Embolic filter with flexible coupling - Patents.com
The embolic filter system addresses orientation issues in tortuous vasculature by allowing articulation between the filter and elongate element, ensuring complete debris capture and reducing release risks through passive or controlled alignment.
Patent Information
- Application Number
- JP2023060771
- Authority / Receiving Office
- JP · JP
- Patent Type
- Patents
- Current Assignee / Owner
- Priority Date
- 2018-10-17
- Filing Date
- 2023-04-04
- Publication Date
- 2024-12-27
- Estimated Expiration
- 2039-10-17
AI Technical Summary
Conventional embolic protection devices struggle with proper orientation within tortuous vasculature, leading to gaps and incomplete capture of embolic debris during removal, risking unintentional release into the bloodstream.
An embolic filter system with an articulating frame that allows for relative movement between the filter and the elongate element, enabling passive or operator-controlled alignment within the vasculature, and a self-expandable design to facilitate complete capture and minimize debris release.
Enhances the ability to align the filter properly within the vasculature, reducing gaps and ensuring complete capture of embolic debris, thereby minimizing the risk of debris release during removal.
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Abstract
Description
[Technical field]
[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Provisional Application No. 62 / 747,026, filed October 17, 2018, which is incorporated by reference in its entirety for all purposes. [Background technology]
[0002] background Endovascular procedures address a wide range of medical needs, including intravascular access, diagnosis, and / or repair by less invasive or relatively less invasive means than surgical approaches. During some endovascular procedures, embolic debris may become dislodged or circulate within the vasculature. Circulating embolic debris may cause mild to extreme cardiovascular complications, leading to stroke and even death.
[0003] Embolic protection devices have been developed and used in connection with various endovascular procedures to help mitigate the risks associated with such procedures. Some embolic protection devices operate to capture embolic debris and filter it from the blood. The captured embolic debris may be aspirated (e.g., actively or passively) prior to removal of the embolic protection device. Additionally or alternatively, the embolic protection device may be configured to trap embolic debris within the embolic protection device such that the embolic debris is retained by the embolic protection device when the embolic protection device is removed from the vasculature. However, a common risk of these procedures is that some or all of the captured embolic debris may be unintentionally released into the vasculature during the removal process.
[0004] Proper orientation of the embolic protection device within the vasculature is a key factor in facilitating capture and removal of embolic debris. However, while conventional devices can be placed within a tortuous vasculature, some lack a means to orient or reposition the device within the vasculature after deployment. Poor orientation of the embolic protection device, for example, due to one or more gaps between the embolic protection device and the vessel wall and / or due to embolic debris not being fully captured by the embolic protection device, can result in embolic debris bypassing the embolic protection device, resulting in unintentional release of embolic debris into the blood upon removal of the embolic protection device from the vasculature. Proper orientation is particularly challenging in tortuous anatomical structures. Summary of the Invention
[0005] Abstract According to a first example ("Example 1"), a medical device includes an embolic filter assembly including an elongate element having a first end and a second end, and a frame having a mounting section, a capturing section distal to the mounting section, and an intermediate section between the mounting section and the capturing section, the mounting section of the embolic filter assembly being coupled to the elongate element at one of the first end and the second end, the intermediate section adapted to enable relative articulation between the capturing section of the frame and the mounting section of the frame, and the mounting section, the capturing section, and the intermediate section being formed from the same material.
[0006] In addition to Example 1, according to another example ("Example 2"), the capture section is radially expandable relative to the mounting section such that the embolic filter assembly is configured to transition between a compressed state and an expanded state in situ.
[0007] According to another example ("Example 3"), in addition to any of the examples, the capture section is radially expandable relative to the intermediate section.
[0008] According to another example ("Example 4"), in addition to any of the examples, the frame is configured such that the capture section is self-expandable.
[0009] In addition to any of the examples, according to another example ("Example 5"), the frame includes a metal alloy.
[0010] In addition to Example 5, according to another example ("Example 6"), the metal alloy includes Nitinol.
[0011] In addition to any of the examples, according to another example ("Example 7"), the frame is unitary such that the mounting section, the capture section, and the intermediate section define a single monolithic component.
[0012] According to another example ("Example 8"), in addition to any of the examples, the intermediate section is spirally shaped.
[0013] According to another example ("Example 9"), in addition to any of the examples, the frame is formed from a cutting tube having a body and a lumen extending therethrough.
[0014] In addition to Example 9, according to another example ("Example 10"), the cut tube is a laser cut tube.
[0015] According to another example ("Example 11"), in addition to any of Examples 9-10, the intermediate section is defined by a spiral cut through the body of the tube that exposes the lumen of the tube.
[0016] According to another example ("Example 12"), in addition to any of Examples 1-8, the attachment section, the capture section and the intermediate section are attached to one another.
[0017] In addition to Example 12, according to another example ("Example 13"), one or more of the capture section and the intermediate section include a wire frame.
[0018] In addition to Example 13, according to another example ("Example 14"), the intermediate section includes a helical winding.
[0019] In addition to any of the examples, according to another example ("Example 15"), the midsection is adapted to bend.
[0020] According to another example ("Example 16"), in addition to any of the examples, the mounting section of the frame defines a first longitudinal axis, the capture section defines a second longitudinal axis, and the intermediate section is adapted to bend such that the first longitudinal axis can deflect up to 270 degrees relative to the second longitudinal axis.
[0021] According to another example ("Example 17") in addition to any of Examples 1-15, the mounting section of the frame defines a first longitudinal axis, the capture section defines a second longitudinal axis, and the intermediate section is adapted to bend such that the first longitudinal axis can deflect up to 180 degrees relative to the second longitudinal axis.
[0022] According to another example ("Example 18") in addition to any of Examples 1-15, the mounting section of the frame defines a first longitudinal axis, the capture section defines a second longitudinal axis, and the intermediate section is adapted to bend such that the first longitudinal axis can deflect up to 90 degrees relative to the second longitudinal axis.
[0023] In addition to any of the examples, according to another example ("Example 19"), the frame has a first end and a second end and a lumen extending through the frame from the first end to the second end.
[0024] In accordance with another example ("Example 20"), in addition to any of the examples, the embolic filter assembly further includes a filter material disposed along the frame.
[0025] In addition to Example 20, according to another example ("Example 21"), the filter material is disposed along the mid-section of the frame.
[0026] According to another example ("Example 22"), in addition to any of Examples 20-21, the filter material is impermeable to embolic debris greater than about 140 μm.
[0027] According to another example ("Example 23") in addition to any of Examples 20-22, the filter material is configured to limit elongation of the middle section below a yield point of the middle section.
[0028] According to another example ("Example 24"), in addition to any of Examples 20-23, the filter material is configured to stretch to accommodate one or more bends and elongations of an intermediate portion of the frame, and a yield strength of the filter material exceeds a yield strength of the intermediate portion.
[0029] According to another example ("Example 25"), in addition to any of Examples 20-24, the filter material includes a polymer material.
[0030] In addition to Example 25, according to another example ("Example 26"), the polymeric material includes ePTFE.
[0031] In addition to any of the examples, according to another example ("Example 27"), one or more of the capture section, the attachment section, and the elongate element are operable to articulate at the intermediate section.
[0032] According to another example ("Example 28"), a system includes an elongate element, a medical device including an expandable portion, and a union located between the expandable portion of the medical device and the elongate element, the union defining a coupling between the elongate element and the medical device, the expandable portion of the medical device extending distally to a distal end of the elongate element, the coupling adapted to enable relative articulation between the medical device and the elongate element, and the medical device and the union comprising the same material.
[0033] In addition to Example 28, according to another example ("Example 29"), the medical device is an embolic filter.
[0034] According to another example ("Example 30"), in addition to any of Examples 28-29, the union includes a helical shaped portion adapted to bend.
[0035] In addition to any of Examples 28-30, according to another example ("Example 31"), the union includes a lumen adapted to allow embolic debris to pass from the medical device to the elongate element, and the union is covered with a filter material.
[0036] In addition to Example 31, according to another example ("Example 32"), the filter material is impermeable to embolic debris greater than about 140 μm.
[0037] According to another example ("Example 33") in addition to any of Examples 31-32, the filter material is configured to limit elongation of the middle section below a yield point of the middle section.
[0038] According to another example ("Example 34") in addition to any of Examples 31-33, the filter material is configured to stretch to accommodate one or more bends and elongations of an intermediate portion of the frame, and a yield strength of the filter material exceeds a yield strength of the intermediate portion.
[0039] According to another example ("Example 35"), in addition to any of Examples 31-34, the filter material includes a polymer material.
[0040] In addition to Example 35, according to another example ("Example 36"), the polymeric material includes ePTFE.
[0041] According to another example ("Example 37"), in addition to any of Examples 28-36, the union is configured to allow the elongate element to articulate up to 45 degrees relative to the medical device.
[0042] According to another example ("Example 38"), in addition to any of Examples 28-36, the union is configured to allow the elongate element to articulate up to 60 degrees relative to the medical device.
[0043] According to another example ("Example 39"), in addition to any of Examples 28-36, the union is configured to allow the elongate element to articulate up to 90 degrees relative to the medical device.
[0044] According to another example ("Example 40"), in addition to any of Examples 28-36, the union is configured to allow the elongate element to articulate up to 180 degrees relative to the medical device.
[0045] According to another example ("Example 41"), in addition to any of Examples 28-36, the union is configured to allow the elongate element to articulate up to 270 degrees relative to the medical device.
[0046] According to another example ("Example 42"), in addition to any of the examples, embolic debris captured by the embolic filter assembly can be aspirated through a lumen of the elongate element.
[0047] According to another example ("Example 43"), in addition to any of the examples, the elongate element is configured to be cut to a desired length prior to use.
[0048] According to another example ("Example 44"), a medical system includes a first elongate element having a first end, a second end, and a first length, wherein the elongate element is configured to be capable of shortening the first length to a second, shorter length; an embolic filter coupled to the first end of the first elongate element, wherein the embolic filter is configured to be transitionable in situ between a radially collapsed configuration and a radially expanded configuration, and wherein the embolic filter is self-expandable, wherein the first elongate element is receivable within a second elongate element such that the first elongate element is advanceable and retractable within the second elongate element, and the second elongate element is configured to be advanced within a patient.
[0049] According to another example ("Example 45"), a method of assembling a medical device includes providing an embolic filter assembly including a filter component coupled to a distal end of a first elongate element; providing a second elongate element having a lumen extending therethrough; inserting a proximal end of the first elongate element into the lumen of the second elongate element; and advancing the proximal end of the first elongate element proximally through the lumen of the second elongate element until the proximal end of the first elongate element is withdrawn from the proximal end of the second elongate element and the filter component is received within the lumen of the second elongate element, such that the first elongate element is advanceable and retractable within the second elongate element, and the second elongate element is configured for advancement within a patient.
[0050] According to another example ("Example 46"), a method of assembling a medical device includes providing an embolic filter assembly including a filter component coupled to a distal end of a first elongate element; providing a constraining sheath having a first end, a second end and a lumen extending through the constraining sheath; providing a second elongate element having a lumen extending therethrough; inserting a proximal end of the first elongate element into the lumen of the constraining sheath at the first end of the constraining sheath; the first elongate element is inserted into the lumen of the second elongate element at the proximal end of the second elongate element; and the second elongate element is inserted into the lumen of the second elongate element at the proximal end of the second elongate element. The method includes advancing a proximal end of the first elongate element through a lumen of the constraining sheath until the proximal end of the first elongate element is withdrawn from the second end of the sheath and the filter component is received within the lumen of the second elongate element.
[0051] In addition to Example 46, according to another example ("Example 47"), the constraining sheath is configured to split, and the method further includes splitting the constraining sheath and removing the constraining sheath from the first elongate element and the second elongate element.
[0052] According to another example ("Example 48") in addition to any of Examples 46-47, the second elongate element is configured to be inserted into a patient.
[0053] In addition to Example 48, according to another example ("Example 49"), the filter component is deployable from a distal end of the second elongate element when the second elongate element is inserted into a patient.
[0054] According to another example ("Example 50"), a method of treatment includes providing an embolic filter assembly including a filter component coupled to a distal end of a first elongate element; providing a constraining sheath having a first end, a second end and a lumen extending through the constraining sheath; providing a second elongate element having a lumen extending through the second elongate element; inserting a proximal end of the first elongate element into the lumen of the constraining sheath at the first end of the constraining sheath; withdrawing the proximal end of the first elongate element from the second end of the constraining sheath until the proximal end of the first elongate element is withdrawn from the second end of the constraining sheath and the filter component is withdrawn from the constraining sheath. the first elongate element is received within the lumen of the constraining sheath; inserting a first end of the constraining sheath into the lumen of the second elongate element at the proximal end of the second elongate element; and advancing the first elongate element and the filter component distally relative to the constraining sheath and second elongate element until the filter component is received within the lumen of the second elongate element; advancing the second elongate element to a treatment area within a patient; and deploying the filter component from the distal end of the second elongate element.
[0055] In addition to Example 50, according to another example ("Example 51"), the second elongate element is advanced to a treatment area within a patient before a first end of the constraining sheath is inserted into a lumen of the second elongate element at a proximal end of the second elongate element.
[0056] In addition to any of Examples 50-51, according to another example ("Example 52"), the constraining sheath is configured to split, and the method further includes splitting the constraining sheath and removing the constraining sheath from the first elongate element and the second elongate element.
[0057] In addition to any of Examples 45-52, according to another example ("Example 53"), the first elongate element has a first length, and the first elongate element is configured such that the first length can be changed to a second, shorter length after the first elongate element is received within a lumen of the second elongate element.
[0058] In addition to Example 53, according to another example ("Example 54"), the first elongate element is configured such that the first length can be changed to the second, shorter length by cutting the elongate element.
[0059] According to another example ("Example 55") in addition to any of Examples 53-54, the first elongate element includes a plurality of predetermined removable sections such that the elongate element can be altered from the first length to the second, shorter length.
[0060] In addition to any of Examples 45-55, according to another example ("Example 56"), the embolic filter assembly includes a lumen extending therethrough from the filter component to a proximal end of the first elongate element, and the method includes coupling a hub to the proximal end of the first elongate element to fluid-tightly seal the lumen of the embolic filter assembly.
[0061] According to another example ("Example 57"), in addition to any of Examples 45-56, the second elongate element is a commercially available catheter.
[0062] In addition to any of Examples 45-57, according to another example ("Example 58"), the first elongate element is color coded to indicate a diameter of the first elongate element, a first color indicating a first diameter and a second color indicating a second, different diameter.
[0063] According to another example ("Example 59") in addition to any of Examples 45-58, the filter component is coupled to the first elongate element via a flexible coupling such that the filter component and the first elongate element are operable to be angled relative to one another.
[0064] According to another example ("Example 59"), in addition to any of Examples 45-59, the treatment area is within the vasculature of a patient.
[0065] While several examples are disclosed, still other examples will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive. [Brief description of the drawings]
[0066] BRIEF DESCRIPTION OF THE DRAWINGS The accompanying drawings are included to provide a further understanding of the disclosure, and are incorporated in and constitute a part of this specification, illustrating and, together with the description, serving to explain the principles of the disclosure.
[0067] [Figure 1] FIG. 1 is a diagram of an embolic filter system, according to some embodiments.
[0068] [Diagram 2] FIG. 2 is a diagram of a filter of an embolic filter system, according to some embodiments.
[0069] [Diagram 3] FIG. 3 is a diagram of an embolic filter system, according to some embodiments.
[0070] [Figure 4] FIG. 4 is a flow chart of a method of assembling an embolic filter system, according to some embodiments.
[0071] [Figure 5A] FIG. 5A is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 5B] FIG. 5B is an illustration of a method of assembling an embolic filter system, according to some embodiments. [Figure 5C] FIG. 5C is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 5D] FIG. 5D is a diagram of a method of assembling an embolic filter system, according to some embodiments.
[0072] [Figure 5E] FIG. 5E is an illustration of a method of deploying an embolic filter system, according to some embodiments. [Figure 5F] FIG. 5F is an illustration of a method of deploying an embolic filter system, according to some embodiments.
[0073] [Figure 6] FIG. 6 is a flow chart of a method of assembling an embolic filter system, according to some embodiments.
[0074] [Figure 7A] FIG. 7A is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 7B] FIG. 7B is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 7C] FIG. 7C is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 7D] FIG. 7D is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 7E] FIG. 7E is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 7F] FIG. 7F is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 7G] FIG. 7G is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 7H] FIG. 7H is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 7I] FIG. 7I is a diagram of a method of assembling an embolic filter system, according to some embodiments. [Figure 7J] FIG. 7J is an illustration of a method of assembling an embolic filter system, according to some embodiments. [Figure 7K]FIG. 7K is an illustration of a method of assembling an embolic filter system, according to some embodiments. [Figure 7L] FIG. 7L is a diagram of a method of assembling an embolic filter system, according to some embodiments.
[0075] [Figure 8] FIG. 8 is a flowchart of a method of implanting an embolic filter system, according to some embodiments.
[0076] [Figure 9] FIG. 9 is a diagram of an articulation element for use in an embolic filter system, according to some embodiments. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0077] Detailed Description Those skilled in the art will readily appreciate that the various aspects of the present disclosure may be implemented by any number of methods and devices configured to perform the intended functions. It should also be noted that the accompanying drawings referenced herein are not necessarily drawn to scale and may be exaggerated to illustrate the various aspects of the present disclosure, and in that respect, the drawings should not be construed as limiting. In describing various examples, the term distal is used to indicate a position along an exemplary device that is proximal or closest to the treatment area within the patient's body. The term proximal is used to indicate a position along an exemplary device that is proximal or closest to the user or operator of the device.
[0078] Various aspects of the present disclosure are directed to embolic filter devices, systems, and methods. An exemplary embolic filter system 1000 is shown in FIG. 1. The embolic filter system 1000 generally includes a filter 1100 and an elongate element 1200. In various examples, the embolic filter system 1000 is configured to allow the filter 1100 and the elongate element 1200 to freely articulate with respect to one another. As discussed in more detail below, in some examples, the filter 1100 includes one or more features that facilitate such relative articulation between the filter 1100 and the elongate element 1200, and in other examples, the embolic filter system 1000 includes one or more additional components, such as one or more unions, that facilitate such relative articulation between the filter 1100 and the elongate element 1200. Providing embolic filter system 1000 with filter 1100 and elongate element 1200 operable to articulate relative to one another allows embolic filter system 1000 to passively orient itself to achieve proper alignment of filter 1100 relative to the vasculature in which it is partially or fully deployed. Alternatively, embolic filter system 1000 can also be manipulated in situ by an operator to achieve such alignment.
[0079] 1 , embolic filter system 1000 includes a distal end 1002 and a proximal end 1004. In some instances, filter 1100 extends distally from elongate element 1200 such that distal end 1102 of filter 1100 at least partially defines distal end 1002 of embolic filter system 1000. Similarly, in some instances, elongate element 1200 extends proximally from filter 1100 such that proximal end 1202 of elongate element 1200 at least partially defines proximal end 1004 of embolic filter system 1000. In various instances, proximal end 1104 of filter 1100 is coupled to elongate element 1200. In some instances, proximal end 1104 of filter 1100 is coupled to distal end 1204 of elongate element 1200. In some examples, coupling the proximal end 1104 of the filter 1100 to the distal end 1204 of the elongate element 1200 includes coupling the proximal end 1104 of the filter 1100 to the distal end 1204 of the elongate element 1200 such that the distal end 1204 of the elongate element 1200 is located distal to the proximal end 1104 of the filter 1100 (such that, for example, the filter 1100 and the elongate element 1200 partially overlap each other).
[0080] In various examples, the embolic filter system 1000 can be used in combination with one or more auxiliary systems. For example, as shown in FIG. 1, one or more auxiliary systems 2000 including one or more auxiliary components can be utilized in combination with the embolic filter system 1000. In some examples, the auxiliary system 2000 and / or its components can be commercial off-the-shelf (COTS) systems and / or components. One non-limiting auxiliary system 2000 includes a COTS catheter. Other non-limiting auxiliary systems 2000 include a restraining sheath including a peel-away sheath, valves and connectors, such as those used to control fluid backflow through one or more of the embolic filter system 1000 and the auxiliary system 2000 (e.g., a Tuohy-Borst connector), and a control handle. The auxiliary system 2000 can be used in connection with one or more of the delivery, deployment, manipulation, and / or removal of the embolic filter system 1000. It should be appreciated that in various examples, the embolic filter system 1000 can itself include one or more of such peel-away sheaths, connectors, and / or valves, such as hemostatic valves.
[0081] Embolic filter system 1000 is generally configured to be advanced to a target site within a patient's vasculature such that one or more components of embolic filter system 1000 (e.g., filter 1100) are antegrade, i.e., "downstream" of the treatment region of the vasculature between the treatment region and one or more anatomical regions, where the presence of embolic debris may lead to complications and damage to anatomical structures. One skilled in the art will appreciate that by positioning the system downstream of the treatment region, emboli and other debris dislodged from the treatment region during the treatment procedure may migrate with the blood flow toward embolic filter system 1000, where the embolic debris may be filtered from the blood.
[0082] Proper orientation of filter 1100 of embolic filter system 1000 within a vessel or region of the vasculature is an important factor in facilitating proper deployment and successful filtration of embolic debris from blood in connection with an intravascular procedure. However, it can be difficult to deploy an embolic filter in a manner that is operable to successfully filter embolic debris from blood in certain portions of the vasculature and / or under certain conditions. The embolic filter system 1000 disclosed herein passively aligns along a surface of the vasculature, such as a vessel wall, causing relative articulation between filter 1100 and elongate element 1200, thus achieving proper alignment of filter 1100 within the vasculature. Alignment within the vasculature generally results in minimization of gaps between filter 1100 and the vessel wall that can serve as a pathway through which embolic debris can bypass embolic filter system 1000. However, in some embodiments, embolic filter system 1000 also provides the ability for an operator to deploy embolic filter system 1000 and then manipulate embolic filter system 1000 to properly align filter 1100 with the vasculature.
[0083] In various examples, articulation is accomplished by advancement and retraction of one or more of elongate elements 1200 while filter 1100 is fully deployed. For example, advancement and / or retraction of elongate elements 1200 while filter 1100 is deployed within the vasculature may operate to impart a compressive or tensile load to one or more of filter 1100 and elongate elements 1200. As noted above, in various examples, filter 1100 can include one or more features that facilitate relative articulation between filter 1100 and elongate elements 1200, while in other examples, embolic filter system 1000 includes one or more additional components, such as one or more unions, that facilitate relative articulation between filter 1100 and elongate elements 1200. In various examples, upon application of compressive and / or tensile loads, the embolic filter system 1000 causes one or more features of the filter 1100 and / or one or more additional components to bend, deflect, or otherwise deform, achieving relative articulation between the filter 1100 and the elongate element 1200.
[0084] Once deployed, embolic filter system 1000 interacts with blood flowing through the region of the vasculature in which it is deployed. In some instances, embolic filter system 1000 can be adapted or otherwise configured to filter blood and / or embolic debris as it flows through or otherwise interacts with embolic filter system 1000. In some instances, embolic filter system 1000 additionally or alternatively redirects blood flow and / or embolic debris from what would be a normal or unimpeded flow of blood and / or embolic debris through the surrounding vasculature. Thus, in various instances, embolic filter system 1000 can be deployed within a region of a patient's vasculature to filter and / or redirect blood and / or embolic debris as it flows through that region.
[0085] 1 and 2, filter 1100 of embolic filter system 1000 includes a body 1106 having distal and proximal ends 1002 and 1004. Filter 1100 generally includes structural elements 1108, an attachment section 1114, and an articulation section 1118. In some instances, articulation section 1118 is intermediate distal and proximal ends 1102 and 1104, and thus may be referred to as a mid-section. FIG. 2 is a two-dimensional plan view of filter 1100 showing the entire circumference of filter 1100, released and laid flat to show the relationship between structural elements 1108, attachment section 1114, and articulation section 1118.
[0086] In various examples, the filter 1100 is a structure configured to interact with blood and / or embolic debris flowing through a patient's vasculature in the area in which the embolic filter system 1000 is deployed. As discussed in more detail below, the filter 1100, or one or more portions thereof, can be formed from cut tubing, wire frames, moldings or extrusions, or combinations thereof. In some examples, one or more portions of the filter 1100 can be formed from a shape memory material, such as Nitinol, such that the one or more portions thereof have or exhibit self-expanding properties, as will be understood by those skilled in the art. However, in other examples, one or more components of the filter 1100 can be formed from other resilient metals that can be made expandable by using an expansion aid (such as a balloon). For example, one or more support elements can be formed from a polymer or a biocompatible metal alloy, such as stainless steel. In some examples, the filter 1100, or one or more portions thereof, can be constructed from a durable elastomeric material, such as polyurethane or high density nylon.
[0087] 1 and 2, filter 1100 includes structural element 1108. Structural element 1108 (also referred to herein as a capture section) is configured to direct or concentrate blood and embolic debris toward an interior region of filter 1100 and, in some examples, elongate element 1200. Thus, structural element 1108 acts as an obstacle to the flow of blood, which interacts with embolic filter system 1000 before flowing downstream of embolic filter system 1000. In various examples, structural element 1108 is configured to transition between a contracted configuration (e.g., FIG. 2) and an expanded configuration (e.g., FIG. 1) in combination with embolic filter system 1000 transitioning from a delivery configuration to a deployed configuration, such that embolic filter system 1000 can be delivered into a blood vessel (e.g., with a small delivery profile) while having the ability to be deployed in situ to a larger deployed profile that serves to block blood flow and filter embolic debris therefrom.
[0088] In the deployed configuration, the filter 1100 generally adopts a trumpet, cone, or frusto-conical shape in that the cross-sectional area of the filter 1100 is different at two different longitudinal locations along the filter 1100 between the distal and proximal ends 1102 and 1104 of the filter 1100. In some instances, the cross-sectional area of the distal end 1102 is greater than the cross-sectional area of the proximal end 1104. In some instances, the filter 1100 generally tapers from the distal end 1102 to the proximal end 1104, for example, as shown in FIGS. 1 and 3. Such a configuration would cause the filter 1100 to operate to funnel blood into the filter 1100 and / or the elongate element 1200, as disclosed herein.
[0089] In various examples, the structural element 1108 includes one or more support elements, such as one or more braids, meshes, lattices, wires, rings, struts, or any other suitable support elements. For example, as shown in Figures 1 and 2, the structural element 1108 includes a plurality of strut elements 1110 collectively arranged to define one or more closed cells 1112 that collectively at least partially define the structural element 1108. As shown, these closed cells 1112 are arranged in one or more rows (e.g., 1, 2, 3, 4, or more than 4 rows). However, it should be understood that braids, meshes, lattices, wires, rings, and other suitable support elements can be utilized in place of or in combination with the strut elements 1110, so long as the structural element 1108 of the filter 1100 is operable to transition between the contracted and expanded configurations.
[0090] In some examples, the closed cells 1112 are configured to change shape to accommodate or facilitate the transition of the structural elements 1108 between expanded and contracted configurations. When the structural elements 1108 are in the expanded configuration, for example, the closed cells can be diamond shaped, as shown in FIG. 1. However, it is understood that the shapes of the closed cells depicted herein should not be construed as limiting, and various alternative shapes (e.g., polygonal) and / or sizes are contemplated.
[0091] It should also be understood that the number of rows of closed cells and / or the number of closed cells per row may be increased or decreased to achieve a desired expansion profile (e.g., deployment diameter) and a desired contraction profile (e.g., delivery diameter), and thus the examples shown herein should not be construed as limiting. In general, for a given closed cell size and shape, increasing the number of closed cells 1112 increases the expansion and contraction profile diameters, and decreasing the number of closed cells 1112 decreases the expansion and contraction profile diameters. Similarly, for a given closed cell size and shape and number of closed cells 1112 per row, increasing the number of rows of closed cells 1112 increases the length of the filter 1100, and decreasing the number of rows of closed cells 1112 decreases the length of the filter 1100.
[0092] In various examples, in addition to the structural element 1108, the filter 1100 includes one or more portions configured to facilitate coupling of the filter 1100 to the elongate element 1200. For example, as shown in FIGS. 1 and 2, the filter 1100 includes an attachment section 1114 configured to interface with the elongate element 1200 to facilitate coupling between the filter 1100 and the elongate element 1200. The attachment section 1114 can include one or more features configured to help secure the elongate element 1200 to the attachment section 1114. For example, as shown in FIG. 2, the attachment section 1114 includes a plurality of apertures 1116. The apertures 1116 provide relief in which material of the elongate element 1200 can reside to facilitate mechanical interference between the filter 1100 and the elongate element 1200. For example, the elongate element 1200 can be coupled to the filter 1100 via melt bonding or other known methods. For example, the elongate element 1200 may be coupled to the filter 1100 using an adhesive such as an ultraviolet (UV) curable adhesive (e.g., a UV curable acrylate), an epoxy, a fluoroelastomer (e.g., FEP), a fluoropolymer adhesive tape, or other means as desired.
[0093] It is understood that while the mounting section 1114 of the filter 1100 is shown including an aperture 1116, the mounting section 1114 may additionally or alternatively include one or more other features configured to aid in coupling the elongate element 1200 with the filter 1100, such as one or more protrusions (e.g., one or more boss features) extending circumferentially or around the interior or exterior of the mounting section 1114 of the filter 1100 and / or extending longitudinally along the interior or exterior of the mounting section 1114. In some such instances, such features may be welded or otherwise attached to the filter in accordance with known methods.
[0094] In various embodiments, located between the structural element 1108 and the attachment section 1114 is an articulation section 1118 adapted to allow the structural element 1108 (e.g., capture section) and the attachment section 1114 of the filter 1100 to articulate relative to one another. Such relative articulation results in the structural element 1108 being operable to articulate relative to the elongate element 1200 (and vice versa). The embolic filter system 1000 shown in FIGS. 1 and 2 includes a filter 1100 having an articulation section 1118 integrated therein (e.g., located between the distal and proximal ends 1102 and 1104 of the filter 1100), although it should be understood that, as discussed in more detail below, an articulation section may additionally or alternatively be disposed between the filter and the elongate element. That is, the articulation section may be included in the embolic filter system as a separate component coupled with each of the filter and the elongate element.
[0095] In various examples, the articulation section 1118 includes a distal section 1120 and a proximal section 1122 and has a length. In some examples, the distal section 1120 defines a location along the filter 1100 where the articulation section 1118 transitions to the structural element 1108. Similarly, in some examples, the proximal section 1122 defines a location along the filter 1100 where the articulation section 1118 transitions to the attachment section 1114.
[0096] In various embodiments, the articulation section 1118 generally comprises a coil (e.g., a helix) or a slotted segment of the filter 1100. In examples involving cut tubes, it is understood that the cuts in the tube forming the coil / helix or slotted segment extend the entire thickness of the tube (e.g., from the outer surface of the tube to the inner surface of the tube) such that the lumen of the tube is exposed. In such examples, cutting through the entire thickness of the tube creates one or more compressible / expandable gaps, as discussed further below. The tubes can be formed from resilient materials, including, but not limited to, metal alloys (e.g., Nitinol), polymers, and elastomeric materials, or combinations thereof. For example, the articulation section 1118 can include nylon reinforced with coils of reinforcing material.
[0097] In various examples, particular aspects or features of the articulation section 1118 (e.g., the pitch of the helix or the size of the slots and the distance therebetween) are selected to provide that the structural element 1108 and one or more of the attachment section 1114 and the elongate element 1200 can articulate with respect to one another a specified amount. For example, particular aspects or features of the articulation section 1118 (e.g., pitch "p") can be configured to allow the structural element 1108 and one or more of the attachment section 1114 and the elongate element 1200 to articulate such that the relative angle defined between their longitudinal axes (i.e., articulation angle) is at most 30 degrees, at most 45 degrees, at most 60 degrees, at most 90 degrees, at most 180 degrees, at most 270 degrees, or greater than 270 degrees, e.g., at most 360 degrees. These relative angles are intended to be illustrative and not limiting. For example, the articulation section 1118 may be configured to adopt an articulation angle between a maximum of 90 degrees and 180 degrees, or between a maximum of 180 degrees and 270 degrees. Additionally or alternatively, in some instances, the length of the articulation section 1118 may be altered to increase, decrease, or otherwise change the number, shape, and configuration of certain aspects or features that facilitate articulation (e.g., number of coils, helical pitch, slot width), thereby altering the degree of passive articulation. For example, an articulation section having a first amount of helical coils arranged at a first pitch may provide a first degree of articulation, while an articulation section having a second amount of helical coils arranged at the first pitch facilitates a second, greater degree of articulation. In various embodiments, the pitch value may range, for example, from 0 degrees to 90 degrees, although various angles are contemplated.
[0098] In various examples, a coil / helix or slot pattern may be cut into the tube to form the articulation section 1118. Alternatively, the coil / helix or slot pattern may be machined or molded as discussed herein. By adapting the articulation section 1118 to bend, deflect or otherwise deform, the articulation section 1118 can be transitioned between a substantially linear state and a substantially curved state. In various examples, the substantially linear state is the steady state configuration of the articulation section 1118, where the articulation section 1118 is not influenced to curve as a result of any external forces acting on the system.
[0099] By configuring the articulation section 1118 with one or more coil / spiral or slot cut patterns, there will be one or more gaps or spaces between adjacent spiral windings or adjacent slots. For example, as shown in FIG. 2, the gap 1124 between a first spiral winding 1126 and a second spiral winding 1128 (e.g., adjacent spiral windings) allows the articulation section 1118 to assume a curvature such that the gap 1124 in a first region of the spiral winding (e.g., at a first angular position) is reduced, maintained, or increased in conjunction with the gap 1124 in a second region of the spiral winding (e.g., at a second angular position offset 180 degrees from the first angular position). One skilled in the art should also understand that the reduction and / or increase in gap space is due, at least in part, to deformation (e.g., bending) of one or more spiral windings (e.g., 1126 and 1128). In some examples, the articular section 1118 including the coil / spiral or slotted pattern can be covered under at least one layer of a flexible polymer such as a fluoropolymer material (e.g., expanded polytetrafluoroethylene ("ePTFE"), expanded modified PTFE or expanded copolymers of PTFE), nylon, polycarbonate, polyethylene, polypropylene, any combination of the above, or other material.
[0100] In various examples, the articulation section 1118 can be configured to elastically deform under normal operating conditions (e.g., the articulation section 1118 is configured to elastically deform to accommodate the maximum articulation motion expected during a given endovascular procedure). By configuring the articulation section 1118 to elastically deform under expected operating conditions (e.g., the expected degree of angulation), the embolic filter system can elastically articulate relative to the elongate element 1200 such that the articulation section 1118 elastically returns to a linear state upon removal of the force required to cause the articulation. With such a configuration, the embolic filter system 1000 will be in a linear alignment for folding and removal following an endovascular procedure.
[0101] In other examples, the articulation section 1118 can be configured to at least partially plastically deform under normal operating conditions (e.g., the articulation section 1118 is configured to at least partially deform to accommodate expected articulation during a given endovascular procedure). By configuring the articulation section 1118 to plastically deform under expected operating conditions (e.g., expected degree of angulation), the embolic filter system allows the filter 1100 to non-elastically articulate with respect to the elongate element 1200 such that the required degree of angulation can be established such that the operator does not need to continue to apply a force to the elongate element 1200 to maintain the desired relative articulation. Thus, a force can be applied to the elongate element 1200 to create the desired degree of relative angulation between the filter 1100 and the elongate element 1200 such that the relative angulation is maintained at least as a result of the plastic deformation of the articulation section 1118 of the filter 1100. In some such instances, retraction of the embolic filter system 1000 into the restraining catheter after an intravascular procedure straightens the articulation section 1118, thereby realigning the structural element 1108 with the elongate element 1200 for removal, such as through a catheter.
[0102] As described above, filter 1100 can include one or more shape memory alloys and thus can include one or more expandable sections. Thus, in various embodiments, filter 1100 is configured to transition between a delivery configuration and a deployed configuration, where one portion of filter 1100 is expanded relative to another portion of filter 1100. For example, in the delivery configuration, each of the various sections of filter 1100 (e.g., structural element 1108, articulation section 1118, and attachment section 1114) exhibits a profile (e.g., diameter) adapted for delivery through a patient's vasculature, such as through or within a delivery catheter, as described further below. Conversely, in the deployed configuration, one or more of the various sections of filter 1100 are expanded relative to one or more of the other various sections of filter 1100. 1, embolic filter system 1000 is shown in a deployed configuration in which structural elements 1108 are expanded relative to each of articulation section 1118, attachment portion 1114, and elongate element 1200. In some instances, filter 1100 is configured such that structural elements 1108 are self-expandable. However, in other instances, filter 1100 is configured such that structural elements 1108 are expandable through the use of an expansion aid (e.g., a balloon).
[0103] In various examples, the elongate element 1200 is a longitudinally extending structure having a proximal end 1202 and a distal end 1204. In some examples, the elongate element 1200 is configured to receive blood and / or embolic debris that is directed into the embolic filter system 1000 by the filter 1100. Thus, in some examples, the elongate element 1200 includes a lumen. In various examples, the elongate element 1200 is configured to be advanceable through the vasculature. Thus, the elongate element 1200 is generally flexible, yet longitudinally stable, and compressible without risk of kinking or buckling under loading conditions consistent with advancement through the vasculature, including advancement through one or more delivery catheters. In some examples, the elongate member 1200 can include braided, wrapped, or cut reinforcing members attached to a body portion of the elongate member 1200 as a framework for adding stability to the structure of the elongate member 1200. The reinforcing member may be braided by weaving multiple wire strands made of suitable materials. Regardless, the reinforcing member (e.g., the wires or filaments forming the reinforcing member) may be made from metals and metal alloys (e.g., Nitinol), polymeric materials, elastomeric materials, natural materials, or any combination of the above. The reinforcing member may be symmetrically braided (e.g., with opposing bias in an over / under configuration to form a typical braid) or have an asymmetric bias, with each strand of the braided wire oriented at a pitch angle ranging from 0° to 10°, 10° to 20°, 20° to 30°, 30° to 40°, 40° to 50°, 50° to 60°, 60° to 70°, 70° to 80°, 80° to 90°, or any combination thereof, relative to the longitudinal axis of the braided wire.
[0104] Thus, the elongate element 1200 can comprise a variety of materials, including, but not limited to, medical grade polymeric materials, including thermoplastic polymers, organosilicon polymers, and polyamides. Polyether block amides (e.g., PEBAX®), nylon, polytetrafluoroethylene (PTFE), and stainless steel are suitable non-limiting examples. The elongate element 1200 can be formed according to known methods, such as by extrusion. In some examples, the elongate element 1200 can include one or more reinforcing elements, such as one or more fibers or braids, extending along or within the material of the elongate element 1200. For example, in some examples, the elongate element 1200 can include coil reinforced nylon or PEBAX.
[0105] In some examples, the elongate element 1200 can be formed using a high durometer material, where the hardness of the elongate element 1200 can be between 50 and 60 Shore hardness units, between 60 and 70 Shore hardness units, between 70 and 80 Shore hardness units, between 80 and 90 Shore hardness units, or any combination thereof. Such materials include thermoplastics, such as, but not limited to, polymethyl methacrylate (PMMA or acrylic), polystyrene (PS), acrylonitrile butadiene styrene (ABS), polyvinyl chloride (PVC), modified polyethylene terephthalate glycol (PETG), cellulose acetate butyrate (CAB); semi-crystalline general purpose plastics including polyethylene (PE), high density polyethylene (HDPE), low density polyethylene (LDPE or LLDPE), polypropylene (PP), polymethylpentene (PMP), polycarbonate (PC), polyphenylene oxide (PPO), modified polyphenylene oxide (Mod PPO), polyphenylene ether (PPE), modified polyphenylene ether ... PPE), thermoplastic polyurethane (TPU); polyamides such as nylon-11 and nylon-12, polyoxymethylene (POM or acetal), polyethylene terephthalate (PET, thermoplastic polyester), polybutylene terephthalate (PBT, thermoplastic polyester), polyimide (PI, imidized plastic), polyamideimide (PAI, imidized plastic), polybenzimidazole (PBI, imidized plastic); polysulfone (PSU), polyetherimide (PEI), polyethersulfone (PES), polyarylsulfone (PAS); polyphenylene sulfide (PPS), polyetheretherketone (PEEK); fluoropolymers including fluorinated ethylene propylene (FEP), ethylene chlorotrifluoroethylene (ECTFE), ethylene, ethylene tetrafluoroethylene (ETFE), polychlorotrifluoroethylene (PCTFE), polyvinylidene fluoride (PVDF), perfluoroalkoxy (PFA) or combinations, copolymers or derivatives thereof.Other commonly known medical grade materials include elastomeric organosilicon polymers and polyether block amides. In particular, polyamides can include nylon 12, nylon 11, nylon 9, nylon 6 / 9, and nylon 6 / 6. In certain embodiments, PET, nylon, and PE can be selected for medical balloons used in high pressure applications. In some embodiments, the elongate element 1200 can include a braided reinforcement structure to improve burst pressure resistance. In some embodiments, the elongate element 1200 can include one or more layers of hydrophilic coating or other types of low friction coatings and / or liners to reduce frictional forces on its surface. The specific choice of material depends on the desired properties or intended use of the balloon.
[0106] The reinforcing members described above can be combined with a high durometer material to form the elongate element 1200 such that the body portion of the elongate element 1200 is reinforced while the end of the elongate element 1200 is inserted into the proximal end 1104 of the filter 1100. In some instances, the high durometer material helps to facilitate bonding of the end of the elongate element 1200 to the proximal end 1104 (e.g., by promoting greater flow and mechanical engagement during heating and / or by increasing friction / stiction engagement). In some instances, bonding can be assisted using an adhesive, such as a UV cured adhesive, as previously described.
[0107] In some examples, blood and / or embolic debris entering the elongate element 1200 flows through a lumen of the elongate element 1200, such as from a distal end 1204 of the elongate element 1200 to a proximal end 1202 of the elongate element 1200. In some examples, one or more auxiliary systems 2000 may be fluidly coupled to a lumen of the elongate element 1200, such as at the proximal end 1202 of the elongate element 1200. In some such examples, such auxiliary systems 2000 may be operable to aspirate contents (e.g., embolic debris and / or blood) of the lumen of the elongate element 1200.
[0108] In some instances, the lumen of elongate element 1200 forms a working lumen through which one or more medical devices (e.g., guidewires, endoprostheses) can be passed to a treatment area proximate embolic filter system 1000. Thus, in various instances, the lumen of elongate element 1200 functions both as a working lumen for medical device delivery and as a structure for redirecting flow embolic debris and / or blood. In some instances, the working lumen of elongate element 1200 can range from 4 Fr to 26 Fr or greater.
[0109] Examples of medical devices that may pass through the lumen of the elongate element 1200 include, but are not limited to, catheters, thrombectomy devices, atherectomy devices, embolectomy devices and related tools, contrast agents, drug delivery agents, and endovascular prostheses, including, for example, stents, stent grafts, valves, and the like.
[0110] In various embodiments, embolic filter system 1000 includes a membrane disposed along one or more portions of filter 1100 and optionally along one or more portions of elongate element 1200. For example, as shown in FIGURE 3, membrane 1300 is disposed about the exterior of structural element 1108 and articulation section 1118 of filter 1100. In these examples, by disposing membrane 1300 along articulation section 1118 and structural element 1108, membrane 1300 operates to filter and retain embolic debris within embolic filter system 1000 that would otherwise be free to escape through voids in structural element 1108 (e.g., closed cells 1112) and articulation section 1118 (e.g., gap 1124). Thus, a configuration with membrane 1300 in combination with an articulation section (e.g., articulation section 1118) that exposes an internal lumen is a configuration that is operable to filter embolic debris from blood while maintaining the ability to freely articulate elongate element 1200 relative to filter 1100 (and vice versa). In some instances, the portion of membrane 1300 extending along articulation section 1118 is blood impermeable.
[0111] Under certain conditions, the force required to withdraw embolic filter system 1000 from the vasculature can be very high (e.g., higher than the force required to bend articulation section 1118 to facilitate articulation between filter 1100 and elongate element 1200). For example, removal of embolic filter system 1000 can include withdrawing embolic filter system 1000 within a delivery catheter, which involves refolding the deployed filter 1100, whereby the distal end of the delivery catheter serves as a support surface that causes filter 1100 to fold radially as embolic filter system 1000 is withdrawn into the lumen of the delivery catheter. In this manner, disposing membrane 1300 around articulation section 1118 operates to increase the tensile strength of articulation section 1118; that is, the tensile strength of the combined membrane 1300 and filter 1100 spiral / slot material exceeds the tensile strength of the filter 1100 spiral / slot material. And while increasing the tensile strength of the articulation section 1118 has the secondary effect of altering the flexibility of the articulation section 1118 (e.g., the degree to which the articulation section 1118 can bend or articulate), it can do so while maintaining a sufficient degree of flexibility in the articulation section 1118 to facilitate the desired degree of articulation between the filter 1100 and the elongate element 1200.
[0112] It should be understood that the membrane 1300 may additionally or alternatively be disposed within the structural element 1108 and around the articulation section 1118. In some instances, the membrane 1300 may optionally extend to cover portions of the overlapping sections of the elongate element 1200 and attachment section 1114 of the filter 1100.
[0113] In some instances, membrane 1300 operates to filter or otherwise condition blood and embolic debris entering embolic filter system 1000. In some instances, membrane 1300 is permeable (e.g., blood-permeable) to certain blood media and impermeable to certain other blood media and / or embolic debris. Specifically, in some instances, membrane 1300 is configured such that certain blood media (e.g., red blood cells, white blood cells, plasma, platelets, etc.) entering embolic filter system 1000 can permeate membrane 1300 of filter 1100 and re-enter the vasculature, while membrane 1300 is impermeable to certain other blood media and embolic debris. In some instances, membrane 1300 is impermeable to embolic debris of a specified size or greater. That is, in some instances, membrane 1300 operates to prevent embolic debris above a specified size from penetrating membrane 1300 of filter 1100 and re-entering the vasculature.
[0114] In some instances, blood media and embolic debris entering embolic filter system 1000 that does not permeate back into the vasculature is captured and retained within filter 1100 or further directed to elongate element 1200. In some instances, as described in more detail below, filter 1100 is collapsible such that blood media and embolic debris captured within filter 1100 can be subsequently removed by removing embolic filter system 1000 from the vasculature.
[0115] In some instances, blood and / or embolic debris directed to the elongate element 1200 may be aspirated therefrom prior to removal of the embolic filter system 1000 from the vasculature. Evacuation of embolic debris trapped within the filter 1100 helps minimize the risk of unintentionally releasing trapped embolic debris into the patient's vasculature when removing the embolic filter system 1000 from the patient's vasculature. For example, a known risk during embolic debris filtration procedures is the risk of peeling off the membrane 1300 of the filter 1100 during removal. An embolic filter filled with embolic debris generally occupies a larger cross-sectional area than an embolic filter without embolic debris. This increased cross-sectional area may be associated with difficulty in sufficiently collapsing the embolic filter into a configuration that allows the embolic filter to be fully retracted into the delivery catheter. Even if the filter is not retracted into the delivery catheter, a filter having a larger diameter as a result of being filled with embolic debris may be difficult to pull through a tortuous vasculature.
[0116] The membrane 1300 can comprise a variety of materials, including, but not limited to, polymers such as expanded polytetrafluoroethylene ("ePTFE"), expanded modified PTFE, expanded copolymers of PTFE, fluoropolymers such as FEP, PFA, nylon, polyurethane, polycarbonate, polyethylene, polyester, silicone and silicone elastomers (e.g., SYLGARD™ 184), urethane, thermoplastic polyurethane, polypropylene, and the like.
[0117] In various examples, one or more regions of such materials may be further or alternatively modified by forming one or more perforations therein to control the permeability of the material. For example, a material such as an expanded fluoropolymer (or another suitable polymer) may be further modified by perforating one or more regions of the material to achieve a specified porosity. Examples include laser cutting or laser drilling holes or perforations into the material. Other materials having woven, knitted or lattice configurations may also serve as suitable materials based on their permeability / porosity. Furthermore, the desired permeability may be achieved by increasing or decreasing layers of the membrane material, as will be understood by those skilled in the art. Additionally or alternatively, the permeability of the membrane 1300 may be optimized by manipulating the microstructure of the membrane material. In some such examples, the node and fibril configuration of the expanded fluoropolymer may be modified / optimized to achieve the desired permeability. For example, an expanded fluoropolymer may be engineered such that the node and fibril configuration of the expanded fluoropolymer is generally impermeable to embolic debris (and other blood media) of a specified size consistent with the discussion below.
[0118] In some instances, the membrane material can be configured such that one or more portions or regions are permeable to media below a specified size, while one or more other portions or regions are impermeable to media above a specified size. In some instances, the size of the pores or perforations (or voids in the node and fibril microstructure) present in the membrane material can vary, for example, from the proximal end to the distal end and / or at one or more discrete locations.
[0119] In various examples, membrane 1300 can be configured such that membrane 1300 is impermeable to embolic debris of about 140 μm or greater. In some such examples, the average pore size (or perforation size of membrane 1300 or void size in the node and fibril microstructure) can be less than 140 μm. In other examples, membrane 1300 can be configured such that membrane is impermeable to embolic debris smaller than 140 μm, such as embolic debris in the range of 40 μm to 99 μm. Such examples are not intended to be limiting. For example, if desired, membrane 1300 can be configured to be permeable to embolic debris of 100 μm, 120 μm, 140 μm, 160 μm, 180 μm, 200 μm (or greater) and any value therebetween, where the average pore size (or perforation size of membrane 1300 or void size in the node and fibril microstructure) may be greater than 150 μm.
[0120] In various embodiments, the embolic filter system 1000 is advanced to a treatment area within the vasculature in a delivery configuration, after which the embolic filter system 1000 is operable to be deployed or otherwise transitioned to a deployed configuration. In the delivery configuration, the embolic filter system 1000 is in a generally contracted configuration. In some instances, in the delivery configuration, the structural element 1108 is radially contracted such that the structural element 1108 is operable to be delivered into a blood vessel, such as through a delivery catheter (e.g., with a small delivery profile), as discussed further below. In some instances, one or more of the articulation section 1118, the attachment section 1114, and one or more regions of the elongate element 1200 may, but need not, be radially contracted further. In the deployed configuration, the structural element 1108 is transitioned to a radially expanded configuration (e.g., FIG. 1 ) operable to occlude blood flow and filter embolic debris therefrom. In some instances, one or more of the articulation section 1118, the attachment section 1114, and one or more regions of the elongate element 1200 may, but need not, be radially expanded further in the delivery configuration.
[0121] After completion of the endovascular procedure, embolic filter system 1000 is operable to be removed from the vasculature. In some instances, embolic debris captured by embolic filter system 1000 may be aspirated or otherwise removed from embolic filter system 1000 prior to removing embolic filter system 1000 from the vasculature, as described herein. In some instances, to remove embolic filter system 1000, embolic filter system 1000 is transitioned from a deployed configuration to a delivery configuration. In some instances, such transition from the deployed configuration to the delivery configuration includes contraction of one or more portions of embolic filter system 1000 (e.g., filter 1100 and one or more portions of elongate element 1200). For example, in various instances, removal of embolic filter system 1000 includes radially contracting or compressing structural elements 1108 of filter 1100 to a profile (e.g., diameter) conducive to endovascular removal. It should be understood that the diameter of structural element 1108 is smaller when embolic filter system 1000 is in the delivery configuration than when embolic filter system 1000 is in the deployed configuration.
[0122] Embolic filter system 1000 is operable to be delivered to a treatment area within the vasculature in association with a variety of different delivery methods. Accordingly, embolic filter system 1000 is also operable to be assembled in a variety of different ways. The following discussion details various assembly and delivery methods associated with embolic filter system 1000.
[0123] Turning now to FIG. 4, a flow chart is shown outlining one example method of medical device assembly including embolic filter system 1000. As shown, step 4000 includes providing embolic filter system 1000. As noted above, the embolic filter assembly generally includes filter 1100 coupled with elongate element 1200, where membrane 1300 extends along one or more portions of filter 1100 and optionally along one or more portions of elongate element 1200. Step 4002 includes providing a delivery catheter. In various examples, the delivery catheter can be a COTS delivery catheter, consistent with the discussion above. Thus, in various examples, the delivery catheter includes an elongate element having a distal end and a proximal end, and a lumen extending therethrough from the proximal end to the distal end. COTS delivery catheter 5000 is shown in FIG 5A along with embolic filter system 1000, which includes filter 1100, elongate element 1200, and membrane 1300. COTS delivery catheter 5000 can optionally include one or more connectors, such as connector 5100, which can include hemostasis valves or other elements. It is understood that embolic filter system 1000 is shown in FIG 5 coiled in a packaged configuration. Thus, it is understood that embolic filter system 1000 is uncoiled prior to use.
[0124] 4, in step 4004, the proximal end of embolic filter system 1000 is inserted into the lumen of the delivery catheter and advanced proximally through the lumen of the delivery catheter until the proximal end of embolic filter system 1000 extends proximally relative to the proximal end of the delivery catheter. For example, as shown in FIG. 5B, the proximal end 1004 of embolic filter system 1000 is inserted into the lumen of delivery catheter 5000 at the distal end 5002 of delivery catheter 5000 and advanced proximally through the lumen of delivery catheter 5000 until the proximal end 1004 of embolic filter system 1000 extends proximally relative to the proximal end 5004 of delivery catheter 5000.
[0125] Returning now to Figure 4, at step 4006, embolic filter system 1000 is retracted proximally until filter 1100 is received within the lumen of delivery catheter 5000. Figures 5C and 5D illustrate the proximal retraction of embolic filter system 1000 relative to delivery catheter 5000, where embolic filter system 1000 is retracted such that filter 1100 is partially received within the lumen of delivery catheter 5000 in Figure 5C, and where embolic filter system 1000 is retracted such that filter 1100 is fully received within the lumen of delivery catheter 5000 in Figure 5D.
[0126] 5D , with filter 1100 fully received within the lumen of delivery catheter 5000, delivery catheter 5000 can be inserted into the patient's vasculature and advanced to a treatment site therein, after which embolic filter system 1000 can be advanced relative to delivery catheter 5000 (e.g., by one or more of advancing embolic filter system 1000 distally relative to delivery catheter 5000 and retracting delivery catheter 5000 proximally relative to embolic filter system 1000) such that filter 1100 extends distally from distal end 5002 of delivery catheter 5000. In some instances, as described above, one or more portions of filter 1100, such as structural element 1108, are configured to radially expand to block blood flow and filter embolic debris therefrom. For example, shown in Figures 5E and 5F is embolic filter system 1000 having been advanced distally relative to delivery catheter 5000 such that filter 1100 extends from the distal end 5002 of delivery catheter 5000. Figure 5E shows a portion of filter 1100 extending from the distal end 5002 of delivery catheter 5000 and partially deployed (e.g., radially expanded), while Figure 5F shows filter 1100 extending from the distal end 5002 of delivery catheter 5000 fully deployed (radially expanded). It will be understood that Figures 5E and 5F are shown with embolic filter system 1000 and delivery catheter 5000 outside the body for clarity.
[0127] Turning now to FIG. 6, a flow chart outlining another exemplary method for medical device assembly including embolic filter system 1000 is shown. As shown, step 6000 includes providing embolic filter system 1000, as similarly discussed above with respect to step 4000 of FIG. 4. Step 6002 includes providing a delivery catheter, as similarly discussed above with respect to step 4002 of FIG. 4. Step 6004 includes providing a constraining sheath, such as a COTS constraining sheath or a constraining sheath specifically designed for use in combination with embolic filter system 1000. The constraining sheath can optionally be a splittable or otherwise configured to be peeled away from embolic filter system 1000 and the delivery system. FIG. 7A provides a view of delivery catheter 5000 with connector 5100 along with embolic filter system 1000 and constraining sheath 7000.
[0128] 6 , in step 4006, the proximal end of embolic filter system 1000 is inserted into the lumen of the constraining sheath and advanced proximally through the lumen of constraining sheath 7000 until the proximal end of embolic filter system 1000 extends proximally relative to the proximal end of the constraining sheath. For example, as shown in FIG. 7B , the proximal end 1004 of embolic filter system 1000 is inserted into the lumen of constraining sheath 7000 at the distal end 7002 of the constraining sheath 7000 and advanced proximally through the lumen of constraining sheath 7000 until the proximal end 1004 of embolic filter system 1000 extends proximally relative to the proximal end 7004 of the constraining sheath 7000.
[0129] Returning now to Figure 6, in step 6008, embolic filter system 1000 is retracted proximally until filter 1100 is received within the lumen of constraining sheath 7000. Figures 7C-7F illustrate proximal retraction of embolic filter system 1000 relative to constraining sheath 7000, where embolic filter system 1000 is retracted such that filter 1100 is partially received within the lumen of constraining sheath 7000 in Figures 7C-7E, and where embolic filter system 1000 is retracted such that filter 1100 is fully received within the lumen of the constraining sheath in Figure 7F. In various examples, as described further below, retraction of embolic filter system 1000 relative to constraining sheath 7000 can optionally be performed using a delivery catheter 5000 inserted within the vasculature. In some instances, retraction of the embolic filter system 1000 relative to the constraining sheath 7000 can also optionally be performed using a guidewire extending through one or more of the delivery catheter 5000, the embolic filter system 1000, and the constraining sheath 7000, as shown in Figures 7C-7F.
[0130] Further, in some examples, the elongate element 1200 can have one or more visible markers on the proximal end (e.g., the end of the elongate element 1200 being handled by the operator in FIG. 7D ) and one or more visible markers on the distal end (e.g., proximal to the filter 1100) so that the operator can know how far the filter 1100 coupled to the distal end of the elongate element 1200 is currently positioned within the patient's body by observing the location of each marker. In some examples, the proximal marker is visible to the naked eye, while the distal marker is visible under fluoroscopy (e.g., radiopaque). In some examples, one or both of the proximal and distal ends include only one visible marker. In some examples, the visible markers are positioned at regular or variable increments (e.g., 1 mm, 0.5 cm, 1 cm, 2 cm increments, or any other suitable increments deemed useful by the operator) along a portion of the length of the elongate element 1200. Similarly, visible markers may also be located at the opposite end of the elongate element 1200 or along the length of the filter 1100 and / or articulation section 1118. As mentioned above, in some instances, the visible marker located at the distal end is a marker that is radiopaque, said marker being made from a material such as tantalum or other metal or alloy that is highly visible in fluoroscopic images. The use of markers located at either or both of the proximal and distal ends may allow the operator to better understand the relative location of the filter 1100 within the patient's body.
[0131] 6, in step 6010, the distal end of the constraining sheath is inserted into the lumen of the delivery catheter at the proximal end of the delivery catheter. For example, turning now to Figures 7G and 7H, the distal end 7002 of the constraining sheath 7000 is inserted into the lumen of the delivery catheter 5000 at the proximal end 5004 of the delivery catheter 5000, with the filter 1100 of the embolic filter system 1000 restrained within the lumen of the constraining sheath 7000. In some examples, this can include inserting the distal end 7002 of the constraining sheath 7000 into a connector of the delivery catheter 5000, such as connector 5100. Figure 7G shows the constraining sheath 7000, within which the filter 1100 of the embolic filter system 1000 is constrained, advancing toward the proximal end 5004 of the delivery catheter 5000, and Figure 7H shows the distal end 7002 of the constraining sheath 7000 inserted into the lumen of the delivery catheter 5000 at the proximal end 5004 of the delivery catheter 5000.
[0132] 6, in step 6012, with the distal end of the constraining sheath inserted into the lumen of the delivery catheter at the proximal end of the delivery catheter, embolic filter system 1000 is advanced distally relative to the constraining sheath and delivery catheter until filter 1100 is received within the lumen of the delivery catheter. For example, as shown in FIG. 7I, with the distal end 7002 of the constraining sheath 7000 inserted into the lumen of the delivery catheter 5000 at the proximal end 5004 of the delivery catheter, embolic filter system 1000 is advanced distally in the direction of arrow "A" relative to the constraining sheath 7000 and delivery catheter 5000 until filter 1100 is received within the lumen of the delivery catheter 5000. FIG. 7J illustrates, in part, embolic filter system 1000 inserted within the lumen of delivery catheter 5000 such that filter 1100 is received within and constrained (eg, radially constrained) by delivery catheter 5000 in the delivery configuration.
[0133] 6 , after filter 1100 of embolic filter system 1000 is received within the lumen of the delivery catheter, the constraining sheath is removed according to step 6014. In various instances, the constraining sheath 7000 is removed from the lumen of the delivery catheter 5000 during removal. In some instances, the constraining sheath 7000 has been advanced proximally along and relative to the elongate element 1200 of the embolic filter system 1000 until the distal end 7002 of the constraining sheath passes through or translates to a location distal to the proximal end 1004 of the embolic filter system. However, in some instances, as described above, the constraining sheath 7000 is splittable or otherwise configured to be peeled away from the embolic filter system 1000 and the delivery catheter 5000. Such a splittable constraining sheath may provide ease of removal when one or more connectors (e.g., Tuohy-Borst connectors) are coupled to elongate elements 1200 of embolic filter system 1000 proximal to constraining sheath 7000. In some such instances, the splittable constraining sheath is removable from embolic filter system 1000 and delivery catheter 5000 without requiring removal of connectors coupled to elongate elements 1200 of embolic filter system 1000 proximal to constraining sheath 7000.
[0134] An example of removal of such a splittable constraining sheath 7000 is shown in Figures 7J and 7K, where the constraining sheath 7000 is shown split into two sections for removal from the embolic filter system 1000 and delivery catheter 5000. Figure 7L shows the embolic filter system 1000 with the filter 1100 fully received within the lumen of the delivery catheter 5000.
[0135] 7L, with filter 1100 fully received within the lumen of delivery catheter 5000, delivery catheter 5000 can be inserted into the patient's vasculature and advanced therein to a treatment site, and then embolic filter system 1000 can be advanced relative to delivery catheter 5000 (e.g., by one or more of advancing embolic filter system 1000 distally relative to delivery catheter 5000 and retracting delivery catheter 5000 proximally relative to embolic filter system 1000) such that filter 1100 extends distally from distal end 5002 of delivery catheter 5000. As described above, one or more portions of filter 1100, such as structural element 1108, are configured to radially expand to block blood flow and filter embolic debris therefrom.
[0136] Turning now to FIG. 8, a flow chart is shown outlining an exemplary method for delivering a medical device including embolic filter system 1000 to a region within a patient's vasculature. As shown, steps 8000-8008 are consistent with steps 6000-6008 described above with respect to FIG. 6. At step 8010, a delivery catheter is inserted into the patient's vasculature and advanced until a distal end of the delivery catheter is disposed in a treatment region of the vasculature. Thus, although the discussion above involves advancing the delivery catheter to a treatment region within the patient's vasculature after embolic filter system 1000 is received within delivery catheter 5000, in some instances, delivery catheter 5000 may instead be inserted into the patient's vasculature and advanced until a distal end of the delivery catheter is disposed in a treatment region of the vasculature prior to inserting embolic filter system 1000 into delivery catheter 5000.
[0137] At step 8012, the distal end of the constraining sheath is inserted into the lumen of the delivery catheter at the proximal end of the delivery catheter. This step is generally consistent with step 6010 of FIG. 6, except that step 8012 is performed with the delivery catheter in situ (i.e., while the delivery catheter is inserted within the patient's vasculature). Accordingly, reference is made to FIGS. 7G and 7H, which show the distal end 7002 of the constraining sheath 7000 being inserted into the lumen of the delivery catheter 5000 at the proximal end 5004 of the delivery catheter 5000. Thus, one of ordinary skill in the art should appreciate that the inventive concepts of the present disclosure provide the ability to perform the step of inserting the constraining sheath into the lumen of the delivery catheter at the proximal end of the delivery catheter in situ or prior to advancement of the delivery catheter to the treatment area within the vasculature.
[0138] Such a versatile system would allow the embolic filter system 1000 to be delivered to remote regions of the vasculature that may be inaccessible with conventional systems. Such a system would also allow the embolic filter system 1000 to be delivered to remote regions of the vasculature while minimizing trauma to the vasculature. For example, one skilled in the art would understand that the stiffness of the delivery catheter is increased when additional components are received within the lumen of the delivery catheter. A relatively stiff delivery catheter may not be operable to navigate tortuous anatomical structures and reach certain regions of the vasculature and / or may injure the vasculature as a result of its inflexibility. The embolic filter system 1000 described herein would allow a relatively flexible delivery catheter to be initially advanced to a treatment region within the vasculature (e.g., in or through a relatively tortuous region) without one or more additional components being placed in the vasculature that would have operated to increase the stiffness of the delivery catheter. Moreover, such a configuration allows the delivery catheter to act as a protective boundary and support surface separating the embolic filter system 1000 from the surrounding vasculature as the embolic filter system 1000 is advanced to the treatment area.
[0139] Steps 8014 and 8016 are consistent with steps 6012 and 6014 described above with respect to Figure 6. Similarly, it should be appreciated that after filter 1100 of embolic filter system 1000 has been advanced through a lumen of a delivery catheter to a treatment site, as illustrated and described above, embolic filter system 1000 is operable to be deployed from a distal end of the delivery catheter (e.g., by one or more of advancing embolic filter system 1000 distally relative to the delivery catheter and retracting the delivery catheter proximally relative to embolic filter system 1000) such that filter 1100 extends distally from the distal end of the delivery catheter and expands to block blood flow and filter embolic debris therefrom.
[0140] The versatility of the embolic filter system 1000 illustrated and described herein also facilitates removal of the embolic filter system 1000 from the vasculature and its repositioning in the field. For example, during or after deployment of the embolic filter system 1000 within the vasculature, an operator may manipulate the angular relationship between the filter 1100 and the elongate element 1200 of the embolic filter system 1000 to achieve better alignment of the filter 1100 with the vessel in which it is deployed. For example, as described above, the embolic filter system 1000 is operable to provide relative articulation between the filter 1100 and the elongate element 1200 via the articulation section 1118, which flexes or curves in response to advancement and retraction of the elongate element 1200. When the filter 1100 is deployed within a vessel, one or more portions of the filter engage the vessel wall, thereby creating an engagement between the filter 1100 and the vessel.
[0141] With filter 1100 engaged with the vessel, elongate element 1200 is operable to be advanced or retracted. Under certain conditions, advancing elongate element 1200 with filter 1100 at least partially engaged with the vessel wall places embolic filter system 1000 in a compressive loading state. In certain instances, such as when filter 1100 is improperly aligned with the vessel in which it is deployed, such a compressive loading state may cause articulation section 1118 of embolic filter system 1000 to bend, thereby causing relative articulation between filter 1100 (or at least its distal end) and elongate element 1200, as described above. Conversely, under certain conditions, retracting elongate element 1200 with filter 1100 at least partially engaged with the vessel wall places embolic filter system 1000 in a tensile loading state. In certain instances, such as when filter 1100 is misaligned with elongate element 1200, such a tensile loading condition straightens articulation section 1118 of embolic filter system 1000, thereby creating a relative articulation between filter 1100 (or at least its distal end) and elongate element 1200, such that filter 1100 and elongate element 1200 move into alignment with one another. Thus, elongate element 1200 can be advanced and retracted to create articulation between filter 1100 (or at least its distal end) and elongate element 1200, which can be utilized to achieve proper alignment of filter 1100 within the vessel. It should be understood that proper alignment of filter 1100 within the vessel does not require alignment between filter 1100 and elongate element 1200, and may require misalignment between filter 1100 and elongate element 1200.
[0142] While the embolic filter system 1000 in the various examples and figures above includes a filter 1100 incorporating an articulation section 1118, in some alternative examples, the embolic filter system 1000 can additionally or alternatively include one or more independent articulation elements that are disposed proximally relative to the filter 1100 and provide for articulation between the filter 1100 and one or more portions of the elongate element 1200. That is, in some examples, the embolic filter system 1000 includes an articulation element that is separate from (e.g., not part of) the filter 1100. For example, the filter 1100 can include a structural element 1108 that does not include an articulation section 1118.
[0143] The articulation element in such examples can be of a form functionally consistent with the articulation section 1118 of the filter 1100 described above, with the exception that the articulation element is not an integral part of the filter 1100, but instead is a separate component, said component being coupled (directly or indirectly) to one or more of the filter 1100 and the elongate element 1200. Thus, in some examples, the articulation element comprises a helically cut or slotted tubular structure. As described above, in examples involving cut tubes, the cut in the tube to form the coil / spiral or slotted segment extends through the thickness of the tube (e.g., from the outer surface of the tube to the inner surface of the tube) so that the lumen of the tube is exposed. Such a full-thickness cut in the tube provides a gap that can accommodate bending of one or more relevant portions of the tube (e.g., bending of one or more helical windings).
[0144] 9 illustrates an exemplary articulation element 9000. As shown, the articulation element has a first end 9002 and a second end 9004. The first end 9002 and the second end 9004 can be configured to interface with one or more of the filter 1100 and the elongate element 1200. For example, in some instances, the articulation element 9000 can be incorporated into the embolic filter system 1000 by coupling the first end 9002 of the articulation element 9000 to the proximal end 1104 of the filter 1100 and by coupling the second end 9004 of the articulation element 9000 to the distal end 1204 (or distal portion) of the elongate element 1200. In such instances, the articulation element 9000 is disposed between the filter 1100 and the elongate element 1200 such that the filter 1100 and the elongate element 1200 can freely articulate with respect to one another.
[0145] Additionally, as shown, the articulation element 9000 includes multiple helical windings, such as helical windings 9006 and 9008. In some instances, as described above, the helical windings are formed in a helical pattern in conjunction with cutting through the thickness of the tube to form one or more helical windings. In various instances, adjacent helical windings are separated from one another by a helical gap 9010. As shown, the helical gap 9010 exposes a lumen 9012 of the articulation element 9000.
[0146] In various examples, and consistent with the discussion above, in addition to or instead of the articulation section 1118, an embolic filter system such as embolic filter system 1000 having an articulation element 9000 can be configured such that membrane 1300 extends along one or more of the exterior of articulation element 9000 and the interior lumen wall of articulation element 9000. Thus, membrane 1300 is operable to filter embolic debris from blood escaping through gap 9010. That is, membrane 1300 is operable to prevent embolic debris from escaping the embolic filter system through gap 9010 in articulation element 9000. In some examples, membrane 1300 can be blood impermeable in the region of articulation element 9000.
[0147] In some embodiments, the elongate element 1200 is configured such that its length may be easily altered in conjunction with an intravascular procedure. For example, in some instances, the elongate element 1200 is operable to be cut such that the length of the elongate element may be altered from a first length to a second, shorter length. In some instances, the elongate element 1200 is configured such that the length of the elongate element 1200 may be altered while the embolic filter system 1000 is received within the lumen of the delivery catheter 5000. In some instances, an attachable / detachable hub is coupled to the proximal end of the elongate element 1200 and fluidly seals the lumen of the delivery catheter 5000. For example, the hub may have a luer taper connection, a hose barb connection, or a combination thereof (e.g., a luer / barb fitting connection) as appropriate for use in forming a leak-tight connection at the proximal end of the elongate element 1200. In some instances, the hub can be permanently attached or coupled to the proximal end of the elongate element 1200, and in other instances, the hub can be removably attached thereto.
[0148] In some examples, the elongate element 1200 includes a plurality of predetermined sections configured to be removed. For example, in some examples, the elongate element 1200 includes a first removable section and a second removable section such that either or both of the first removable section and the second removable section can be removed to change the length of the elongate element from a first length to a second, shorter length. In some examples, the removable sections can be configured to be removed by cutting. In some other examples, the removable sections can be additionally or alternatively configured to be removed by twisting, bending, or pulling the removable sections relative to the remainder of the elongate element 1200.
[0149] In some instances, one or more portions or components of the embolic filter system 1000, such as the elongate element 1200, can be color coded to indicate a diameter of the elongate element 1200, where a first color indicates a first diameter (e.g., 6 Fr) and a second color indicates a second, different diameter. Such color coding can aid a user in identifying an appropriate diameter for use with a COTS delivery catheter in connection with an endovascular procedure.
[0150] It should be understood that the configurations discussed herein are scalable in that they can be scaled up or down for different applications. That is, while certain configurations discussed herein are shown and described in relation to placement within, for example, the aortic arch, the versatility of the system provides for implementation in virtually any other area of a patient's vasculature. For example, the various configurations discussed herein can be scaled for application within various peripheral vessels and lumens, such as the brachiocephalic and / or carotid and / or subclavian arteries. Similarly, when relating to the aortic arch, the present disclosure can be used in relation to femoral, transapical and open chest approaches. Furthermore, the present disclosure should not be construed as limiting application to blood vessels proximate to the heart. For example, the devices and systems described herein can be implemented throughout the body's vasculature, including the vasculature above and below the heart, to prevent the migration of embolic debris during various other revascularization procedures. Furthermore, the embodiments can be used in relation to various organisms having mammalian anatomy as well as humans. Thus, the embodiments described herein are intended to cover modifications and variations within the scope of the present disclosure. Thus, embolic filter system 1000 can be formed in a variety of different sizes, which can optionally be based on COTS delivery catheter sizes, such that embolic filter system 1000 can be manufactured in a variety of sizes for use in conjunction with COTS delivery catheters of various sizes. As noted above, one or more components of embolic filter system 1000 can be color coded based on such sizing.
[0151] The scope of the invention of this application has been described above both generally and with reference to specific examples. It will be apparent to those skilled in the art that various changes and modifications can be made in the examples without departing from the scope of the present disclosure. Similarly, various components discussed in the embodiments discussed herein can be combined. Thus, the embodiments are intended to cover the modifications and modifications within the scope of the present invention. (Aspect) (Aspect 1) an elongate element having a first end and a second end; an embolic filter assembly including a frame having a mounting section, a capture section distal to said mounting section, and an intermediate section between said mounting section and said capture section; a mounting section of the embolic filter assembly coupled to the elongate element at one of the first end and the second end, the mid-section adapted to permit relative articulation between the capture section of the frame and the mounting section of the frame, and the mounting section, the capture section and the mid-section formed from the same material. (Aspect 2) The medical device of any one of the preceding aspects, wherein the capture section is radially expandable relative to the attachment section such that the embolic filter assembly is configured to transition between a compressed state and an expanded state in situ. (Aspect 3) 20. The medical device of any one of the preceding aspects, wherein the capture section is radially expandable relative to the intermediate section. (Aspect 4) 23. The medical device of any one of the preceding aspects, wherein the frame is configured such that the capture section is self-expandable. (Aspect 5) 20. The medical device of any one of the preceding aspects, wherein the frame comprises a metal alloy. (Aspect 6) The medical device of embodiment 5, wherein the metal alloy comprises Nitinol. (Aspect 7) 20. The medical device of any one of the preceding aspects, wherein the frame is unitary such that the mounting section, the capture section and the intermediate section define a single monolithic component. (Aspect 8) 20. The medical device of any one of the preceding embodiments, wherein the intermediate section is helically shaped. (Aspect 9) 20. The medical device of any one of the preceding aspects, wherein the frame is formed from a cutting tube having a body and a lumen extending therethrough. (Aspect 10) 10. The medical device of embodiment 9, wherein the cutting tube is a laser cutting tube. (Aspect 11) 11. The medical device of any one of embodiments 9-10, wherein the intermediate section is defined by a spiral cut through the body of the tube exposing the lumen of the tube. (Aspect 12) The medical device of any one of the preceding embodiments, wherein the attachment section, the capture section and the intermediate section are attached to one another. (Aspect 13) 13. The medical device of embodiment 12, wherein one or more of the capture section and the intermediate section comprise a wire frame. (Aspect 14) The medical device of embodiment 13, wherein the intermediate section comprises a helical winding. (Aspect 15) 20. The medical device of any one of the preceding aspects, wherein the mid-section is adapted to bend.
Claims
1. an elongate element having a first end and a second end; an embolic filter assembly including a frame having a mounting section, a capture section distal to said mounting section, and an intermediate section between said mounting section and said capture section; a mounting section of the embolic filter assembly coupled to the elongate element at one of the first end and the second end, the embolic filter assembly including a filter material disposed along the mid-section of the frame, the mid-section adapted to permit relative articulation between a capture section of the frame and the mounting section of the frame, the mounting section, the capture section and the mid-section being formed from the same material; A medical device, wherein the mounting section of the frame defines a first longitudinal axis and the capture section defines a second longitudinal axis different from the first longitudinal axis.
2. 10. The medical device of claim 1, wherein the intermediate section is adapted to bend such that the first longitudinal axis can deflect up to 270 degrees relative to the second longitudinal axis.
3. 10. The medical device of claim 1, wherein the intermediate section is adapted to bend such that the first longitudinal axis can deflect up to 180 degrees relative to the second longitudinal axis.
4. 10. The medical device of claim 1, wherein the intermediate section is adapted to bend such that the first longitudinal axis can deflect up to 90 degrees relative to the second longitudinal axis.
5. The medical device of any one of claims 1 to 4, wherein the frame has a first end and a second end and a lumen extending through the frame from the first end to the second end.
6. The medical device of any one of claims 1 to 5, wherein the filter material is impermeable to embolic debris greater than 100 micrometers (μm).
7. The medical device of any one of claims 1 to 6, wherein the filter material is configured to limit elongation of the midsection below a yield point of the midsection.
8. 8. The medical device of claim 1, wherein the filter material is configured to stretch to accommodate one or more bending and elongation of the mid-section of the frame, and wherein a yield strength of the filter material exceeds a yield strength of the mid-section.
9. The medical device of any one of claims 1 to 8, wherein the filter material comprises a polymeric material.
10. The medical device of claim 9 , wherein the polymeric material comprises ePTFE.
11. The medical device of any one of claims 1 to 10, wherein one or more of the capture section, the attachment section and the elongate element are operable to articulate at the intermediate section.
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