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Micro-Macro Endovascular Occlusion Device and Methodology

Active Publication Date: 2019-05-16
DEMERITT JOHN S
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

The present invention provides an improved vascular occlusion device and a surgical method for treating segmental vascular pathology. The device has a large space filling capacity in relation to the delivery catheter diameter, allowing for the occlusion of large vessels or aneurysms. An elongated microcatheter-deliverable vascular plug or occlusion device can be placed in a strategic manner to simultaneously occlude both proximally and distally to the lesion, reducing the risk of aneurysm rupture and altered hemodynamics. The invention also provides a solution for long segment vascular disease, allowing for the placement of multiple devices through a microcatheter or balloon catheter to create a stable intravascular occlusive construct.

Problems solved by technology

Despite these features many coils are often required to occlude blood flow increasing procedure time and potentially cost.
Coils can also be unreliable with regards to their geometry and vascular space filling properties after deployment.
Detachable balloons can be difficult to navigate through blood vessels and can prematurely detach.
Premature balloon detachment can lead to migration and occlusion of normal blood vessels resulting in complications.
Balloons can deflate over time resulting in recurrence of the treated vascular pathology such as has been reported in caroticocavernous fistula.
This device may not immediately lead to thrombosis particularly in patients with clotting disorders, requiring more than one device.
The device can be difficult to deliver and precisely deploy.
In addition the device may not provide long-term occlusion, which has been reported in pulmonary arteriovenous fistula in particular.
The largest MVP microcatheter deliverable covered plug can only treat vessels up to 5 mm in diameter, a distinct disadvantage.
Larger MVP covered plugs require delivery through 4 or 5 French catheters depending on the target vessel size; these larger catheters are often too big and rigid to easily traverse the desired vasculature.
The use of these larger 4 and 5 French catheters to target the more distal vasculature can lead to technical failures, vessel spasm and vascular injury.
The device may not be ideal for high flow situations with possible migration considering it's small footprint and vessel anchoring capabilities.
These larger 5 French diagnostic catheters are often difficult to advance more distally into the primary or secondary aortic branch vessels such as the hepatic artery, splenic artery, renal artery, internal carotid artery and hypogastric artery to name a few.
In addition, microcatheters are advantageous for traversing tortuous anatomy, often difficult or impossible with larger 5 French catheters.
Venous embolization often entails occluding even larger caliber vessels than arteries, often necessitating larger guiding catheters or sheaths for device delivery, such as the uncovered Amplatzer plugs.
This can be difficult and or cumbersome to achieve with current available devices.
Initial occlusion of the downstream portion of the vessel relative to the fusiform aneurysm can result in increased flow and pressure in the aneurysm resulting in rupture.
Although effective this process can be cumbersome when using current methods, particularly for larger aneurysms, requiring multiple coils to fill the aneurysm sac.

Method used

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Examples

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Embodiment Construction

[0063]The present vascular occlusion device or plug, e.g., plug 20 (FIGS. 1A and 1B), is deliverable through a microcatheter 18, which can occlude a wide range of vessel sizes from small to large, currently not possible with available microcatheter deliverable devices. The design allows for the occlusion of vessels both smaller and larger than 5 mm, the current upper limit for a microcatheter deliverable plug.

[0064]In an expanded deployment configuration as shown in FIGS. 1A and 1B, a self-expanding and self-configuring vascular plug or occlusion device 20 takes an expanded form of a three-dimensional spiraling tubular structure 22, optionally covered with an impermeable or partially permeable membrane 23, which allows for large vessel occlusion via microcatheter 18, currently not possible with available devices. FIG. 1A shows relative distraction or separation of coiled segments or windings 19 of plug or occlusion device 20 while FIG. 1B shows relative compaction of the coiled segm...

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Abstract

A vascular plug comprises a superstructure expandable from a collapsed percutaneous insertion configuration to an expanded deployment or use configuration. The superstructure is comprised of both primary and secondary three-dimensional shapes allowing for the occlusion of a wide range of vessel sizes from small to large through a disproportionately small delivery catheter. The plug includes a shape memory element for the generation of radial force and the creation of the larger secondary three-dimensional twisting or helical superstructure as is needed for target vessel occlusion.

Description

BACKGROUND OF THE INVENTION[0001]The present disclosure generally relates to a device and methodology for occluding arterial and venous blood vessels under a variety of pathologic conditions. Many endovascular devices exist for occluding blood flow including coils, detachable balloons, and most recently expandable mechanical occlusive devices with or without coverings impervious to blood flow. Coils can be covered with fibers or coated with material such as hydrogel to enhance clot formation. Despite these features many coils are often required to occlude blood flow increasing procedure time and potentially cost. Coils can also be unreliable with regards to their geometry and vascular space filling properties after deployment. In addition coils and or clot can easily migrate distally under high flow condition such as arteriovenous fistula in the lungs or elsewhere in the body. Blood vessels occluded by coils can reopen or recanalize as has been reported in pulmonary arteriovenous fi...

Claims

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Application Information

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IPC IPC(8): A61B17/12A61B17/00
CPCA61B17/12145A61B17/12172A61B17/1215A61B17/12177A61B17/12113A61B17/0057A61B2017/00867A61B2017/1205A61B2017/12127A61B2017/00592A61B2017/00632A61B17/12031A61B17/12036A61B17/12109A61B17/12122A61B2017/00292A61B17/1214A61B2017/00778A61B2017/12054
Inventor DEMERITT, JOHN S.
Owner DEMERITT JOHN S
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