The present invention relates to a delivery and detachment system for an implantable intravascular treatment device (e.g., embolic coil) used during an endovascular treatment or procedure. In particular, the present invention is directed to a delivery and detachment system for implantation of an implantable intravascular treatment deice (e.g., embolic coil) in the intravascular treatment of a brain aneurysm. In the present inventive improved delivery and detachment system the securement wire is able to withstand forces during detachment/deployment of the implantable intravascular treatment device (e.g., embolic coil) at a target site.
Implantable intravascular treatment devices are commonly used in endovascular procedures or treatments of various vascular ailments, for example, brain aneurysms. Typically, a guide catheter is inserted into the femoral artery in patient's leg and, while guided by imaging, navigated through the vessel to the target site in the brain (e.g., a proximal side of the aneurysm), as shown in
The present invention is directed to an improved mechanical delivery and detachment system in which the implantable intravascular treatment device (e.g., embolic coil) is releasably secured to the distal end thereof via a securement wire that itself is robustly attached along an axial section thereof to the inner wall of the proximal inner tube via one or more supplemental connection points able to withstand forces during deployment.
An aspect of the present invention is directed to an improved mechanical delivery and detachment system in which the implantable intravascular treatment device (e.g., embolic coil) is releasably secured to the distal end thereof via a securement wire that itself is robustly attached along an axial section thereof to the inner wall of the proximal inner tube via one or more supplemental connection points able to withstand forces during deployment.
Another aspect of the present invention relates to a delivery and detachment system for an implantable intravascular treatment device, wherein the system includes: an outer delivery tube having a proximal end, an opposite distal end, and a lumen defined axially therein; and a proximal inner tube having a proximal end, an opposite distal end, and a lumen defined axially therein. The proximal inner tube is telescopically slidable within the lumen of the outer delivery tube and has a weld window radially inward cutout defined therein along an axial section thereof between but not including the proximal and distal ends. The system further including a securement wire disposed axially within the lumen of the proximal inner tube, wherein the securement wire is secured to an inner wall of the lumen of the proximal inner tube via at one supplemental connection point coinciding with the weld window.
A still further aspect of the present invention is directed to a method of making the delivery and detachment system for an implantable intravascular treatment system described in the preceding paragraph. Initially, the proximal inner tube is assembled telescopically in the lumen of the outer delivery tube so that the proximal end of the proximal inner tube extends beyond the proximal end of the outer delivery tube without concealing the weld window. Then, the securement wire and at least one positioning wire is threaded in a direction from the distal end to the proximal end of the proximal inner tube through the lumen of the proximal inner tube until the proximal end of each of the securement wire and the at least one positioning wire extends beyond the proximal end of the proximal inner tube. Next, the securement wire is forced in direct physical contact with an inner wall of the lumen of the proximal inner tube coinciding with the weld window by manipulating the securement wire and/or the at least one positioning wire. Within the weld window, at least one supplemental connection point is created between the securement wire and the inner wall of the lumen of the proximal inner tube along an axial section in direct physical contact with one another. Then the at least one positioning wire is withdrawn in a proximal direction from the proximal inner tube.
The foregoing and other features of the present invention will be more readily apparent from the following detailed description and drawings illustrative of the invention wherein like reference numbers refer to similar elements throughout the several views and in which:
In the description, the terms “distal” or “proximal” are used in the following description with respect to a position or direction relative to the treating physician or medical interventionalist. “Distal” or “distally” are a position distant from or in a direction away from the physician or interventionalist. “Proximal” or “proximally” or “proximate” are a position near or in a direction toward the physician or medical interventionist. The terms “occlusion”, “clot” or “blockage” are used interchangeably.
During an endovascular treatment procedure (e.g., coil embolization), it is desirable for the delivery and detachment system to reliably and accurately deliver the implantable intravascular treatment device (e.g., embolic coil) to a precise location or target site (e.g., aneurysm) within a vessel or artery; and, once properly positioned, ensure complete deployment (detachment or separation) of the implantable intravascular treatment device from the system. Referring to
Minimal, if any, restraint prohibiting or minimizing dislodgement of the securement wire 515 from the proximal inner tube 505 is provided by the proximal bead 570 primarily serving to aid easy insertion in the delivery and detachment device. During detachment of the implantable intravascular treatment device when forces imposed on the securement wire may exceed that of the break load of the wire itself, a high probability exists of unintended detachment of the securement wire 515 from the proximal inner tube 505 when the proximal bead 570 is the sole point connecting the two components. The design of the present inventive delivery and detachment system provides one or more supplemental connection points (e.g., spot welds) between the securement wire and the proximal inner tube thereby exceeding in overall strength the connection provided by the proximal bead 570 alone.
A laser cutout made radially inward in the proximal inner tube 505 creates a weld window 545 providing an access point through which the two components (securement wire 515 and proximal inner tube 505) are secured together via the creation of one or more supplemental connection points (e.g., one or more supplemental spot welds). These one or more supplemental connection points being in addition to that of the proximal bead 570 disposed at the proximal end of the securement wire 515 securing it to the proximal end of the proximal inner tube 505. In contrast to the arrangement of the proximal bead 570 located at the proximal end of the securement wire 515, the one or more supplemental connection points are located along an axial section (between, but not including the proximal and distal ends) of the securement wire 515. The length in the axial/longitudinal direction as well as the length in a lateral direction that defines the weld window cutout in the proximal inner tube 505 is selected, as desired, with several competing factors. On the one hand, the cutout is sufficient in size to: (i) visibly position therein the securement wire in direct physical contact with the inner wall of the proximal inner tube; and (ii) allow for creation of the desired size and number of one or more supplemental connection point(s) (e.g., laser spot weld(s)) between the two components (e.g., the securement wire and the inner wall of the proximal inner tube)) to achieve a desired target strength. While on the other hand, the proximal inner tube retains sufficient rigidity or strength (i.e., higher tensile strength—less frangible). Addressing each factor, clearly a laser cutout sufficiently large in size (width in a lateral direction and/or length in an axial direction) is selected to accommodate the desired quantity and size spot weld(s) to prohibit or minimize detachment of the securement wire from the proximal inner tube, while a cutout too large in size may negatively diminish or weaken the integrity/rigidity (i.e., lower tensile strength—more frangible) of the proximal inner tube. Keeping these competing factors in mind, by way of example, the cutout may be designed with a width in a lateral direction in a range of approximately 0.0019 inches-approximately 0.0045 inches and a length in an axial direction in a range of approximately 0.012 inches-approximately 0.016 inches. In addition, the proximal edge of the most proximal weld window is preferably ≥approximately 1 mm in an axial direction from the proximal end/tip of the proximal inner tube.
Prior to creating the one or more lap spot welds (the one or more supplemental connection points) the securement wire 515 and proximal inner tube 505 are forced in direct physical contact with one another along an axial section (between but not including the respective proximal and distal ends). This is accomplished by filling the space in the lumen of the proximal inner tube 505 having the securement wire 515 threaded therethrough with one or more positioning wires 550, 550′ as necessary to ensure proper fitment. The one or more positioning wires 550, 550′ are manipulated forcing the securement wire 515 in direct physical contact against the inner wall of the proximal inner tube 505 along an axial region coinciding (aligned) with the weld window 545 so that one or more secure spot welds (supplemental connection point(s)) 560, 560′ therebetween may be created.
First, during assembly as the proximal inner tube 505 with the weld window 545 cutout defined radially inward therein is pulled over the securement wire 515 (
In the exemplary process in
Once the securement wire 515 is maneuvered to the securing position (i.e., in direct physical contact along an axial section with the inner wall of the proximal inner tube 505), as depicted in
To prevent the unintentional welding of the positioning wires when creating the lap spot welds (one or more supplemental connection points), the positioning wires 550, 550′ may be made of a heat resistant material or coated with a lubricous outer layer (e.g., Polytetrafluoroethylene (PTFE)). Once the desired weld bonds (one or more supplemental connection points) have been created, the positioning wires may be easily withdrawn in a proximal direction. In the exemplary embodiment in
Still referring to
Thus, the desired size and strength of each spot weld (supplemental connection point) may be realized by varying any one or more of the parameter settings (e.g., travel speed, current, and/or voltage). Specifically, the higher power and greater length of time the larger in size and stronger the spot weld (supplemental connection point). In addition to varying such power parameter settings, the laser beam may be focused or defocused, wherein the energy is diluted when the laser is defocused in comparison to that while focused. In
If more than one weld is created, the strength of each weld may be selected, as desired. For example, the strength of each weld may be selected to decrease with the weld closest to the proximal end/tip of the proximal inner tube being the strongest and the weld furthest from the proximal end/tip of the proximal inner tube being the weakest. Not only strength but spacing or arrangement of the welds may also be selected, as desired. In the exemplary configuration depicted in
To sustain even greater forces, the strength of the one or more weld bond(s) (one or more supplemental connection points) between the securement wire and proximal inner tube may be enhanced by application of a biocompatible adhesive. Such modification calls for one or more secondary cutouts (e.g., laser cuts) (hereinafter referred to as “adhesive windows”) to be made in the proximal inner tube. Preferably, each adhesive window is aligned in an axial direction with one another and separated radially approximately 180° from the weld window. The length in an axial direction of the adhesive window may vary so long as the adhesive is able to wick. For instance, the length in an axial direction of a single adhesive window or multiple adhesive windows together may span substantially the same length in an axial direction as that of the weld window. Alternatively, the length in an axial direction of a single adhesive window may be substantially smaller (e.g., a mere hole) relative to the larger length in an axial direction of the weld window. Preferably, each adhesive window substantially coincides/aligns/overlaps with the weld window.
Referring to the side view of the example shown in
If the weld window is arranged closer to the outer delivery tube 510 (i.e., the proximal end of the weld window preferably being approximately 16 mm from the proximal end of the proximal inner tube) the construction of the proximal inner tube is weakened with increased potential for breakage. To reinforce or supplement the otherwise weakened wall of the proximal inner tube slack is intentionally added so that the proximal inner tube 505 may be telescopically pushed/slid in a distal direction within the lumen of the outer delivery tube 510 until the weld window 545 is concealed/hidden therein. Thereafter, the outer delivery tube 510 is crimped securing in position the proximal inner tube 505 therein. As a result, the weakened or fragile area of the wall of the proximal inner tube surrounding the weld and adhesive windows (along with the spot and adhesive welds created therein) are encased, concealed, protected, or shielded by the outer delivery tube providing both protection and rigidity/strength during regular use minimizing or eliminating any risk of breakage.
Thereafter, the implantable intravascular treatment device (e.g., embolic coil) is loaded on to the delivery and detachment device. The proximal inner tube together with the securement wire secured thereto via the one or more spot welds (supplemental connection points) as a unit is then advanced in a distal direction until the entire weld window 545 (along with the adhesive windows, spot welds and adhesive welds) is fully concealed, protected, or shielded by the outer delivery tube 510 (hereinafter referred to as the “concealed position”) (
The present inventive delivery and detachment system has been shown and described with respect to implantation of an embolic coil during a coil embolization procedure in the treatment of an intracranial aneurysm. It is contemplated and within the intended scope of the present invention to utilize the present inventive delivery and detachment system for delivering other types of implantable intravascular treatment devices used in other endovascular treatment procedures.
Thus, while there have been shown, described, and pointed out fundamental novel features of the invention as applied to a preferred embodiment thereof, it will be understood that various omissions, substitutions, and changes in the form and details of the systems/devices illustrated, and in their operation, may be made by those skilled in the art without departing from the spirit and scope of the invention. For example, it is expressly intended that all combinations of those elements and/or steps that perform substantially the same function, in substantially the same way, to achieve the same results be within the scope of the invention. Substitutions of elements from one described embodiment to another are also fully intended and contemplated. It is also to be understood that the drawings are not necessarily drawn to scale, but that they are merely conceptual in nature. It is the intention, therefore, to be limited only as indicated by the scope of the claims appended hereto.
Every issued patent, pending patent application, publication, journal article, book or any other reference cited herein is each incorporated by reference in their entirety.
Number | Name | Date | Kind |
---|---|---|---|
8795316 | Balgobin et al. | Aug 2014 | B2 |
9532792 | Galdonik et al. | Jan 2017 | B2 |
9532873 | Kelley | Jan 2017 | B2 |
9533344 | Monetti et al. | Jan 2017 | B2 |
9539011 | Chen et al. | Jan 2017 | B2 |
9539022 | Bowman | Jan 2017 | B2 |
9539122 | Burke et al. | Jan 2017 | B2 |
9539382 | Nelson | Jan 2017 | B2 |
9549830 | Bruszewski et al. | Jan 2017 | B2 |
9554805 | Tompkins et al. | Jan 2017 | B2 |
9561125 | Bowman et al. | Feb 2017 | B2 |
9572982 | Burnes et al. | Feb 2017 | B2 |
9579484 | Barnell | Feb 2017 | B2 |
9585642 | Dinsmoor et al. | Mar 2017 | B2 |
9615832 | Bose et al. | Apr 2017 | B2 |
9615951 | Bennett et al. | Apr 2017 | B2 |
9622753 | Cox | Apr 2017 | B2 |
9636115 | Henry et al. | May 2017 | B2 |
9636439 | Chu et al. | May 2017 | B2 |
9642675 | Werneth et al. | May 2017 | B2 |
9655633 | Leynov et al. | May 2017 | B2 |
9655645 | Staunton | May 2017 | B2 |
9655989 | Cruise et al. | May 2017 | B2 |
9662129 | Galdonik et al. | May 2017 | B2 |
9662238 | Dwork et al. | May 2017 | B2 |
9662425 | Lilja et al. | May 2017 | B2 |
9668898 | Wong | Jun 2017 | B2 |
9675477 | Thompson | Jun 2017 | B2 |
9675782 | Connolly | Jun 2017 | B2 |
9676022 | Ensign et al. | Jun 2017 | B2 |
9692557 | Murphy | Jun 2017 | B2 |
9693852 | Lam et al. | Jul 2017 | B2 |
9700262 | Janik et al. | Jul 2017 | B2 |
9700399 | Acosta-Acevedo | Jul 2017 | B2 |
9717421 | Griswold et al. | Aug 2017 | B2 |
9717500 | Tieu et al. | Aug 2017 | B2 |
9717502 | Teoh et al. | Aug 2017 | B2 |
9724103 | Cruise et al. | Aug 2017 | B2 |
9724526 | Strother et al. | Aug 2017 | B2 |
9750565 | Bloom et al. | Sep 2017 | B2 |
9757260 | Greenan | Sep 2017 | B2 |
9764111 | Gulachenski | Sep 2017 | B2 |
9770251 | Bowman et al. | Sep 2017 | B2 |
9770577 | Li et al. | Sep 2017 | B2 |
9775621 | Tompkins et al. | Oct 2017 | B2 |
9775706 | Peterson et al. | Oct 2017 | B2 |
9775732 | Khenansho | Oct 2017 | B2 |
9788800 | Mayoras, Jr. | Oct 2017 | B2 |
9795391 | Saatchi et al. | Oct 2017 | B2 |
9801980 | Karino et al. | Oct 2017 | B2 |
9808599 | Bowman et al. | Nov 2017 | B2 |
9833252 | Sepetka et al. | Dec 2017 | B2 |
9833604 | Lam et al. | Dec 2017 | B2 |
9833625 | Waldhauser et al. | Dec 2017 | B2 |
20170007264 | Cruise et al. | Jan 2017 | A1 |
20170007265 | Guo et al. | Jan 2017 | A1 |
20170020670 | Murray et al. | Jan 2017 | A1 |
20170020700 | Bienvenu et al. | Jan 2017 | A1 |
20170027640 | Kunis et al. | Feb 2017 | A1 |
20170027692 | Bonhoeffer et al. | Feb 2017 | A1 |
20170027725 | Argentine | Feb 2017 | A1 |
20170035436 | Morita | Feb 2017 | A1 |
20170035567 | Duffy | Feb 2017 | A1 |
20170042548 | Lam | Feb 2017 | A1 |
20170049596 | Schabert | Feb 2017 | A1 |
20170071737 | Kelley | Mar 2017 | A1 |
20170072452 | Monetti et al. | Mar 2017 | A1 |
20170079671 | Morero et al. | Mar 2017 | A1 |
20170079680 | Bowman | Mar 2017 | A1 |
20170079766 | Wang et al. | Mar 2017 | A1 |
20170079767 | Leon-Yip | Mar 2017 | A1 |
20170079812 | Lam et al. | Mar 2017 | A1 |
20170079817 | Sepetka et al. | Mar 2017 | A1 |
20170079819 | Pung et al. | Mar 2017 | A1 |
20170079820 | Lam et al. | Mar 2017 | A1 |
20170086851 | Wallace et al. | Mar 2017 | A1 |
20170086996 | Peterson et al. | Mar 2017 | A1 |
20170095259 | Tompkins et al. | Apr 2017 | A1 |
20170100126 | Bowman et al. | Apr 2017 | A1 |
20170100141 | Morero et al. | Apr 2017 | A1 |
20170100143 | Grandfield | Apr 2017 | A1 |
20170100183 | Iaizzo et al. | Apr 2017 | A1 |
20170113023 | Steingisser et al. | Apr 2017 | A1 |
20170147765 | Mehta | May 2017 | A1 |
20170151032 | Loisel | Jun 2017 | A1 |
20170165062 | Rothstein | Jun 2017 | A1 |
20170165065 | Rothstein et al. | Jun 2017 | A1 |
20170165454 | Tuohy et al. | Jun 2017 | A1 |
20170172581 | Bose et al. | Jun 2017 | A1 |
20170172766 | Vong et al. | Jun 2017 | A1 |
20170172772 | Khenansho | Jun 2017 | A1 |
20170189033 | Sepetka et al. | Jul 2017 | A1 |
20170189035 | Porter | Jul 2017 | A1 |
20170215902 | Leynov et al. | Aug 2017 | A1 |
20170216484 | Cruise et al. | Aug 2017 | A1 |
20170224350 | Shimizu et al. | Aug 2017 | A1 |
20170224355 | Bowman et al. | Aug 2017 | A1 |
20170224467 | Piccagli et al. | Aug 2017 | A1 |
20170224511 | Dwork et al. | Aug 2017 | A1 |
20170224953 | Tran et al. | Aug 2017 | A1 |
20170231749 | Perkins et al. | Aug 2017 | A1 |
20170252064 | Staunton | Sep 2017 | A1 |
20170265983 | Lam et al. | Sep 2017 | A1 |
20170281192 | Tieu et al. | Oct 2017 | A1 |
20170281331 | Perkins et al. | Oct 2017 | A1 |
20170281344 | Costello | Oct 2017 | A1 |
20170281909 | Northrop et al. | Oct 2017 | A1 |
20170281912 | Melder et al. | Oct 2017 | A1 |
20170290593 | Cruise et al. | Oct 2017 | A1 |
20170290654 | Sethna | Oct 2017 | A1 |
20170296324 | Argentine | Oct 2017 | A1 |
20170296325 | Marrocco et al. | Oct 2017 | A1 |
20170303939 | Greenhalgh et al. | Oct 2017 | A1 |
20170303942 | Greenhalgh et al. | Oct 2017 | A1 |
20170303947 | Greenhalgh et al. | Oct 2017 | A1 |
20170303948 | Wallace et al. | Oct 2017 | A1 |
20170304041 | Argentine | Oct 2017 | A1 |
20170304097 | Corwin et al. | Oct 2017 | A1 |
20170304595 | Nagasrinivasa et al. | Oct 2017 | A1 |
20170312109 | Le | Nov 2017 | A1 |
20170312484 | Shipley et al. | Nov 2017 | A1 |
20170316561 | Helm et al. | Nov 2017 | A1 |
20170319826 | Bowman et al. | Nov 2017 | A1 |
20170333228 | Orth et al. | Nov 2017 | A1 |
20170333236 | Greenan | Nov 2017 | A1 |
20170333678 | Bowman et al. | Nov 2017 | A1 |
20170340383 | Bloom et al. | Nov 2017 | A1 |
20170348014 | Wallace et al. | Dec 2017 | A1 |
20170348514 | Guyon et al. | Dec 2017 | A1 |
20180250150 | Majercak et al. | Sep 2018 | A1 |
20180280667 | Keren | Oct 2018 | A1 |
20200046370 | Gorochow | Feb 2020 | A1 |
20200397444 | Montidoro | Dec 2020 | A1 |
20210015484 | Lorenzo | Jan 2021 | A1 |
20210346002 | Lorenzo et al. | Nov 2021 | A1 |
20220054136 | Blumenstyk | Feb 2022 | A1 |
Entry |
---|
European Search Report in counterpart EP Application No. 22 20 9578.8 (8 pp.)(dated Apr. 5, 2023). |
Number | Date | Country | |
---|---|---|---|
20230165588 A1 | Jun 2023 | US |