The present invention relate to aneurysm treatment devices and more particularly, to improved delivery systems for embolic implants that prevent premature implant deployment.
Numerous intravascular implant devices are known in the field. Many are deployed mechanically, via systems that combine one or more catheters and wires for delivery. Examples of implants that can be delivered mechanically include embolic elements, stents, grafts, drug delivery implants, flow diverters, filters, stimulation leads, sensing leads, or other implantable structures delivered through a microcatheter. Some obstetric and gastrointestinal implants may also be implanted via similar systems that combine one or more catheters and wires. Devices that may be released or deployed by mechanical means vary greatly in design but can employ a similar delivery catheter and wire system. Many such catheter-based delivery systems include a wire for retention of the implant in the catheter until the time for release of the device. These systems are then actuated by retracting or pulling the wire relative to the catheter. Such a wire is referred to herein as a “pull wire”.
One issue with current catheter-based delivery systems is premature detachment of the implantable device. Premature detachment occurs when the implant is detached from the delivery system before reaching the treatment site. This may occur due to the tortuosity experienced by the delivery system as it passes through the vasculature of the patient, which can cause an increase in friction between the “pull wire” and the delivery system causing the pull wire to move proximally while the delivery system is moving distally.
Accordingly, there is a need for an improved implant delivery system that prevents premature detachment of the implant as it is delivered through tortuous vasculature. This disclosure is directed to this and other considerations.
Various systems and methods of deploying an implant to a target location of a body vessel are disclosed. A delivery system can include a tubular body having a lumen extending therethrough. A pull wire can extend through the lumen with the pull wire including a distal portion. An elastic loop wire can include a loop opening which is positioned approximate a distal end of the tubular body and can include a proximal attachment point that is affixed to the pull wire. The elastic loop wire and the pull wire can be positioned to secure the implantable medical device to the delivery system. The elastic loop wire can be effective to inhibit premature detachment of the implantable medical device from the delivery system by inhibiting proximal translation of the pull wire with respect to the loop opening of the elastic loop wire.
In one aspect, a delivery system for deploying an implantable medical device to a target location of a body vessel is disclosed. The delivery system can include a tubular body that includes a lumen extending therethrough. The delivery system can include a pull wire extending through the lumen. The pull wire can include a distal portion. The delivery system can include an elastic loop wire that has loop opening at a distal portion of the loop wire that is positioned approximate a distal end of the tubular body. The elastic loop wire can include a proximal attachment point that is affixed to the pull wire. The elastic loop wire and the pull wire can be positioned to secure the implantable medical device to the delivery system. The elastic loop wire can be effective to inhibit premature detachment of the implantable medical device from the delivery system by inhibiting proximal translation of the pull wire with respect to the loop opening of the elastic loop wire.
In some embodiments, the tubular body can include a proximal tube, a support coil distal to the proximal tube, and a distal tube that is distal to the support coil.
In some embodiments, the pull wire is translated proximally by more than approximately 6 millimeters to thereby release the implantable medical device from the delivery system.
In some embodiments, the elastic loop wire is configured to stretch in response to the proximal translation of the pull wire.
In some embodiments, the stretching of the elastic loop wire applies tension to the pull wire that inhibits proximal translation of the pull wire with respect to the loop opening of the elastic loop wire.
In some embodiments, the support coil can include interference cuts.
In some embodiments, the distal tube can further include a compressed distal portion that is positioned approximate the implantable medical device. The compressed distal portion can provide an elastic force against the implantable medical device to thereby facilitate the release of the implantable medical device from the delivery system.
In some embodiments, the compressed distal portion can further include a spiral-cut portion of the distal tube.
In some embodiments, the elastic loop wire has a Young's Modulus of approximately 2 GPa.
In some embodiments, the proximal attachment point of the elastic loop wire can include a weld to the pull wire.
In some embodiments, the proximal attachment point of the elastic loop wire can include one or more knots between respective ends of the loop wire and the pull wire.
In some embodiments, the pull wire is constructed of a nonelastic material.
In some embodiments, the distal tube can further include interference cuts in the tubular body.
In another aspect, a method is disclosed. The method can include providing a sub-assembly. Providing the sub-assembly can include providing an implantable medical device approximate a distal end of a pull wire. Providing the sub-assembly can include positioning an elastic loop wire including a loop opening at a distal portion of the loop wire approximate a locking portion of the implantable medical device. Providing the sub-assembly can include positioning the loop opening through the locking portion of the implantable medical device. Providing the sub-assembly can include positioning the distal end of the pull wire through the loop opening thereby securing the implantable medical device to the sub-assembly. Providing the sub-assembly can include attaching a proximal attachment point of the elastic loop wire to the pull wire. The method can include providing a tubular body comprising a lumen extending therethrough. The method can include positioning the sub-assembly at least partly within the lumen such that the implantable medical device abuts a distal end of the tubular body. The method can include securing a proximal end of the pull wire to a proximal end of the tubular body, thereby securing the implantable medical device to the tubular body.
In some embodiments, the method can include translating the pull wire proximally by more than 6 millimeters to thereby release the implantable medical device from the tubular body.
In some embodiments, the method can include causing the elastic loop wire to stretch in response to proximal translation of the pull by less than approximately 6 millimeters and applying tension to the pull wire by the stretched elastic loop wire to thereby inhibit proximal translation of the pull wire with respect to the loop opening of the elastic loop wire.
In some embodiments, the tubular body can include a proximal tube, a proximal support tube disposed in the lumen of the tubular body, a support coil distal to the proximal tube, and a distal tube distal to the support coil.
In some embodiments, the method can include attaching the proximal attachment point of the elastic loop wire to the pull wire by tying one or more knots between respective ends of the loop wire to the pull wire.
In some embodiments, the distal tube can further include a compressible distal portion and the method can include compressing the compressible distal portion, translating the pull wire proximally by more than approximately 6 millimeters, and decompressing the compressible distal portion to thereby providing an elastic force against the implantable medical device that facilitates the release of the implantable medical device from the tubular body.
In some embodiments, the method can include attaching the proximal attachment point of the elastic loop wire to the pull wire by welding respective ends of the elastic loop wire to the pull wire.
The above and further aspects of this invention are further discussed with reference to the following description in conjunction with the accompanying drawings, in which like numerals indicate like structural elements and features in various figures. The drawings are not necessarily to scale, emphasis instead being placed upon illustrating principles of the invention. The figures depict one or more implementations of the inventive devices, by way of example only, not by way of limitation.
The following description of certain examples of the invention should not be used to limit the scope of the present invention. The drawings, which are not necessarily to scale, depict selected embodiments and are not intended to limit the scope of the invention. The detailed description illustrates by way of example, not by way of limitation, the principles of the invention. Other examples, features, aspects, embodiments, and advantages of the invention will become apparent to those skilled in the pertinent art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the invention. As will be realized, the invention is capable of other different or equivalent aspects, all without departing from the invention. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.
Any one or more of the teachings, expressions, versions, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, versions, examples, etc. that are described herein. The following-described teachings, expressions, versions, examples, etc. should therefore not be viewed in isolation relative to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those skilled in the pertinent art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.
As used herein, the terms “about” or “approximately” for any numerical values or ranges indicate a suitable dimensional tolerance that allows the part or collection of components to function for its intended purpose as described herein. More specifically, “about” or “approximately” may refer to the range of values±10% of the recited value, e.g. “about 90%” may refer to the range of values from 81% to 99%. In addition, as used herein, the terms “patient,” “host,” “user,” and “subject” refer to any human or animal subject and are not intended to limit the systems or methods to human use, although use of the subject invention in a human patient represents a preferred embodiment.
Turning to the figures,
A loop wire opening 405 of loop wire 400 can be located at a distal portion 404 of loop wire 400 and can extend through a locking member 18 of implant 12. The distal end 144 of pull wire 140 can be positioned through the loop wire opening 405 of loop wire 400 to secure implant 12 to the delivery system 10. The proximal portion of the loop wire 400 can be attached to the pull wire 140 approximately at the distal end 554 of support coil 550, for example by attaching loop wire proximal ends 406, 408 to the pull wire 140 at a proximal attachment point 410. The attachment method of loop wire 400 to pull wire 140 can be of any type known in the pertinent art, including but not limited to welding proximal ends 406, 408 to pull wire 140 and/or forming knots between proximal ends 406, 408 and the pull wire 140. According to some embodiments, the loop wire 400 can be made of an elastic material, such that proximal translation of the pull wire 140 can cause the loop wire 400 to stretch and become tensioned, which provides a resistant force against further proximal translation of pull wire 140. Accordingly, the elastic loop wire 400 can be effective to prevent premature detachment of implant 12 from delivery system 10. Additionally, the loop wire 400 can be effective to hold distal tube 570 in compression until implant 12 is released from delivery system 10. Collectively, implant 12, elastic loop wire 400, and pull wire 140 can be referred to as a sub-assembly 450 of the delivery system 10, as can be seen in
When the delivery system 10 is assembled, the support coil 550 and sleeve 500 can be more flexible than the distal tube 570 and the proximal tube 100. One way to measure flexibility is to perform a three-point bend test wherein a portion of the delivery system 10 is held fixed at two end points, a force is applied perpendicularly to the delivery system 10 centrally between the points, and flexibility is quantified by the length of deflection of the delivery system 10 caused by the force. When measured in this way, in some examples, the support coil 550 and sleeve 500 can be about 1.5 times more flexible than the distal tube 570 and about 20 times more flexible than the proximal tube 100. That is, when the three-point test is performed identically on the three sections 100, 550, and 570, the coiled section deflect over a length that is about 1.5 times the deflection of the distal tube 570 and about 20 times the length of deflection of the proximal tube 100. Flexibility can be measured in other ways as would be appreciated and understood by a person having pertinent skill in the requisite art. When the delivery system 10 is assembled, the support coil 550 and sleeve 500 can be more flexible than the distal tube 570 and the proximal tube 100 as flexibility is determined by other means as would be known to a person of ordinary skill in the art.
According to some embodiments, the distal tube 570 can include a compressible distal portion 300, which can be compressed and formed from a spiral-cut portion of the distal tube 570, formed by a laser cutting operation. Additionally, or alternatively, the compressible distal portion 300 can be formed of a wound wire, spiral ribbon, or other arrangement allowing axial adjustment according to the present invention. Preferably, compressible distal portion 300 is in the elongated condition at rest and automatically or resiliently returns to the elongated condition from a compressed condition, unless otherwise constrained. In some embodiments, the loop wire 400 is effective to hold the compressed distal portion 300 in compression while the implant 12 is delivered to the treatment site.
Pull wire 140 can be constructed out of any suitable material, for example, pull wire 140 can be constructed of stainless steel or memory shape material, such as nitinol. According to some embodiments, pull wire 140 can additionally be coated with polytetrafluoroethylene (PTFE).
The compressible portion 306 can have a difference in length (distance of compression) when measured in the compressed configuration and the original, uncompressed configuration of about 0.5 mm to about 0.75 mm. Greater elastic force E can be achieved by using a greater distance of compression. The distance of compression can be determined by the sizing of the loop wire 400, the shape of the locking portion 18, and the shape of the distal end 304 of the compressible distal portion 300.
In block 620, a proximal attachment point 410 of elastic loop wire 400 can be attached to the pull wire 140. Now the loop opening 405 located on distal end 404 of loop wire 400 is secured to the distal end 144 of the pull wire 140 and the loop wire 400 is secured to the pull wire 140 at the proximal attachment point 410 at a location proximal to the distal end 404 of loop wire 400.
In block 624, the method can include providing a tubular body 90. The tubular body can include a lumen 608 extending therethrough. As discussed in reference to
In block 628, the method can include positioning the sub-assembly 450 at least partly within the lumen 608 such that the implantable medical device abuts a distal end 94 of the tubular body 90. For example, a proximal end of the sub-assembly 450 can be inserted through the distal end 94 of the tubular body 90 until the implantable medical device 12 abuts the distal end 94 of tubular body 90.
In block 632, a proximal end of the pull wire 140 can be secured to a proximal end 92 of the tubular body 90, thereby securing the implantable medical device 12 to the tubular body 90. For example, a proximal end of pull wire 140 can be positioned through support tube 110, and a pull wire bead 142 can be welded, glued, or otherwise attached to the proximal end of the pull wire after it has been positioned through proximal support tube 110 of the tubular body 90. The pull wire bead 142 can be sized such that the pull wire bead 142 is larger than the space (lumen) between the proximal support tube 110 such that the pull wire bead 142 interferes with the proximal support tube 110 and proximal support tube 110 retains the pull wire bead 142 proximal to the proximal tube 100.
In optional block 633, the method can include compressing a compressible distal portion 300 of the tubular body 90. For example, before proximal end of the pull wire 140 is secured to a proximal end 92 of the tubular body, the pull wire 140 can be tensioned to a predetermined tension, thereby preloading or pre-tensioning the pull wire causing the compressible distal portion 300 to be compressed.
In optional block 634, the method can include causing the loop wire to stretch in response to proximal translation of the pull wire by less than approximately 6 millimeters. In optional block 635, the method can include applying tension to the pull wire 140 by the stretched elastic loop wire 400 to thereby inhibit proximal translation of the pull wire 140 with respect to the loop opening 405. Accordingly, the tensioned loop wire 400 can be effective to prevent premature detachment of the implant 12 from the delivery system 10.
In block 636, the method can include translating the pull wire proximally by more than approximately 6 millimeters to thereby release the implantable medical device 12 from the tubular body 90 of delivery system 10.
According to some embodiments, the tubular body 90 can further include a proximal tube 100, a support coil 550 distal to proximal tube 100, and a distal tube 570 distal to the support coil 550.
In some embodiments, attaching the proximal attachment point 410 of the elastic loop wire 400 to the pull wire can include tying one or more knots between respective ends 406, 408 of the loop wire 400 to the pull wire. In some embodiments, attaching the proximal attachment point 410 of elastic loop wire 400 to the pull wire 140 can include welding respective ends 406, 408 of the elastic loop wire 400 to the pull wire 140.
According to some embodiments, the distal tube 570 can include a compressible distal portion 300. The method can include compressing the compressible distal portion 300, translating the pull wire proximally by more than approximately 6 millimeters and decompressing the compressible distal portion 300 thereby providing an elastic force E against the implantable medical device 12 that facilitates the release of the implantable medical device 12 from the tubular body 90.
The descriptions contained herein are examples of embodiments of the invention and are not intended in any way to limit the scope of the invention. As described herein, the invention contemplates many variations and modifications of the implantation system and associated methods, including alternative geometries of system components, alternative materials, additional or alternative method steps, etc. Modifications apparent to those skilled in the pertinent art are intended to be within the scope of the claims which follow.
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