CA2425544C - Mechanism for the deployment of endovascular implants - Google Patents
Mechanism for the deployment of endovascular implants Download PDFInfo
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- CA2425544C CA2425544C CA002425544A CA2425544A CA2425544C CA 2425544 C CA2425544 C CA 2425544C CA 002425544 A CA002425544 A CA 002425544A CA 2425544 A CA2425544 A CA 2425544A CA 2425544 C CA2425544 C CA 2425544C
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/1214—Coils or wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/1214—Coils or wires
- A61B17/1215—Coils or wires comprising additional materials, e.g. thrombogenic, having filaments, having fibers, being coated
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12163—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a string of elements connected to each other
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12181—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices
- A61B17/1219—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device formed by fluidized, gelatinous or cellular remodelable materials, e.g. embolic liquids, foams or extracellular matrices expandable in contact with liquids
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00477—Coupling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
- A61B2017/00539—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated hydraulically
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/1205—Introduction devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/1205—Introduction devices
- A61B2017/12054—Details concerning the detachment of the occluding device from the introduction device
Abstract
A mechanism for the deployment of a filamentous endovascular device includes an elongate, flexible, hollow deployment tube having an open proximal end, and a coupling element attached to the proximal end of the endovascular device.
The deployment tube includes a distal section terminating in an open distal end, with a lumen defined between the proximal and distal ends. A retention sleeve is fixed around the distal section and includes a distal extension extending a short distance past the distal end of the deployment tube. The endovascular device is attached to the distal end of the deployment tube during the manufacturing process by fixing the retention sleeve around the coupling element, so that the coupling element is releasably held within the distal extension of the deployment tube.
The deployment tube includes a distal section terminating in an open distal end, with a lumen defined between the proximal and distal ends. A retention sleeve is fixed around the distal section and includes a distal extension extending a short distance past the distal end of the deployment tube. The endovascular device is attached to the distal end of the deployment tube during the manufacturing process by fixing the retention sleeve around the coupling element, so that the coupling element is releasably held within the distal extension of the deployment tube.
Description
2 OF ENDOVASCULAR IMPLANTS
3
4 CROSS-REFERENCE TO RELATED APPLICATIONS
Not Applicable 8 Not Applicable BACKGROUND OF THE INVENTION
11 This invention relates to the field of methods and devices for the 12 embolization of vascular aneurysms and similar vascular 13 abnormalities. More specifically, the present invention relates to a 14 mechanism for deploying an endovascular implant, such as a microcoil, into a targeted vascular site, and releasing or detaching the 16 implant in the site.
17 The embolization of blood vessels is desired in a number of 18 clinical situations. For example, vascular embolization has been used 19 to control vascular bleeding, to occlude the blood supply to tumors, and to occlude vascular aneurysms, particularly intracranial 21 aneurysms. In recent years, vascular embolization for the treatment of 22 aneurysms has received much attention. Several different treatment 23 modalities have been employed in the prior art. U.S. Patent No.
24 4,819,637 - Dormandy, Jr. et al., for example, describes a vascular embolization system that employs a detachable balloon delivered to 26 the aneurysm site by an intravascular catheter. The balloon is carried 27 into the aneurysm at the tip of the catheter, and it is inflated inside the 28 aneurysm with a solidifying fluid (typically a polymerizable resin or 29 gel) to occlude the aneurysm. The balloon is then detached from the catheter by gentle traction on the catheter. While the balloon-type 1 embolization device can provide an effective occlusion of many types 2 of aneurysms, it is difficult to retrieve or move after the solidifying 3 fluid sets, and it is difficult to visualize unless it is filled with a contrast 4 material. Furthermore, there are risks of balloon rupture during inflation and of premature detachment of the balloon from the 6 catheter.
7 Another approach is the direct injection of a liquid polymer 8 embolic agent into the vascular site to be occluded. One type of liquid 9 polymer used in the direct injection technique is a rapidly polymerizing liquid, such as a cyanoacrylate resin, particularly 11 isobutyl cyanoacrylate, that is delivered to the target site as a liquid, 12 and then is polymerized in situ. Alternatively, a liquid polymer that is 13 precipitated at the target site from a carrier solution has been used. An 14 example of this type of embolic agent is a cellulose acetate polymer mixed with bismuth trioxide and dissolved in dimethyl sulfoxide 16 (DMSO). Another type is ethylene vinyl alcohol dissolved in DMSO.
17 On contact with blood, the DMSO diffuses out, and the polymer 18 precipitates out and rapidly hardens into an embolic mass that 19 conforms to the shape of the aneurysm. Other examples of materials used in this "direct injection" method are disclosed in the following 21 U.S. Patents: 4,551,132 - Pa.sztor et al.; 4,795,741 - Leshchiner et al.;
22 5,525,334 - Ito et al.; and 5,580,568 - Greff et al.
23 The direct injection of liquid polymer embolic agents has proven 24 difficult in practice. For example, migration of the polymeric material from the aneurysm and into the adjacent blood vessel has presented a 26 problem. In addition, visualization of the embolization material 27 requires that a contrasting agent be mixed with it, and selecting 28 embolization materials and contrasting agents that are mutually 1 compatible may result in performance compromises that are less than 2 optimal. Furthermore, precise control of the deployment of the 3 polymeric embolization material is difficult, leading to the risk of 4 improper placement and/or premature solidification of the material.
Moreover, once the embolization material is deployed and solidified, it 6 is difficult to move or retrieve.
7 Another approach that has shown promise is the use of 8 thrombogenic filaments, or filamentous embolic implants. One type of 9 filamentous implant is the so-called "microcoil". Microcoils may be made of a biocompatible metal alloy (typically platinum and tungsten) 11 or a suitable polymer. If made of metal, the coil may be provided with 12 Dacron fibers to increase thrombogenicity. The coil is deployed 13 through a microcatheter to the vascular site. Examples of microcoils 14 are disclosed in the following U.S. patents: 4,994,069 - Ritchart et al.;
Not Applicable 8 Not Applicable BACKGROUND OF THE INVENTION
11 This invention relates to the field of methods and devices for the 12 embolization of vascular aneurysms and similar vascular 13 abnormalities. More specifically, the present invention relates to a 14 mechanism for deploying an endovascular implant, such as a microcoil, into a targeted vascular site, and releasing or detaching the 16 implant in the site.
17 The embolization of blood vessels is desired in a number of 18 clinical situations. For example, vascular embolization has been used 19 to control vascular bleeding, to occlude the blood supply to tumors, and to occlude vascular aneurysms, particularly intracranial 21 aneurysms. In recent years, vascular embolization for the treatment of 22 aneurysms has received much attention. Several different treatment 23 modalities have been employed in the prior art. U.S. Patent No.
24 4,819,637 - Dormandy, Jr. et al., for example, describes a vascular embolization system that employs a detachable balloon delivered to 26 the aneurysm site by an intravascular catheter. The balloon is carried 27 into the aneurysm at the tip of the catheter, and it is inflated inside the 28 aneurysm with a solidifying fluid (typically a polymerizable resin or 29 gel) to occlude the aneurysm. The balloon is then detached from the catheter by gentle traction on the catheter. While the balloon-type 1 embolization device can provide an effective occlusion of many types 2 of aneurysms, it is difficult to retrieve or move after the solidifying 3 fluid sets, and it is difficult to visualize unless it is filled with a contrast 4 material. Furthermore, there are risks of balloon rupture during inflation and of premature detachment of the balloon from the 6 catheter.
7 Another approach is the direct injection of a liquid polymer 8 embolic agent into the vascular site to be occluded. One type of liquid 9 polymer used in the direct injection technique is a rapidly polymerizing liquid, such as a cyanoacrylate resin, particularly 11 isobutyl cyanoacrylate, that is delivered to the target site as a liquid, 12 and then is polymerized in situ. Alternatively, a liquid polymer that is 13 precipitated at the target site from a carrier solution has been used. An 14 example of this type of embolic agent is a cellulose acetate polymer mixed with bismuth trioxide and dissolved in dimethyl sulfoxide 16 (DMSO). Another type is ethylene vinyl alcohol dissolved in DMSO.
17 On contact with blood, the DMSO diffuses out, and the polymer 18 precipitates out and rapidly hardens into an embolic mass that 19 conforms to the shape of the aneurysm. Other examples of materials used in this "direct injection" method are disclosed in the following 21 U.S. Patents: 4,551,132 - Pa.sztor et al.; 4,795,741 - Leshchiner et al.;
22 5,525,334 - Ito et al.; and 5,580,568 - Greff et al.
23 The direct injection of liquid polymer embolic agents has proven 24 difficult in practice. For example, migration of the polymeric material from the aneurysm and into the adjacent blood vessel has presented a 26 problem. In addition, visualization of the embolization material 27 requires that a contrasting agent be mixed with it, and selecting 28 embolization materials and contrasting agents that are mutually 1 compatible may result in performance compromises that are less than 2 optimal. Furthermore, precise control of the deployment of the 3 polymeric embolization material is difficult, leading to the risk of 4 improper placement and/or premature solidification of the material.
Moreover, once the embolization material is deployed and solidified, it 6 is difficult to move or retrieve.
7 Another approach that has shown promise is the use of 8 thrombogenic filaments, or filamentous embolic implants. One type of 9 filamentous implant is the so-called "microcoil". Microcoils may be made of a biocompatible metal alloy (typically platinum and tungsten) 11 or a suitable polymer. If made of metal, the coil may be provided with 12 Dacron fibers to increase thrombogenicity. The coil is deployed 13 through a microcatheter to the vascular site. Examples of microcoils 14 are disclosed in the following U.S. patents: 4,994,069 - Ritchart et al.;
5,133,731 - Butler et al.; 5,226,911 - Chee et al.; 5,312,415 - Palermo;
16 5,382,259 - Phelps et al.; 5,382,260 - Dormandy, Jr. et al.; 5,476,472 -17 Dormandy, Jr. et al.; 5,578,074 - Mirigian; 5,582,619 - Ken; 5,624,461 18 - Mariant; 5,645,558 - Horton; 5,658,308 - Snyder; and 5,718,711 -19 Berenstein et al.
The microcoil approach has met with some success in treating 21 small aneurysms with narrow necks, but the coil must be tightly 22 packed into the aneurysm to avoid shifting that can lead to 23 recanalization. Microcoils have been less successful in the treatment of 24 larger aneurysms, especially those with relatively wide necks. A
disadvantage of microcoils is that they are not easily retrievable; if a 26 coil migrates out of the aneurysm, a second procedure to retrieve it and 27 move it back into place is necessary. Furthermore, complete packing 28 of an aneurysm using microcoils can be difficult to achieve in practice.
1 A specific type of microcoil that has achieved a measure of 2 success is the Guglielmi Detachable Coil ("GDC"). The GDC
3 employs a platinum wire coil fixed to a stainless steel guidewire by a 4 welded connection. After the coil is placed inside an aneurysm, an electrical current is applied to the guidewire, which oxidizes the weld
16 5,382,259 - Phelps et al.; 5,382,260 - Dormandy, Jr. et al.; 5,476,472 -17 Dormandy, Jr. et al.; 5,578,074 - Mirigian; 5,582,619 - Ken; 5,624,461 18 - Mariant; 5,645,558 - Horton; 5,658,308 - Snyder; and 5,718,711 -19 Berenstein et al.
The microcoil approach has met with some success in treating 21 small aneurysms with narrow necks, but the coil must be tightly 22 packed into the aneurysm to avoid shifting that can lead to 23 recanalization. Microcoils have been less successful in the treatment of 24 larger aneurysms, especially those with relatively wide necks. A
disadvantage of microcoils is that they are not easily retrievable; if a 26 coil migrates out of the aneurysm, a second procedure to retrieve it and 27 move it back into place is necessary. Furthermore, complete packing 28 of an aneurysm using microcoils can be difficult to achieve in practice.
1 A specific type of microcoil that has achieved a measure of 2 success is the Guglielmi Detachable Coil ("GDC"). The GDC
3 employs a platinum wire coil fixed to a stainless steel guidewire by a 4 welded connection. After the coil is placed inside an aneurysm, an electrical current is applied to the guidewire, which oxidizes the weld
6 connection, thereby detaching the coil from the guidewire. The
7 application of the current also creates a positive electrical charge on the
8 coil, which attracts negatively-charged blood cells, platelets, and
9 fibrinogen, thereby increasing the thrombogenicity of the coil. Several coils of different diameters and lengths can be packed into an 11 aneurysm until the aneurysm is completely filled. The coils thus create 12 and hold a thrombus within the aneurysm, inhibiting its displacement 13 and its fragmentation.
14 The advantages of the GDC procedure are the ability to withdraw and relocate the coil if it migrates from its desired location, 16 and the enhanced ability to promote the formation of a stable 17 thrombus within the aneurysm. Nevertheless, as in conventional 18 microcoil techniques, the successful use of the GDC procedure has 19 been substantially limited to small aneurysms with narrow necks.
A more recently developed type of filamentous embolic implant 21 is disclosed in U.S. Patent No. 6,015,424 - Rosenbluth et al., assigned 22 to the assignee of the present invention. This type of filamentous 23 embolic implant is controllably transformable from a soft, compliant 24 state to a rigid or semi-rigid state. Specifically, the transformable filamentous implant may include a polymer that is transformable by 26 contact with vascular blood or with injected saline solution, or it may 27 include a metal that is transformable by electrolytic corrosion. One 28 end of the implant is releasably attached to the distal end of an 1 elongate, hollow deployment wire that is insertable through a 2 microcatheter to the target vascular site. The implant and the 3 deployment wire are passed through the microcatheter until the distal 4 end of the deployment wire is located within or adjacent to the target 5 vascular site. At this point, the filamentous implant is detached from 6 the wire. In this device, the distal end of the deployment wire 7 terminates in a cup-like holder that frictionally engages the proximal 8 end of the filamentous implant. To detach the filamentous implant, a 9 fluid (e.g., saline solution) is flowed through the deployment wire and enters the cup-like holder through an opening, thereby pushing the 11 filamentous implant out of the holder by fluid pressure.
12 While filamentous embolic implants have shown great promise, 13 improvement has been sought in the mechanisms for deploying these 14 devices. In particular, improvements have been sought in the coupling mechanisms by which the embolic implant is detachably 16 attached to a deployment instrument for installation in a target 17 vascular site. Examples of recent developments in this area are 18 described in the following patent publications: U.S. 5,814,062 -19 Sepetka et al.; U.S. 5,891,130 - Palermo et al.; U.S. 6,063,100 - Diaz et al.; U.S. 6,068,644 - Lulu et al.; and EP 0 941 703 Al - Cordis 21 Corporation.
22 There is still a need for further improvements in field of coupling 23 mechanisms for detachably attaching an embolic implant to a 24 deployment instrument. Specifically, there is still a need for a coupling mechanism that provides for a secure attachment of the 26 embolic implant to a deployment instrument during the deployment 27 process, while also allowing for the easy and reliable detachment of the 28 embolic implant once it is properly situated with respect to the target 1 site. It would also be advantageous for such a mechanism to allow 2 improved control of the implant during deployment, and specifically to 3 allow the implant to be easily repositioned before detachment.
4 Furthermore, the coupling mechanism should be adaptable for use with a wide variety of endovascular implants, and it should not add 6 appreciably to their costs.
9 Broadly, the present invention is a mechanism for the deployment of a filamentous endovascular device, such as an embolic 11 implant, comprising an elongate, flexible, hollow deployment tube 12 having an open proximal end, and a coupling element attached to the 13 proximal end of the endovascular device. The deployment tube 14 includes a distal section terminating in an open distal end, with a lumen defined between the proximal and distal ends. A retention 16 sleeve is fixed around the distal section and includes a distal extension 17 extending a short distance past the distal end of the deployment tube.
18 The endovascular device is attached to the distal end of the 19 deployment tube during the manufacturing process by fixing the retention sleeve around the coupling element, so that the coupling 21 element is releasably held within the distal extension proximate the 22 distal end of the deployment tube. In use, the deployment tube, with 23 the implant attached to its distal end, is passed intravascularly through 24 a microcatheter to a target vascular site until the endovascular device is fully deployed within the site. To detach the endovascular device from 26 the deployment tube, a biocompatible liquid (such as saline solution) is 27 injected through the lumen of the deployment tube so as to apply 28 pressure to the upstream (interior) side of the coupling element. The 1 coupling element is thus pushed out of the retention sleeve by the fluid 2 pressure of the liquid, thereby detaching the endovascular device from 3 the deployment tube.
4 The coupling element may be a solid "plug" of polymeric material or metal, or it may be formed of a hydrophilic polymer that 6 softens and becomes somewhat lubricious when contacted by the 7 injected liquid. With the latter type of material, the hydration of the 8 hydrophilic material results in physical changes that reduce the 9 adhesion between the coupling element and the sleeve, thereby facilitating the removal of the coupling element from the sleeve upon 11 the application of liquid pressure. Alternatively, the coupling element 12 can be made principally of a non-hydrophilic material (polymer or 13 metal), coated with a hydrophilic coating.
14 In a specific preferred embodiment, the retention sleeve is made of polyethylene terephthalate (PET), and the coupling element is made 16 of a hydrogel, such as a polyacrylamide/acrylic acid mixture. In 17 another preferred embodiment, both the retention sleeve and the 18 coupling element are made of a polyolefm. In still another preferred 19 embodiment, the retention sleeve is formed of a fluoropolymer, and the coupling element is formed of a metal. Hydrophilic coatings, such 21 as those disclosed in U.S. Patents Nos. 5,001,009 and 5,331,027, may 22 be applied to any of the non-hydrophilic coupling elements.
23 In an alternative embodiment, the retention sleeve is made of a 24 shape memory metal, such as the nickel-titanium alloy known as nitinol. In this alternative embodiment, the coupling element would 26 be made of one of the hydrophilic materials mentioned above, or it 27 may be made of a non-hydrophilic material with a hydrophilic coating.
28 The deployment tube, in the preferred embodiment, comprises a I main section having an open proximal end, a distal section terminating 2 in an open distal end, and a transition section connected between the 3 main and distal sections. A continuous fluid passage lumen is defined 4 between the proximal and distal ends. The distal section is shorter and more flexible than the transition section, and the transition section is 6 shorter and more flexible than the main section. This varying 7 flexibility is achieved by making the main section as a continuous 8 length of flexible, hollow tube, the transition section as a length of 9 hollow, flexible laser-cut ribbon coil, and the distal section as a length of flexible, hollow, helical coil. The sections may be joined together by 11 any suitable means, such as soldering.
12 Advantageously, an axial air purge passage may be provided 13 through the coupling element. The purge passage is dimensioned to 14 allow the passage of saline solution through it, but not a relatively high viscosity contrast agent. Before the deployment tube and the attached 16 implant are introduced intravascularly to the target site, a saline 17 solution is injected under low pressure through the lumen of the 18 deployment tube to displace air from the lumen out through the purge 19 passage. After the implant is located within the target site, a high viscosity contrast agent is injected into the deployment tube lumen to 21 purge the remaining saline solution through the purge passage, but, 22 because the contrast agent cannot pass through the purge passage, it 23 builds up pressure on the proximal surface of the coupling element 24 until the pressure is sufficient to push the coupling element out of the retention sleeve.
26 Any of the embodiments may employ an anti-airflow 27 mechanism for preventing the inadvertent introduction of air into the 28 vasculature during deployment of the implant. One such mechanism 1 comprises an airtight, compliant membrane sealingly disposed over the 2 distal end of the deployment tube. The membrane is expanded or 3 distended distally in response to the injection of the liquid, thereby 4 forcing the implant out of the retention sleeve.
Another such anti-airflow mechanism comprises an intemal 6 stylet disposed axially through the deployment tube. The stylet has a 7 distal outlet opening adjacent the distal end of the deployment tube, 8 and a proximal inlet opening in a fitting attached to the proximal end 9 of the deployment tube. The fitting includes a gas/air venting port in fluid communication with the proximal end of the deployment tube.
11 The gas venting port, in turn, includes a stop-cock valve. In use, the 12 liquid is injected through the stylet with the stop-cock valve open. The 13 injected liquid flows out of the stylet outlet opening and into the 14 deployment tube, hydraulically pushing any entrapped air out of the venting port. When liquid begins flowing out of the venting port, 16 indicating that any entrapped air has been fully purged from the 17 deployment tube, the stop-cock is closed, allowing the continued flow 18 of the liquid to push the implant out of the retention sleeve, as 19 described above.
As will be appreciated more fully from the detailed description 21 below, the present invention provides a secure attachment of the 22 embolic implant to a deployment instrument during the deployment 23 process, while also allowing for the easy and reliable detachment of the 24 embolic implant once it is properly situated with respect to the target site. The present invention also provides improved control of the 26 implant during deployment, and specifically it allows the implant to be 27 easily repositioned before detachment. Furthermore, the present 28 invention is readily adaptable for use with a wide variety of 1 endovascular implants, without adding appreciably to their costs.
4 Figure 1 is an elevational view of an endovascular device 5 deployment mechanism in accordance with a preferred embodiment of 6 the present invention, showing the mechanism with an endovascular 7 implant device attached to it;
8 Figure 2 is a longitudinal cross-sectional view of the deployment 9 mechanism and the endovascular implant of Figure 1, taken along line
14 The advantages of the GDC procedure are the ability to withdraw and relocate the coil if it migrates from its desired location, 16 and the enhanced ability to promote the formation of a stable 17 thrombus within the aneurysm. Nevertheless, as in conventional 18 microcoil techniques, the successful use of the GDC procedure has 19 been substantially limited to small aneurysms with narrow necks.
A more recently developed type of filamentous embolic implant 21 is disclosed in U.S. Patent No. 6,015,424 - Rosenbluth et al., assigned 22 to the assignee of the present invention. This type of filamentous 23 embolic implant is controllably transformable from a soft, compliant 24 state to a rigid or semi-rigid state. Specifically, the transformable filamentous implant may include a polymer that is transformable by 26 contact with vascular blood or with injected saline solution, or it may 27 include a metal that is transformable by electrolytic corrosion. One 28 end of the implant is releasably attached to the distal end of an 1 elongate, hollow deployment wire that is insertable through a 2 microcatheter to the target vascular site. The implant and the 3 deployment wire are passed through the microcatheter until the distal 4 end of the deployment wire is located within or adjacent to the target 5 vascular site. At this point, the filamentous implant is detached from 6 the wire. In this device, the distal end of the deployment wire 7 terminates in a cup-like holder that frictionally engages the proximal 8 end of the filamentous implant. To detach the filamentous implant, a 9 fluid (e.g., saline solution) is flowed through the deployment wire and enters the cup-like holder through an opening, thereby pushing the 11 filamentous implant out of the holder by fluid pressure.
12 While filamentous embolic implants have shown great promise, 13 improvement has been sought in the mechanisms for deploying these 14 devices. In particular, improvements have been sought in the coupling mechanisms by which the embolic implant is detachably 16 attached to a deployment instrument for installation in a target 17 vascular site. Examples of recent developments in this area are 18 described in the following patent publications: U.S. 5,814,062 -19 Sepetka et al.; U.S. 5,891,130 - Palermo et al.; U.S. 6,063,100 - Diaz et al.; U.S. 6,068,644 - Lulu et al.; and EP 0 941 703 Al - Cordis 21 Corporation.
22 There is still a need for further improvements in field of coupling 23 mechanisms for detachably attaching an embolic implant to a 24 deployment instrument. Specifically, there is still a need for a coupling mechanism that provides for a secure attachment of the 26 embolic implant to a deployment instrument during the deployment 27 process, while also allowing for the easy and reliable detachment of the 28 embolic implant once it is properly situated with respect to the target 1 site. It would also be advantageous for such a mechanism to allow 2 improved control of the implant during deployment, and specifically to 3 allow the implant to be easily repositioned before detachment.
4 Furthermore, the coupling mechanism should be adaptable for use with a wide variety of endovascular implants, and it should not add 6 appreciably to their costs.
9 Broadly, the present invention is a mechanism for the deployment of a filamentous endovascular device, such as an embolic 11 implant, comprising an elongate, flexible, hollow deployment tube 12 having an open proximal end, and a coupling element attached to the 13 proximal end of the endovascular device. The deployment tube 14 includes a distal section terminating in an open distal end, with a lumen defined between the proximal and distal ends. A retention 16 sleeve is fixed around the distal section and includes a distal extension 17 extending a short distance past the distal end of the deployment tube.
18 The endovascular device is attached to the distal end of the 19 deployment tube during the manufacturing process by fixing the retention sleeve around the coupling element, so that the coupling 21 element is releasably held within the distal extension proximate the 22 distal end of the deployment tube. In use, the deployment tube, with 23 the implant attached to its distal end, is passed intravascularly through 24 a microcatheter to a target vascular site until the endovascular device is fully deployed within the site. To detach the endovascular device from 26 the deployment tube, a biocompatible liquid (such as saline solution) is 27 injected through the lumen of the deployment tube so as to apply 28 pressure to the upstream (interior) side of the coupling element. The 1 coupling element is thus pushed out of the retention sleeve by the fluid 2 pressure of the liquid, thereby detaching the endovascular device from 3 the deployment tube.
4 The coupling element may be a solid "plug" of polymeric material or metal, or it may be formed of a hydrophilic polymer that 6 softens and becomes somewhat lubricious when contacted by the 7 injected liquid. With the latter type of material, the hydration of the 8 hydrophilic material results in physical changes that reduce the 9 adhesion between the coupling element and the sleeve, thereby facilitating the removal of the coupling element from the sleeve upon 11 the application of liquid pressure. Alternatively, the coupling element 12 can be made principally of a non-hydrophilic material (polymer or 13 metal), coated with a hydrophilic coating.
14 In a specific preferred embodiment, the retention sleeve is made of polyethylene terephthalate (PET), and the coupling element is made 16 of a hydrogel, such as a polyacrylamide/acrylic acid mixture. In 17 another preferred embodiment, both the retention sleeve and the 18 coupling element are made of a polyolefm. In still another preferred 19 embodiment, the retention sleeve is formed of a fluoropolymer, and the coupling element is formed of a metal. Hydrophilic coatings, such 21 as those disclosed in U.S. Patents Nos. 5,001,009 and 5,331,027, may 22 be applied to any of the non-hydrophilic coupling elements.
23 In an alternative embodiment, the retention sleeve is made of a 24 shape memory metal, such as the nickel-titanium alloy known as nitinol. In this alternative embodiment, the coupling element would 26 be made of one of the hydrophilic materials mentioned above, or it 27 may be made of a non-hydrophilic material with a hydrophilic coating.
28 The deployment tube, in the preferred embodiment, comprises a I main section having an open proximal end, a distal section terminating 2 in an open distal end, and a transition section connected between the 3 main and distal sections. A continuous fluid passage lumen is defined 4 between the proximal and distal ends. The distal section is shorter and more flexible than the transition section, and the transition section is 6 shorter and more flexible than the main section. This varying 7 flexibility is achieved by making the main section as a continuous 8 length of flexible, hollow tube, the transition section as a length of 9 hollow, flexible laser-cut ribbon coil, and the distal section as a length of flexible, hollow, helical coil. The sections may be joined together by 11 any suitable means, such as soldering.
12 Advantageously, an axial air purge passage may be provided 13 through the coupling element. The purge passage is dimensioned to 14 allow the passage of saline solution through it, but not a relatively high viscosity contrast agent. Before the deployment tube and the attached 16 implant are introduced intravascularly to the target site, a saline 17 solution is injected under low pressure through the lumen of the 18 deployment tube to displace air from the lumen out through the purge 19 passage. After the implant is located within the target site, a high viscosity contrast agent is injected into the deployment tube lumen to 21 purge the remaining saline solution through the purge passage, but, 22 because the contrast agent cannot pass through the purge passage, it 23 builds up pressure on the proximal surface of the coupling element 24 until the pressure is sufficient to push the coupling element out of the retention sleeve.
26 Any of the embodiments may employ an anti-airflow 27 mechanism for preventing the inadvertent introduction of air into the 28 vasculature during deployment of the implant. One such mechanism 1 comprises an airtight, compliant membrane sealingly disposed over the 2 distal end of the deployment tube. The membrane is expanded or 3 distended distally in response to the injection of the liquid, thereby 4 forcing the implant out of the retention sleeve.
Another such anti-airflow mechanism comprises an intemal 6 stylet disposed axially through the deployment tube. The stylet has a 7 distal outlet opening adjacent the distal end of the deployment tube, 8 and a proximal inlet opening in a fitting attached to the proximal end 9 of the deployment tube. The fitting includes a gas/air venting port in fluid communication with the proximal end of the deployment tube.
11 The gas venting port, in turn, includes a stop-cock valve. In use, the 12 liquid is injected through the stylet with the stop-cock valve open. The 13 injected liquid flows out of the stylet outlet opening and into the 14 deployment tube, hydraulically pushing any entrapped air out of the venting port. When liquid begins flowing out of the venting port, 16 indicating that any entrapped air has been fully purged from the 17 deployment tube, the stop-cock is closed, allowing the continued flow 18 of the liquid to push the implant out of the retention sleeve, as 19 described above.
As will be appreciated more fully from the detailed description 21 below, the present invention provides a secure attachment of the 22 embolic implant to a deployment instrument during the deployment 23 process, while also allowing for the easy and reliable detachment of the 24 embolic implant once it is properly situated with respect to the target site. The present invention also provides improved control of the 26 implant during deployment, and specifically it allows the implant to be 27 easily repositioned before detachment. Furthermore, the present 28 invention is readily adaptable for use with a wide variety of 1 endovascular implants, without adding appreciably to their costs.
4 Figure 1 is an elevational view of an endovascular device 5 deployment mechanism in accordance with a preferred embodiment of 6 the present invention, showing the mechanism with an endovascular 7 implant device attached to it;
8 Figure 2 is a longitudinal cross-sectional view of the deployment 9 mechanism and the endovascular implant of Figure 1, taken along line
10 2- 2 of Figure 1;
11 Figure 3 is a cross-sectional view, similar to that of Figure 2,
12 showing the first step in separating the implant from the deployment
13 tube of the deployment mechanism;
14 Figure 4 is a cross-sectional view, similar to that of Figure 3, showing the deployment mechanism and the implant after the act of 16 separation;
17 Figure 5 is a cross-sectional view of the endovascular implant 18 deployment mechanism incorporating a first type of anti-airflow 19 mechanism;
Figure 6 is a cross sectional view of the deployment mechanism 21 of Figure 5, showing the mechanism with an endovascular implant 22 device attached to it;
23 Figure 7 is a cross-sectional view, similar to that of Figure 6, 24 showing the implant in the process of deployment;
Figure 8 is a cross-sectional view, similar to that of Figure 7, 26 showing deployment device after the implant has been deployed;
27 Figure 9 is an elevational view of the endovascular implant 28 deployment device incorporating a second type of anti-airflow I mechanism, showing the device with an implant attached to it;
2 Figure 10 is a cross-sectional view of the distal portion of the 3 deployment device of Figure 9 and the proximal portion of the 4 implant, taken along line 10 - 10 of Figure 9;
Figure 11 is a cross-sectional view of the deployment device and 6 the attached implant;
7 Figure 12 is a cross-sectional view, similar to that of Figure 11, 8 showing the implant in the process of deployment;
9 Figure 13 is an elevational view of an endovascular implant deployment device in accordance with a modified form of the preferred 11 embodiment of the invention, showing the device with an implant 12 attached to it;
13 Figure 14 is a cross-sectional view taken along line 14 - 14 of 14 Figure 13;
Figures 15-17 are cross-sectional views, similar to that of Figure 16 14, showing the process of deploying the implant;
17 Figure 18 is a cross-sectional view of the endovascular implant 18 deployment device incorporating a modified form of the first type of 19 anti-airflow mechanism, showing the device with an implant attached to it; and 21 Figure 19 is a cross-sectional view, similar to that of Figure 18, 22 showing the implant in the process of deployment.
Referring first to Figure 1, a deployment mechanism for an 26 endovascular device, in accordance with the present invention, 27 comprises an elongate, flexible, hollow deployment tube 10 having an 28 open proximal end I 1(see Figure 11) and a distal section terminating 1 in an open distal end 13, with a continuous fluid passage lumen 15 2 defined between the proximal and distal ends. A retention sleeve 12 is 3 fixed around the distal section of the deployment tube 10, and it 4 includes a distal extension 17 extending a short distance past the distal end 13 of the deployment tube. The deployment mechanism further 6 comprises a coupling element 14 fixed to the proximal end of a 7 filamentous endovascular device 16 (only the proximal portion of 8 which is shown), which may, for example, be an embolic implant.
9 The deployment tube 10 is made of stainless steel, and it is preferably formed in three sections, each of which is dimensioned to 11 pass through a typical microcatheter. A proximal or main section l0a 12 is the longest section, about 1.3 to 1.5 meters in length. The main 13 section 10a is formed as a continuous length of flexible, hollow tubing 14 having a solid wall of uniform inside and outside diameters. In a specific preferred embodiment, the inside diameter is about 0.179 mm, 16 and the outside diameter is about 0.333 mm. An intermediate or 17 transition section 10b is soldered to the distal end of the main section 18 10a, and is formed as a length of hollow, flexible laser-cut ribbon coil.
19 In a specific preferred embodiment, the transition section 10b has a length of about 300 mm, an inside diameter of about 0.179 mm, and 21 an outside diameter of about 0.279 mm. A distal section 10c is 22 soldered to the distal end of the transition section l Ob, and is formed as 23 a length of flexible, hollow helical coil. In a specific preferred 24 embodiment, the distal section lOc has a length of about 30 mm, an inside diameter of about 0.179 mm, and an outside diameter of about 26 0.253 mm. A radiopaque marker (not shown) may optionally be 27 placed about 30 mm proximal from the distal end of the distal section 28 lOc. It will be appreciated that the transition section lOb will be more 1 flexible than the main section 10a, and that the distal section 10c will 2 be more flexible than the transition section lOb.
3 The coupling element 14 is fastened to the proximal end of the 4 endovascular device 16. The endovascular deyice 16 is advantageously of the type disclosed and claimed in United States Patent 6,238,403, 6 assigned to the assignee of the present invention, although 7 the invention can readily be adapted to other types of endovascular 8 devices. Specifically, the endovascular device 16 is an embolization 9 device that comprises a plurality of biocompatible, highly-expansible, hydrophilic embolizing elements 20 (only one of which is shown in the 11 drawings), disposed at spaced intervals along a filamentous carrier 22 12 in the form of a suitable length of a very thin, highly flexible filament 13 of nickel/titanium alloy. The embolizing elements 20 are separated 14 from each other on the carrier by radiopaque spacers in the form of highly flexible microcoils 24 (only one of which is shown in the 16 drawings) made of platinum or platinum/tungsten alloy, as in the 17 thrombogenic microcoils of the prior art, as described above. In a 18 preferred embodiment, the embolizing elements 20 are made of a 19 hydrophilic, macroporous, polymeric, hydrogel foam material, in particular a water-swellable foam matrix formed as a macroporous 21 solid comprising a foam stabilizing agent and a polymer or copolymer 22 of a free radical polymerizable hydrophilic olefin monomer cross-23 linked with up to about 10% by weight of a multiolefin-functional 24 cross-linking agent. Such a material is described in U.S. Patent No.
5,750,585 - Park et al., The mater$al may be modified, or provided with 26 additives, to make the implant visible by conventional imaging 27 techniques.
1 The endovascular device 16 is modified by extending the 2 filamentous carrier 22 proximally so that it provides an attachment site 3 for the coupling element 14 at the proximal end of the carrier 22. A
4 sealing retainer 26 terminates the proximal end of the carrier 22, providing a sealing engagement against the distal end of the coupling 6 element 14.
7 The coupling element 14 is removably attached to the distal end 8 of the deployment tube by the retention sleeve 12, which is secured to 9 the deployment tube 10 by a suitable adhesive or by solder (preferably gold-tin solder). The retention sleeve 12 advantageously covers the 11 transition section 10b and the distal section 10c of the deployment 12 tube, and its proximal end is attached to the distal end of the main 13 section l0a of the deployment tube 10. The retention sleeve 12 has a 14 distal portion that extends distally past the distal end of the deployment tube 10 and surrounds and encloses the coupling element 16 14. The coupling element 14 has an outside diameter that is greater 17 than the normal or relaxed inside diameter of the retention sleeve 12, 18 so that the coupling element 14 is retained within the retention sleeve 19 12 by friction and/or the radially inwardly-directed polymeric forces applied by the retention sleeve 12.
21 The coupling element 14 may be a solid "plug" of polymeric 22 material or metal, or it may be formed of a hydrophilic polymer that 23 softens and becomes somewhat lubricious when contacted by a 24 hydrating liquid, as discussed below. With the latter type of material, the hydration of the hydrophilic material results in physical changes 26 that reduce the adhesion between the coupling element 14 and the 27 sleeve 12, thereby facilitating the removal of the coupling element 14 28 from the sleeve 12 upon the application of liquid pressure to the 1 upstream (proximal) side of the coupling element 14, as will be 2 described below. Alternatively, the coupling element 14 can be made 3 principally of a non-hydrophilic material (polymer or metal), and 4 coated with a hydrophilic coating.
5 In a first preferred embodiment, the retention sleeve 12 is made 6 of polyethylene terephthalate (PET) or polyimide, and the coupling 7 element 14 is made either of a metal (preferably platinum) or of a 8 hydrogel, such as a polyacrylamide/acrylic acid mixture. In another 9 preferred embodiment, both the retention sleeve 12 and the coupling 10 element 14 are made of a polyolefin. In still another preferred 11 embodiment, the retention sleeve 12 is formed of a fluoropolymer, and 12 the coupling element 14 is formed of a metal. Hydrophilic coatings, 13 such as those disclosed in U.S. Pater2t~s Nos. 5,001,009 and 5,331,027,may be 14 applied to any of the non-hydrophilic coupling elements 14. In these
17 Figure 5 is a cross-sectional view of the endovascular implant 18 deployment mechanism incorporating a first type of anti-airflow 19 mechanism;
Figure 6 is a cross sectional view of the deployment mechanism 21 of Figure 5, showing the mechanism with an endovascular implant 22 device attached to it;
23 Figure 7 is a cross-sectional view, similar to that of Figure 6, 24 showing the implant in the process of deployment;
Figure 8 is a cross-sectional view, similar to that of Figure 7, 26 showing deployment device after the implant has been deployed;
27 Figure 9 is an elevational view of the endovascular implant 28 deployment device incorporating a second type of anti-airflow I mechanism, showing the device with an implant attached to it;
2 Figure 10 is a cross-sectional view of the distal portion of the 3 deployment device of Figure 9 and the proximal portion of the 4 implant, taken along line 10 - 10 of Figure 9;
Figure 11 is a cross-sectional view of the deployment device and 6 the attached implant;
7 Figure 12 is a cross-sectional view, similar to that of Figure 11, 8 showing the implant in the process of deployment;
9 Figure 13 is an elevational view of an endovascular implant deployment device in accordance with a modified form of the preferred 11 embodiment of the invention, showing the device with an implant 12 attached to it;
13 Figure 14 is a cross-sectional view taken along line 14 - 14 of 14 Figure 13;
Figures 15-17 are cross-sectional views, similar to that of Figure 16 14, showing the process of deploying the implant;
17 Figure 18 is a cross-sectional view of the endovascular implant 18 deployment device incorporating a modified form of the first type of 19 anti-airflow mechanism, showing the device with an implant attached to it; and 21 Figure 19 is a cross-sectional view, similar to that of Figure 18, 22 showing the implant in the process of deployment.
Referring first to Figure 1, a deployment mechanism for an 26 endovascular device, in accordance with the present invention, 27 comprises an elongate, flexible, hollow deployment tube 10 having an 28 open proximal end I 1(see Figure 11) and a distal section terminating 1 in an open distal end 13, with a continuous fluid passage lumen 15 2 defined between the proximal and distal ends. A retention sleeve 12 is 3 fixed around the distal section of the deployment tube 10, and it 4 includes a distal extension 17 extending a short distance past the distal end 13 of the deployment tube. The deployment mechanism further 6 comprises a coupling element 14 fixed to the proximal end of a 7 filamentous endovascular device 16 (only the proximal portion of 8 which is shown), which may, for example, be an embolic implant.
9 The deployment tube 10 is made of stainless steel, and it is preferably formed in three sections, each of which is dimensioned to 11 pass through a typical microcatheter. A proximal or main section l0a 12 is the longest section, about 1.3 to 1.5 meters in length. The main 13 section 10a is formed as a continuous length of flexible, hollow tubing 14 having a solid wall of uniform inside and outside diameters. In a specific preferred embodiment, the inside diameter is about 0.179 mm, 16 and the outside diameter is about 0.333 mm. An intermediate or 17 transition section 10b is soldered to the distal end of the main section 18 10a, and is formed as a length of hollow, flexible laser-cut ribbon coil.
19 In a specific preferred embodiment, the transition section 10b has a length of about 300 mm, an inside diameter of about 0.179 mm, and 21 an outside diameter of about 0.279 mm. A distal section 10c is 22 soldered to the distal end of the transition section l Ob, and is formed as 23 a length of flexible, hollow helical coil. In a specific preferred 24 embodiment, the distal section lOc has a length of about 30 mm, an inside diameter of about 0.179 mm, and an outside diameter of about 26 0.253 mm. A radiopaque marker (not shown) may optionally be 27 placed about 30 mm proximal from the distal end of the distal section 28 lOc. It will be appreciated that the transition section lOb will be more 1 flexible than the main section 10a, and that the distal section 10c will 2 be more flexible than the transition section lOb.
3 The coupling element 14 is fastened to the proximal end of the 4 endovascular device 16. The endovascular deyice 16 is advantageously of the type disclosed and claimed in United States Patent 6,238,403, 6 assigned to the assignee of the present invention, although 7 the invention can readily be adapted to other types of endovascular 8 devices. Specifically, the endovascular device 16 is an embolization 9 device that comprises a plurality of biocompatible, highly-expansible, hydrophilic embolizing elements 20 (only one of which is shown in the 11 drawings), disposed at spaced intervals along a filamentous carrier 22 12 in the form of a suitable length of a very thin, highly flexible filament 13 of nickel/titanium alloy. The embolizing elements 20 are separated 14 from each other on the carrier by radiopaque spacers in the form of highly flexible microcoils 24 (only one of which is shown in the 16 drawings) made of platinum or platinum/tungsten alloy, as in the 17 thrombogenic microcoils of the prior art, as described above. In a 18 preferred embodiment, the embolizing elements 20 are made of a 19 hydrophilic, macroporous, polymeric, hydrogel foam material, in particular a water-swellable foam matrix formed as a macroporous 21 solid comprising a foam stabilizing agent and a polymer or copolymer 22 of a free radical polymerizable hydrophilic olefin monomer cross-23 linked with up to about 10% by weight of a multiolefin-functional 24 cross-linking agent. Such a material is described in U.S. Patent No.
5,750,585 - Park et al., The mater$al may be modified, or provided with 26 additives, to make the implant visible by conventional imaging 27 techniques.
1 The endovascular device 16 is modified by extending the 2 filamentous carrier 22 proximally so that it provides an attachment site 3 for the coupling element 14 at the proximal end of the carrier 22. A
4 sealing retainer 26 terminates the proximal end of the carrier 22, providing a sealing engagement against the distal end of the coupling 6 element 14.
7 The coupling element 14 is removably attached to the distal end 8 of the deployment tube by the retention sleeve 12, which is secured to 9 the deployment tube 10 by a suitable adhesive or by solder (preferably gold-tin solder). The retention sleeve 12 advantageously covers the 11 transition section 10b and the distal section 10c of the deployment 12 tube, and its proximal end is attached to the distal end of the main 13 section l0a of the deployment tube 10. The retention sleeve 12 has a 14 distal portion that extends distally past the distal end of the deployment tube 10 and surrounds and encloses the coupling element 16 14. The coupling element 14 has an outside diameter that is greater 17 than the normal or relaxed inside diameter of the retention sleeve 12, 18 so that the coupling element 14 is retained within the retention sleeve 19 12 by friction and/or the radially inwardly-directed polymeric forces applied by the retention sleeve 12.
21 The coupling element 14 may be a solid "plug" of polymeric 22 material or metal, or it may be formed of a hydrophilic polymer that 23 softens and becomes somewhat lubricious when contacted by a 24 hydrating liquid, as discussed below. With the latter type of material, the hydration of the hydrophilic material results in physical changes 26 that reduce the adhesion between the coupling element 14 and the 27 sleeve 12, thereby facilitating the removal of the coupling element 14 28 from the sleeve 12 upon the application of liquid pressure to the 1 upstream (proximal) side of the coupling element 14, as will be 2 described below. Alternatively, the coupling element 14 can be made 3 principally of a non-hydrophilic material (polymer or metal), and 4 coated with a hydrophilic coating.
5 In a first preferred embodiment, the retention sleeve 12 is made 6 of polyethylene terephthalate (PET) or polyimide, and the coupling 7 element 14 is made either of a metal (preferably platinum) or of a 8 hydrogel, such as a polyacrylamide/acrylic acid mixture. In another 9 preferred embodiment, both the retention sleeve 12 and the coupling 10 element 14 are made of a polyolefin. In still another preferred 11 embodiment, the retention sleeve 12 is formed of a fluoropolymer, and 12 the coupling element 14 is formed of a metal. Hydrophilic coatings, 13 such as those disclosed in U.S. Pater2t~s Nos. 5,001,009 and 5,331,027,may be 14 applied to any of the non-hydrophilic coupling elements 14. In these
15 einbodiments, the retention sleeve 12 may be formed as a"shrink
16 tube" that is fitted over the coupling element 14 and then shrunk in
17 place by the application of heat to secure the coupling element in
18 place. The heat shrinking process semi-crystallizes the polymeric
19 chains so that sleeve is somewhat stiffened and made resistant to radial expansion (although still expansible axially). Alternatively, the 21 retention sleeve 12 may be made of an elastic polymer that is stretched 22 to receive the coupling element 14, and then retains the coupling 23 element 14 by the resulting elastomeric forces that are directed radially 24 inwardly.
In an alternative embodiment, the retention sleeve 12 is made of 26 a shape rrlemory metal, such as the nickel-titanium alloy known as 27 nitinol. In this altemative embodiment, the coupling element 14 1 would be made of one of the hydrophilic materials mentioned above, 2 or it may be made of a non-hydrophilic material with a hydrophilic 3 coating. In this embodiment, the retention sleeve 12 is radially 4 stretched to receive the coupling element 14, and it retains the coupling element 14 by the forces resulting from the tendency of the shape 6 memory metal to return to its original configuration.
7 Use of the deployment mechanism of the present invention is 8 illustrated in Figures 3 and 4. The endovascular device 16 and the 9 deployment tube 10 are passed intravascularly through the lumen of a microcatheter (not shown) until the endovascular device 16 is situated 11 in a targeted vascular site, such as an aneurysm. A suitable hydrating 12 liquid 30, such as saline solution, is then injected into the interior of 13 the deployment tube, under pressure, as show in Figure 3. The 14 pressure of the liquid against the upstream side of the coupling element pushes the coupling element 14 out of the retention sleeve 12 to 16 separate the endovascular device 16 from the deployment tube, as 17 shown in Figure 4. While the retention sleeve may deform in the axial 18 direction during the separation process, it does not substantially 19 expand in the radial direction. If the coupling element 14 is made of a hydrophilic material, or if it has a hydrophilic coating, the physical 21 changes in the coupling element 14 due to the hydrophilic properties of 22 the coupling element 14 or its coating, as described above, will 23 facilitate the separation process. The deployment tube 10 and the 24 microcatheter are then withdrawn.
It will be appreciated that, until the liquid 30 is injected, the 26 deployment tube 10 can be manipulated to shift the position of the 27 endovascular device 16, which will stay attached to the deployment 28 tube 10 during the manipulation. Thus, repositioning of the 1 endovascular device 16 is facilitated, thereby providing better 2 placement of the device 16 within the targeted site.
3 In many instances, it will be desired to take special precautions 4 against the introduction of air into the vasculature. Accordingly, the present invention may be adapted to incorporate an anti-airflow 6 mechanism. A first type of anti-airflow mechanism, illustrated in 7 Figures 5 - 8, comprises a flexible, expansible, compliant membrane 8 40, preferably of silicone rubber, sealingly disposed over the distal end 9 of the deployment tube 10. The distal end of the deployment tube 10 is covered by a thin, flexible, polymeric sheath 42, and the membrane 40 11 is attached to the sheath 42 by a suitable biocompatible adhesive, such 12 as cyanoacrylate. As shown in Figure 6, the endovascular device 16 is 13 attached to the deployment tube 10 by means of the retention sleeve 12 14 and the coupling element 14, as described above, with the membrane 40 disposed between the distal end of the deployment tube 10 and the 16 proximal end of the coupling element 14.
17 In use, as shown in Figures 7 and 8, the liquid 30 is injected into 18 the deployment tube, as described above. Instead of directly impacting 19 the coupling element 14, however, it expands the membrane 40 distally from the distal end of the deployment tube 10 (Fig. 7), thereby pushing 21 the coupling element 14 out of the retention sleeve to deploy the 22 endovascular device 16. After the deployment, the membrane 23 resiliently returns to its original position (Fig. 8). Thus, the injected 24 liquid 30 is completely contained in a closed system, and any air that may be entrapped in the deployment tube 10 is prevented from 26 entering the vasculature by the airtight barrier present by the 27 membrane 40.
28 Figures 9 - 12 illustrate a second type of anti-airflow mechanism 1 that may be used with the present invention. This second type of anti-2 airflow mechanism comprises an internal stylet 50 disposed axially 3 through the deployment tube 10. The stylet 50 has a flexible distal 4 portion 52 terminating in an outlet opening 54 adjacent the distal end of the deployinent tube 10, and a proximal inlet opening 56 that 6 communicates with an inlet port 58 in a fitting 60 attached to the 7 proximal end of the deployment tube. The fitting 60 includes a gas 8 venting port 62 in fluid communication with the proximal end of the 9 deployment tube. The gas venting port 62, in turn, includes a stop-cock valve 64.
11 The operation of the second type of anti-airflow mechanism 12 during deployment of the endovascular device 16 is shown in Figures 13 11 and 12. As shown in Figure 11, with the stop-cock valve 64 open, 14 the liquid 30 is injected into the stylet 50 through the inlet port 58 by means such as a syringe 66. The injected liquid 30 flows through the 16 stylet 50 and out of the stylet outlet opening 54 and into the 17 deployment tube 10, hydraulically pushing any entrapped air 18 (indicated by arrows 68 in Figure 11) out of the venting port 62. When 19 the liquid 30 begins flowing out of the venting port 62, indicating that any entrapped air has been fully purged from the deployment tube 10, 21 the stop-cock valve 64 is closed (as shown in Figure 12), allowing the 22 continued flow of the liquid 30 to push the endovascular device 16 out 23 of the retention sleeve 12, as described above.
24 Figures 13-17 illustrate a modification of the preferred embodiment of the invention that facilitates the performance of an air 26 purging step before the deployment tube and the endovascular device 27 are intravascularly passed to the target site. This modification 28 includes a modified coupling element 14' having an axial air purge 1 passage 72. The purge passage 72 is provided through a central 2 coupling element portion 74 contained within an inner microcoil 3 segment 761ocated coaxially within the coupling element 14'. The 4 diameter of the purge passage 72 is preferably between about 0.010 mm and about 0.025 mm, for the purpose to be described below.
6 A detachment zone indicator sleeve 70, attached to the distal 7 extension 17 of the retention sleeve 12 by a bond joint 71, is disposed 8 coaxially around a proximal portion (approximately one-half) of the 9 distal extension 17 of the retention sleeve 12, leaving approximately the distal half of the distal extension 17 exposed. The detachment 11 zone indicator sleeve 70 thus overlaps the juncture between the 12 coupling element 14' and the distal end of the deployment tube 10, and 13 reinforces the retention sleeve 12 at this juncture against the stresses 14 resulting from the bending of the assembly as it is passed intravascularly to the target vascular site. Furthermore, the 16 detachment zone indicator sleeve 70 restrains the retention sleeve 70 17 from radial expansion. The detachment zone indicator sleeve 70 may 18 be made of polyimide or platinum. If made of polyimide, its color is 19 advantageously one that contrasts with the color of the retention sleeve 12, so that the detachment zone (i.e., the juncture between the 21 coupling element 14' and the deployment tube 10) can be easily 22 visualized before the intravascular deployment. If made of platinum, 23 the detachment zone can be visualized within the body by X-ray or 24 other conventional visualization methods.
As shown in Figure 15, before the deployment tube 10 and the 26 endovascular device are introduced intravascularly, as described 27 above, saline solution 30 is injected into the lumen 15 to purge air from 28 the mechanism. The purged air exits through the purge passage, as 1 indicated by the arrows 78 in Figure 15, and out the distal end (not 2 shown) of the endovascular device. It may be advantageous to place 3 the distal end of the endovascular device in a receptacle of sterile saline 4 solution, so that the cessation air bubbles may be noted, indicating a 5 complete purging of air. The saline is injected at a sufficiently low 6 pressure (such as by use of a 3 cc syringe), that the coupling element 7 14' is not pushed out of the retention sleeve 12. Some of the saline 8 solution 30 also is purged through the purge passage 72, the diameter 9 of which is sufficiently large to allow the relatively free flow of the 10 saline solution 30 through it.
11 After the endovascular device has been located in the target 12 vascular site, as described above, a contrast agent 73 is injected into the 13 lumen 15, as shown in Figure 16. The contrast agent 73 has a much 14 higher viscosity than the saline solution 30 (3-10 cP vs. approximately 15 1 cP). Therefore, the contrast agent 73 pushes the remaining saline 16 solution 30 out through the purge passage 72. Because of the relatively 17 high viscosity of the contrast agent 73 and the relatively small diameter 18 of the purge passage 72, the contrast agent 73 does not pass easily 19 through the purge passage 72. As the contrast agent 73 continues to
In an alternative embodiment, the retention sleeve 12 is made of 26 a shape rrlemory metal, such as the nickel-titanium alloy known as 27 nitinol. In this altemative embodiment, the coupling element 14 1 would be made of one of the hydrophilic materials mentioned above, 2 or it may be made of a non-hydrophilic material with a hydrophilic 3 coating. In this embodiment, the retention sleeve 12 is radially 4 stretched to receive the coupling element 14, and it retains the coupling element 14 by the forces resulting from the tendency of the shape 6 memory metal to return to its original configuration.
7 Use of the deployment mechanism of the present invention is 8 illustrated in Figures 3 and 4. The endovascular device 16 and the 9 deployment tube 10 are passed intravascularly through the lumen of a microcatheter (not shown) until the endovascular device 16 is situated 11 in a targeted vascular site, such as an aneurysm. A suitable hydrating 12 liquid 30, such as saline solution, is then injected into the interior of 13 the deployment tube, under pressure, as show in Figure 3. The 14 pressure of the liquid against the upstream side of the coupling element pushes the coupling element 14 out of the retention sleeve 12 to 16 separate the endovascular device 16 from the deployment tube, as 17 shown in Figure 4. While the retention sleeve may deform in the axial 18 direction during the separation process, it does not substantially 19 expand in the radial direction. If the coupling element 14 is made of a hydrophilic material, or if it has a hydrophilic coating, the physical 21 changes in the coupling element 14 due to the hydrophilic properties of 22 the coupling element 14 or its coating, as described above, will 23 facilitate the separation process. The deployment tube 10 and the 24 microcatheter are then withdrawn.
It will be appreciated that, until the liquid 30 is injected, the 26 deployment tube 10 can be manipulated to shift the position of the 27 endovascular device 16, which will stay attached to the deployment 28 tube 10 during the manipulation. Thus, repositioning of the 1 endovascular device 16 is facilitated, thereby providing better 2 placement of the device 16 within the targeted site.
3 In many instances, it will be desired to take special precautions 4 against the introduction of air into the vasculature. Accordingly, the present invention may be adapted to incorporate an anti-airflow 6 mechanism. A first type of anti-airflow mechanism, illustrated in 7 Figures 5 - 8, comprises a flexible, expansible, compliant membrane 8 40, preferably of silicone rubber, sealingly disposed over the distal end 9 of the deployment tube 10. The distal end of the deployment tube 10 is covered by a thin, flexible, polymeric sheath 42, and the membrane 40 11 is attached to the sheath 42 by a suitable biocompatible adhesive, such 12 as cyanoacrylate. As shown in Figure 6, the endovascular device 16 is 13 attached to the deployment tube 10 by means of the retention sleeve 12 14 and the coupling element 14, as described above, with the membrane 40 disposed between the distal end of the deployment tube 10 and the 16 proximal end of the coupling element 14.
17 In use, as shown in Figures 7 and 8, the liquid 30 is injected into 18 the deployment tube, as described above. Instead of directly impacting 19 the coupling element 14, however, it expands the membrane 40 distally from the distal end of the deployment tube 10 (Fig. 7), thereby pushing 21 the coupling element 14 out of the retention sleeve to deploy the 22 endovascular device 16. After the deployment, the membrane 23 resiliently returns to its original position (Fig. 8). Thus, the injected 24 liquid 30 is completely contained in a closed system, and any air that may be entrapped in the deployment tube 10 is prevented from 26 entering the vasculature by the airtight barrier present by the 27 membrane 40.
28 Figures 9 - 12 illustrate a second type of anti-airflow mechanism 1 that may be used with the present invention. This second type of anti-2 airflow mechanism comprises an internal stylet 50 disposed axially 3 through the deployment tube 10. The stylet 50 has a flexible distal 4 portion 52 terminating in an outlet opening 54 adjacent the distal end of the deployinent tube 10, and a proximal inlet opening 56 that 6 communicates with an inlet port 58 in a fitting 60 attached to the 7 proximal end of the deployment tube. The fitting 60 includes a gas 8 venting port 62 in fluid communication with the proximal end of the 9 deployment tube. The gas venting port 62, in turn, includes a stop-cock valve 64.
11 The operation of the second type of anti-airflow mechanism 12 during deployment of the endovascular device 16 is shown in Figures 13 11 and 12. As shown in Figure 11, with the stop-cock valve 64 open, 14 the liquid 30 is injected into the stylet 50 through the inlet port 58 by means such as a syringe 66. The injected liquid 30 flows through the 16 stylet 50 and out of the stylet outlet opening 54 and into the 17 deployment tube 10, hydraulically pushing any entrapped air 18 (indicated by arrows 68 in Figure 11) out of the venting port 62. When 19 the liquid 30 begins flowing out of the venting port 62, indicating that any entrapped air has been fully purged from the deployment tube 10, 21 the stop-cock valve 64 is closed (as shown in Figure 12), allowing the 22 continued flow of the liquid 30 to push the endovascular device 16 out 23 of the retention sleeve 12, as described above.
24 Figures 13-17 illustrate a modification of the preferred embodiment of the invention that facilitates the performance of an air 26 purging step before the deployment tube and the endovascular device 27 are intravascularly passed to the target site. This modification 28 includes a modified coupling element 14' having an axial air purge 1 passage 72. The purge passage 72 is provided through a central 2 coupling element portion 74 contained within an inner microcoil 3 segment 761ocated coaxially within the coupling element 14'. The 4 diameter of the purge passage 72 is preferably between about 0.010 mm and about 0.025 mm, for the purpose to be described below.
6 A detachment zone indicator sleeve 70, attached to the distal 7 extension 17 of the retention sleeve 12 by a bond joint 71, is disposed 8 coaxially around a proximal portion (approximately one-half) of the 9 distal extension 17 of the retention sleeve 12, leaving approximately the distal half of the distal extension 17 exposed. The detachment 11 zone indicator sleeve 70 thus overlaps the juncture between the 12 coupling element 14' and the distal end of the deployment tube 10, and 13 reinforces the retention sleeve 12 at this juncture against the stresses 14 resulting from the bending of the assembly as it is passed intravascularly to the target vascular site. Furthermore, the 16 detachment zone indicator sleeve 70 restrains the retention sleeve 70 17 from radial expansion. The detachment zone indicator sleeve 70 may 18 be made of polyimide or platinum. If made of polyimide, its color is 19 advantageously one that contrasts with the color of the retention sleeve 12, so that the detachment zone (i.e., the juncture between the 21 coupling element 14' and the deployment tube 10) can be easily 22 visualized before the intravascular deployment. If made of platinum, 23 the detachment zone can be visualized within the body by X-ray or 24 other conventional visualization methods.
As shown in Figure 15, before the deployment tube 10 and the 26 endovascular device are introduced intravascularly, as described 27 above, saline solution 30 is injected into the lumen 15 to purge air from 28 the mechanism. The purged air exits through the purge passage, as 1 indicated by the arrows 78 in Figure 15, and out the distal end (not 2 shown) of the endovascular device. It may be advantageous to place 3 the distal end of the endovascular device in a receptacle of sterile saline 4 solution, so that the cessation air bubbles may be noted, indicating a 5 complete purging of air. The saline is injected at a sufficiently low 6 pressure (such as by use of a 3 cc syringe), that the coupling element 7 14' is not pushed out of the retention sleeve 12. Some of the saline 8 solution 30 also is purged through the purge passage 72, the diameter 9 of which is sufficiently large to allow the relatively free flow of the 10 saline solution 30 through it.
11 After the endovascular device has been located in the target 12 vascular site, as described above, a contrast agent 73 is injected into the 13 lumen 15, as shown in Figure 16. The contrast agent 73 has a much 14 higher viscosity than the saline solution 30 (3-10 cP vs. approximately 15 1 cP). Therefore, the contrast agent 73 pushes the remaining saline 16 solution 30 out through the purge passage 72. Because of the relatively 17 high viscosity of the contrast agent 73 and the relatively small diameter 18 of the purge passage 72, the contrast agent 73 does not pass easily 19 through the purge passage 72. As the contrast agent 73 continues to
20 flow into the lumen 15, pressure builds up on the proximate side of the
21 coupling element 14', until it is pushed out of the retention sleeve 12,
22 as shown in Figure 17.
23 A modified form of the first type of anti-airflow mechanism is
24 shown in Figures 18 and 19. This modification comprises a flexible, but non-compliant barrier in the form of a non-compliant membrane 26 40', preferably of PET, sealingly disposed over the distal end of the 27 deployment tube 10. The distal end of the deployment tube 10 is 28 covered by a thin, flexible, polymeric sheath 42', and the membrane 40' 1 is attached to the sheath 42' by a suitable biocompatible adhesive, such 2 as cyanoacrylate. As shown in Figure 18, the membrane 40' is shaped 3 so that it normally assumes a first or relaxed position, in which its 4 central portion extends proximally into the lumen 15 of the deployment tube 10. The endovascular device 16 is attached to the 6 deployment tube 10 by means of a frictional fit between the membrane 7 40' and the coupling element 14, the former forming a tight-fitting 8 receptacle for the latter. The retention may be enhanced by a suitable 9 adhesive (e.g., cyanoacrylate). The coupling element 14 is thus contained within lumen 15 near the distal end of the deployment tube 11 10.
12 Figure 19 shows the use of the modified form of the first type of 13 anti-airflow device in the deployment of the endovascular device 16.
14 As described above, the liquid 30 is injected into the deployment tube 10, pushing the membrane 40' distally from the distal end toward a 16 second or extended position, in which projects distally from the distal 17 end of the deployment tube 10. As the membrane 40' is pushed toward 18 its extended position, it pushes the coupling element 14 out of the 19 distal end of the deployment tube 10 to deploy the endovascular device 16. Thus, the injected liquid 30 is completely contained in a closed 21 system, and any air that may be entrapped in the deployment tube 10 22 is prevented from entering the vasculature by the airtight barrier 23 present by the membrane 40'.
24 It will thus be appreciated that the present invention provides a coupling mechanism that yields a secure attachment of the 26 endovascular device to a deployment instrument during the 27 deployment process, while also allowing for the easy and reliable 28 detachment of the endovascular device once it is properly situated with 1 respect to the target site. The coupling mechanism of the present 2 invention also provides improved control of the endovascular device 3 during deployment, and specifically it allows the endovascular device 4 to be easily repositioned before detachment. In addition, the coupling mechanism of the present invention advantageously includes an 6 effective mechanism for precluding airflow into the vasculature during 7 the deployment process. Furthermore, the coupling mechanism of the 8 present invention is readily adaptable for use with a wide variety of 9 endovascular devices, without adding appreciably to their costs.
Although a number of specific embodiments are described I 1 above, it should be appreciated that these embodiments are exemplary 12 only, particularly in terms of materials and dimensions. For example, 13 many suitable materials for both the coupling element 14 and the 14 retention sleeve 12 may be found that will yield satisfactory performance in particular applications. Also, the exemplary 16 dimensions given above may be changed to suit different specific 17 clinical needs. These modifications and others that may suggest 18 themselves to those skilled in the pertinent arts are deemed to be 19 within the spirit and scope of the present invention, as defined in the claims that follow.
12 Figure 19 shows the use of the modified form of the first type of 13 anti-airflow device in the deployment of the endovascular device 16.
14 As described above, the liquid 30 is injected into the deployment tube 10, pushing the membrane 40' distally from the distal end toward a 16 second or extended position, in which projects distally from the distal 17 end of the deployment tube 10. As the membrane 40' is pushed toward 18 its extended position, it pushes the coupling element 14 out of the 19 distal end of the deployment tube 10 to deploy the endovascular device 16. Thus, the injected liquid 30 is completely contained in a closed 21 system, and any air that may be entrapped in the deployment tube 10 22 is prevented from entering the vasculature by the airtight barrier 23 present by the membrane 40'.
24 It will thus be appreciated that the present invention provides a coupling mechanism that yields a secure attachment of the 26 endovascular device to a deployment instrument during the 27 deployment process, while also allowing for the easy and reliable 28 detachment of the endovascular device once it is properly situated with 1 respect to the target site. The coupling mechanism of the present 2 invention also provides improved control of the endovascular device 3 during deployment, and specifically it allows the endovascular device 4 to be easily repositioned before detachment. In addition, the coupling mechanism of the present invention advantageously includes an 6 effective mechanism for precluding airflow into the vasculature during 7 the deployment process. Furthermore, the coupling mechanism of the 8 present invention is readily adaptable for use with a wide variety of 9 endovascular devices, without adding appreciably to their costs.
Although a number of specific embodiments are described I 1 above, it should be appreciated that these embodiments are exemplary 12 only, particularly in terms of materials and dimensions. For example, 13 many suitable materials for both the coupling element 14 and the 14 retention sleeve 12 may be found that will yield satisfactory performance in particular applications. Also, the exemplary 16 dimensions given above may be changed to suit different specific 17 clinical needs. These modifications and others that may suggest 18 themselves to those skilled in the pertinent arts are deemed to be 19 within the spirit and scope of the present invention, as defined in the claims that follow.
Claims (22)
1. A combination of a deployment mechanism for deploying a filamentous endovascular device having a proximal end, and a filamentous endovascular device, the combination of said deployment mechanism and said filamentous endovascular device comprising:
an elongate, flexible, hollow deployment tube having an open proximal end, a distal section terminating in an open distal end, and a lumen defined between the proximal and distal ends;
a retention sleeve fixed to the distal section of the deployment tube and having a distal extension extending a short distance past the open distal end of the deployment tube;
a coupling element attached to the proximal end of the endovascular device and releasably held within the distal extension of the retention sleeve proximate the distal end of the deployment tube so as to be axially displaceable from the retention sleeve in response to fluid pressure applied to the coupling element through the lumen and the distal end of the deployment tube; and anti-air flow means, operatively associated with one of the deployment tube and the coupling element, for substantially preventing the passage of air from the lumen and the distal end of the deployment tube into the patient's vasculature during or after deployment of the endovascular device.
an elongate, flexible, hollow deployment tube having an open proximal end, a distal section terminating in an open distal end, and a lumen defined between the proximal and distal ends;
a retention sleeve fixed to the distal section of the deployment tube and having a distal extension extending a short distance past the open distal end of the deployment tube;
a coupling element attached to the proximal end of the endovascular device and releasably held within the distal extension of the retention sleeve proximate the distal end of the deployment tube so as to be axially displaceable from the retention sleeve in response to fluid pressure applied to the coupling element through the lumen and the distal end of the deployment tube; and anti-air flow means, operatively associated with one of the deployment tube and the coupling element, for substantially preventing the passage of air from the lumen and the distal end of the deployment tube into the patient's vasculature during or after deployment of the endovascular device.
2. The combination of Claim 1, wherein the coupling element is formed from a non-hydrophilic material.
3. The combination of Claim 1, wherein the coupling element is formed from a hydrophilic material.
4. The combination of Claim 2, wherein the coupling element is provided with a hydrophilic coating.
5. The combination of Claim 3, wherein the retention sleeve is made of polyethylene terephthalate and the coupling element is made of a hydrophilic polymeric hydrogel.
6. The combination of Claim 1, wherein the retention sleeve and the coupling element are formed from a polyolefin.
7. The combination of Claim 2, wherein the retention sleeve is made of a fluorocarbon and the coupling element is made of metal.
8. The combination of Claim 1, wherein the retention sleeve is made of a shape memory nickel-titanium alloy.
9. The combination of Claim 1, wherein the deployment tube further includes a proximal main section and an intermediate transition section between the main section and the distal section.
10. The combination of Claim 9, wherein the distal section is shorter and more flexible than the transition section, and the transition section is shorter and more flexible than the main section.
11. The combination of Claim 10, wherein the main section is a continuous, tubular section; the transition section is formed as a laser-cut ribbon coil; and the distal section is formed as a helical coil.
12. The combination of Claim 11, wherein the retention sleeve covers the transition section and the distal section of the deployment tube.
13. The combination of Claim 12, wherein the retention sleeve has a proximal end that is attached to the main section of the deployment tube.
14. The combination of Claim 1, wherein the retention sleeve has a relaxed diameter that is less than the diameter of the coupling element.
15. The combination of Claim 1, wherein said anti-air flow means comprises:
a fluid-tight barrier disposed between the distal end of the deployment tube and the coupling element, the barrier being movable in a distal direction by fluid pressure applied through the lumen to displace the coupling element axially from the retention sleeve.
a fluid-tight barrier disposed between the distal end of the deployment tube and the coupling element, the barrier being movable in a distal direction by fluid pressure applied through the lumen to displace the coupling element axially from the retention sleeve.
16. The combination of Claim 15, wherein the barrier comprises a compliant membrane secured to the deployment tube so as to cover the distal end.
17. The combination of Claim 15, wherein the barrier comprises a flexible membrane secured to the deployment tube so as to cover the distal end and having a central portion, the membrane being movable between a first position, in which its central portion extends proximally into the lumen of the deployment tube, and a second position, in which its central portion is projected distally from the distal end of the deployment tube.
18. The combination of Claim 1, wherein said anti-air flow means comprises:
a fitting attached to the proximal end of the deployment tube, the fitting having a fluid inlet, a gas venting port in fluid communication with the lumen, and a valve in the gas venting port for controlling gas flow therethrough; and a flexible, hollow stylet disposed axially through the fitting and lumen, the stylet having a distal opening proximate the distal end of the deployment tube and a proximal opening in fluid communication with the fluid inlet of the fitting.
a fitting attached to the proximal end of the deployment tube, the fitting having a fluid inlet, a gas venting port in fluid communication with the lumen, and a valve in the gas venting port for controlling gas flow therethrough; and a flexible, hollow stylet disposed axially through the fitting and lumen, the stylet having a distal opening proximate the distal end of the deployment tube and a proximal opening in fluid communication with the fluid inlet of the fitting.
19. The combination of Claim 1, wherein said anti-air flow means comprises a purge passage through said coupling element, said purge passage being dimensioned so as to permit the flow of saline solution therethrough, without permitting the free flow therethrough of a fluid having a viscosity greater than about 3 cP, at pressures that are sufficiently low that the coupling element is not pushed out of the retention sleeve.
20. The combination according to Claim 15 comprising wherein said barrier is resiliently expansible in a distal direction by fluid pressure applied through the lumen.
21. The combination of Claim 20, wherein the barrier comprises a resiliently expansible membrane secured to the deployment tube so as to cover the distal end.
22. The use of a liquid under pressure as an agent to deploy a filamentous endovascular device into a target vascular site, wherein the filamentous endovascular device has a proximate end releasably coupled to an elongate, flexible, hollow deployment tube having an open proximal end, a distal section terminating in an open distal end, and a lumen define between the proximal and distal ends and also having a coupling element releasably attached to the deployment tube adjacent the open distal end thereof, whereby the liquid under pressure is injected through the lumen to separate the endovascular device from the deployment tube in response to the liquid pressure applied to the coupling element through the open distal end of the deployment tube.
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| US09/692,248 US6607538B1 (en) | 2000-10-18 | 2000-10-18 | Mechanism for the deployment of endovascular implants |
| US09/692,248 | 2000-10-18 | ||
| PCT/US2001/032588 WO2002032326A2 (en) | 2000-10-18 | 2001-10-18 | Mechanism for the deployment of endovascular implants |
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| CA2425544A1 CA2425544A1 (en) | 2002-04-25 |
| CA2425544C true CA2425544C (en) | 2008-08-12 |
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| CA002425544A Expired - Fee Related CA2425544C (en) | 2000-10-18 | 2001-10-18 | Mechanism for the deployment of endovascular implants |
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| US (1) | US6607538B1 (en) |
| EP (2) | EP1339328B1 (en) |
| JP (3) | JP3906151B2 (en) |
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-
2000
- 2000-10-18 US US09/692,248 patent/US6607538B1/en not_active Expired - Lifetime
-
2001
- 2001-10-18 CN CNB018176054A patent/CN1330278C/en not_active Expired - Fee Related
- 2001-10-18 AT AT01983174T patent/ATE385743T1/en not_active IP Right Cessation
- 2001-10-18 JP JP2002535565A patent/JP3906151B2/en not_active Expired - Fee Related
- 2001-10-18 AU AU1462302A patent/AU1462302A/en active Pending
- 2001-10-18 DE DE60132800T patent/DE60132800T2/en not_active Expired - Lifetime
- 2001-10-18 WO PCT/US2001/032588 patent/WO2002032326A2/en active IP Right Grant
- 2001-10-18 AU AU2002214623A patent/AU2002214623B2/en not_active Ceased
- 2001-10-18 BR BR0114738-2A patent/BR0114738A/en not_active IP Right Cessation
- 2001-10-18 EP EP01983174A patent/EP1339328B1/en not_active Expired - Lifetime
- 2001-10-18 ES ES01983174T patent/ES2301567T3/en not_active Expired - Lifetime
- 2001-10-18 EP EP07024599A patent/EP1925258A3/en not_active Withdrawn
- 2001-10-18 CN CNA200710110171XA patent/CN101123058A/en active Pending
- 2001-10-18 CA CA002425544A patent/CA2425544C/en not_active Expired - Fee Related
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2006
- 2006-08-18 JP JP2006223306A patent/JP2006305386A/en active Pending
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2010
- 2010-06-23 JP JP2010143165A patent/JP2010246956A/en active Pending
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| WO2002032326A2 (en) | 2002-04-25 |
| AU1462302A (en) | 2002-04-29 |
| JP2006305386A (en) | 2006-11-09 |
| JP2010246956A (en) | 2010-11-04 |
| DE60132800T2 (en) | 2009-05-14 |
| EP1339328B1 (en) | 2008-02-13 |
| EP1925258A2 (en) | 2008-05-28 |
| JP2004511294A (en) | 2004-04-15 |
| EP1339328A2 (en) | 2003-09-03 |
| AU2002214623B2 (en) | 2006-03-09 |
| CN1469724A (en) | 2004-01-21 |
| CN101123058A (en) | 2008-02-13 |
| WO2002032326A3 (en) | 2002-09-06 |
| JP3906151B2 (en) | 2007-04-18 |
| DE60132800D1 (en) | 2008-03-27 |
| ATE385743T1 (en) | 2008-03-15 |
| ES2301567T3 (en) | 2008-07-01 |
| CA2425544A1 (en) | 2002-04-25 |
| CN1330278C (en) | 2007-08-08 |
| EP1925258A3 (en) | 2009-05-13 |
| US6607538B1 (en) | 2003-08-19 |
| BR0114738A (en) | 2004-02-10 |
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