The present disclosure relates generally to an embolic coil delivery system, and more particularly to a system for loading an embolic coil on an outer surface of a flexible elongate body and advancing a delivery catheter over the flexible elongate body to contact and unload the embolic coil.
Embolization procedures are designed to create an artificial blockage within a vessel to block blood from flowing downstream from the blockage. These procedures are used to treat several conditions, including, for example, aneurysms, hemorrhages, and lesions or growths. Specifically, for example, an embolic device may be used to occlude blood flow to an aneurysm and, thus, reduce the risk of the aneurysm rupturing and producing internal hemorrhaging. Embolic devices may include physical barriers, such as coils, balloons, chemicals, and the like. According to one type of embolization procedure, a plurality of embolic coils are delivered to the embolization site. These coils may vary in stiffness, such that a stiffer coil may provide a strong radial force to maintain the position of the artificial blockage, while a softer coil may be used as packing material to occupy space at the blockage.
During an embolic coil delivery procedure, the one or more embolic coils are typically delivered to the embolization site in the vasculature of a patient through the use of a catheter delivery system. Specifically, the embolic coils are loaded into the lumen of a catheter and the catheter is inserted into the vasculature such that the distal end of the catheter is proximate the embolization site. The embolic coils are then advanced through the lumen of the catheter using a pusher wire or pressurized fluid until the coils exit the distal end of the catheter. Unfortunately, this delivery procedure suffers drawbacks, including those caused by the resistance created by the one or more coils loaded into the catheter lumen. For example, this resistance to the force created by the pusher wire or pressurized fluid may lead to procedural complications, including imprecise positioning of the embolic coils within the patient vasculature.
The present disclosure is directed toward one or more of the problems set forth above.
In one aspect, an embolic coil delivery system includes a flexible elongate body having a distal segment. An embolic coil is loaded on the flexible elongate body at the distal segment and contacts an outer surface of the flexible elongate body. The embolic coil delivery system also includes a delivery catheter sized to advance over the flexible elongate body during an embolic coil delivery procedure, wherein a distal segment of the delivery catheter contacts the embolic coil during the embolic coil delivery procedure.
In another aspect, a preloaded wire guide for an embolic coil delivery system includes a mandril wire guide having a distal segment. An embolic coil is loaded on the mandril wire guide at the distal segment and contacts an outer surface of the flexible elongate body. A delivery sheath is positioned over the embolic coil.
In yet another aspect, a method of delivering an embolic coil to a delivery site within a patient vessel includes loading the embolic coil around an outer surface of a distal segment of a flexible elongate body. The distal segment of the flexible elongate body is advanced through the patient vessel to the delivery site, and the embolic coil is unloaded from the flexible elongate body at least in part by advancing a delivery catheter over the flexible elongate body and contacting the embolic coil with a distal segment of the delivery catheter.
Referring to
The embolic coil delivery system 10 may generally include a flexible elongate body 14, which may be a solid structure, as shown, or may be hollow, with an outer tube defining an internal lumen. According to the exemplary embodiment, the flexible elongate body 14 may be a mandril wire guide 15 formed from stainless steel, or other commonly selected material, to provide a desired combination of stiffness and flexibility. For example, a certain degree of stiffness may be required for pushability and trackability, while a certain degree of flexibility may be required for improving vasculature navigation. It should be appreciated that the stiffness of the flexible elongate body 14 may be consistent along a longitudinal axis A of the body 14 or may vary, depending on the specifics of the procedure to be performed and the performance characteristics desired.
As shown, the flexible elongate body 14 may include a distal segment 16 that is tapered. The taper, which may increase flexibility of elongate body 14, may be gradual or abrupt, and may begin at any position along the flexible elongate body 14 from a proximal end 18 to a distal end 20 of the body 14. In addition, a thermoplastic polymer coating 22, such as a polyester or polyether block amide, may be provided at the distal end 20 of the flexible elongate body 14. Particularly, the polymer coating 22 may provide a desirable lubricity profile that exhibits low friction during introduction of the flexible elongate body 14 through a vessel of the patient. A coating, such as a thermoplastic coating, may also be provided along an entire length of the flexible elongate body 14. For example, an outer surface 24 of the flexible elongate body 14 may be coated with high density polyethylene (HDPE), polytetrafluoroethylene (PTFE), polyethylene terephthalate (PET), polyester or polyether block amide (PEBA), polyurethane, polyimide, polyolefin, nylon, or any combination thereof. The coatings, including the polymer coating 22, may be applied by, for example, over-extrusion, dip-coating, melt fusion, heat shrinking, or using other known application means.
The embolic coil delivery system 10 may also include a first embolic coil 26 and a second embolic coil 28 loaded on the flexible elongate body 14 at the distal segment 16 of the body 14. Although two embolic coils 26 and 28 are shown, any number of coils, including only one coil, may be loaded on the flexible elongate body 14. The embolic coils 26 and 28 may be helically wound coils, randomly wound coils, coils would within other coils, or may have various other coil configurations. Further, the coils may be made from a radiopaque metallic material, such as, for example, platinum or stainless steel. According to some embodiments, a first stiffness measurement, or durometer, of the first coil 26 may be different than a second stiffness measurement of the second coil 28. The embolic coils 26 and 28, which may have various configurations, may be frictionally engaged with the outer surface 24 of the flexible elongate body 14 to maintain a loaded, or relatively fixed position of the embolic coils 26 and 28 relative to the body 14. The flexible elongate body 14, with the embolic coils 26 and 28 loaded thereon, may also be referenced as a preloaded wire guide 30.
A delivery sheath 32 may be positioned over the embolic coils 26 and 28, as shown in the exemplary embodiment. The delivery sheath 32 may be made from a flexible film, such as, for example, a medical grade polyethylene film, and may be positioned over a segment of the outer surface 24 of the flexible elongate body 24, including the segment supporting the embolic coils 26 and 28. A distal end 34 or, more specifically, an open distal end of the delivery sheath 32 may be removably attached to the flexible elongate body 14 at an axial position of the body 14 that is distally spaced from the embolic coils 26 and 28. Specifically, according to one embodiment, the delivery sheath 32 may have an attached distal end 34 and an unattached proximal end 36 that is unattached relative to the flexible elongate body 14. The unattached proximal end 36, according to the exemplary embodiment, may extend from the attached distal end 34 toward the proximal end 18 of the flexible elongate body 14.
The removable attachment of the delivery sheath 32 to the flexible elongate body 14 at the attached distal end 34 may include any attachment that facilitates removal of the delivery sheath 32, or at least the portion that covers the embolic coils 26 and 28, while the flexible elongate body 14 is positioned within the vasculature of the patient. Thus, the removable attachment may be as simple as a perforated tear away section or may be relatively complex, such as including a repositioning device that may be manipulated externally from the vasculature of the patient. Although a delivery sheath 32 is described, it should be appreciated that another component capable of shielding the embolic coils 26 and 28 and/or maintaining a loaded position of the coils 26 and 28 during an embolic coil delivery procedure may be substituted for the delivery sheath 32.
The embolic coil delivery system 10 may also include a delivery catheter 38 sized to advance over the flexible elongate body 14 during an embolic coil delivery procedure. Specifically, the delivery catheter 38 may include a tube 40 defining an internal lumen 42 extending from a distal segment 44 to a proximal segment 46, wherein the lumen 42 defines an inner diameter d1 that substantially matches an outer diameter d2 of the flexible elongate body 14. As used herein, “matches” means that the inner diameter d1 is slightly greater than the outer diameter d2 or otherwise sized such that the distal segment 44 of the delivery catheter 38 may advance over the flexible elongate body 14 and contact the embolic coils 26 and 28 during an embolic coil delivery procedure. As such, the distal segment 44 may be suitably shaped to urge the coils 26 and 28 from the flexible elongate body 14. The delivery catheter 38 may comprise a lubricious material such as PTFE and may or may not include a reinforcement material to provide kink resistance and torqueability while retaining a desired level of flexibility. As should be appreciated, the delivery catheter 38 may be a multi-layer tube comprised of various other materials, or may even include single polymeric tubes. It should also be appreciated that the materials and overall construction of the delivery catheter 38 and flexible elongate body 14 may be selected to improve or enhance usability of the embolic coil delivery system 10.
The present disclosure is generally applicable to embolic coil delivery systems for use in percutaneous endovascular procedures. More specifically, the present disclosure finds application in procedures to deliver an embolic coil to a delivery site within the vascular system of a patient. Further the present disclosure finds specific application in procedures during which a plurality of embolic coils are delivered to the delivery site within the vasculature of the patient to provide an artificial blockage.
Referring to
At the first stage of the embolic coil delivery procedure, shown in
A next stage of the embolic coil delivery procedure is shown in
Turning now to
The embolic coil delivery system of the present disclosure provides a system for placement of embolic coil into the vasculature of a patient that can be done in a precise and controlled manner, while maintaining overall simplicity, reliability, and manufacturability. This alternative means for delivering embolic coils does not suffer from the drawbacks of conventional catheter delivery systems relating to resistance provided by the coils loaded into the catheter lumen. As such, the present embolic coil delivery system may be particularly useful in procedures for delivering a plurality of embolic coils.
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.
This application claims priority to provisional patent application 61/535,553, filed Sep. 16, 2011, with the same title.
Number | Date | Country | |
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61535553 | Sep 2011 | US |