The present invention relates to medical devices. More particularly, the present invention relates to a delivery system for deploying an embolization coil and a method for positioning and deploying an embolization coil at a deployment site in a patient's vasculature.
Embolization coils and microcoils are used in the peripheral, cardiac, and neurological vasculature to occlude blood vessels for a variety of clinical goals. Two basic delivery methods have been developed for the delivery and deployment of a coil at a desired deployment site in a patient's vasculature. In both methods, a catheter is advanced through the patient's vasculature until the distal end of the catheter reaches the deployment site.
In the basic pushable coil delivery method, the coil is advanced through the lumen of the catheter and out the distal end of the catheter at the deployment site using a pusher wire. The pusher wire does not attach to the coil. While these pushable coil methods offer simplicity in use, they often provide insufficient control of the coil during deployment.
In detachable coil delivery methods, the pusher wire attaches to the coil. After deployment of the coil, a medical practitioner detaches the pusher wire from the coil before removing the delivery system from the patient's vasculature. Detachable coils are particularly useful when the anatomy of the patient's vasculature is distal and tortuous and when very precise placement of the coil is needed. However, detachment of the pusher wire from the coil is often difficult.
The present invention generally provides a delivery system, a delivery assembly, and a method for deploying an embolization coil at a deployment site in a patient's vasculature. Embodiments of the present invention provide enhanced control of the embolization coil during the positioning and deployment of the coil. These embodiments also provide a simpler and more reliable means of coil detachment and deployment than existing detachable coil delivery systems.
In one embodiment, the present invention provides a delivery system for deploying an embolization coil having a proximal portion. The delivery system comprises a delivery tube having a first end and a second end. The delivery tube has a first lumen formed through the first end and the second end. The first lumen has a first lumen diameter. The delivery system further comprises a flexible sleeve having a third end and a fourth end. The flexible sleeve extends distally from the second end of the delivery tube to the fourth end of the flexible sleeve. The flexible sleeve has a second lumen formed through the third end and the fourth end and in fluid communication with the first lumen. The second lumen has a second lumen diameter. The flexible sleeve is configured to frictionally engage the proximal portion of the embolization coil in the second lumen. The delivery system further comprises a mandril slidably disposed within the first lumen and the second lumen to push the proximal portion of the embolization coil out of the second lumen to deploy the embolization coil.
In another embodiment, the present invention provides an embolization coil delivery assembly. The delivery assembly comprises a delivery tube having a first end and a second end. The delivery tube has a first lumen formed through the first end and the second end. The first lumen has a first lumen diameter. The delivery assembly further comprises a flexible sleeve having a third end and a fourth end. The flexible sleeve extends distally from the second end of the delivery tube to the fourth end of the flexible sleeve. The flexible sleeve has a second lumen formed through the third end and the fourth end and in fluid communication with the first lumen. The second lumen has a second lumen diameter. The delivery assembly further comprises an embolization coil having a proximal portion and a distal portion. The proximal portion of the embolization coil is disposed within the second lumen of the flexible sleeve. The flexible sleeve frictionally engages the proximal portion of the embolization coil. The delivery assembly further comprises a mandril slidably disposed within the first lumen and the second lumen to push the proximal portion of the embolization coil out of the second lumen to deploy the embolization coil.
In yet another embodiment, the present invention provides a method for positioning and deploying an embolization coil at a deployment site in a patient's vasculature. The method comprises percutaneously inserting a catheter into the patient's vasculature. The cathether has a proximal end and a distal end. The catheter has a catheter lumen formed through the proximal end and the distal end. The method further comprises advancing the catheter through the patient's vasculature until the distal end of the catheter is disposed at the deployment site, and the proximal end of the catheter is disposed outside of the patient's vasculature. The method further comprises inserting an embolization coil delivery assembly constructed in accordance with the present invention into the catheter lumen through the proximal end of the catheter. The method further comprises positioning the embolization coil at the deployment site. The method further comprises advancing the mandril distally through the first lumen and the second lumen to push the proximal portion of the embolization coil out of the second lumen to deploy the embolization coil.
Further objects, features, and advantages of the present invention will become apparent from consideration of the following description and the appended claims when taken in connection with the accompanying drawings.
a is a cross-sectional view of a delivery system for deploying an embolization coil in accordance with a second embodiment of the present invention;
b is a cross-sectional view of a delivery system for deploying an embolization coil in accordance with a third embodiment of the present invention;
c is a cross-sectional view of a delivery system for deploying an embolization coil in accordance with a fourth embodiment of the present invention;
The present invention generally provides a delivery system, a delivery assembly, and a method for deploying an embolization coil at a deployment site in a patient's vasculature. Embodiments of the present invention provide enhanced control of the embolization coil during the positioning and deployment of the coil. These embodiments also provide a simpler and more reliable means of coil detachment and deployment than existing detachable coil delivery systems.
As shown in
The delivery tube 12 may be constructed from any suitable material that will provide sufficient flexibility and resistance to kinking. For example, the delivery tube 12 may be constructed from stainless steel, platinum, nitinol, nylon, braid reinforced nylon, or any other suitable material. In some embodiments, the delivery tube 12 may be constructed as a coiled wire guide.
The flexible sleeve 20 has a proximal third end 22 and a distal fourth end 24. The flexible sleeve 20 extends distally from the second end 16 of the delivery tube 12 to the fourth end 24 of the flexible sleeve 20. In the embodiment shown in
The flexible sleeve 20 may be constructed from a flexible polymer, such as nylon or polytetrafluoroethylene (PTFE), or any other suitable material. Preferably, the flexible sleeve 20 is constructed from a flexible polymer. In some embodiments, the flexible sleeve 20 may be constructed from a dissolvable agent, such as poly-lactic-co-glycolic acid (PLGA), or any other suitable dissolvable agent. The flexible sleeve 20 may also include a radiopacifier, such as barium sulfate, or any other suitable radiopacifier.
The flexible sleeve 20 is fixedly attached to the delivery tube 12. In the embodiment shown in
As shown in
Similarly, the second lumen diameter b is selected based on the size of embolization coil to be used for a particular application. The second lumen diameter b is preferably selected to be slightly smaller than the outer diameter of the embolization coil to be deployed using the delivery system, such that the flexible sleeve 20 forms a tight friction fit with the embolization coil. Preferably, the second lumen diameter b is between about 0.014 and 0.016 inches, more preferably about 0.015 inches, or between about 0.021 and 0.023 inches, more preferably about 0.022 inches.
Depending on the desired properties of the delivery tube 12 and the size of embolization coil to be used for a particular application, as described above, the second lumen diameter b may be substantially equal to or greater than the first lumen diameter a. In the embodiments shown in
Referring again to
The mandril 30 may be constructed from a superelastic material (e.g., nitinol), a metal (e.g., stainless steel), or any other suitable material. Preferably, the mandril 30 is constructed from nitinol.
The first substantially cylindrical surface 42 and the second substantially cylindrical surface 44 have a first portion diameter c and a second portion diameter d, respectively. As shown in
The first portion diameter c and the second portion diameter d are also selected based on the size of embolization coil to be used for a particular application. The first portion diameter c is selected to be larger than the inner diameter of the embolization coil, and the second portion diameter d is selected to be smaller than the inner diameter of the embolization coil. Preferably, the first portion diameter c is between about 0.005 and 0.007 inches, more preferably about 0.006 inches, or between about 0.010 and 0.014 inches, more preferably about 0.012 inches. Preferably, the second portion diameter d is between about 0.003 and 0.005 inches, more preferably about 0.004 inches, or between about 0.006 and 0.010 inches, more preferably about 0.008 inches.
In a preferred embodiment, as shown in
The embolization coil 60 has an outer diameter e and an inner diameter f. Preferably, the outer diameter e of the embolization coil 60 is between about 0.012 and 0.016 inches, more preferably between about 0.013 and 0.015 inches, or between about 0.016 and 0.026 inches, more preferably between about 0.019 and 0.023 inches. Preferably, the inner diameter f of the embolization coil 60 is between about 0.004 and 0.006 inches, more preferably about 0.005 inches, or between about 0.008 and 0.012 inches, more preferably about 0.010 inches. As shown in
The embolization coil 60 may be constructed from stainless steel wire, a superelastic material, cobalt-chromium-nickel-molybdenum-iron alloy, cobalt-chrome alloy, platinum or any other suitable material.
As shown in
As indicated in box 406, and as illustrated in
As shown in
As indicated in box 408, the method 400 further comprises positioning the embolization coil 60 at the deployment site 92. The step of positioning the embolization coil 60 may comprise the series of sub-steps indicated in boxes 408a-408d.
As indicated in box 408a, and as illustrated in
If the flexible sleeve 20 includes a radiopacifier, a medical practitioner may monitor the location of the fourth end 24 of the flexible sleeve 20 by imaging to determine whether the positioning of the embolization coil 60 at the deployment site 92 is satisfactory. As indicated in box 408b, if the positioning of the embolization coil 60 is not satisfactory, the step indicated in box 408 may further comprise retracting the embolization coil delivery assembly 50 proximally through the catheter lumen 84 to pull the distal portion 64 of the embolization coil 60 back into the catheter lumen 84 through the distal end of the catheter 80. This retraction is accomplished by pulling part of the delivery tube 12 out of the catheter lumen 84 through the proximal end of the catheter 80. Such retraction is possible because of the friction fit between the flexible sleeve 20 and the proximal portion 62 of the embolization coil 60.
As indicated in box 408c, once the embolization coil 60 has been retracted into the catheter lumen 84, the practitioner may reposition the catheter 80 in the patient's vasculature 90 to more precisely place the distal end 82 of the catheter 80 at the deployment site 92. As indicated in box 408d, after properly positioning the distal end 82 of the catheter 80, the practitioner may once again advance the embolization coil delivery assembly 50 distally through the catheter lumen 84 until the fourth end 24 of the flexible sleeve 20 reaches the distal end 82 of the catheter 80, as shown in
If the flexible sleeve 20 includes a radiopacifier, the practitioner may once again monitor the location of the fourth end 24 of the flexible sleeve 20 by imaging to determine whether the positioning of the embolization coil 60 at the deployment site 92 is satisfactory. If the positioning is not satisfactory, the steps indicated in boxes 408b-408d may be repeated as necessary to properly position the embolization coil 60 at the deployment site 92.
If the positioning is satisfactory, the practitioner may deploy the embolization coil 60, as indicated in box 410, by advancing the mandril 30 distally through the first lumen of the delivery tube 12 and the second lumen of the flexible sleeve 20. As the mandril 30 is advanced through the first and second lumens, the shoulder surface 48 of the mandril 30 contacts the proximal end of the embolization coil 60, pushing the proximal portion 62 of the embolization coil 60 out of the second lumen.
After the proximal portion 62 of the embolization coil 60 has been pushed out of the second lumen, as shown in
As indicated in box 410a, the step indicated in box 410 may comprise advancing the mandril 30 distally through the first lumen and the second lumen until the proximal portion 62 of the embolization coil 60 exits the fourth end 24 of the flexible sleeve 20. As discussed above, the advancement of the mandril 30 causes the shoulder surface 48 to contact the proximal end of the embolization coil 60, pushing the proximal portion 62 of the embolization coil 60 out of the second lumen of the flexible sleeve 20.
As indicated in box 410b, the step indicated in box 410 may further comprise further advancing the mandril 30 distally through the first lumen and the second lumen to position the embolization coil 60 at the deployment site 92. As discussed above, even after the proximal portion 62 of the embolization coil 60 has been expelled from the flexible sleeve 20, as shown in
Once the practitioner is satisfied with the positioning of the embolization coil 60, the mandril 30 may be retracted proximally through the first and second lumens of the delivery tube 12 and the flexible sleeve 20. As shown in
While the present invention has been described in terms of certain preferred embodiments, it will be understood that the invention is not limited to the disclosed embodiments, as those having skill in the art may make various modifications without departing from the scope of the following claims.