Claims
- 1. A reducer for insertion in a blood vessel, comprising:
at least one narrowed section having a first diameter; and at least one flared section having a diameter at least 20% greater than said first diameter, wherein said reducer is formed of a material and has a geometry that does not cause coagulation of blood in its vicinity.
- 2. A reducer according to claim 1, wherein said reducer is operative to increase a coronary artery blood pressure when inserted in a coronary vein.
- 3. A reducer according to claim 1, wherein said reducer is operative to modify a coronary artery blood flow distribution when inserted in a coronary vein.
- 4. A reducer according to claim 1, wherein said reducer is operative to increase a coronary sinus blood pressure when inserted in a coronary sinus.
- 5. A reducer according to claim 1, wherein said reducer is operative to increase an intra-myocardial perfusion when inserted in a coronary sinus.
- 6. A reducer according to any of claims 1-5, wherein said flared section includes at least one area adapted to contact a wall of a vein.
- 7. A reducer according to claim 6, wherein said area is made large enough to prevent damage to the wall.
- 8. A reducer according to claim 7, wherein said area has an axial extent of at least 2 mm.
- 9. A reducer according to claim 7, wherein said area has an axial extent of at least 4 mm.
- 10. A reducer according to any of claims 1-9, wherein said flared section has an outside edge.
- 11. A reducer according to claim 10, wherein said outside edge lies on a single plane.
- 12. A reducer according to claim 10 or claim 11, wherein said outside edge is defined by a plurality of elongate sections that cooperate to define a maximal rim for said reducer.
- 13. A reducer according to any of claims 10-12, wherein said outside edge is smooth.
- 14. A reducer according to any of claims 10-13, wherein said outside edge is curved inwards towards an axis of said reducer.
- 15. A reducer according to any of claims 10-14, wherein said outside edge is coated with a soft material.
- 16. A reducer according to any of claims 1-15, wherein said reducer doesn't cause turbulence inside a lumen defined by said narrowed section and said flared section.
- 17. A reducer according to any of claims 1-16, wherein said narrowed section comprises a ring segment having a different surface design from flared section.
- 18. A reducer according to any of claims 1-17, wherein said narrowed section comprises a solid ring.
- 19. A reducer according to any of claims 1-17, wherein said narrowed section comprises an array of cell elements.
- 20. A reducer according to any of claims 1-19, wherein said reducer is expanded, after insertion, from an unexpanded configuration to an expanded configuration.
- 21. A reducer according to claim 20, wherein said flared section is plastically deformable to provide said configuration change.
- 22. A reducer according to claim 20, wherein said flared section is self-expanding to provide said configuration change.
- 23. A reducer according to any of claims 20-22, wherein said narrowed section self-expanding to provide said configuration change.
- 24. A reducer according to any of claims 20-22, wherein said narrowed section is plastically deformable to provide said configuration change.
- 25. A reducer according to claim 20, wherein said narrowed section does not expand.
- 26. A reducer according to claim 20, wherein said narrowed section is further expandable after said reducer is in said expanded configuration.
- 27. A reducer according to any of claims 1-26, comprising a ring mounted outside of said narrowed section, said ring defining a maximal diameter of said narrowed section.
- 28. A reducer according to any of claims 1-27, wherein said narrowed section is formed of a pliable material.
- 29. A reducer according to any of claims 1-27, wherein said reducer is formed of at least one of an elastic material, a shape-memory material and a super-elastic material.
- 30. A reducer according to any of claims 1-29, wherein different parts of said reducer have different degrees of resistance to deforming.
- 31. A reducer according to claim 30, wherein said narrowed section has a greater resistance to deformation than said flared section.
- 32. A reducer according to claim 30, wherein a rim area of said flared section has a greater resistance to deformation than an adjacent part of said flared section.
- 33. A reducer according to any of claims 1-32, wherein said narrowed section has an axial extent of between 1 mm and 5 mm.
- 34. A reducer according to any of claims 1-33, wherein said reducer has an axial extent of between 10 nm and 30 mm.
- 35. A reducer according to any of claims 1-34, wherein said narrowed section has a cross-sectional area of less than 70% of a maximum cross-sectional area of said flared section.
- 36. A reducer according to any of claims 1-34, wherein said narrowed section has a cross-sectional area of less than 50% of a maximum cross-sectional area of said flared section.
- 37. A reducer according to any of claims 1-34, wherein said narrowed section has a cross-sectional area of less than 40% of a maximum cross-sectional area of said flared section.
- 38. A reducer according to any of claims 1-34, wherein said narrowed section has a cross-sectional area of less than 30% of a maximum cross-sectional area of said flared section.
- 39. A reducer according to any of claims 1-34, wherein said narrowed section has a cross-sectional area of less than 20% of a maximum cross-sectional area of said flared section.
- 40. A reducer according to any of claims 1-39, wherein said flared section has an axial extent of between 4 mm and 10 mm.
- 41. A reducer according to any of claims 1-40, wherein said reducer is adapted for insertion in a human coronary sinus.
- 42. A reducer according to any of claims 1-41, wherein said reducer is adapted for insertion in a human coronary vein.
- 43. A reducer according to claim 41 or claim 42, wherein said adaptation is by size.
- 44. A reducer according to any of claims 1-43, wherein said at least one flared section comprises at least two flared sections.
- 45. A reducer according to any of claims 1-44, wherein said reducer describes an hourglass figure.
- 46. A reducer according to any of claims 1-45, wherein said flared section is dense, to reduce blood flow therethrough.
- 47. A reducer according to any of claims 1-46, wherein said flared section is coated, to reduce blood flow therethrough.
- 48. A reducer according to any of claims 1-47, wherein said reducer is formed of a soft material, to reduce contact force against an enclosing vessel wall.
- 49. A reducer according to any of claims 1-48, wherein said reducer is operative to release a slow release molecule after it is deployed.
- 50. A reducer according to any of claims 1-49, wherein said reducer has an outside surface adapted to attach to a wall of a vein.
- 51. A reducer according to any of claims 1-50, wherein said narrowed section comprises a valve.
- 52. A reducer for insertion in a blood vessel having a diameter, comprising:
at least one narrowed section having a first diameter; and at least one flared section having a diameter at least 20% greater than said first diameter, wherein said reducer is adapted to be plastically deformed from a first configuration in which said reducer is unexpanded to a second configuration in which said reducer is expanded.
- 53. A reducer according to claim 52, wherein said narrowing section has a length of at least 10% of a total axial length of said reducer.
- 54. A reducer according to claim 52, wherein said narrowing section has a length of at least 20% of a total axial length of said reducer.
- 55. A reducer for insertion in a blood vessel having a diameter, comprising:
at least one narrowed section having a first diameter; and at least one flared section having a diameter greater than said first diameter, wherein said reducer is adapted to contact a vein at said flared section.
- 56. A reducer according to claim 55, wherein said adaptation comprises forming said flared section to reduce a probability of damage to said vein.
- 57. A reducer according to claim 55, wherein said adaptation comprises forming said reducer of a soft material to reduce a contact force between said reducer and said vein.
- 58. A reducer according to claim 55, wherein said reducer is adapted to cause coagulation in an area defined between said reducer and a wall of said vein.
- 59. A reducer for insertion in a blood vessel having a diameter, comprising:
at least one narrowed section having a first diameter; and at least one flared section having a diameter at least 20% greater than said first diameter, wherein said flared section is resistant to blood flow across a wall of said section, such that at least 50% of blood flow through the reducer passes through a lumen defined by said flared section and said narrowed section.
- 60. A reducer according to claim 59, wherein at least 80% of blood flow through the reducer passes through a lumen defined by said flared section and said narrowed section.
- 61. A reducer according to claim 59, wherein at least 90% of blood flow through the reducer passes through a lumen defined by said flared section and said narrowed section.
- 62. A reducer for insertion in a blood vessel having a diameter, comprising:
at least one narrowed section having a first diameter; and at least one flared section having a diameter substantially greater than said first diameter, wherein said flared section and said narrowed section cooperate to substantially reduce blood flow through a lumen defined by said sections, relative to flow through a cylinder having a maximal diameter of the flared section
- 63. A blood vessel reducer delivery kit, comprising:
a guide catheter; a plastically deformable reducer having an hour-glass figure when deformed and adapted to ride on said catheter; and a balloon having an inflation profile matching said hour-glass figure.
- 64. A method of reducer selection, comprising:
determining a desired hemodynamic effect in a coronary vascular system; and selecting a reducer having a suitable geometry to achieve said desired hemodynamic effect, from a set of reducers of different geometries.
- 65. A method according to claim 64, wherein said desired effect is at least one of: increase in myocardial perfusion pressure, increase in myocardial pressure, increase in myocardial perfusion duration, increase in coronary artery pressure, redistribution of blood flow in coronary arteries, increase in pressure in a coronary sinus and/or a restarting of a coronary artery autoregulation mechanism.
- 66. A method of affecting hemodynamic parameters of a coronary system, comprising:
selecting a reducer for reducing a diameter of a coronary vein; and implanting said reducer in said coronary vein.
- 67. A method according to claim 66, wherein said coronary vein is a coronary sinus.
- 68. A kit for reducing blood flow in a venous system, comprising: a plurality of vascular implants, each defining a narrowed section, said plurality of implants including at least two implants with different geometrical properties.
- 69. A kit according to claim 68, wherein said two implants have different degrees of narrowing.
- 70. A kit according to claim 68 or claim 69, wherein said two implants have different outer diameters, for matching different coronary veins.
Priority Claims (1)
Number |
Date |
Country |
Kind |
09/534,968 |
Mar 2000 |
US |
|
RELATED APPLICATIONS
[0001] This application is related to U.S. application Ser. No. 09/534,968, filed Mar. 27, 2000 the disclosure of which is incorporated herein by reference.
PCT Information
Filing Document |
Filing Date |
Country |
Kind |
PCT/IL01/00284 |
3/27/2001 |
WO |
|