Complex wire formed devices

Information

  • Patent Grant
  • 11617593
  • Patent Number
    11,617,593
  • Date Filed
    Monday, February 22, 2021
    3 years ago
  • Date Issued
    Tuesday, April 4, 2023
    a year ago
Abstract
The devices and methods described herein relate to jointless construction of complex structures. Such devices have applicability in through-out the body, including clearing of blockages within body lumens, such as the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.
Description
FIELD OF THE INVENTION

The devices described herein are constructed in wire form where the wires diverge from a main bundle to form a variety of shapes that form a composite device. The benefit of such a diverging wire construction is that the composite complex device can be of a “joint-less” construction. Such devices have applicability in through-out the body, including clearing of blockages within body lumens, such as the vasculature, by addressing the frictional resistance on the obstruction prior to attempting to translate and/or mobilize the obstruction within the body lumen.


BACKGROUND OF THE INVENTION

Many medical device applications require advancement of device in a reduced profile to a remote site within the body, where on reaching a target site, the device assumes or is deployed into a relatively larger profile. Applications in the cerebral vasculature are one such example of medical procedures where a catheter advances from a remote part of the body (typically a leg) through the vasculature and into the cerebral region of the vasculature to deploy a device. Accordingly, the deployed devices must be capable of achieving a larger profile while being able to fit within a small catheter or microcatheter. In addition, the degree to which a physician is limited in accessing remote regions of the cerebral vasculature is directly related to the limited ability of the device to constrain into a reduced profile for delivery.


Treatment of ischemic stroke is one such area where a need remains to deliver a device in a reduced profile and deploy the device to ultimately remove a blockage in an artery leading to the brain. Left untreated, the blockage causes a lack of supply of oxygen and nutrients to the brain tissue. The brain relies on its arteries to supply oxygenated blood from the heart and lungs. The blood returning from the brain carries carbon dioxide and cellular waste. Blockages that interfere with this supply eventually cause the brain tissue to stop functioning. If the disruption in supply occurs for a sufficient amount of time, the continued lack of nutrients and oxygen causes irreversible cell death (infarction). Accordingly, immediate medical treatment of an ischemic stroke is critical for the recovery of a patient.


Naturally, areas outside of ischemic stroke applications can also benefit from devices that can assume a profile for ultimate delivery to remote regions of the body.


Regardless of the area where the device is to be used, when fabricating such a device the joints between adjacent shapes or sections of the device often impede the ability of the device to assume a sufficiently reduced profile or interfere with the geometry/stiffness of the device causing problems when navigating the device through the body. Also, joints lead to potential failure locations, and may lead to fractured and embolized components within the body. Such joints may include welded, glued, or otherwise separately joined pieces into one or more points of connection.


Accordingly, a need remains for devices that can assume deployed configurations and are fabricated to eliminate or reduce the number of joints and/or connection points in the device. Doing so allows the device to have a compact and smooth configuration making it easier for delivery through a microcatheter, and leads to a safer device less prone to breaking or embolizing.


SUMMARY OF THE INVENTION

The examples discussed herein show the inventive device in a form that is suitable to retrieve obstructions or clots within the vasculature. The term obstructions may include blood clot, plaque, cholesterol, thrombus, naturally occurring foreign bodies (i.e., a part of the body that is lodged within the lumen), a non-naturally occurring foreign body (i.e., a portion of a medical device or other non-naturally occurring substance lodged within the lumen.) However, the devices are not limited to such applications and can apply to any number of medical applications where elimination or reduction of the number of connection points is desired.


In one variation of the devices described herein, the device comprises a main bundle or group of wires that diverge to form a device having various shapes but few or no connections points or joints (where fabrication of such a construction is referred to as “jointless”).


The term shape (or shaped section), when applied to the various shapes of the device, is intended to identify different parts of the device where the wires/fibers form different sections or portions of the device. Each such region or shape has a structure that serves a different function of the device. In one example of such a device, a first shape can be a connector portion and a second shape can be a basket or mesh shape. In this case, the first shape (the connector portion) has a different structure and serves a different function than the second shape (the basket or mesh shape). In another example, a first shape can be a connector portion, a second shape can be a traversing section, and the third shape can be a second connector shape. Again, each shape serves a different function (although in this example the first and third shapes may have similar structures). In most variations of the device, adjacent shapes will have different structures or will be separated by the wires that diverge/converge to form adjacent shapes (e.g., two adjacent shapes, each forming connector shapes but are separated by wires that traverse between the connector shapes). The different shapes may not necessarily be spaced axially along the device; instead, as shown below, two shapes may form a single connector portion (e.g., see FIG. 6C).


In one variation, the device is adapted for delivery through a catheter and includes a main bundle comprising a group of wires having a first end extending through the catheter and a second end, where the main bundle of wires diverge at the second end to form a first shaped section, the first shaped section further comprises an expanded profile and a reduced profile for delivery through the catheter, a plurality of individual subsets of wires each diverging from the first shaped section to form a second shaped section, and where the individual subsets of wires converge to form a third shaped section, where the third shaped section comprises an expanded profile and a reduced profile for delivery through the catheter, and where the convergence and divergence of wires occurs without junctions between wires.


The term diverge includes uncoupling or separating of joined wires. In addition, a group of wires that form a first shape may all diverge to form a new composite shape. For example, a bundle of wires may form a loop shape and ultimately bend to extend in a direction substantially normal to the loop shape. In such a case, the wires can be considered to diverge from the loop shape to form a second shape.


The devices of the present invention typically include a main bundle from which the wires extend. In most case, the main bundle extends for a length sufficient to withdraw the device from a body of a patient. Accordingly, in such cases, the main bundle shall extend through the length of a catheter. In alternate constructions, the main bundle may be affixed to a single wire or member. In such cases, the single wire or member is used to manipulate the device, which allows shortening of the length of the main bundle.


Devices of the present invention can incorporate any number of wires of different characteristics including, but not limited to, materials, shapes, sizes and/or diameters. Clearly, the number of permutations of device configurations is significant. Providing devices with such a composite construction allows for the manipulation of the device's properties to suite the intended application.


In an additional variation, the devices can also include a basket or mesh shape structure that assists in the removal of obstructions from the body. In some cases, these basket structures are used as a capturing section. Although any number of shapes is contemplated, a few examples of such shapes include a basket, a filter, a bag, a coil, a helical wire structure, a mesh, a single wound wire, and a plurality of crossing wires.


In some cases where the device is intended to remove obstructions from the vasculature, the device and catheter may be constructed to permit relative rotation of the ends of the device such that upon rotation a portion of the device converts to a high friction surface to aid in removing the obstruction.


As noted herein, the joint-less construction improves the flexibility and strength of the device by eliminating joints, connection points, or other attachment points. In addition, the joint-less construction improves the ability of the device to be delivered through a small microcatheter. As a result, the device and microcatheter are able to access remote regions of the vasculature.


The devices may be fabricated to be self-expanding upon deployment from a catheter. Alternatively, the devices can be constructed from shape-memory alloys such that they automatically deploy upon reaching a pre-determined transition temperature.


When used in the vasculature to retrieve obstructions, the devices may include a low friction mode (such as a set of parallel wires, or wires extending axially along the lumen or vessel) that converts to an increased friction mode (such as a compressed set of wires acting on the obstruction or a twisted set of wires acting on the obstruction). The increase in friction is an increase in the friction between the obstruction and the device (as opposed to the vessel wall. In some cases, the low friction mode is a low surface area mode and the high friction mode is a high surface area mode. When configured in the low friction mode, the device is better suited to engage the obstruction without the undesirable effect of prematurely mobilizing the obstruction or compacting the obstruction (e.g., when wires are slid across the obstruction in a transverse motion). Upon engaging the obstruction, the device will conform to a high friction mode with respect to the obstruction (in some cases the device will have an increased surface area mode). This high friction mode permits the device to better grip the obstruction for ultimate removal of the obstruction.


The operation of the devices and method described herein secure the obstruction, overcome the elastic forces of the obstruction, and then remove the obstruction from the anatomy without losing or fractionating the obstruction. In one variation of the invention, this is accomplished by the obstruction removal device interacting with the obstruction in the following manner: (1) a portion of the wires are delivered distal to the obstruction by passing either through the obstruction or between the obstruction and the vascular wall; (2) the traversing wires are pulled proximally to engage a basket shaped section of the device around the obstruction, the basket shaped section engages the obstruction without causing significant mobilization of the obstruction; (3) the device is pulled further proximally and the surrounding portion now mobilizes the obstruction.


As shown below, variations of the devices have a configuration that provides a path for a portion of the device to surround the obstruction. The paths are made using sets or subsets of wires that allow for low frictional translation of the device over the obstruction without causing axial translation of the obstruction. This mechanism is described in more detail below.


Once in the proper position, a portion of the device increases the frictional contact with the obstruction to disperse the pulling force more evenly across the obstruction. The increase points of contact allow for removal of the obstruction through tortuous anatomy while ensuring that the obstruction will not escape the encapsulation.


It should be noted that reference to surrounding, capturing or securing the obstruction includes partially and/or fully surrounding, engulfing, encapsulating, and/or securing the obstruction. In any case, a portion of the device engages the obstruction prior to translation of the obstruction within the lumen. As noted herein, a portion of the device may convert into a surrounding section (e.g., when wires reorient to increase the friction acting on the obstruction). Accordingly, these wires convert into a surrounding section.


It should be noted that in some variations of the invention, all or some of the device can be designed to increase their ability to adhere to the obstruction. For example, the wires may be coupled to an energy source (e.g., RF, ultrasonic, or thermal energy) to “weld” to the obstruction. Application of energy to the device can allow the surrounding portion to deform into the obstruction and “embed” within the obstruction. Alternatively, the device can impart a positive charge to the obstruction to partially liquefy the obstruction sufficiently to allow for easier removal. In another variation, a negative charge could be applied to further build thrombus and nest the device for better pulling force. The wires can be made stickier by use of a hydrophilic substance(s), or by chemicals that would generate a chemical bond to the surface of the obstruction. Alternatively, the filaments may reduce the temperature of the obstruction to congeal or adhere to the obstruction.


Additional devices and methods for treating ischemic stroke are discussed in commonly assigned U.S. patent application Ser. No. 11/671,450 filed Feb. 5, 2007; Ser. No. 11/684,521 filed Mar. 9, 2007; Ser. No. 11/684,535 filed Mar. 9, 2007; Ser. No. 11/684,541 filed Mar. 9, 2007; Ser. No. 11/684,546 filed Mar. 9, 2007; and Ser. No. 11/684,982 filed Mar. 12, 2007; the entirety of each of which is incorporated by reference. The principles of the invention as discussed herein may be applied to the above referenced cases to produce devices useful in treating ischemic stroke. In other words, the wire-shaped construction of devices according to present invention may assume the shapes disclosed in the above-referenced cases.





BRIEF DESCRIPTION OF THE DRAWINGS

Each of the following figures diagrammatically illustrates aspects of the invention. Variation of the invention from the aspects shown in the figures is contemplated.



FIG. 1A illustrates an example of a device according to the present invention when used in a system for removing obstructions from body lumens.



FIG. 1B illustrates a first variation of the device having a joint-less construction.



FIG. 1C illustrates another variation of a main bundle of wires diverging in a joint-less construction.



FIG. 2A illustrates an example of an obstruction lodged within a body lumen.



FIGS. 2B to 2F illustrate advancement of a catheter beyond an obstruction and placement of a variation of the inventive device around the obstruction.



FIGS. 2G to 2H illustrate devices according to the present invention once converted to a high friction mode.



FIGS. 3A to 3B illustrate additional variations of the inventive device having a basket or mesh structure formed from diverging wires.



FIGS. 3C to 3D show positioning a variation of a device distally to an obstruction to ultimately translate a basket shaped section over the obstruction.



FIGS. 4A to 4B illustrate another variation of a portion a device configured to convert from a low friction mode to a high friction mode.



FIG. 5 illustrates an example of manufacturing a device by orienting the wires on a planar fixture.



FIGS. 6A to 6D illustrate variations of the shaped sections that can be formed from the wires forming the device.



FIG. 6E illustrates hooks, fibers, and/or barbs for increasing the ability of the device to remove obstructions.



FIGS. 7A to 7C illustrate additional variations of shapes for use in the devices according to the present invention.



FIGS. 8A to 8F also illustrate additional variations of obstruction removal devices, focusing mainly on variations of the surrounding portion.



FIGS. 9A to 9C show another variation of a medical device having multiple bundles of wires where the wires diverge to form capturing sections.





DETAILED DESCRIPTION

It is understood that the examples below discuss uses in the cerebral vasculature (namely the arteries). However, unless specifically noted, variations of the device and method are not limited to use in the cerebral vasculature. Instead, the invention may have applicability in various parts of the body. Moreover, the invention may be used in various procedures where the benefits of the method and/or device are desired.



FIG. 1A illustrates a system 10 for removing obstructions from body lumens as described herein. In the illustrated example, this variation of the system 10 is suited for removal of an obstruction in the cerebral vasculature. Typically, the system 10 includes a catheter 12 microcatheter, sheath, guide-catheter, or simple tube/sheath configuration for delivery of the obstruction removal device to the target anatomy. The catheter should be sufficient to deliver the device as discussed below. The catheter 12 may optionally include an inflatable balloon 18 for temporarily blocking blood flow or for expanding the vessel to release the obstruction.


It is noted that any number of catheters or microcatheters maybe used to locate the catheter/microcatheter 12 carrying the obstruction removal device (not illustrated) at the desired target site. Such techniques are well understood standard interventional catheterization techniques. Furthermore, the catheter 12 may be coupled to auxiliary or support components 14, 16 (e.g., energy controllers, power supplies, actuators for movement of the device(s), vacuum sources, inflation sources, sources for therapeutic substances, pressure monitoring, flow monitoring, various bio-chemical sensors, bio-chemical substance, etc.) Again, such components are within the scope of the system 10 described herein.


In addition, devices of the present invention may be packaged in kits including the components discussed above along with guiding catheters, various devices that assist in the stabilization or removal of the obstruction (e.g., proximal-assist devices that holds the proximal end of the obstruction in place preventing it from straying during removal or assisting in the removal of the obstruction), balloon-tipped guide catheters, dilators, etc.



FIG. 1B illustrates a first variation of a device according to the features described herein. As shown, the device 200 generally includes a main bundle 202 comprising a group of individual wires 204. The individual wires 204 may be comprised of a number of different wires, or a single type of wire. Variations of the wires 204 are discussed in detail below; however, the wires 204 can be strands, filaments, or any similar structure that is able to be joined to form the device. The bundle 106 may be braided, wrapped, twisted, or joined in any manner such that they do not separate or become unbundled except where desired. As shown, the main bundle 202 diverges to form a first shaped section 206. In this particular example, the bundle 202 diverges in two sections 208, 210 which then diverge again to form the first shape 206.


Next, the wires 204 forming the first shape 206 diverge in groups or subsets of wires 212, 214, 216, 218, to form a second shaped section 220. Ultimately, the subsets of wires 212, 214, 216, 218 converge to form a third shaped section 224. The ends of the wires 204 may terminate in the final shape of the device. In other variations, the device is constructed such that the shapes formed by the divergence and convergence of the wires are formed by the center of the individual wires where all the ends of the wires are located in the main bundle 202. In such a configuration, the device will not contain any terminating ends. In such a case, the wires forming the shapes are continuous and the device is completely joint or connection free.


In the illustrated variation, the first shaped section and third shaped section 206, 224 form loop shapes while the second shaped section forms a series of traversing elements that extend between the loops. When formed into traversing elements, the wires extend substantially parallel to one another and normal to the shaped sections so that they can span between the first and third shaped sections.


As noted below, any number of shapes may be formed with this joint-less construction. In addition, the devices described herein may have any number of shaped sections. For example, in the illustrated variation, the first and second 206, 224 shaped sections form two loop type structures. However, the device may be constructed such that the wires diverge to form any number of looped shaped structures.


In any case, the individual wires 204 form a composite device 200 having individual sections that can serve various functions upon deployment of the device 200. The divergence and convergence of the wires minimizes the numbers of joints or connections that would otherwise be required to form the composite shape. Such a configuration produces a smooth geometry given that the wires forming the device 200 are continuous.



FIG. 1C illustrates a partial view of another variation of a device 200 according to the present invention. In this variation, the device 200 comprises a main bundle 202 where the main bundle 202 diverges to form the first shape 206. In contrast with the device shown in FIG. 1B, the main bundle 206 does not diverge to form sections 208, 210 prior to forming the first shape 206.


It is noted that any number of shapes, configurations, as well as any number of joined wires may be contemplated to form devices under the present disclosure. However, variations of the invention include selecting a number of wires 204 to produce specific structural properties to the device. For example, if it is desired that each subset 212, 214, 216, 218, have at least two wires, then naturally the first section, third section, and main bundle 202 must have at least two wires. However, in some cases, it may be desired that these sections have additional wires to impart the required characteristics. For example, in the illustrated variation, the main bundle may comprise any number of wires that do not diverge to form subsequent shapes in the device. In other words, not all of the wires forming a section are required to diverge to form an adjacent section. Instead, these non-diverging wires may simply “loop” back away from the device. In an additional variation, one or more wires may diverge to form a first shape and part of a second shape. Then the wires can loop back to converge again with the main bundle.


Of course, the opposite construction is also within the scope of this disclosure. Namely, that each wire from the main bundle diverges to form an adjacent section or shape.



FIGS. 2A to 2F show one example of the deployment of a basic structure of a device according to the present invention about an obstruction in a vessel. The figures are intended to demonstrate the initial placement of the device immediately prior to removal of the obstruction either using a filter or by torquing, rotating and/or twisting the device ends relative to one another. This action converts the device from a low friction device to a high friction device (where the low/high friction is the friction between the device and the obstruction). This action may also be referred to as a low surface area mode converting to a high surface area mode (in cases where the device extends beyond the obstruction and relative motion between ends of the device causes the device to shrink in axial length as it is twisted.)



FIG. 2A illustrates an example of an obstruction 2 lodged within a body lumen or vessel 6. In the case where the vessel is a cerebral artery, the obstruction may result in an ischemic stroke. Using standard interventional catheterization techniques, a microcatheter 102 and guidewire 104 traverse the obstruction. The microcatheter 102 may be advanced through the obstruction 2. Alternatively, the microcatheter 102 may “push” aside the obstruction and is advanced around the obstruction. In any case, the microcatheter 102 travels from the near end 3 (or proximal side) of the obstruction 2 to the far end 4 (or distal side) of the obstruction 2. It is noted that the catheter 102 may be centered or off-center with respect to the obstruction 2. Furthermore, the device may or may not be used with a guidewire to navigate to the site and traverse the obstruction.



FIG. 2B shows another variation where a microcatheter 102 traverses the obstruction 2 between the wall of the vessel 6 and the obstruction 2. As shown, the open end of the microcatheter 102 is distal to the obstruction 2 and is now positioned to deploy devices for removal of the obstruction 2. This variation shows the device after removal of any guidewire. However, some variations of the device may be placed without an accompanying guidewire. Moreover, the structures discussed herein may be directly incorporated into a guidewire assembly where deployment may require a sheath or other covering to release the components from constraint.



FIG. 2C illustrates deployment of a portion of the device 200 from within the microcatheter 102 distal to the obstruction 2. In this example, the third shaped section 224 deploys distally to the obstruction 2. As noted herein, depending on the properties of the device 200 as determined by the types of wires used, third shaped section 224 can be self-expanding such that it assumes, or moves towards, the expanded profile (as shown) upon deployment from the constraint of the microcatheter 102. Alternatively, the third-shaped section 224 can be actuated to assume the shape (e.g., upon reaching a transition temperature where one or more wires comprise a shape memory alloy).



FIG. 2D shows withdrawal of the microcatheter 102 to the proximal side 3 of the obstruction 2. The spacing between the third shaped section 224 and the obstruction 2 may vary. In some cases, the third shaped section 224 will move closer towards the obstruction 2 during spacing of the remainder of the device as discussed below. The third shaped section 224 remains in place either using the inherent friction of the wires against the vessels and/or obstruction 2. Alternatively, or in combination, a wire-type member (not shown) may provide an opposing force against the third shaped section 224 as the catheter 102 moves proximal to the obstruction 2.


As noted above, this variation of the device 200 include a plurality of subsets 212, 214, 216, 218 that traverse between the first and third shaped sections 206, 224. As shown in FIG. 2E, eventually, second shaped section 220 spans across the obstruction 2 as shown.



FIG. 2F illustrates the device 200 after the second shaped section 220 separate about the obstruction 2 This action causes the second shaped section 220 to span the obstruction 2 while reorienting towards an exterior of the obstruction 2. The subsets of wires may remain partially or fully within the obstruction 2. However, given that the filaments are spaced about the loops formed by the first shaped section 206 and third shaped section 224, the filaments shall separate radially over the obstruction allowing for the subsequent ensnaring and removal of the obstruction 2.


Spacing the subsets that traverse across the obstruction can occur via a number of modes such as tensioning, expanding, spreading separating and/or withdrawing the wires. Regardless of the mode used, the subsets are intended to be positioned at or near a surface of the obstruction so that they can reduce the effects of any friction between the obstruction and the lumen or vessel wall.



FIGS. 2G to 2H illustrates examples of the device 200 that ensnare the obstruction 2 after the device is in the configuration demonstrated by above. In these cases, the devices 200 transform from a low friction mode to a higher friction mode for removal of the obstruction 2.



FIGS. 2G to 2H illustrate rotation of the ends of the device 206 and 224 relative to one another. The resulting action converts the device 200 to a high friction mode to ensnare the obstruction 2 within the traversing section formed by the wires in the second shaped section 220. As noted herein, either connector may rotate while another connector remains stationary. Alternatively, each connector may rotate with the rate of rotation for one connector being slower than another. In yet another variation, each connector may be rotated in opposite directions.


Although the variation shows only four individual subsets of wires traversing across between the first and third shaped sections 206 and 224 any number subsets may be used so long as the rotation converts the wires into a relatively increased friction mode as compared to the low friction mode (when the subsets are in a parallel configuration). The low friction mode is represented by FIG. 2F. FIG. 2G illustrates a device in a high friction mode where the subsets of wires forming the second shaped section 220 twist and cross one another over the length of the obstruction 2. It should be noted that additional shaped sections 206, 220, and/or 224 may be required to produce the crossing pattern shown in FIG. 2G, or other preferred patterns when the device is twisted to convert to a high friction mode.


In contrast, the device 200 may be configured to transform as shown in FIG. 2H. In this case, conversion of the device 200 causes twisting at points 116 where the twist points 116 are proximal and distal to the obstruction 2. To accomplish this, the device 200 can be selected to have a length greater than the targeted obstruction 2. Upon rotation, the second shaped section 220 formed from the subsets of wires that traverse across obstruction remain uncrossed over the length of the obstruction 2. In some cases, the second shaped section 220 can experience some twisting and will not remain parallel. The relative motion of the ends 206 and 224 as well as the twist points 116 causes the second shaped section 220 to exert a compressive force on the obstruction 2 without crossing one another over the length of the obstruction. Accordingly, while the surface area in contact between the second shaped section 220 and obstruction 2 remains relatively the same, the compressive action of the second shaped section 220 onto the obstruction converts the device 200 to a high friction mode on the obstruction.


The rotation of the ends of the device 206, 224 can be performed in any number of ways as known to those skilled in the art. In either case, the obstruction 2 becomes ensnared (and/or encapsulated) and can be removed from the body.



FIG. 3A illustrates another variation of a device where the wires 204 diverge from an end of the device 200 to form a basket 226 shape or structure. The basket structure 226 may also be referred to as a filter or surrounding portion. In variations of the device, the basket 226 is sufficiently permeable to allow blood flow therethrough. As noted above, basket 226 may be any structure that covers, encapsulates, engulfs, and/or ensnares the obstruction either fully or partially. Accordingly, although the basket 226 is illustrated as a filter/bag, the wires may diverge to form a coil, helical shape, other mesh structure, or any other structure that may translate or remove the obstruction 2 once the frictional component is addressed.



FIG. 3B shows a top view of a variation of a device 200 showing another configuration of a basket shape 226 formed by wires that diverge from an end of the device 200. In this variation, the wires 204 diverge in subsets 228 from the third shaped section 224. However, the subsets 228 continue to diverge at the far end of the device to form a mesh region 230 (i.e., an area of dense wire coverage). This mesh region 230 can increase the contact area between the wires 204 and the obstruction, which assists in removal of the obstruction. Divergence of wires could occur multiple times as wires head to the distal region of basket, creating a basket with denser and denser coverage moving distally.



FIG. 3C depicts a variation of the device similar to that of FIG. 3A. As shown, the device 200 is deployed distally to the obstruction 2 As shown, this deployment allows the subsets of wires that extend along the device 200 to expand within the vessel 6 prior to contacting the occlusion 2.


Next, as shown in FIG. 3D, the device 200 is pulled over the occlusion 2. As noted herein, the subsets of wires that form the second shaped portion 220 addresses the frictional forces that act between the obstruction and the vessel wall. Conventional devices that provide a bag attached to a wire (such as a vascular filter or distal protection device), are typically unable to remove the obstruction because they cannot overcome these frictional forces that lodge the clot against the vessel wall. Typically, such conventional devices are only designed to “catch” free floating clots. Providing low friction with respect to the clot and the vessel allows for positioning of the device without disrupting or further compacting the clot against the vessel wall. Once the wires of the device surround or are spaced about the obstruction, they reduce the friction between the clot and vessel wall by reducing points of contact. Once these wires surround the clot, they permit translation of the device to permit a basket shaped section 226 to surround the obstruction for removal. Eventually, the device 200 is pulled so that the basket shaped section 226 captures the obstruction 2 allowing it to be removed.



FIG. 4A illustrates a variation of a device 200 where the first shaped section is a loop shaped member 206 and the third shaped section 224 forms a closed end where the wires converge. As shown, subsets 212, 214, 216, 218 diverge from the first shaped section 206 and extend substantially parallel to the loop. Rather than converging to form another loop, the subsets converge to form a shaped section 224 having a closed end configuration. FIG. 4B illustrates the variation of FIG. 4A after it converts to a high friction mode over the obstruction 2 via rotation of the first shaped section 206. As with other variations, the number of subsets may vary as needed. In addition, the subsets of wires 212, 214, 216, 218 can further diverge to form a denser mesh pattern at or towards the third shaped section 224.


As shown, rotation of the shaped section 206 forms a twist point 116 proximal to the obstruction 2. In some cases, the subsets of wires 212, 214, 216, 218 can experience some twisting and may not remain parallel. The rotation of the shaped section 206 as well as the twist point 116 causes the subsets of wires 212, 214, 216, 218 to exert a compressive force on the obstruction 2 without crossing one another over the length of the obstruction. Accordingly, while the surface area in contact between the subsets of wires 212, 214, 216, 218 and obstruction 2 remains relatively the same, the compressive action of the subsets of wires onto the obstruction converts the device 200 to a high friction mode on the obstruction.



FIG. 5 shows one example of a method for constructing devices according to the present invention. A main bundle of wires 202 is brought into a fixture (not shown). The fixture permits routing of the wires in the pattern as shown. In this particular variation, the main bundle comprises 8 wires. However, number of wires is intended for exemplary purposes only. Clearly, any number of wires may be used. As shown the wires diverge in the region marked 232 to form four separate subsets of wires 212, 214, 216, 218. Again, in this example, each subset of wire comprises 2 individual wires. This configuration is for illustrative purposes as the number of wires in each subset is not required to be the same for all.


Next, the wires converge in the region marked as 234. It is noted that if the device is constructed on a planar fixture, the wires (once oriented) will be wrapped around a cylindrical structure and heat set to impart the shapes shown above. Accordingly, the regions marked by 232 and 234 assume partial loop shapes as the planar wire assembly is wrapped around the cylindrical fixture. In alternate variations, the wires may be oriented on a cylindrical fixture and heat set into a final shape. Doing so obviously eliminates the need to wrap the planar wire assembly about a cylindrical structure.


As shown, once the wires form the region marked as 234, they diverge once again to form a basket shaped section or filter 226 as discussed above. Accordingly, upon wrapping the device wires, the region marked as 234 assumes a loop shaped section. The wires forming the basket shaped section or filter 226 can either terminate at the end of the basket or filter 226. Alternatively, the wires can be looped around such that they eventually extend back through the main bundle 202 or loop back and terminate in any portion of the device.


The above described wire form construction allows for a number of configurations depending on the particular application. For example, the individual wires 204 may themselves comprise a bundle of smaller wires or filaments. In addition, the wires can be selected from materials such as stainless steel, titanium, platinum, gold, iridium, tantalum, nitinol, and/or polymeric strands. In addition, the wires used in a device may comprise a heterogeneous structure by using combinations of wires of different materials to produce a device having the particular desired properties. For example, one or more wires in the device may comprise a shape memory or superelastic alloy to impart predetermined shapes or resiliency to the device. In some variations, the mechanical properties of select wires can be altered. In such a case, the select wires can be treated to alter properties including: brittleness, ductility, elasticity, hardness, malleability, plasticity, strength, and toughness.


In addition, the device may include a number of radiopaque wires, such as gold and platinum for improved visibility under fluoroscopic imaging. In other words, any combination of materials may be incorporated into the device. In addition to the materials, the size of the wires may vary as needed. For example, the diameters of the wires may be the same or may vary as needed.


In addition, the individual wires may have cross-sectional shapes ranging from circular, oval, d-shaped, rectangular shape, etc. Moreover, the device is not limited to having wires having the same cross-sectional shape. Instead, the device can have wires having different cross-sectional shapes. To illustrate one such example, a device can have 8-12 wires made of 0.003″ round superelastic material (e.g., nitinol). The device may additionally have 2-4 wires made from 0.002″ platinum for fluoroscopy. Of the 8-12 nitinol wires, 1-4 of these wires can be made of a larger diameter or different cross-section to increase the overall strength of the device. Finally, a couple of polymer fibers can be added where the fibers have a desired surface property for clot adherence, etc. Such a combination of wires provides a composite device with properties not conventionally possible in view of other formation means (such as laser cutting or etching the shape from a tube or joining materials with welds, etc.). Clearly, any number of permutations is possible given the principles of the invention.


In another example, the device may be fabricated from wires formed from a polymeric material or composite blend of polymeric materials. The polymeric composite can be selected such that it is very floppy until it is exposed to either the body fluids and or some other delivered activator that causes the polymer to further polymerize or stiffen for strength. Various coatings could protect the polymer from further polymerizing before the device is properly placed. The coatings could provide a specific duration for placement (e.g., 5 minutes) after which the covering degrades or is activated with an agent (that doesn't affect the surrounding tissues) allowing the device to increase in stiffness so that it doesn't stretch as the thrombus is pulled out. For example, shape memory polymers would allow the device to increase in stiffness.


As discussed herein, the shaped section connectors may be other structures than loops. Moreover, variations of the invention include connectors that may be drawn down to a smaller size to facilitate removal from the body after securing the obstruction. This may be accomplished by torquing the device or part thereof, by re-sheathing part or all of the device or by any mechanical means designed into the features of the device itself. Any of these actions, or combination thereof, may also serve to compress or decrease the diameter of the obstruction itself to facilitate removal from the body.


As with the above examples, the illustrated variation shown above, the shaped portions are formed in a loop or partial loop shape. However, as described herein, the connectors may also comprise various alternate shapes (e.g., a circle, an arcuate shape, a partial circular shape, a loop, an oval, a square, a rectangle, a polygon, an overlapping loop, a pair of semi-circles, a flower shape, and a FIG. 8, other shapes, etc.) FIGS. 6A to 6D illustrate some possible shapes for use in the device. The various shapes may be heat set to be either self expanding (i.e., superelastic) or the use of shape memory alloys can allow for the device to assume the particular shape upon reaching a desired transition temperature. In certain cases, such as where the shape is an overlapping loop, a pair of semi-circles, a flower shape, a FIG. 8, or other complex/discontinuous shape, such a shape may be formed by a single bundle or by one or more separate portions of wire that diverge from the main bundle.



FIG. 6A illustrates a main bundle of wires 202 that diverge in three arcuate shaped portions 242, 244, 246. Naturally, the device may have more or less arcuate shaped sections. In this illustration, the segments forming the arcuate 242, 244, 246 shaped portions may simply bend to form segments that traverse across the device (as shown above.) However, such traversing sections are omitted to illustrate the arcuate shape.



FIG. 6B illustrates a main bundle 202 that ultimately diverges to form an overlapping loop shape 248. As shown, the ends of the overlapping loop may then proceed to form the traversing subsets 212, 214 discussed above. In addition, additional subsets of wires may diverge from a location other than the end of the overlapping loop shape 248.



FIG. 6C illustrates a main bundle that diverges to form two semi-circular or partial circular shapes 250, 252. In this variation, the two shapes are located along the same axial section of the device but the shapes are separate. Again, the ends of the partial circular shapes 250, 252 may diverge to form the traversing section of the device. Alternatively, the traversing wires can come from other locations.



FIG. 6D illustrates a main bundle 202 that diverges to form a “figure-8” shape. As with other variations, additional subsets (not shown) of wires may diverge from the “figure-8” shape to form the traversing subsets. In addition, flower shaped sections may be formed by the use of additional circular shapes that form the petals of the flower shape or via the use of multiple “figure-8” shapes.


The exemplary shapes discussed above permit the shaped section to adjust in diameter in response to placement in varying diameters of body lumens. It is noted that a device may have different shaped sections on different ends of the device.


While many different shapes are contemplated to be within the scope of this disclosure, the shapes will depend upon the ultimate application of the device. As noted herein, the illustrated examples have particular applicability in retrieving obstructions from the vasculature. Accordingly, for these applications the shaped sections should form a shape so that they can expand against a vessel wall without causing trauma to the vessel. For example, upon release from the catheter, the shaped section can assume their resting shape and expand within the vessel. The resting shape can be constructed to have a size slightly greater than that of the vessel. Sizing the device relative to the target vessel may assist in placing the parts of the device against a vessel.


In an additional aspect, the shaped sections may be designed to have an unconstrained shape that is larger than the intended target vessel or simply different than a cross sectional profile of the intended vessel (i.e., not circular or tubular, but e.g., linear or other different shape). In such an example, as the shaped section is released from the delivery catheter, the shape section attempts to return to the unconstrained shape. In those variations where the unconstrained shape is different from the circular profile of the vessel, the leading wire assumes a shape that accommodates the vessel but is more rigid and stable since its unconstrained shape is entirely different from that of the vessel. In other words, the shaped section continually exerts an outward force on the vessel.


In yet another aspect, the shaped sections shown herein may not necessarily lie in the same plane. Instead, they can be axially spaced by an offset. One benefit of constructing the device to have non-planar shaped section is that the configuration might allow for delivery of the device delivered via a smaller microcatheter because the shaped sections do not interfere with one another when collapsed to fit within the microcatheter.


Another aspect applicable to all variations of the devices is to configure the devices (whether the traversing filament or the surrounding portion) for better adherence to the obstruction. One such mode includes the use of coatings that bond to certain clots (or other materials causing the obstruction.) For example, the wires may be coated with a hydrogel or adhesive that bonds to a thrombus. Accordingly, as the device secures about a clot, the combination of the additive and the mechanical structure of the device may improve the effectiveness of the device in removing the obstruction.


Such improvements may also be mechanical or structural. For example, as shown in FIG. 6E, the traversing members may have hooks, fibers, or barbs 154 that grip into the obstruction when the device converts to a high friction mode. The hooks, fibers, or barbs 154 incorporated into any portion of the device. However, it will be important that such features do not hinder the ability of the practitioner to remove the device from the body.


In addition to additives, the device can be coupled to an RF or other power source (such as 14 or 16 in FIG. 1), to allow current, ultrasound or RF energy to transmit through the device and induce clotting or cause additional coagulation of a clot or other the obstruction.


The methods described herein may also include treating the obstruction prior to attempting to remove the obstruction. Such a treatment can include applying a chemical or pharmaceutical agent with the goal of making the occlusion shrink or to make it more rigid for easier removal. Such agents include, but are not limited to chemotherapy drugs, or solutions, a mild formalin, or aldehyde solution.


Although not illustrated, the devices and methods described herein may also be useful in removing obstructions lodged within bifurcations in the anatomy. Generally, bifurcations greatly increase the frictional forces on the obstructions since the obstruction tends to be lodged in both branching sections of the bifurcation. In such cases, the use of the presently described devices and methods may also include an additional “puller” device that advances beyond the portion of the obstruction partially located in the bifurcated vessel.


As for other details of the present invention, materials and manufacturing techniques may be employed as within the level of those with skill in the relevant art. The same may hold true with respect to method-based aspects of the invention in terms of additional acts that are commonly or logically employed. In addition, though the invention has been described in reference to several examples, optionally incorporating various features, the invention is not to be limited to that which is described or indicated as contemplated with respect to each variation of the invention.



FIGS. 7A to 7C illustrate additional variations of obstruction removal devices. In these variations, the wires may diverge from the main wire bundle 202 to form any number of shapes and structures and specifically not form loop or the shaped sections discussed above. For example, in FIGS. 7A to 7B the wires diverge to ultimately form a basket or filter shape 226.



FIGS. 8A to 8F illustrate various additional configurations for construction of join-less devices 200. As shown, the main bundle of wires 202 diverges so that one or more wires forms the illustrated shapes.



FIGS. 9A to 9C show another variation of a medical device according to the principles of the invention. As shown, the device 200 comprises a first and second main bundles 202, where the main bundles comprise a plurality of wires. The devices further include a first shape and second shapes 206 formed by a divergence of the plurality of wires into a plurality of individual first subsets of wires. In these variations, the wires diverge to form a network of individual single wires as shown in region 226. The shapes form a three dimensional structure that is useful for removal of obstruction from within the body. In FIG. 9B, each shape comprises a structure that forms a portion of the basket where a network of wires forms an end of the basket. In FIGS. 9A and 9C the network of wires forms the entire basket.


As noted above, the shapes 206 may range from a circle, an arcuate shape, a partial circular shape, a loop, an oval, a square, a rectangle, a polygon, an overlapping loop, a pair of semi-circles, a flower shape, and a FIG. 8 (as shown above).


Various changes may be made to the invention described and equivalents (whether recited herein or not included for the sake of some brevity) may be substituted without departing from the true spirit and scope of the invention. Also, any optional feature of the inventive variations may be set forth and claimed independently, or in combination with any one or more of the features described herein. Accordingly, the invention contemplates combinations of various aspects of the embodiments or combinations of the embodiments themselves, where possible. Reference to a singular item, includes the possibility that there are plural of the same items present. More specifically, as used herein and in the appended claims, the singular forms “a,” “and,” “said,” and “the” include plural references unless the context clearly dictates otherwise.

Claims
  • 1. A device for removing an obstruction from a blood vessel, the device comprising: an expandable structure including a continuous wire construction having a plurality of wires, the expandable structure including: a distal end configured to be positioned distal to the obstruction,a proximal end configured to be positioned proximal to the obstruction, andan intermediate portion between first and second regions of the expandable structure in which the expandable structure converges inwardly,wherein at least one of the wires of the expandable structure along the intermediate portion extends longitudinally and substantially parallel to another one of the wires of the expandable structure, andwherein, when the expandable structure is deployed in the blood vessel, the expandable structure is configured to hold the obstruction via the intermediate portion between the first and second regions.
  • 2. The device of claim 1, wherein the intermediate portion is configured to form a shaped section about the obstruction between the first and second regions.
  • 3. The device of claim 1, wherein, when the expandable structure is deployed in the blood vessel, the intermediate portion is configured to expand within the blood vessel and embed into the obstruction.
  • 4. The device of claim 1, further comprising a catheter configured to deploy the expandable structure into the blood vessel.
  • 5. The device of claim 4, wherein the catheter is coupled to a vacuum source.
  • 6. The device of claim 1, wherein the expandable structure is self-expanding.
  • 7. The device of claim 1, wherein the expandable structure is coupled to an energy source.
  • 8. The device of claim 1, wherein the first and second regions are between the proximal and distal ends of the expandable structure.
  • 9. The device of claim 1, wherein the first region is located distal to the second region.
  • 10. The device of claim 1, wherein the first and second regions are narrower than the intermediate portion.
  • 11. A device for removing an obstruction from a blood vessel, the device comprising: an expandable structure having a continuous construction with a plurality of interconnected filaments, the expandable structure including: a distal end configured to be positioned distal to the obstruction,a proximal end configured to be positioned proximal to the obstruction, andan intermediate portion between first and second narrowed regions of the expandable structure,wherein at least one of the interconnected filaments of the expandable structure along the intermediate portion extends longitudinally and substantially parallel to another one of the interconnected filaments of the expandable structure, andwherein, when the expandable structure is deployed in the blood vessel, the expandable structure is configured to hold the obstruction via the intermediate portion between the first and second narrowed regions.
  • 12. The device of claim 11, wherein the intermediate portion is configured to form a shaped section about the obstruction between the first and second narrowed regions.
  • 13. The device of claim 11, wherein, when the expandable structure is deployed in the blood vessel, the intermediate portion is configured to expand within the blood vessel and engage the obstruction.
  • 14. The device of claim 11, further comprising a catheter configured to introduce the expandable structure into the blood vessel.
  • 15. The device of claim 14, wherein the catheter is coupled to a vacuum source.
  • 16. The device of claim 11, wherein the expandable structure is self-expanding.
  • 17. The device of claim 11, wherein the expandable structure is coupled to an energy source.
  • 18. The device of claim 11, wherein the first and second narrowed regions are located between the proximal and distal ends of the expandable structure.
  • 19. The device of claim 11, wherein the first narrowed region is located distal to the second narrowed region.
  • 20. The device of claim 11, wherein at least some of the interconnected filaments converge inwardly to form the first and second narrowed regions.
CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No. 16/119,891, filed Aug. 31, 2018, which is a continuation of U.S. patent application Ser. No. 15/056,456, filed on Feb. 29, 2016, now U.S. Pat. No. 10,076,346, which is a continuation of U.S. patent application Ser. No. 13/946,901, filed on Jul. 19, 2013, now U.S. Pat. No. 9,271,747, which is a continuation of U.S. patent application Ser. No. 11/736,537, filed on Apr. 17, 2007, now U.S. Pat. No. 8,512,352, all of which are incorporated herein by reference in their entirety.

US Referenced Citations (356)
Number Name Date Kind
1054960 Butner Mar 1913 A
2918919 Wallace Dec 1959 A
2943626 Enrico Jul 1960 A
3108593 Glassman Oct 1963 A
3108594 Glassman Oct 1963 A
3996938 Clark Dec 1976 A
4347846 Dormia Sep 1982 A
4611594 Grayhack et al. Sep 1986 A
4612931 Dormia Sep 1986 A
4633871 Shinozuka Jan 1987 A
4699147 Chilson et al. Oct 1987 A
4790812 Hawkins, Jr. et al. Dec 1988 A
4807626 Mcgirr Feb 1989 A
4832055 Palestrant May 1989 A
4873978 Ginsburg Oct 1989 A
4969891 Gewertz Nov 1990 A
5057114 Wittich et al. Oct 1991 A
5059178 Ya Oct 1991 A
5098441 Wechler Mar 1992 A
5102415 Guenther et al. Apr 1992 A
5147400 Kaplan et al. Sep 1992 A
5152777 Goldberg et al. Oct 1992 A
5190554 Coddington, III et al. Mar 1993 A
5192286 Phan et al. Mar 1993 A
5300086 Gory et al. Apr 1994 A
5330482 Gibbs et al. Jul 1994 A
5397320 Essig et al. Mar 1995 A
5443478 Purdy Aug 1995 A
5458375 Anspach, Jr. et al. Oct 1995 A
5496330 Bates et al. Mar 1996 A
5509900 Kirkman Apr 1996 A
5611803 Heaven et al. Mar 1997 A
5653684 Laptewicz et al. Aug 1997 A
5658296 Bates et al. Aug 1997 A
5709704 Nott et al. Jan 1998 A
5733302 Myler et al. Mar 1998 A
5741325 Chaikof et al. Apr 1998 A
5792156 Perouse Aug 1998 A
5827324 Cassell et al. Oct 1998 A
5846251 Hart Dec 1998 A
5895398 Wensel et al. Apr 1999 A
5947995 Samuels Sep 1999 A
5968090 Ratcliff et al. Oct 1999 A
5971938 Hart et al. Oct 1999 A
5972019 Engelson et al. Oct 1999 A
5989266 Foster Nov 1999 A
6001118 Daniel et al. Dec 1999 A
6033394 Vidlund et al. Mar 2000 A
6053932 Daniel et al. Apr 2000 A
6066149 Samson et al. May 2000 A
6066158 Engelson et al. May 2000 A
6096053 Bates Aug 2000 A
6099534 Bates et al. Aug 2000 A
6159220 Gobron et al. Dec 2000 A
6165200 Tsugita et al. Dec 2000 A
6168579 Tsugita Jan 2001 B1
6168603 Leslie et al. Jan 2001 B1
6174318 Bates et al. Jan 2001 B1
6190394 Lind et al. Feb 2001 B1
6217609 Haverkost Apr 2001 B1
6221006 Dubrul et al. Apr 2001 B1
6224612 Bates et al. May 2001 B1
6245089 Daniel et al. Jun 2001 B1
6248113 Fina Jun 2001 B1
6264664 Avellanet Jul 2001 B1
6299612 Ouchi Oct 2001 B1
6302895 Gobron et al. Oct 2001 B1
6309399 Barbut et al. Oct 2001 B1
6325807 Que Dec 2001 B1
6348056 Bates et al. Feb 2002 B1
6350266 White et al. Feb 2002 B1
6364895 Greenhalgh Apr 2002 B1
6371971 Tsugita et al. Apr 2002 B1
6383195 Richard May 2002 B1
6383196 Leslie et al. May 2002 B1
6402761 Mcalister Jun 2002 B2
6402771 Palmer et al. Jun 2002 B1
6409750 Hyodoh et al. Jun 2002 B1
6416505 Fleischman et al. Jul 2002 B1
6425909 Dieck et al. Jul 2002 B1
6436112 Wensel et al. Aug 2002 B2
6443972 Bosma et al. Sep 2002 B1
6458139 Palmer et al. Oct 2002 B1
6485497 Wensel et al. Nov 2002 B2
6494884 Gifford, III et al. Dec 2002 B2
6506204 Mazzocchi Jan 2003 B2
6514273 Voss et al. Feb 2003 B1
6517550 Konya et al. Feb 2003 B1
6530935 Wensel et al. Mar 2003 B2
6537297 Tsugita et al. Mar 2003 B2
6540657 Cross, III et al. Apr 2003 B2
6544279 Hopkins et al. Apr 2003 B1
6551342 Shen et al. Apr 2003 B1
6575997 Palmer et al. Jun 2003 B1
6585753 Eder et al. Jul 2003 B2
6592605 Lenker et al. Jul 2003 B2
6592607 Palmer et al. Jul 2003 B1
6602265 Dubrul et al. Aug 2003 B2
6602271 Adams et al. Aug 2003 B2
6605102 Mazzocchi et al. Aug 2003 B1
6610077 Hancock et al. Aug 2003 B1
6616679 Khosravi et al. Sep 2003 B1
6620148 Tsugita Sep 2003 B1
6620172 Dretler et al. Sep 2003 B1
6635068 Dubrul et al. Oct 2003 B1
6636758 Sanchez et al. Oct 2003 B2
6638245 Miller et al. Oct 2003 B2
6641590 Palmer et al. Nov 2003 B1
6645199 Jenkins et al. Nov 2003 B1
6652505 Tsugita Nov 2003 B1
6652537 Mercereau et al. Nov 2003 B2
6652548 Evans et al. Nov 2003 B2
6660021 Palmer et al. Dec 2003 B1
6663650 Sepetka et al. Dec 2003 B2
6673042 Samson et al. Jan 2004 B1
6673080 Reynolds et al. Jan 2004 B2
6679893 Tran Jan 2004 B1
6685738 Chouinard et al. Feb 2004 B2
6692508 Wensel et al. Feb 2004 B2
6692509 Wensel et al. Feb 2004 B2
6695858 Dubrul et al. Feb 2004 B1
6702782 Miller et al. Mar 2004 B2
6709465 Mitchell et al. Mar 2004 B2
6712835 Mazzocchi et al. Mar 2004 B2
6730104 Sepetka et al. May 2004 B1
6740096 Teague et al. May 2004 B2
6745080 Koblish Jun 2004 B2
6746468 Sepetka et al. Jun 2004 B1
6749619 Ouriel et al. Jun 2004 B2
6755813 Ouriel et al. Jun 2004 B2
6800080 Bates Oct 2004 B1
6824545 Sepetka et al. Nov 2004 B2
6840950 Stanford et al. Jan 2005 B2
6872211 White et al. Mar 2005 B2
6872216 Daniel et al. Mar 2005 B2
6890341 Dieck et al. May 2005 B2
6893431 Naimark et al. May 2005 B2
6905503 Gifford, III et al. Jun 2005 B2
6913612 Palmer et al. Jul 2005 B2
6936059 Belef Aug 2005 B2
6939362 Boyle et al. Sep 2005 B2
6945977 Demarais et al. Sep 2005 B2
6953465 Dieck et al. Oct 2005 B2
6964672 Brady et al. Nov 2005 B2
7004955 Shen et al. Feb 2006 B2
7004956 Palmer et al. Feb 2006 B2
7037320 Brady et al. May 2006 B2
7058456 Pierce Jun 2006 B2
7097653 Freudenthal et al. Aug 2006 B2
7101380 Khachin et al. Sep 2006 B2
7169165 Belef et al. Jan 2007 B2
7179273 Palmer et al. Feb 2007 B1
7182771 Houser et al. Feb 2007 B1
7220271 Clubb et al. May 2007 B2
7235061 Tsugita Jun 2007 B2
7316692 Huffmaster Jan 2008 B2
7534252 Sepetka et al. May 2009 B2
7591825 Leslie et al. Sep 2009 B2
7691121 Rosenbluth et al. Apr 2010 B2
7731722 Lavelle et al. Jun 2010 B2
8105333 Sepetka et al. Jan 2012 B2
8142445 Teague Mar 2012 B2
8157811 Shinozuka et al. Apr 2012 B2
8211115 Cheng et al. Jul 2012 B2
8267940 Sepetka et al. Sep 2012 B2
8512352 Martin Aug 2013 B2
8535334 Martin Sep 2013 B2
8545526 Martin et al. Oct 2013 B2
8603014 Alleman et al. Dec 2013 B2
8801748 Martin Aug 2014 B2
8837800 Bammer et al. Sep 2014 B1
9119656 Bose et al. Sep 2015 B2
9126018 Garrison Sep 2015 B1
9211132 Bowman Dec 2015 B2
9241699 Kume et al. Jan 2016 B1
9254371 Martin et al. Feb 2016 B2
9265512 Garrison et al. Feb 2016 B2
9271747 Martin Mar 2016 B2
9271748 Martin Mar 2016 B2
9308007 Cully et al. Apr 2016 B2
9399118 Kume et al. Jul 2016 B2
9445828 Turjman et al. Sep 2016 B2
9445829 Brady et al. Sep 2016 B2
9492637 Garrison et al. Nov 2016 B2
9539022 Bowman Jan 2017 B2
9561345 Garrison et al. Feb 2017 B2
9579119 Cully et al. Feb 2017 B2
9585741 Ma Mar 2017 B2
9642635 Vale et al. May 2017 B2
9655633 Leynov et al. May 2017 B2
9717514 Martin et al. Aug 2017 B2
9737318 Monstadt et al. Aug 2017 B2
9770251 Bowman et al. Sep 2017 B2
9801643 Hansen et al. Oct 2017 B2
9861783 Garrison et al. Jan 2018 B2
9993257 Losordo et al. Jun 2018 B2
10028782 Orion Jul 2018 B2
10029008 Creighton Jul 2018 B2
10039906 Kume et al. Aug 2018 B2
10076346 Martin Sep 2018 B2
10925625 Martin Feb 2021 B2
20010031971 Dretler et al. Oct 2001 A1
20010041909 Tsugita et al. Nov 2001 A1
20010044634 Don et al. Nov 2001 A1
20010051810 Dubrul et al. Dec 2001 A1
20020002396 Fulkerson Jan 2002 A1
20020004667 Adams et al. Jan 2002 A1
20020026211 Khosravi et al. Feb 2002 A1
20020058904 Boock et al. May 2002 A1
20020062135 Mazzocchi et al. May 2002 A1
20020072764 Sepetka et al. Jun 2002 A1
20020082558 Samson et al. Jun 2002 A1
20020123765 Sepetka et al. Sep 2002 A1
20020151928 Leslie et al. Oct 2002 A1
20020169474 Kusleika et al. Nov 2002 A1
20020188314 Anderson et al. Dec 2002 A1
20020193825 Mcguckin et al. Dec 2002 A1
20030004542 Wensel et al. Jan 2003 A1
20030023265 Forber Jan 2003 A1
20030040771 Hyodoh et al. Feb 2003 A1
20030050663 Khachin et al. Mar 2003 A1
20030060782 Bose et al. Mar 2003 A1
20030093087 Jones et al. May 2003 A1
20030139750 Shinozuka et al. Jul 2003 A1
20030144687 Brady et al. Jul 2003 A1
20030153935 Mialhe Aug 2003 A1
20030191492 Gellman et al. Oct 2003 A1
20030195556 Stack et al. Oct 2003 A1
20040068288 Palmer et al. Apr 2004 A1
20040073243 Sepetka et al. Apr 2004 A1
20040079429 Miller et al. Apr 2004 A1
20040116941 Reynolds et al. Jun 2004 A1
20040122445 Butler et al. Jun 2004 A1
20040133232 Rosenbluth et al. Jul 2004 A1
20040138692 Phung et al. Jul 2004 A1
20040153025 Seifert et al. Aug 2004 A1
20040153118 Clubb et al. Aug 2004 A1
20040172056 Guterman et al. Sep 2004 A1
20040199201 Kellett et al. Oct 2004 A1
20040199243 Yodfat Oct 2004 A1
20040210116 Nakao Oct 2004 A1
20040267301 Boylan et al. Dec 2004 A1
20050004594 Nool et al. Jan 2005 A1
20050033348 Sepetka et al. Feb 2005 A1
20050038447 Huffmaster Feb 2005 A1
20050043680 Segal et al. Feb 2005 A1
20050043756 Lavelle et al. Feb 2005 A1
20050049619 Sepetka et al. Mar 2005 A1
20050055033 Leslie et al. Mar 2005 A1
20050055047 Greenhalgh Mar 2005 A1
20050059995 Sepetka et al. Mar 2005 A1
20050075648 Komiya Apr 2005 A1
20050080356 Dapolito et al. Apr 2005 A1
20050085826 Nair et al. Apr 2005 A1
20050085847 Galdonik et al. Apr 2005 A1
20050085849 Sepetka et al. Apr 2005 A1
20050090857 Kusleika et al. Apr 2005 A1
20050090858 Pavlovic Apr 2005 A1
20050096668 Mcalister May 2005 A1
20050125024 Sepetka et al. Jun 2005 A1
20050131450 Nicholson et al. Jun 2005 A1
20050171566 Kanamaru Aug 2005 A1
20050203571 Mazzocchi et al. Sep 2005 A1
20050209609 Wallace Sep 2005 A1
20050216030 Sepetka et al. Sep 2005 A1
20050216050 Sepetka et al. Sep 2005 A1
20050234501 Barone Oct 2005 A1
20050234505 Diaz et al. Oct 2005 A1
20050251151 Teague Nov 2005 A1
20050261706 Cheng et al. Nov 2005 A1
20050267491 Kellett et al. Dec 2005 A1
20050277978 Greenhalgh Dec 2005 A1
20050283166 Greenhalgh Dec 2005 A1
20050283186 Berrada et al. Dec 2005 A1
20060004404 Khachin et al. Jan 2006 A1
20060009784 Behl et al. Jan 2006 A1
20060047286 West Mar 2006 A1
20060058836 Bose et al. Mar 2006 A1
20060058837 Bose et al. Mar 2006 A1
20060058838 Bose et al. Mar 2006 A1
20060095070 Gilson et al. May 2006 A1
20060129166 Lavelle Jun 2006 A1
20060129180 Tsugita et al. Jun 2006 A1
20060155305 Freudenthal et al. Jul 2006 A1
20060190070 Dieck et al. Aug 2006 A1
20060195137 Sepetka et al. Aug 2006 A1
20060229638 Abrams et al. Oct 2006 A1
20060253145 Lucas Nov 2006 A1
20060276805 Yu Dec 2006 A1
20060282111 Morsi Dec 2006 A1
20060293697 Nakao et al. Dec 2006 A1
20070112374 Paul et al. May 2007 A1
20070118165 Demello et al. May 2007 A1
20070185500 Martin et al. Aug 2007 A1
20070185501 Martin et al. Aug 2007 A1
20070197103 Martin et al. Aug 2007 A1
20070198029 Martin et al. Aug 2007 A1
20070198030 Martin et al. Aug 2007 A1
20070208367 Fiorella et al. Sep 2007 A1
20070225749 Martin et al. Sep 2007 A1
20070265656 Amplatz et al. Nov 2007 A1
20080109031 Sepetka et al. May 2008 A1
20080183198 Sepetka et al. Jul 2008 A1
20080188885 Sepetka et al. Aug 2008 A1
20080262528 Martin Oct 2008 A1
20080262532 Martin Oct 2008 A1
20090069828 Martin et al. Mar 2009 A1
20090192518 Leanna et al. Jul 2009 A1
20090287291 Becking et al. Nov 2009 A1
20090299393 Martin et al. Dec 2009 A1
20100076452 Sepetka et al. Mar 2010 A1
20100185210 Hauser et al. Jul 2010 A1
20110166586 Sepetka et al. Jul 2011 A1
20110288572 Martin Nov 2011 A1
20120143230 Sepetka et al. Jun 2012 A1
20120197285 Martin et al. Aug 2012 A1
20130030461 Marks et al. Jan 2013 A1
20130281788 Garrison Oct 2013 A1
20140005717 Martin et al. Jan 2014 A1
20140031856 Martin Jan 2014 A1
20140148841 Martin May 2014 A1
20140276074 Warner Sep 2014 A1
20140343595 Monstadt et al. Nov 2014 A1
20150359547 Vale et al. Dec 2015 A1
20160015402 Brady et al. Jan 2016 A1
20160015935 Chan et al. Jan 2016 A1
20160106448 Brady et al. Apr 2016 A1
20160106449 Brady et al. Apr 2016 A1
20160113663 Brady et al. Apr 2016 A1
20160113665 Brady et al. Apr 2016 A1
20160151618 Powers et al. Jun 2016 A1
20160157985 Vo et al. Jun 2016 A1
20160174996 Martin Jun 2016 A1
20160199620 Pokorney et al. Jul 2016 A1
20160296690 Kume et al. Oct 2016 A1
20160302808 Loganathan et al. Oct 2016 A1
20160375180 Anzai Dec 2016 A1
20170079766 Wang et al. Mar 2017 A1
20170079767 Leon-yip Mar 2017 A1
20170086862 Vale et al. Mar 2017 A1
20170100143 Grandfield Apr 2017 A1
20170105743 Vale et al. Apr 2017 A1
20170164963 Goyal Jun 2017 A1
20170215902 Leynov et al. Aug 2017 A1
20170224953 Tran et al. Aug 2017 A1
20170281909 Northrop et al. Oct 2017 A1
20170290599 Youn et al. Oct 2017 A1
20180049762 Seip et al. Feb 2018 A1
20180084982 Yamashita et al. Mar 2018 A1
20180116717 Taff et al. May 2018 A1
20180132876 Zaidat May 2018 A1
20180140314 Goyal et al. May 2018 A1
20180140315 Bowman et al. May 2018 A1
20180140354 Lam et al. May 2018 A1
20180185614 Garrison et al. Jul 2018 A1
20190015121 Martin Jan 2019 A1
Foreign Referenced Citations (47)
Number Date Country
3501707 Jul 1986 DE
1312314 May 2003 EP
2319575 Nov 2013 EP
2002537943 Nov 2002 JP
2008539958 Nov 2008 JP
2014004219 Jan 2014 JP
2018118132 Aug 2018 JP
20180102877 Sep 2018 KR
WO 9409845 May 1994 WO
WO 9509586 Apr 1995 WO
WO 9601591 Jan 1996 WO
WO 9617634 Jun 1996 WO
WO 9619941 Jul 1996 WO
WO 9727808 Aug 1997 WO
WO 9727893 Aug 1997 WO
WO 9803120 Jan 1998 WO
WO 0053120 Sep 2000 WO
WO 0072909 Dec 2000 WO
WO 0132254 May 2001 WO
WO 0154622 Aug 2001 WO
WO 0167967 Sep 2001 WO
WO 0202162 Jan 2002 WO
WO 0228291 Apr 2002 WO
WO 03000334 Jan 2003 WO
WO 03061730 Jul 2003 WO
WO 03089039 Oct 2003 WO
WO 2006031410 Mar 2006 WO
WO 2006122076 Nov 2006 WO
WO 2007092820 Aug 2007 WO
WO 2008036156 Mar 2008 WO
WO 2008131116 Oct 2008 WO
WO 2009034456 Mar 2009 WO
WO 2009086482 Jul 2009 WO
WO 2011091383 Jul 2011 WO
WO 2012009675 Jan 2012 WO
WO 2012162437 Nov 2012 WO
WO 2015141317 Sep 2015 WO
WO 2017192999 Nov 2017 WO
WO 2018019829 Feb 2018 WO
WO 2018033401 Feb 2018 WO
WO 2018046408 Mar 2018 WO
WO 2018137029 Aug 2018 WO
WO 2018137030 Aug 2018 WO
WO 2018145212 Aug 2018 WO
WO 2018156813 Aug 2018 WO
WO 2018172891 Sep 2018 WO
WO 2018187776 Oct 2018 WO
Non-Patent Literature Citations (1)
Entry
Extended European Search Report dated Apr. 7, 2017; European Application No. 08807060.2; 9 pages.
Related Publications (1)
Number Date Country
20210177443 A1 Jun 2021 US
Continuations (4)
Number Date Country
Parent 16119891 Aug 2018 US
Child 17249134 US
Parent 15056456 Feb 2016 US
Child 16119891 US
Parent 13946901 Jul 2013 US
Child 15056456 US
Parent 11736537 Apr 2007 US
Child 13946901 US