The present disclosure relates generally to a delivery system for detachable treatment devices, and more particularly to a delivery system for compressing an overlap of a deployment wire and a treatment device within an attachment zone of a delivery sheath.
Medical treatment devices, such as, for example, embolization coils, microcoils, and plugs, are used to restrict or block blood flow to arterio-venous malformations and other vascular lesions. For example, these treatment devices may be delivered into an aneurysm of a patient to prevent blood from entering the aneurysm. Embolization is typically a non-surgical, minimally invasive procedure that involves pushing or injecting the treatment devices, or, alternatively, detaching the treatment devices at the treatment site. Both delivery methods offer benefits and suffer drawbacks, particularly depending on the specifics of the procedure being performed.
According to one example, U.S. Pat. No. 6,183,491 to Lulo discloses an embolic coil deployment system with an improved embolic coil. The embolic coil deployment system includes a positioning catheter having a distal tip for retaining the embolic coil. When a hydraulic pressure is applied to an interior of the positioning catheter, the distal section of the positioning catheter expands radially to release the embolic coil. In order to prevent the proximal portion of the embolic coil from stretching or unwinding, a platinum support wire is welded to a proximal sealing plug, which serves to prevent the flow of fluid through the lumen of the embolic coil. Although the embolic coil deployment system of Lulo may be suitable for some applications, there is a continuing need for improved deployment systems, including those that offer control, reliability, simplicity, and the ability to navigate tortuous anatomy.
The present disclosure is directed toward one or more of the problems or issues set forth above.
In one aspect, a detachable treatment device delivery system includes a delivery sheath defining a lumen extending from a proximal opening to a distal opening. A treatment device has a proximal attachment segment configured for receipt within the delivery sheath. The detachable treatment device delivery system also includes a deployment wire configured for receipt within the delivery sheath. A delivery configuration is defined by an overlap of a distal segment of the deployment wire and the proximal attachment segment of the treatment device along a longitudinal axis of the delivery sheath within an attachment zone defined by the delivery sheath. According to the delivery configuration, an inner surface of the delivery sheath defining the attachment zone is outwardly expanded and compressed around the deployment wire and the treatment device at the overlap. In a deployed configuration, the deployment wire is within the delivery sheath and is proximally spaced from the attachment zone, and the proximal attachment segment of the treatment device is distally spaced from the attachment zone and the distal opening.
In another aspect, a method of deploying a treatment device using a detachable treatment device delivery system is provided. The detachable treatment device delivery system includes a delivery sheath defining a lumen extending from a proximal opening to a distal opening, and a deployment wire. The method includes compressing an overlap of a distal segment of the deployment wire and a proximal attachment segment of the treatment device within an attachment zone defined by the delivery sheath using the delivery sheath. An inner surface of the delivery sheath is outwardly expanded at the overlap responsive to the compressing step. The method also includes proximally retracting the deployment wire within the delivery sheath such that the deployment wire is proximally spaced from the attachment zone, and releasing the treatment device from the delivery sheath through the distal opening responsive to the proximally retracting step such that the proximal attachment segment of the treatment device is distally spaced from the attachment zone and the distal opening.
Referring to
The detachable treatment device delivery system 10 includes a delivery sheath 12 having an elongate tubular body 14 defining a lumen 16 extending from a proximal opening 18 to a distal opening 20. In the present disclosure, “proximal” will be used to refer to the end of a component or feature that is closest to a clinician, while “distal” is used to refer to a component or feature that is farthest away from the clinician. Such meanings are consistent with conventional use of the terms and, as such, should be understood by those skilled in the art.
The elongate tubular body 14 may be made from any common medical tube material, such as, for example, polytetrafluoroethylene (PTFE), high density polyethylene (HDPE), nylon, polyetheretherketone (PEEK), or any vinyl, plastic, rubber, silicone, or metal and may exhibit both stiffness, or firmness, and flexibility. Materials as well as dimensions may vary depending on the particular application. However, it may be desirable to dimension the delivery sheath 12 for receipt within a particular catheter or microcatheter. For example, the delivery sheath 12 may have an outer diameter, according to all potential configurations, that is less than 0.035 inch, or other selected catheter inner diameter. A length of the delivery sheath 12 may be between about 50 centimeters to about 225 centimeters, which may correspond substantially to a delivery catheter with which the detachable treatment device delivery system 10 is to be used.
A treatment device 22, which may, for example, be an embolization coil 24, has a proximal attachment segment 26 configured for receipt within the delivery sheath 12. According to a delivery configuration, as shown in
Although treatment device 22 is exemplified as an embolization coil, it should be appreciated that various other treatment devices, including plugs, may be used with the detachable treatment device delivery system 10 instead of the embolization coil 24. To accommodate use with the detachable treatment device delivery system 10, the treatment device 22 preferably includes the proximal attachment segment 26, which is configured for receipt within the delivery sheath 12. In particular, the proximal attachment segment 26 should be sized and shaped for receipt within the delivery sheath 12 and configured for detachable retention within the delivery sheath 12 as described herein. The proximal attachment segment 26 may be integral with the distal end 28, or the proximal attachment segment 26 and the distal end 28 may be separate components that are attached together using known attachment means.
The detachable treatment device delivery system 10 also includes a deployment wire 30 configured for receipt within the delivery sheath 12. The deployment wire 30 may have an elongate body 32 made from any of a variety of medical grade materials, including those identified with respect to the delivery sheath 12. As shown in the delivery configuration of
The delivery configuration of
According to embodiments in which the delivery sheath 12 defines a single lumen 16, such as the embodiment of
According to some embodiments, a compressive band 48 may be positioned over the delivery sheath 12 at the attachment zone Z. The compressive band 48 may assist in providing a compressive force to maintain the releasable engagement of the deployment wire 30 and the treatment device 22 at the overlap 42. The compressive band 48 may be, or may include, a radiopaque marker 50 to facilitate fluoroscopic visualization of the attachment zone Z. Additional or alternative radiopaque markings may be provided on components of the detachable treatment device delivery system 10, including radiopaque markings on portions of the deployment wire 30 and/or treatment device 22.
The handle 38 may be manipulated to move the detachable treatment device delivery system 10 from the delivery configuration of
According to an alternative embodiment, as shown in
The proximal attachment segment 82, which may be integral with or a separate component from a distal end 86 of the treatment device 84, may be urged against a preformed coiled shape in a delivery configuration, as shown. Alternatively, the proximal attachment segment 82 may have a preformed straightened shape that remains straightened after the treatment device 84 has been deployed. According to the embodiment of
The first and second lumens 64 and 70, along with the distal segment 88 of the deployment wire 76 and the proximal attachment segment 82 of the treatment device 84, may be sized such that the combined diameter of the deployment wire 76, the treatment device 84, and the wall 90 are great enough to radially expand the delivery sheath 62 at the overlap 92 as the deployment wire 76 and treatment device 84 are compressed together in a releasable engagement.
Turning now to
Referring generally to
Those skilled in the art should appreciate that the detachable treatment device delivery system 10 may be provided in the preloaded state described above and may also include a delivery cannula for maintaining a straightened configuration of the distal end 28 of the treatment device 22 during delivery. The delivery cannula may be configured to retract during advancement of the detachable treatment device delivery system 10 through a delivery catheter. The delivery catheter, according to one example, may then maintain a straightened configuration of the distal end 28 of the treatment device 22 as the detachable treatment device delivery system 10 is advanced, in the delivery configuration, to a treatment site within a patient site, such as, for example, a vascular structure.
When the detachable treatment device delivery system 10 is properly positioned, the handle 38 may be manipulated to proximally retract the deployment wire 30 within the delivery sheath 12 such that the deployment wire 30 is proximally spaced from the attachment zone Z. As such, the treatment device 22 may be released from the delivery sheath 12 through the distal opening 20 in response to the retraction of the deployment wire 30 such that the proximal attachment segment 26 of the treatment device 22 is distally spaced from the attachment zone Z and the distal opening 20.
It should be appreciated that testing may be conducted to determine a desired amount of compression to provide the releasable engagement of the treatment device 22. In particular, it may be desired to provide sufficient compression to reliably retain the treatment device 22 in an attached configured as the detachable treatment device delivery system 10 navigates tortuous anatomy and is moved both proximally and distally. However, if too much compression is provided, it might be difficult to retract the deployment wire 30 and/or retraction of the deployment wire 30 may undesirably retract the proximal attachment segment 26 of the treatment device 22. According to some embodiments, the compressive band 48 may be helpful in arriving at a desired level of compression. The detachable treatment device delivery system 10 may provide a low profile mechanism for providing control and reliable detachment of the treatment device 22 at a treatment site.
It should be understood that the above description is intended for illustrative purposes only, and is not intended to limit the scope of the present disclosure in any way. Thus, those skilled in the art will appreciate that other aspects of the disclosure can be obtained from a study of the drawings, the disclosure and the appended claims.
Number | Name | Date | Kind |
---|---|---|---|
5217484 | Marks | Jun 1993 | A |
5261916 | Engelson | Nov 1993 | A |
5263964 | Purdy | Nov 1993 | A |
5304195 | Twyford, Jr. et al. | Apr 1994 | A |
5405379 | Lane | Apr 1995 | A |
5417708 | Hall et al. | May 1995 | A |
5891155 | Irie | Apr 1999 | A |
6183491 | Lulo | Feb 2001 | B1 |
6773448 | Kusleika et al. | Aug 2004 | B2 |
6849081 | Sepetka et al. | Feb 2005 | B2 |
7118539 | Vrba et al. | Oct 2006 | B2 |
7344553 | Opolski et al. | Mar 2008 | B2 |
7371251 | Mitelberg et al. | May 2008 | B2 |
7618435 | Opolski | Nov 2009 | B2 |
7942894 | West | May 2011 | B2 |
8062325 | Mitelberg et al. | Nov 2011 | B2 |
8118817 | Tekulve | Feb 2012 | B2 |
8292872 | Soetermans | Oct 2012 | B2 |
8333796 | Tompkins et al. | Dec 2012 | B2 |
20010002438 | Sepetka et al. | May 2001 | A1 |
20050107823 | Leone et al. | May 2005 | A1 |
20050149107 | Jones | Jul 2005 | A1 |
20050283182 | Pierce | Dec 2005 | A1 |
20060025801 | Lulo et al. | Feb 2006 | A1 |
20060025802 | Sowers | Feb 2006 | A1 |
20060025803 | Mitelberg et al. | Feb 2006 | A1 |
20060116709 | Sepetka et al. | Jun 2006 | A1 |
20060116714 | Sepetka | Jun 2006 | A1 |
20070179520 | West | Aug 2007 | A1 |
20070299422 | Inganas | Dec 2007 | A1 |
20080046092 | Davis | Feb 2008 | A1 |
20080097462 | Mitelberg et al. | Apr 2008 | A1 |
20080097508 | Jones | Apr 2008 | A1 |
20080114391 | Dieck et al. | May 2008 | A1 |
20080221654 | Buiser et al. | Sep 2008 | A1 |
20080228215 | Strauss | Sep 2008 | A1 |
20090270877 | Johnson et al. | Oct 2009 | A1 |
20090287291 | Becking et al. | Nov 2009 | A1 |
20120041472 | Tan et al. | Feb 2012 | A1 |
20120209310 | Chen et al. | Aug 2012 | A1 |
20120265237 | Evert | Oct 2012 | A1 |
20130072961 | Cage et al. | Mar 2013 | A1 |
Number | Date | Country |
---|---|---|
9426175 | Nov 1994 | WO |
Entry |
---|
Sandeep Vaidya, M.D., Kathleen R. Tozer, M.D and Jarvis Chen, M.D.; An Overview of Embolic Agents; pp. 204-215. |
Jorge E. Lopera, M.D., F.S.I.R.; Embolization in Trauma: Principles and Techniques; pp. 14-28. |
Number | Date | Country | |
---|---|---|---|
20150057699 A1 | Feb 2015 | US |
Number | Date | Country | |
---|---|---|---|
61869130 | Aug 2013 | US |