The use of embolic devices to prevent rupture, or to minimize blood loss in case of rupture, of aneurysms has become a relatively routine medical procedure. The basic approach is to deliver the device to the site of an aneurysm using a steerable catheter that is inserted in a vessel at a remote location and is then directed to a position adjacent to the aneurysm. A pusher wire, with the embolic device attached to its distal end, is then threaded through the catheter and beyond until the device is situated in the aneurysm. The presently preferred embolic device is a coil of wire, typically platinum/tungsten alloy, that when stretched assumes a linear helical configuration and when relaxed assumes a convoluted configuration that will fill the interior of the aneurysm. The convoluted configuration may be completely random or it may be controlled using shape-memory alloys. The wire generally has a diameter of 2-6 mils while the coils are usually in the range of 10-30 mils in diameter. The coils may be of any length appropriate for the intended use. Depending on its size, from one to a great many coils may used to fill a single aneurysm. Once in place, the embolic devise initiates formation of a thrombus that is soon complemented by a collagenous material that further lessens the potential for rupture or for significant blood loss should the aneurysm break.
Once a coil is in place in the aneurysm, it is detached from the distal end of the pusher wire. Detachment can be accomplished in numerous ways including mechanically (unscrew, remove key from slot, separate ball and socket, etc.), electrolytically (disintegration of junction between metals having different standard electrode potentials) and energetically (vibrational cohesive disruption). Electrolytic detachment is one of the currently favored method of releasing an embolic device due it lack of a need for complex remote manipulation of the connection and, therefore, its speed and precision.
In virtually all electrolytically separable embolic device delivery systems presently in use, the embolic device is attached essentially to the end of the pusher wire, the difference in electrode potential between the pusher wire metal and that of which the embolic device is constructed supplying the requisite potential. The pusher wire, however, is generally relatively stiff, a necessary characteristic that allows it to be controllably threaded through the catheter and beyond to position the embolic device at the target site.
While the current devices work well, certain advantages might accrue if the distal end of the device were somewhat more flexible than the pusher wire itself. For instance, without limitation, some operators might find that such a device provides a softer feel as the embolic device is positioned and released. This invention provides such a flexible device.
Thus, in one aspect, the present invention, a device for releasing an embolic assembly at a target site in a vessel of a patient, comprising:
In an aspect of this invention the flexible member comprises a second wire comprising a second electrically-conductive substance, which may be the same as, or different than, the first electrically-conductive substance, the second wire having a helical coil segment and, distal to the helical coil segment, a straight segment; wherein the helical coil segment is fixedly coupled to the distal end of the core wire and is also fixedly encased in the first non-conductive substance and at least a portion of the straight segment is bare, the bare portion being coupled to a proximal end of a third electrically-conductive substance, which is different from the second electrically-conductive substance, the third electrically conductive substance having a distal end that is operatively coupled to the embolic assembly.
In an aspect of this invention, the third electrically-conductive substance is, along with the proximal end of the embolic assembly, encased in a non-conductive substance that may be the same as, or different than, the first non-conductive substance.
In an aspect of this invention, the third electrically-conductive substance comprises an electrically conductive wire that is fixedly helically wound around the bare portion of the straight segment of the second wire.
In an aspect of this invention, the helically wound segment of the second wire comprises a first and a second helically wound portion, the portions being independently open- or closed-pitched, the first portion being at least partially fixedly encased in the first non-conductive substance and being coupled to the distal end of the core wire, the second portion optionally being partially encased in the first non-conductive substance, the second portion being distal to the first portion and coupled to the third electrically-conductive substance.
In an aspect of this invention, the first and second portions of the helically-wound segment are both closed pitched.
In an aspect of this invention, the first and second portions of the helically-wound segment are both open-pitched.
In an aspect of this invention, the first portion of the helically wound segment is open-pitched and the second portion is closed-pitched.
In an aspect of this invention, the second portion of the helically-wound segment is at least partially surface-coated with a second non-conductive substance, which may be the same as, or different from, the first non-conductive substance.
In an aspect of this invention, the core wire comprises stainless steel or nitinol; the first non-conductive substance comprises a first non-conductive polymer; the second wire independently comprises stainless steel or nitinol and the third electrically-conductive substance comprises a platinum-tungsten alloy.
In an aspect of this invention, the core wire comprises stainless steel or nitinol; the first non-conductive substance comprises a first non-conductive polymer; the second wire independently comprises stainless steel or nitinol; the third electrically-conductive substance comprises a platinum-tungsten alloy and the second non-conductive substance comprises a second non-conductive polymer, which may be the same as, or different from, the first non-conductive polymer.
In an aspect of this invention, the flexible member comprises a first loop having a first and a second end, both of which are operatively coupled to the distal end of the core wire, a distal portion of which is optionally bare and a second loop having a first and a second end, both of which are operatively coupled to the proximal end of the embolic assembly, wherein the first and second loops are interlinked.
In an aspect of this invention, the first and second ends of the first loop are operatively coupled to a bare portion of the distal end of the core wire by a second electrically-conductive substance that is different from the first electrically-conductive substance, the second electrically-conductive substance having a proximal end fixedly coupled to the distal end of the bare portion of the core wire and a distal end that, along with the two ends of the first loop, is fixedly encased in a second non-conductive substance, which may be the same as, or different than, the first non-conductive substance.
In an aspect of this invention, the second electrically-conductive substance comprises an electrically conductive wire that is helically wound around the bare portion of the distal end of the core wire and the ends of the first loop.
In an aspect of this invention, the first electrically-conductive substance comprises stainless steel or nitinol; the first non-conductive substance comprises a first non-conductive polymer; the second electrically-conductive substance comprises a platinum-tungsten alloy and the second non-conductive substance comprises a second non-conductive polymer, which may be the same as, or different than, the first non-conductive polymer.
In an aspect of this invention the flexible member comprises a second wire comprising a second electrically-conductive substance, which may be the same as, or different than, the first electrically-conductive substance, and having a proximal and an distal end, the second wire further having, at its proximal end, a first helical coil segment and, at its distal end, a first loop segment, the helical coil segment being fixedly coupled to the distal end of the core wire and a third wire comprising a third conductive substance, which is different than the second conductive substance, and having a proximal and a distal end, the third wire further having a second loop segment at its proximal end, wherein the first and second loop segments are interlinked and the distal end of the second helical segment and the proximal end of the embolic assembly are fixedly encased in a second non-conductive substance.
In an aspect of this invention, the first and second conductive substances comprise stainless steel or nitinol; the first non-conductive substance comprises a first non-conductive polymer; the third conductive substance comprises a platinum-titanium alloy and the second non-conductive substance comprises a second non-conductive polymer, which may be the same as, or different than, the first non-conductive substance.
In an aspect of this invention, the above device(s) further comprises a stretch resistant member having a first and a second end, the first end being fixedly coupled to the distal end of the core wire and the second end being fixedly coupled to the flexible member.
In an aspect of this invention, the above device(s) further comprise a non-conductive bushing at a distal end of the first non-conductive substance, the bushing having a lumen through which the distal end of the core wire, or the distal end of a flexible member, passes.
An aspect of this invention is a method for releasing an embolic assembly at a target site in a patient's body, comprising:
In an aspect of this invention, in the above method, the flexible member comprises a second wire comprising a second electrically-conductive substance, which may be the same as, or different than, the first electrically-conductive substance, the second wire having a helical coil segment and, distal to the helical coil segment, a straight segment wherein the helical coil segment is fixedly coupled to the distal end of the core wire and is also fixedly encased in the first non-conductive substance and at least a portion of the straight segment is bare, the bare portion being coupled to a proximal end of a third electrically-conductive substance, which is different from the second electrically-conductive substance, the third electrically conductive substance having a distal end that is operatively coupled to the embolic assembly.
In an aspect of this invention, in the above method, the third electrically-conductive substance comprises an electrically conductive wire that is fixedly helically wound around the bare portion of the straight segment of the second wire.
In an aspect of this invention, in the above method, the helically wound segment of the second wire comprises a first and a second helically wound portion, the portions being independently open- or closed-pitched, the first portion being at least partially fixedly encased in the first non-conductive substance and being coupled to the distal end of the core wire, the second portion optionally being partially encased in the first non-conductive substance, the second portion being distal to the first portion and coupled to the third electrically-conductive substance.
In an aspect of this invention, in the above method, the first and second portions of the helically wound segment are both closed-pitched.
In an aspect of this invention, in the above method, the first and second portions of the helically wound segment are both open-pitched.
In an aspect of this invention, in the above method, the first portion of the helically would segment is open-pitched and the second portion is closed-pitched.
In an aspect of this invention, in the above method, the second portion of the helically-wound segment is at least partially surface-coated with a second non-conductive substance, which may be the same as, or different from the first non-conductive substance.
In an aspect of this invention, in the above method, the flexible member comprises a first loop having a first and a second end, both of which are fixedly coupled to the distal end of the core wire, a distal portion of which is optionally bare and a second loop having a first and a second end both of which are operatively coupled to the proximal end of the embolic assembly wherein the first and second loops are interlinked.
In an aspect of this invention, in the above method, the first and second ends of the first loop are operatively coupled to a bare portion of the distal end of the core wire by a second electrically-conductive substance that is different from the first electrically-conductive substance, the second electrically-conductive substance having a proximal end fixedly coupled to the bare portion of the distal end of the core wire and a distal end that, along with the two ends of the first loop, is fixedly encased in a second non-conductive substance, which may be the same as, or different than, the first non-conductive substance.
In an aspect of this invention, in the above method, the flexible member comprises a second wire comprising a second electrically-conductive substance, which may be the same as, or different than, the first electrically-conductive substance, and having a proximal and an distal end, the second wire further having, at its proximal end, a first helical coil segment and, at its distal end, a first loop segment, the helical coil segment being fixedly coupled to the distal end of the core wire and a third wire comprising a third conductive substance, which is different than the second conductive substance, and having a proximal and a distal end, the third wire further having a second loop segment at its proximal end wherein the first and second loop segments are interlinked and the distal end of the second helical segment and the proximal end of the embolic assembly are fixedly encased in a second non-conductive substance.
In an aspect of this invention, the above method further comprises a stretch resistant member having a first and a second end, the first end being fixedly coupled to the distal end of the core wire and the second end being fixedly coupled to the flexible member.
In an aspect of this invention, the above method further comprises a non-conductive bushing coupled to a distal end of the first non-conductive substance and having a lumen through which the distal end of the core wire, or the distal end of the flexible member, passes.
In an aspect of this invention, the target site is selected from the group consisting of an aneurysm, an arteriovenous malformation, a fistula, a blood vessel or any other body lumen.
The figures and description of each of them below are intended solely to aid in the understanding of the invention herein. They are not intended, nor should they be construed, to limit the scope of this invention in any manner whatsoever. For example, where a helical coil is being represented, out of necessity only a certain number of actual turns can be shown. The number of turns shown, however, is not to be construed as limiting the scope of this invention in any manner whatsoever; more or less turns are possible and are within the scope of this invention. Also, the pitch of the helical coils is not limited to that shown in the figures. The pitch can be varied to impart any desired degree of flexibility to the segments of the device containing the coils.
As shown in
Yet another embodiment of the present invention is schematically depicted in
Eyelet loop 60 can be made of any non-conductive material. Presently preferred are those that can form a fiber or fiber-like structure. PET is a presently preferred substance with the desired characteristics. Embolic assembly member 40 has a distal helically wound coil region 90 and an eyelet loop 95, which is interlinked with eyelet loop 60. As above, the embodiments shown in
The specific embodiments of the device set forth herein for improving the flexibility of the distal end of an embolic device delivery apparatus are provided for the purpose of illustration only and are not intended, nor should they be construed, to limit the invention herein in any manner whatsoever. Many alterations and modifications of the device herein will become apparent to those skilled in the art based on the disclosures herein; all such alterations and modifications are within the scope of this invention.
Number | Name | Date | Kind |
---|---|---|---|
4867173 | Leoni | Sep 1989 | A |
4994069 | Ritchart et al. | Feb 1991 | A |
5108407 | Geremia et al. | Apr 1992 | A |
5122136 | Guglielmi et al. | Jun 1992 | A |
5217484 | Marks | Jun 1993 | A |
5234437 | Sepetka | Aug 1993 | A |
5250071 | Palermo | Oct 1993 | A |
5261916 | Engelson | Nov 1993 | A |
5304195 | Twyford, Jr. et al. | Apr 1994 | A |
5350397 | Palermo et al. | Sep 1994 | A |
5354295 | Guglielmi et al. | Oct 1994 | A |
5423829 | Pham et al. | Jun 1995 | A |
5540680 | Guglielmi et al. | Jul 1996 | A |
5624449 | Pham et al. | Apr 1997 | A |
5667767 | Greff et al. | Sep 1997 | A |
5669905 | Scheldrup et al. | Sep 1997 | A |
5690671 | McGurk et al. | Nov 1997 | A |
5695480 | Evans et al. | Dec 1997 | A |
5702361 | Evans et al. | Dec 1997 | A |
5795331 | Cragg et al. | Aug 1998 | A |
5830178 | Jones et al. | Nov 1998 | A |
5855578 | Guglielmi et al. | Jan 1999 | A |
5891128 | Gia et al. | Apr 1999 | A |
5891130 | Palermo et al. | Apr 1999 | A |
5895385 | Guglielmi et al. | Apr 1999 | A |
5916235 | Guglielmi | Jun 1999 | A |
5925037 | Guglielmi et al. | Jul 1999 | A |
5925062 | Purdy | Jul 1999 | A |
5928226 | Guglielmi et al. | Jul 1999 | A |
5935148 | Villar et al. | Aug 1999 | A |
5941888 | Wallace et al. | Aug 1999 | A |
5944714 | Guglielmi et al. | Aug 1999 | A |
5947962 | Guglielmi et al. | Sep 1999 | A |
5947963 | Guglielmi | Sep 1999 | A |
5964797 | Ho | Oct 1999 | A |
5976126 | Guglielmi | Nov 1999 | A |
5984929 | Bashiri et al. | Nov 1999 | A |
6010498 | Guglielmi | Jan 2000 | A |
6017977 | Evans et al. | Jan 2000 | A |
6059779 | Mills | May 2000 | A |
6063070 | Eder | May 2000 | A |
6063104 | Villar et al. | May 2000 | A |
6066133 | Guglielmi et al. | May 2000 | A |
6077260 | Wheelock et al. | Jun 2000 | A |
6083220 | Guglielmi et al. | Jul 2000 | A |
6086577 | Ken et al. | Jul 2000 | A |
6146373 | Cragg et al. | Nov 2000 | A |
6156061 | Wallace et al. | Dec 2000 | A |
6165178 | Bashiri et al. | Dec 2000 | A |
6193708 | Ken et al. | Feb 2001 | B1 |
6231573 | Amor et al. | May 2001 | B1 |
6281263 | Evans et al. | Aug 2001 | B1 |
6303100 | Ricci et al. | Oct 2001 | B1 |
6342202 | Evans et al. | Jan 2002 | B1 |
6344041 | Kupiecki et al. | Feb 2002 | B1 |
6397850 | Scheldrup et al. | Jun 2002 | B1 |
6425893 | Guglielmi | Jul 2002 | B1 |
7238194 | Monstadt et al. | Jul 2007 | B2 |
20040078050 | Monstadt et al. | Apr 2004 | A1 |
Number | Date | Country | |
---|---|---|---|
20040199175 A1 | Oct 2004 | US |