Self-Expanding Mesh Occluder for Wide-Neck Aneurysm Coil Support
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Solution Overview
Problem
Current endovascular treatments for intracranial aneurysms, such as balloon- and stent-assisted coiling, face challenges with wide-necked and ruptured aneurysms due to complications like coil prolapse, clot formation, and the need for dual antiplatelet therapy, while existing endosaccular devices are limited in accessibility and versatility.
Innovation Solution
A self-expanding mesh occlusive device coupled with an embolic coil, designed for low-profile delivery through smaller microcatheters, positioned over the aneurysm neck to prevent coil prolapse and promote endothelialization, reducing blood flow and enabling treatment of wide-neck, bifurcation, and sidewall aneurysms without adjunctive implants or dual antiplatelet therapy.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If conventional coiling is used for wide-necked aneurysms, then the procedure is simpler, but coils may prolapse through the neck into the parent vessel causing serious complications
Solution Approach 1:
The mesh is deployed within the aneurysm sac before coil embolization to create a protective barrier. This preliminary action prevents coil prolapse through the aneurysm neck while allowing subsequent coil packing without requiring balloon or stent assistance
Solution Approach 2:
The mesh acts as an intermediary structure between the coils and the aneurysm neck. It provides a scaffolding that supports the coils and prevents them from migrating into the parent vessel, eliminating the need for additional neck-bridging devices
2Reliability
If balloon or stent is added to prevent coil migration, then coil stability improves, but procedure time, cost, and complexity increase
Solution Approach 1:
The mesh and coils are combined into a single integrated system where the mesh is delivered through the same microcatheter as the coils. This merging eliminates the need for separate balloon or stent delivery systems and their associated procedures
Solution Approach 2:
The mesh serves multiple functions: it prevents coil prolapse, provides structural support within the aneurysm sac, and facilitates coil deployment. This multi-functionality replaces the need for separate balloon or stent devices
3Reliability
If stent or balloon is deployed during procedure, then coil stability improves, but risk of intraprocedural clot formation and endothelial damage increases
Solution Approach 1:
The mesh serves as an intermediary that protects the endothelial lining from direct contact with coils and deployment instruments. This eliminates the mechanical trauma and clot formation risk associated with stent or balloon deployment across the aneurysm neck
4Reliability
If neck-bridging stent is permanently positioned, then coil stability improves, but chronic clot formation risk increases requiring dual antiplatelet therapy
Solution Approach 1:
The mesh is extracted from the parent vessel and positioned entirely within the aneurysm sac, removing the foreign body that would otherwise require chronic antiplatelet therapy. This eliminates the source of chronic clot formation while maintaining coil stability
Solution Approach 2:
The mesh is designed as a temporary, absorbable structure that provides acute stability during healing but does not require long-term maintenance. Unlike permanent stents, it does not necessitate dual antiplatelet therapy
5Reliability
If flow diverter is positioned in parent vessel, then aneurysm occlusion improves, but dual antiplatelet therapy is required increasing hemorrhagic risk
Solution Approach 1:
Instead of placing the occlusive device in the parent vessel (flow diverter approach), the mesh is inverted and positioned within the aneurysm sac. This reverses the location and mechanism, achieving occlusion without requiring DAPT
6Reliability
If existing endosaccular devices are used, then coil prolapse prevention improves, but accessibility to small distal vessels is limited
Solution Approach 1:
The mesh is constructed as a thin, flexible structure that can be compressed to a low profile for delivery through small microcatheters. This flexibility enables access to distal intracranial vessels while maintaining the ability to provide effective coil support when deployed
7Reliability
If mesh is positioned over aneurysm neck, then blood flow reduction improves, but coil packing density may be reduced
Solution Approach 1:
The mesh is positioned specifically at the aneurysm neck where flow reduction is most critical, while leaving the aneurysm dome open for optimal coil packing. This localized approach maintains high coil density in the dome while providing flow diversion at the neck
Data Source
AI summary
Devices, systems, and methods for treating vascular defects are disclosed herein. One aspect of the present technology, for example, includes an occlusive device comprising a mesh having a low-profile state for intravascular delivery to the aneurysm and a deployed state, the mesh comprising a first end portion, a second end portion, and a length extending between the first and second end portions, and a first lateral edge, a second lateral edge, and a width extending between the first and second lateral edges. The mesh may have a predetermined shape in the deployed state in which (a) the mesh is curved along its width, (b) the mesh is curved along its length, and (c) the mesh has an undulating contour across at least a portion of one or both of its length or its width. The mesh is configured to be positioned within the aneurysm in the deployed state such that the mesh extends over the neck of the aneurysm.