HEMANGIOMA OCCLUSION APPARATUS, HEMANGIOMA OCCLUSION AND TREATMENT APPARATUS, AND HEMANGIOMA OCCLUSION SYSTEM
20230310004 · 2023-10-05
Inventors
- Shuang GUO (Shanghai, CN)
- Mengqi Chang (Shanghai, CN)
- Bing CHEN (Shanghai, CN)
- Yuanyi Guo (Shanghai, CN)
- Huina LU (Shanghai, CN)
- Yiqun Bruce WANG (Shanghai, CN)
Cpc classification
A61B2090/3966
HUMAN NECESSITIES
International classification
Abstract
An aneurysm occlusion device (10), a therapeutic apparatus for aneurysm occlusion and an aneurysm occlusion system are disclosed. The aneurysm occlusion device (10) includes at least an expandable mesh structure (11) having an expanded configuration with a planar spiral shape and a compressed configuration for delivery into an aneurysm (30) from a blood vessel. The expandable mesh structure (11) can be compressed within a catheter (40) and can recover the expanded configuration with the spiral shape after being released from the catheter (40). The aneurysm occlusion device (10) achieves stable, compliant packing while providing the advantages of among others, avoiding rupture of the aneurysm (30), preventing thrombosis in a blood vessel, increasing coverage of an opening at the aneurysm neck, promoting thrombosis in the aneurysm and accelerating embolization of the aneurysm (30).
Claims
1. An aneurysm occlusion device, comprising at least an expandable mesh structure, wherein the expandable mesh structure has an expanded configuration with a planar spiral shape and a compressed configuration for delivery into an aneurysm from a blood vessel.
2. The aneurysm occlusion device of claim 1, further comprising a guide structure at least partially disposed in a lumen of the expandable mesh structure, wherein when the expandable mesh structure is in the spiral shape, at least a part of the guide structure in the lumen of the expandable mesh structure is expanded into a spiral shape.
3. The aneurysm occlusion device of claim 1, further comprising a guide structure at least partially disposed at an outer side of a distal end of the expandable mesh structure, wherein at least a part of the guide structure at the outer side of the distal end of the expandable mesh structure has an expanded configuration with a spiral shape and a compressed configuration for delivery into an aneurysm from a blood vessel.
4. The aneurysm occlusion device of claim 3, wherein the guide structure is entirely disposed at the outer side the distal end of the expandable mesh structure, and wherein a proximal end of the guide structure is coupled to the distal end of the expandable mesh structure.
5. The aneurysm occlusion device of claim 4, wherein the guide structure is configured as a planar spiral by spiraling a linear member about an axis, and wherein the guide structure spirals in a same direction as the expandable mesh structure.
6. The aneurysm occlusion device of claim 5, wherein the guide structure and the expandable mesh structure spiral in a same plane, wherein an axis of spiraling of the guide structure coincides with an axis of spiraling of the expandable mesh structure; and/or wherein the planar spiral of the guide structure in the expanded configuration is located within a first spiral turn of the expandable mesh structure proximate a distal end thereof.
7. (canceled)
8. The aneurysm occlusion device of claim 1, wherein the expandable mesh structure has a cross-sectional area increasing and then decreasing from a proximal end to a distal end.
9. The aneurysm occlusion device of claim 8, wherein the expandable mesh structure comprises a proximal section, a middle section and a distal section which are sequentially connected along an axis, and wherein: the proximal section has a cross-sectional area gradually increasing from a proximal end to a distal end; and/or the distal section has a cross-sectional area gradually increasing from a distal end to a proximal end; and/or wherein the cross-sectional area of the expandable mesh structure repeatedly increases and decreases from a proximal end to a distal end; and/or wherein a maximum outer diameter of the expandable mesh structure is ⅕ -½ of an outer diameter of a largest spiral turn in the expandable mesh structure.
10. (canceled)
11. (canceled)
12. The aneurysm occlusion device of claim 1, wherein: a distal end of the expandable mesh structure is secured to a distal radiopaque ring; and/or a proximal end of the expandable mesh structure is fixedly coupled to a proximal radiopaque ring.
13. The aneurysm occlusion device of claim 1, wherein the expandable mesh structure is braided from 48-144 filaments made of a shape memory material and having a diameter of from 0.0005 inches to 0.002 inches.
14. The aneurysm occlusion device of claim 13, wherein: the expandable mesh structure is braided from radiopaque filaments; or from a mixture of radiopaque and non-radiopaque filaments.
15. The aneurysm occlusion device of claim 1, wherein the expandable mesh structure has at least one spiral turn, and wherein the expandable mesh structure has 1 to 5 spiral turns.
16. (canceled)
17. The aneurysm occlusion device of claim 2, wherein the guide structure has ¼-3 spiral turns.
18. (canceled)
19. The aneurysm occlusion device of claim 2, wherein an outer diameter of a largest spiral turn in the guide structure does not exceed ½ of an outer diameter of a largest spiral turn in the expandable mesh structure.
20. The aneurysm occlusion device of claim 2, wherein the guide structure is made of a material containing a radiopaque material.
21. The aneurysm occlusion device of claim 1, wherein a bulge radially extending outward is provided at a proximal end of the expandable mesh structure, and wherein: the bulge is a closed ring, which is circumferentially continuous or non-continuous; or the bulge is an unclosed ring .
22. (canceled)
23. A therapeutic apparatus for aneurysm occlusion, comprising the aneurysm occlusion device of claim 1 and a push pod, wherein the push pod is coupled to a proximal end of the expandable mesh structure in the aneurysm occlusion device.
24. The therapeutic apparatus for aneurysm occlusion of claim 23, wherein the push pod extends in a direction tangential to a spiral contour of the spiral shape of the expandable mesh structure in the expanded configuration.
25. An aneurysm occlusion system, comprising the aneurysm occlusion device of claim 1 and a catheter, wherein the expandable mesh structure is configured to be compressed within the catheter and to recover the expanded configuration with the spiral shape after being released from the catheter.
26. The aneurysm occlusion system of claim 25, wherein the catheter has an inner diameter of 0.017, 0.021 or 0.027 inches.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0053]
[0054]
[0055]
[0056]
[0057]
[0058]
[0059]
[0060] In these figures, [0061] 10, an aneurysm occlusion device; [0062] 11, an expandable mesh structure; 111, a distal end of an expandable mesh structure; 112, a proximal end of an expandable mesh structure; 113, a distal section; 114, a middle section; 115, a proximal section; 116, a bulge; 12, a guide structure; 121, a proximal end of a guide structure; 122, a distal end of a guide structure; 13, a distal radiopaque ring; 14, a proximal radiopaque ring; 20, a push pod; 30, an aneurysm; 40, a catheter; D1, an outer diameter of a largest spiral turn in a guide structure; D2, an outer diameter of a largest spiral turn in an expandable mesh structure; and D3, a maximum outer diameter of an expandable mesh structure.
[0063] Throughout the figures, the same reference numbers are used to denote the same or like elements.
DETAILED DESCRIPTION
[0064] Objects, advantages and features of the present invention will become more apparent from the following detailed description when taken in conjunction with the accompanying drawings. Note that the figures are provided in a very simplified form not necessarily drawn to exact scale for the only purpose of facilitating easy and clear description of the disclosed embodiments.
[0065] As used herein, the singular forms “a”, “an” and “the” include plural referents, unless the context clearly dictates otherwise. As used herein and in the appended claims, the term “or” is generally employed in the sense including “and/or”, unless the context clearly dictates otherwise. The term “multiple” is generally employed in the sense including “two or more”, unless the context clearly dictates otherwise. The term “several” is generally employed in the sense including “an indefinite number of”, unless the context clearly dictates otherwise. The term “proximal end” generally refers to an end closer to an operator operating a medical device, and the term “distal end” generally refers to an end of the device that enters a human body first, unless the context clearly dictates otherwise.
[0066] Reference is now made to
[0067] In some embodiments, the guide structure 12 is at least partially disposed within a lumen of the expandable mesh structure 11. When the expandable mesh structure 11 is in the spiral shape, the guide structure 12 is at least partially expanded within the lumen of the expandable mesh structure 11 into a spiral shape. In this process, the part of the guide structure 12 within the expandable mesh structure 11 may spiral synchronously or asynchronously with the expandable mesh structure 11, but the present invention is not so limited. However, supporting the expandable mesh structure 11 with the guide structure 12 therein increases supporting strength of the entire device, ensures its stability and makes it less prone to displacement.
[0068] In some other embodiments, at least a part of the guide structure 12 is disposed at the outer side of a distal end of the expandable mesh structure 11 and has an expanded configuration with a spiral shape and a compressed configuration for delivery into the aneurysm from a blood vessel. Preferably, the guide structure 12 is entirely disposed at the outer side of the distal end of the expandable mesh structure 11. In this case, the guide structure 12 at outer side of the distal end of the expandable mesh structure 11, as a whole, has an expanded configuration with a spiral shape and a compressed configuration for delivery into the aneurysm from a blood vessel. Moreover, a proximal end 121 of the guide structure 12 is coupled to the distal end 111 of the expandable mesh structure 11, facilitating guidance of the expandable mesh structure 11 by the spiral of the guide structure located at outer side of the distal end. This enables the expandable mesh structure 11 to more easily recover a predetermined shape and more stably maintain the shape.
[0069] Further, the part of the guide structure 12 located at outer side of the distal end of the expandable mesh structure 11 is configured as a planar spiral or a three-dimensional spiral by spiraling a linear member about an axis. In the case of the part of the guide structure 12 being located at outer side of the distal end of the expandable mesh structure 11 being configured as a planar spiral, the guide structure 12 spirals in the same direction as the expandable mesh structure 11. Preferably, an axis of spiraling of the guide structure 12 coincides with an axis of spiraling of the expandable mesh structure 11, and the guide structure 12 and the expandable mesh structure 11 spiral in the same plane. In this way, guided by the guide structure 12 in the shape of a planar spiral located at outer side of the distal end, the expandable mesh structure 11 can more easily recover the planar spiral shape after being released into the aneurysm and more stably maintain the shape. Thus, the aneurysm can be effectively isolated, ensuring a desirable embolization effect. Alternatively, in the case of the part of the guide structure 12 being located at outer side of the distal end of the expandable mesh structure 11 being configured as a three-dimensional spiral, the guide structure 12 and the expandable mesh structure 11may spiral in the same direction or different directions. Preferably, the two spiral in the same direction in order to avoid bending of the spirals at the distal end 122 during delivery, which may affect shape recovery of the expandable mesh structure 11 within the aneurysm. In the case of the part of the guide structure 12 being located at outer side of the distal end of the expandable mesh structure 11 being configured as a three-dimensional spiral, an axis of spiraling of the guide structure 12 at the distal end 122 may coincide with an axis of spiraling of the expandable mesh structure 11, or not. However, the present invention is not limited in any way in this regard. Further, in the expanded configuration, the planar spiral structure of the part of the guide structure 12 located at outer side of the distal end of the expandable mesh structure 11 is situated within the first spiral turn proximate the distal end of the expandable mesh structure 11, for example, as shown in
[0070] As noted above, the expandable mesh structure 11 has a compressed configuration and an expanded configuration. When in the expanded configuration, the expandable mesh structure 11 comprises the shape of a planar spiral. The compressed configuration of the expandable mesh structure 11 can facilitate delivery of the expandable mesh structure 11 through a catheter 40 into the aneurysm from a blood vessel. More specifically, the expandable mesh structure 11 is loaded in the catheter 40 (see
[0071] In embodiments of the present invention, there is also provided a therapeutic apparatus for aneurysm occlusion including the aneurysm occlusion device 10 and a push pod 20 for advancing the aneurysm occlusion device 10. The proximal end 112 of the expandable mesh structure 11 is configured to be detachably coupled to the push pod 20. Additionally, the push pod 20 is preferred to extend in a direction tangential to a spiral contour of the planar spiral of the expandable mesh structure 11 in the expanded configuration. In this way, the expandable mesh structure 11 can be advanced and released in a way that an outer surface of its largest spiral turn covers an opening 31 at the neck of an aneurysm (see
[0072] Further, the guide structure 12 is preferred to be an elongate structure (i.e., a linear member) in its expanded configuration, which has an outer diameter much smaller than an outer diameter of the expandable mesh structure 11 when the latter is in the expanded configuration. In this way, compared with the expandable mesh structure 11, the guide structure 12 is more elongate and more flexible, thus providing a better guide and enabling the expandable mesh structure 11 to more easily recover the planar spiral shape in the aneurysm. Furthermore, when the guide structure 12 is located at outer side of the distal end of the expandable mesh structure 11, it can also function to relieve tension from the expandable mesh structure 11 during its release, thereby reducing impact on the wall of the aneurysm and resistance to pushing and making the pushing easier.
[0073] At least a part of the guide structure 12, especially the portion within the expandable mesh structure 11, is preferred to be radiopaque. To this end, the guide structure 12 may be wholly or partially made of a radiopaque material. The radiopaque material may be selected, for example, as platinum (Pt), a platinum-iridium (Pt-Ir) alloy, gold (Au) or the like, without limiting the present invention. In one embodiment, the linear member of the guide structure 12 may be formed by densely winding a metal wire (e.g., a platinum-tungsten alloy, a nickel-titanium alloy, stainless steel or the like) on a metal core bar into a primary coil, and the spiral-shaped guide structure 12 may be obtained by subjecting the primary coil (i.e., linear member) to a shaping process using a mold with a predetermined shape. In another embodiment, the linear member of the guide structure 12 may be a flexible mesh tube formed by cutting a metal tube, and the spiral-shaped guide structure 12 may be obtained by elongating the flexible meshtube and then subjecting it to a shaping process. In yet another embodiment, the linear member of the guide structure 12 may be a braided tube, and the spiral-shaped guide structure 12 may be obtained by elongating the braided tube and then subjecting it to a shaping process. In other embodiments, an elongate shape can be obtained without an elongation process.
[0074] The expandable mesh structure 11 is preferably formed by spirally winding braided tube. Preferably, the braided tube is formed of 48-144 filaments with a diameter of 0.0005-0.002 inches. In this way, a dense mesh with a high mesh opening density can be constructed, which can effectively block blood flow and promote thrombosis in the aneurysm and allows improved coverage of the aneurysm neck. Materials suitable for fabrication of the filaments may include shape memory materials, which may be metal materials with shape memory properties, such as nickel titanium (Ni-Ti) alloys, nickel-titanium-cobalt alloys (Ni-Ti-Co), double-layer composite metal wires (e.g., Ni-Ti@Pt), etc. The material of the filaments may also be a polymer material with certain shape recovery properties, such as polydioxanone (PDO), poly(l-lactide-co-ε-caprolactone) (PLC), polyurethane (PU), amorphous polynorbornene or a combination thereof. Herein, the filaments are made of a shape memory metal or a polymer material with certain shape recovery properties, which imparts shape memory and recovery properties to the mesh. Preferably, the expandable mesh structure 11 is braided from radiopaque filament. Alternatively, the expandable mesh structure 11 may be braided from both radiopaque and non-radiopaque filaments. With this design, the expandable mesh structure 11 will be radiopaque to X-ray fluoroscopy, while exhibiting sufficient elasticity, which enables the expandable mesh structure 11 to have strong ability to recover and maintain its original shape. The present invention is not limited to any particular radiopaque material of the radiopaque filaments, and for example, platinum (Pt), platinum iridium alloys (Pt-Ir), gold (Au) and the like can be suitably used.
[0075] In the expanded configuration, the guide structure 12 is preferred to have no more than 3 spiral turns and has at least ¼ spiral turn. More preferably, it has ¼ to 2 spiral turns. Considering that an excessive outer diameter of the spiral of the guide structure 12 tends to adversely affect the advancement or expansion of the expandable mesh structure 11, an outer diameter D1 of the largest spiral turn of the guide structure 12 is limited to a value not exceeding ½ of the outer diameter D2 of the largest spiral turn in the expandable mesh structure 11. When the number of spiral turns exceeds 5, the aneurysm occlusion device 10 will experience increased resistance to advancement and greater friction during shape recovery in the aneurysm. As a result, the expandable mesh structure 11 is less likely to recover its planar spiral shape. Therefore, in the expanded configuration, the expandable mesh structure 11 is preferred to have no more than 5 spiral turns and may have at least 1, more preferably, 1-3 spiral turns.
[0076] In an exemplary embodiment, as shown in
[0077] In another exemplary embodiment, as shown in
[0078] Additionally, the expandable mesh structure 11 preferably has a cross-sectional area increasing and then decreasing from the proximal end 112 to the distal end 111. That is, the outer diameter of the expandable mesh structure 11 is not constant. Further, the expandable mesh structure 11 includes a distal section 113, a middle section 114 and a proximal section 115 that are sequentially connected along an axis. The distal section 113 preferably has a cross-sectional area (or diameter) increasing from the distal end 111 to the middle section 114, and/or the proximal section 115 preferably has a cross-sectional area (or diameter) increasing from the proximal end 112 to the middle section 114. In other embodiments, the cross-sectional area of the expandable mesh structure 11 may repeatedly increase and decrease from the proximal end 112 to the distal end 111. That is, it may repeatedly widen and narrow. This design can facilitate configuration of the expandable mesh structure 11 into a fusiform shape (swollen at the middle and tapering to each end), which in turn facilitates compression thereof into a smaller size. Moreover, it enables the aneurysm occlusion device to be more flexible, and pushed and advanced while experiencing less resistance and exerting a reduced impact on the aneurysm wall. The distal section 113 can provide a guiding function, which facilitates shaping of the expandable mesh structure 11. This design enables the expandable mesh structure 11 to have a greater mesh opening density at the proximal section 115 and an even greater mesh opening density at the distal section 113. It also imparts to the aneurysm occlusion device 10 increased strength, better support and stability within the spiral and improved resistance to displacement. The present is not limited to any particular mesh opening density distribution of the middle section 114, and for example, the middle section 114 may have a uniform or non-uniform mesh opening density.
[0079] When in the expanded configuration, the maximum outer diameter D3 of the expandable mesh structure 11 is not smaller than ⅕ of the outer diameter D2 of the largest spiral turn in the expandable mesh structure 11 and is preferably equal to ⅕-½, more preferably ⅓-½ thereof. One advantage of this design is that sufficient friction is ensured between the outer surface of the largest spiral turn in the expandable mesh structure 11 and the aneurysm wall to decrease the likeliness of displacement of the aneurysm occlusion device 10. Another advantage is that support force of the aneurysm occlusion device 10 is dispersed, avoiding damage to aneurysm wall possibly caused by local excessive pressure. A third advantage is that it is ensured that the outer surface of the largest spiral turn in the expandable mesh structure 11 can cover the aneurysm neck as completely as possible, so as to increase coverage of the aneurysm neck and hence to accelerate thrombosis within the aneurysm.
[0080] Further, in order to facilitate size control of the spiral, during actual fabrication, adjacent spiral turns in the planar spiral guide structure 12 are preferably closely brought together. For example, in the case of multiple spiral turns, an outer wall of the first spiral turn is closely fitted against an inner wall of the second spiral turn, an outer wall of the second spiral turn is closely fitted against an inner wall of the third spiral turn, and so forth. Likewise, adjacent spiral turns in the expandable mesh structure 11 are preferably closely brought together. Moreover, an inner wall of the first spiral turn of the expandable mesh structure 11 proximate the distal end (i.e., an inner wall of the expandable mesh structure 11 itself) is preferably closely fitted against an outer wall of the outermost spiral turn in the guide structure 12 proximate the proximal end (i.e., the outer surface of the guide structure 12 itself) to facilitate shaping of the expandable mesh structure 11 under the guidance of the guide structure 12. Further, when the guide structure 12 is in the shape of a three-dimensional spiral, preferably, the outer diameter of the largest spiral turn thereof does not exceed an outer diameter of the first spiral turn of the expandable mesh structure 11 proximate the distal end. For example, in the case of the guide structure 12 having multiple spiral turns, the outer diameter of the first spiral turn of the guide structure 12 proximate the distal end is preferably smaller than an outer diameter of each remaining spiral turn, and an outer diameter of each remaining spiral turn of the guide structure 12 does not exceed the outer diameter of the first spiral turn of the expandable mesh structure 11 proximate distal end. Each remaining spiral turn of the guide structure 12 may have an equal or unequal outer diameter and preferably has an equal outer diameter. In addition, the outer diameter of the first spiral turn of the guide structure 12 proximate distal end may be not smaller than ⅔ of the outer diameter of each remaining spiral turn of the guide structure 12, and the outer diameter of each remaining spiral turn of the guide structure 12 is more preferably not smaller than ⅔ of the outer diameter of the first spiral turn in the expandable mesh structure 11 proximate distal end. This design is advantageous in, during release and shape recovery of the expandable mesh structure 11, providing a space for planar packing of the expandable mesh structure 11 and avoiding the spiral of the guide structure 12 from occupying additional space to affect the release and shape recovery of the expandable mesh structure 11 in the aneurysm. It would be appreciated that the first spiral turn of the guide structure 12 refers to the spiral turn at the most distal end thereof and that the first spiral turn of the expandable mesh structure 11 likewise refers to the spiral turn at the most distal end thereof.
[0081] The aneurysm occlusion device 10 may further include a distal radiopaque ring 13 (see
[0082] The aneurysm occlusion device 10 may further include a proximal radiopaque ring 14 (see
[0083] In alternative embodiments, the guide structure 12 may be omitted from the aneurysm occlusion device 10, for example, as shown in
[0084] Further, in order to increase stability of the aneurysm occlusion device 10, a bulge radially extending outward 116 is preferably provided at the proximal end 112 of the expandable mesh structure 11, as shown in
[0085] How the aneurysm occlusion device 10 of the present invention operates will be described below with reference to
[0086] At first, the aneurysm occlusion device 10 is loaded into the catheter 40 for delivery. The aneurysm occlusion device 10 is loaded in the compressed configuration, in which both the expandable mesh structure 11 and the guide structure 12 are elongated into linear shapes, resulting in a radial size of the device that is small enough to allow the device to be accommodated in the catheter 40 having a small inner diameter. Optionally, the inner diameter of the catheter 40 may be 0.017 inches, 0.021 inches or 0.027 inches. After that, as shown in
[0087] Referring to
[0088] It would be appreciated that the aneurysm occlusion device 10 is so deployed in the aneurysm 30 that the expandable mesh structure 11 spirals in a plane of the aneurysm 30 that intersects a plane where the neck of the aneurysm 30 lies. The expandable mesh structure 11 spirals in said plane, and the outer surface of the expandable mesh structure 11 spans over the neck of the aneurysm 30 so that the proximal end 112 of the expandable mesh structure 11 is sandwiched between the aneurysm wall and the outer surface.
[0089] In embodiments of the present invention, there is also provided an aneurysm occlusion system including the aneurysm occlusion device 10 and the catheter 40. The expandable mesh structure 11 is compressed and contracted within the catheter 40 and recovers an expanded configuration with a spiral shape after being released from the catheter 40.
[0090] In summary, compared with the prior art, the therapeutic apparatus for aneurysm occlusion of the present invention allows release with a simpler operation, provides high embolization efficiency, less relies on experience of a physician implementing the surgical procedure and can reduce the required surgical time. Moreover, it can cover the neck of an aneurysm without having to be oriented in a specific direction and thus can be suitably used to treat both regular and irregular aneurysms. It comprises a stable shape within an aneurysm while ensuring effective occlusion of an opening at the aneurysm neck, and prevents its proximal end from being located at middle of the opening at aneurysm neck or from herniating. Further, the distal end is wrapped or oriented inwardly and will not have an impact on the aneurysm wall, avoiding the risk of rupture of the aneurysm.
[0091] The description presented above is merely that of some preferred embodiments of the present invention and does not limit the scope thereof in any sense. Any and all changes and modifications made by those of ordinary skill in the art based on the above teachings fall within the scope as defined in the appended claims.