003 B2
6545097 Pinchuk et al. Apr 2003 B2
6551305 Ferrera et al. Apr 2003 B2
6551340 Konya et al. Apr 2003 B1
6575896 Silverman et al. Jun 2003 B2
6589230 Gia et al. Jul 2003 B2
6602261 Greene, Jr. et al. Aug 2003 B2
6602524 Batich et al. Aug 2003 B2
6605111 Bose et al. Aug 2003 B2
6629947 Sahatjian et al. Oct 2003 B1
6632531 Blankenship Oct 2003 B2
6635069 Teoh et al. Oct 2003 B1
6638291 Ferrera et al. Oct 2003 B1
6652883 Goupil et al. Nov 2003 B2
6669652 Anderson et al. Dec 2003 B2
6680046 Boschetti Jan 2004 B1
6699222 Jones et al. Mar 2004 B1
7029486 Schaefer et al. Apr 2006 B2
7053134 Baldwin et al. May 2006 B2
7094369 Buiser et al. Aug 2006 B2
7131997 Bourne et al. Nov 2006 B2
7326225 Ferrera et al. Feb 2008 B2
20010001835 Greene, Jr. et al. May 2001 A1
20010016210 Mathiowitz et al. Aug 2001 A1
20010036451 Goupil et al. Nov 2001 A1
20010051670 Goupil et al. Dec 2001 A1
20020010481 Jayaraman Jan 2002 A1
20020082499 Jacobsen et al. Jun 2002 A1
20020197208 Ruys et al. Dec 2002 A1
20030007928 Gray Jan 2003 A1
20030018356 Schaefer et al. Jan 2003 A1
20030032935 Damiano et al. Feb 2003 A1
20030108614 Volkonsky et al. Jun 2003 A1
20030120302 Minck et al. Jun 2003 A1
20030183962 Buiser et al. Oct 2003 A1
20030185895 Lanphere et al. Oct 2003 A1
20030185896 Buiser et al. Oct 2003 A1
20030187320 Freyman Oct 2003 A1
20030194390 Krall et al. Oct 2003 A1
20030203985 Baldwin et al. Oct 2003 A1
20030206864 Mangin Nov 2003 A1
20030215519 Schwarz et al. Nov 2003 A1
20030233150 Bourne et al. Dec 2003 A1
20040076582 DiMatteo et al. Apr 2004 A1
20040091543 Bell et al. May 2004 A1
20040092883 Casey, III et al. May 2004 A1
20040096662 Lanphere et al. May 2004 A1
20040101564 Rioux et al. May 2004 A1
20040111044 Davis et al. Jun 2004 A1
20040153025 Seifert et al. Aug 2004 A1
20040161451 Pierce et al. Aug 2004 A1
20040181174 Davis et al. Sep 2004 A2
20040186377 Zhong et al. Sep 2004 A1
20040243168 Ferrera et al. Dec 2004 A1
20050025800 Tan Feb 2005 A1
20050033350 Ken et al. Feb 2005 A1
20050037047 Song Feb 2005 A1
20050095428 DiCarlo et al. May 2005 A1
20050129775 Lanphere et al. Jun 2005 A1
20050196449 DiCarlo et al. Sep 2005 A1
20050226935 Kamath et al. Oct 2005 A1
20050238870 Buiser et al. Oct 2005 A1
20050263916 Lanphere et al. Dec 2005 A1
20060045900 Richard et al. Mar 2006 A1
20060116711 Elliott et al. Jun 2006 A1
20060173090 Baldwin et al. Aug 2006 A1
20060199009 Anderson et al. Sep 2006 A1
20060199010 DiCarlo et al. Sep 2006 A1
20060210710 Buiser et al. Sep 2006 A1
20060247610 Lanphere et al. Nov 2006 A1
20060292300 Tan Dec 2006 A1
20070004973 Tan Jan 2007 A1
20070059375 Bourne et al. Mar 2007 A1
20070083219 Buiser et al. Apr 2007 A1
Foreign Referenced Citations (82)
Number Date Country
A-7618698 Oct 1998 AU
233 303 Feb 1986 DE
3834705 Apr 1990 DE
94 14 868.6 Dec 1994 DE
100 26 620 Mar 2002 DE
0 067 459 Dec 1982 EP
0 122 624 Oct 1984 EP
0 123 235 Oct 1984 EP
0 402 031 Dec 1990 EP
0 422 258 Apr 1991 EP
0 458 079 Nov 1991 EP
0 458 745 Nov 1991 EP
0 470 569 Feb 1992 EP
0 547 530 Jun 1993 EP
0 600 529 Jun 1994 EP
0 623 012 Nov 1994 EP
0 706 376 Apr 1996 EP
0 730 847 Sep 1996 EP
0 744 940 Dec 1996 EP
0 764 047 Mar 1997 EP
0 797 988 Oct 1997 EP
0 820 726 Jan 1998 EP
0 865 773 Sep 1998 EP
0 993 337 Apr 2000 EP
2 641 692 Jul 1990 FR
59-196738 Nov 1984 JP
62-45637 Feb 1987 JP
4-74117 Mar 1992 JP
6-57012 Mar 1994 JP
9-110678 Apr 1997 JP
9-316271 Dec 1997 JP
10-130329 May 1998 JP
2000189511 Jul 2000 JP
2001079011 Mar 2001 JP
2002-017848 Jan 2002 JP
421658 Feb 2001 TW
WO 9112823 May 1991 WO
WO 9221327 Dec 1992 WO
WO 9319702 Oct 1993 WO
WO 9406503 Mar 1994 WO
WO 9406503 Mar 1994 WO
WO 9410936 May 1994 WO
WO 9503036 Feb 1995 WO
WO 9522318 Aug 1995 WO
WO 9533553 Dec 1995 WO
WO 9622736 Aug 1996 WO
WO 9637165 Nov 1996 WO
WO 9639464 Dec 1996 WO
WO 9804616 Feb 1998 WO
WO 9810798 Mar 1998 WO
WO 9826737 Jun 1998 WO
WO 9847532 Oct 1998 WO
WO 9900187 Jan 1999 WO
WO 9912577 Mar 1999 WO
WO 9942038 Aug 1999 WO
WO 9943380 Sep 1999 WO
WO 9957176 Nov 1999 WO
WO 0023054 Apr 2000 WO
WO 0032112 Jun 2000 WO
WO 0040259 Jul 2000 WO
WO 0053105 Sep 2000 WO
WO 0071196 Nov 2000 WO
WO 0074633 Dec 2000 WO
WO 0112359 Feb 2001 WO
WO 0166016 Sep 2001 WO
WO 0170291 Sep 2001 WO
WO 0172281 Oct 2001 WO
WO 0176845 Oct 2001 WO
WO 0193920 Dec 2001 WO
WO 0211696 Feb 2002 WO
WO 0234298 May 2002 WO
WO 0234299 May 2002 WO
WO 0234300 May 2002 WO
WO 0243580 Jun 2002 WO
WO 02096302 Dec 2002 WO
WO 03013552 Feb 2003 WO
WO 03051451 Jun 2003 WO
WO 03082359 Oct 2003 WO
WO 2004019999 Mar 2004 WO
WO 2004040972 May 2004 WO
WO 2004073688 Sep 2004 WO
WO 2005009253 Feb 2005 WO
Related Publications (1)
Number Date Country
20070083226 A1 Apr 2007 US