CONICAL VEIN FILTER WITH IMPROVED BALANCE
20180235741 ยท 2018-08-23
Inventors
- Kasper Klausen (Lille Skensved, DK)
- Jens Kold (Lille Skensved, DK)
- Jeppe Brockhaus Johnsen (Froerup, DK)
- Susan Osbaeck (Glumsoe, DK)
Cpc classification
A61F2220/0016
HUMAN NECESSITIES
A61F2/0105
HUMAN NECESSITIES
International classification
Abstract
Disclosed herein is a removable vena cava filter for capturing thrombi in a blood vessel. The filter includes a plurality of primary struts having first ends attached together at their first ends. The filter also includes a plurality of secondary struts spaced between the primary struts and having third ends attached together along the longitudinal axis. Each secondary strut freely extends from the third end to a fourth end avoiding contact with other secondary struts and primary struts. The filter has an expanded configuration, in which the second arcs of the plurality of secondary struts may define a cavity having a hemiovoid shape, such that an ovoid formed from a reflection of the hemiovoid shape of the cavity does not extend beyond the end boundary of the filter defined by the second ends of the primary struts.
Claims
1. A filter for capturing thrombi in a blood vessel, the filter comprising: a plurality of primary struts having first ends attached together along a longitudinal axis, each primary strut extending from the first end arcuately with respect to the longitudinal axis to a second end to define a first length, the arcuate segment including a first curved portion and a second curved portion, the first curved portion extending from the first end away from the longitudinal axis, the second curved portion extending from the first curved portion toward the longitudinal axis to the second end, each of the plurality of primary struts having a first thickness; and a plurality of secondary struts spaced between the primary struts and having third ends attached along the longitudinal axis, each secondary strut extending from the third end to a fourth end to define a second length less than the first length, each secondary strut extending arcuately with respect to the longitudinal axis and linearly radially, each secondary strut including a first arc and a second arc, the first arc extending from the third end away from the longitudinal axis, the second arc extending from the first arc toward the longitudinal axis and terminating at the fourth end, each of the plurality of secondary struts having a second thickness, the first thickness being about one to about two times the second thickness.
2. The filter of claim 1, wherein each second end is a free end terminating in an anchoring hook for engaging a wall of the blood vessel.
3. The filter of claim 1, wherein each fourth end is a free end not terminating in a hook.
4. The filter of claim 1, further comprising a collet surrounding the first ends and the third ends to form a hub.
5. The filter of claim 4, wherein the hub further comprises a retrieval hook extending opposite the plurality of primary and secondary struts for removal of the filter from the blood vessel.
6. The filter of claim 1, wherein the filter is movable between a collapsed configuration and an expanded configuration.
7. The filter of claim 1, wherein when the filter is in the expanded configuration, the fourth ends of the secondary struts are positioned nearer the longitudinal axis than at least another portion of the second arc.
8. The filter of claim 1, wherein each primary strut and secondary strut is formed of at least one of a superelastic material, a stainless steel wire, Nitinol, a cobalt-chromium-nickel-molybdenum-iron alloy, and a cobalt-chrome alloy.
9. A filter for capturing thrombi in a blood vessel, the filter comprising: a plurality of primary struts having first ends attached together along a longitudinal axis, each primary strut extending from the first end arcuately with respect to the longitudinal axis to a second end to define a first length, the arcuate segment including a first curved portion and a second curved portion, the first curved portion extending from the first end away from the longitudinal axis, the second curved portion extending from the first curved portion toward the longitudinal axis to an anchoring hook at the second end; and a plurality of secondary struts spaced between the primary struts and having third ends attached along the longitudinal axis, each secondary strut extending from the third end to a fourth end to define a second length less than the first length, each secondary strut extending arcuately with respect to the longitudinal axis and linearly radially, each secondary strut including a first arc and a second arc, the first arc extending from the third end away from the longitudinal axis, the second arc extending from the first arc toward the longitudinal axis and terminating at the fourth end to define an extended wall-contacting portion; the filter being movable between a collapsed configuration and an expanded configuration such that, when the filter is in the expanded configuration and constrained within the body vessel, the anchoring hooks of the primary struts and the second arcs of the secondary struts engage the wall of the body vessel, a second radial force exerted by each secondary strut is at least equal to a first radial force exerted by each primary strut.
10. The filter of claim 9, wherein the ratio of radial force exerted by one of the plurality of secondary struts is at least twice the radial force exerted by one of the plurality of primary struts.
11. The filter of claim 9, wherein each fourth end is a free end not terminating in a hook.
12. The filter of claim 9, wherein when the filter is in the expanded configuration, the fourth ends of the secondary struts are positioned nearer the longitudinal axis than at least another portion of the second arc.
13. A filter for capturing thrombi in a blood vessel, the filter comprising: a plurality of primary struts having first ends attached together along a longitudinal axis, each primary strut extending from the first end arcuately with respect to the longitudinal axis to a second end to define a first length, each arcuate segment including a first curved portion and a second curved portion, the first curved portion extending from the first end away from the longitudinal axis, the second curved portion extending from the first curved portion toward the longitudinal axis to a second end, the plurality of second ends defining a device end of the filter; and a plurality of secondary struts spaced between the primary struts and having third ends attached along the longitudinal axis, each secondary strut extending from the third end to a fourth end to define a second length less than the first length, each secondary strut extending arcuately with respect to the longitudinal axis and linearly radially, each secondary strut including a first arc and a second arc, the first arc extending from the third end away from the longitudinal axis, the second arc extending from the first arc toward the longitudinal axis and terminating at the fourth end; the filter being movable between a collapsed configuration and an expanded configuration, wherein when the filter is in the expanded configuration, the second arcs of the plurality of secondary struts define a cavity having a hemiovoid shape, such that an ovoid formed from a reflection of the hemiovoid shape of the cavity does not extend beyond the end boundary of the filter defined by the second ends of the primary struts.
14. The filter of claim 13, wherein the fourth ends define the boundary of the largest cross-section of the hemiovoid shape.
15. The filter of claim 13, wherein each second end is a free end terminating in an anchoring hook for engaging a wall of the blood vessel.
16. The filter of claim 13, wherein each fourth end is a free end not terminating in a hook.
17. The filter of claim 13, further comprising a collet surrounding the first ends and the third ends to form a hub.
18. The filter of claim 13, wherein the hub further comprises a retrieval hook extending opposite the plurality of primary and secondary struts for removal of the filter from the blood vessel.
19. The filter of claim 13, wherein when the filter is in the expanded configuration, the fourth ends of the secondary struts are positioned nearer the longitudinal axis than at least another portion of the second arc.
20. The filter of claim 13, wherein each primary strut and secondary strut is formed of at least one of a superelastic material, a stainless steel wire, Nitinol, a cobalt-chromium-nickel-molybdenum-iron alloy, and a cobalt-chrome alloy.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE INVENTION
[0025] About or substantially mean that two given quantities (e.g. lengths, areas or volumes) are within 10%, preferably within 5%, more preferably within 1%. For example, a first quantity of length can be within 10% of a second length quantity.
[0026] Adjacent referred to herein is near, near to, or in close proximity with.
[0027] Longitudinally and derivatives thereof will be understood to mean along the longitudinal axis of the device or device assembly. When the device is implanted in a body vessel, longitudinal may instead pertain to an axis running centrally through the body vessel, which in the instance of an untilted filter will be at least partially coincident with longitudinal as pertains to the device axis.
[0028] Curve, as used herein, means a bend in a rounded fashion, in contrast to an angle, which includes two straight segments meeting at or emanating from a vertex.
[0029] A structure having a soft S-shape includes two curves arranged substantially as the curves of the letter S, with each curve having a radius of curvature greater than the length of the structure.
[0030] The terms proximal and distal and derivatives thereof will be understood in the frame of reference of a device implanted within a body vessel. Thus, in some cases, particularly during retrieval of the filter, proximal refers to locations closer to the physician and distal refers to the locations farther away from the physician (e.g., deeper in the patient's vasculature).
[0031] The term biocompatible refers to a material that is substantially non-toxic in the in vivo environment of its intended use, and that is not substantially rejected by the patient's physiological system (i.e., is non-antigenic).
[0032] As used herein, the term body vessel means any body passage lumen that conducts fluid, including but not limited to blood vessels, esophageal, intestinal, biliary, urethral and ureteral passages.
[0033] In accordance with one embodiment of the present invention,
[0034] In one embodiment, the primary struts 12 may be formed of a superelastic material, stainless steel wire, Nitinol, colbalt-chromium-nickel-molybdenum-iron alloy, cobalt-chrome alloy, or any other suitable superelastic material that will result in a self-opening or self-expanding filter. In this embodiment, the primary struts 12 are preferably formed from wire having a round cross-section with a diameter of at least about 0.30 millimeters (mm) to about 0.60 mm, or about 0.36 mm to about 0.45 mm. It is not necessary that the primary struts have a round or near round cross-section.
[0035] Each primary strut 12 may include an arcuate segment 16 having a soft S-shape. Each arcuate segment 16 is formed with a first curved portion 20 that is configured to softly bend away from the longitudinal or central axis X of the filter 10 and a second curved portion 23 that is configured to softly bend toward the longitudinal axis of the filter 10. Due to the soft bends of each arcuate segment 16, a prominence or a point of inflection on the primary strut 12 is substantially avoided to aid in non-traumatically engaging the vessel wall. In some embodiments, a primary strut 12 may also include a third arcuate segment for formation of a barb or a hook element.
[0036] In another embodiment, the primary struts 12 may include an angle, such as an obtuse angle, or may be substantially straight segments.
[0037] In certain embodiments, the primary struts 12 may include anchoring hooks 26 that will anchor in the vessel wall when the filter 10 is deployed at a delivery location in the blood vessel. In one embodiment, and as illustrated in
[0038] In some embodiments, such as when the primary struts 14 terminate with anchoring hooks 26, the strut ends 15 will not represent an end 90 of the device. In other embodiments, such as when the anchoring hooks 26 lie along a length of a primary strut 14, the strut ends 15 may represent an end 90 of the device.
[0039] In the expanded state, each arcuate segment 16 extends arcuately with respect to the longitudinal axis X (as shown in
[0040] In an embodiment in which the primary struts 12 have a soft S-shape, the soft bends of each arcuate segment 16 allow each primary strut 12 to cross another primary strut 12 along the longitudinal axis X in the collapsed state such that each anchoring hook 26 faces the longitudinal axis X for filter retrieval or delivery.
[0041] When the filter 10 is deployed in a blood vessel, the anchoring hooks 26 engage the walls of the blood vessel to define a first axial portion to secure the filter in the blood vessel. The anchoring hooks 26 prevent the filter 10 from migrating from the delivery location in the blood vessel where it has been implanted. The primary struts 12 are shaped and dimensioned such that, when the filter 10 is freely expanded in an unconstrained fashion, the filter 10 has a diameter of between about 25 mm and about 45 mm, or between about 30 mm and about 35 mm. The filter 10 may also have a length from the collet 11 to the furthest end of the primary struts 12 of between about 3 centimeters (cm) and about 7 cm, or about 4 cm to about 6 cm, or about 4.3 cm to about 4.5 cm. For example, the filter 10 may have a diameter of about 35 mm and a length of about 4.5 cm.
[0042] The primary struts may have a structure as illustrated in
[0043] The filter 10 further includes a plurality of secondary struts 30 having connected ends 32 that independently emanate from hub 11. Hub 11 attaches by crimping the connected ends 32 at the center point A of the secondary struts 30 together with the primary struts 12. In this embodiment, each primary strut 12 has two secondary struts 30 in side-by-side relationship with the primary strut 12. The secondary struts 30 independently extend from the third ends 32 to fourth ends 34 to centralize the filter 10 in the expanded state in the blood vessel. The fourth ends 34 may be free ends unconnected to another portion of the device. The third ends 32 may be connected ends which occupy the interior of collet or hub 11; that is, the hub 11 may house a bundle of first ends 14 of the primary struts 14 and third ends 32 of secondary struts 30.
[0044] As shown in
[0045] The secondary struts 30 may be made from the same type of material as the primary struts 12. In this embodiment, each of the secondary struts 30 is formed of a first arc 40 and a second arc 42. The first arc 40 extends from the third end 32 away from the longitudinal axis X. The second arc 42 extends from the first arc 40 towards the longitudinal axis X. As shown, two secondary struts 30 are located on each side of one primary strut 12 to form the filtering portion of the filter 10. In one embodiment, the hub or collet 11 may be made of the same material as the primary struts and secondary struts to minimize the possibility of galvanic corrosion when implanted.
[0046] When freely expanded, fourth ends 34 of the secondary struts 30 will expand radially outwardly to a diameter of about 25 mm to about 45 mm, or about 30 mm to about 35 mm, to engage the vessel wall. The second arcs 42 of the fourth ends 34 engage the wall of a blood vessel to define a second axial portion, where the vessel wall is engaged by at least a portion of the second arcs 42. In certain embodiments, the extreme (fourth) end of a secondary strut 30 may curve inward, pointing back to the center of the vessel into which it has been implanted, but a more upstream portion of the second arc 42 may contact the vessel wall. The secondary struts 30 function to stabilize the position of the filter 10 about the center of the blood vessel in which it is deployed. As a result, the filter 10 has two layers or portions of struts longitudinally engaging the vessel wall of the blood vessel. In the illustrated embodiment, the length of the filter 10 is effectively defined by the length of a primary strut 12, as the secondary struts 30 do not extend beyond the ends 15 of the primary struts 12.
[0047] It is to be noted that any state in which the filter 10 takes on a generally conical or open shape may be considered an expanded state. In particular, an unconstrained expanded state is realized when the filter 10 is entirely unconstrained, when it is in neither the delivery system nor the vessel in which it is intended to be implanted, such as when sitting on a tabletop. However, when implanted, the filter 10 is also in an expanded state. It will be appreciated by one of skill in the art that the unconstrained expanded state permits the filter to have larger width/diameter dimensions than the inward force cause by pushing against a vessel wall will permit in the implanted expanded state.
[0048] As shown in
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[0050] Line 70 is drawn at the point where fourth ends 34 of filter device 10 align. In this embodiment, it can be seen from
[0051] Line 80 is drawn at the second ends 15 of filter 10. The primary struts 12 of filter 10 extend beyond the line 80 to a furthest point 90. In the depicted embodiment, second ends 15 define an overall longer filter device 10 in the case of the filter that accords with the principles of the present disclosure. In another embodiment, the length of the filter device 10 may be substantially equal to that of prior art device 10.
[0052] Taken together, the features of the present invention give rise to a filter 10 in which both the primary struts 12 and the secondary struts 30 make a substantial contribution to the radial force exerted against the wall of a body vessel in which the device 10 is implanted, which provides sufficient radial force to avoid migration of the device after implantation. The smaller radius of curvature of the second arcs 42 of the secondary struts 30 translates to a shorter distance from the hub 11 at which the secondary struts 30 reach an outer periphery of the device, and therefore form a wall-contacting portion of these struts 30. The distance between the wall-contacting portion of the secondary struts 30 and that of primary struts 12 (including, in some embodiments, hook 26) is increased relative to the prior art filter 10. In certain embodiments, the fourth ends 34 of the secondary struts 30 may lie at a point about halfway between hub 11 and the second ends 15 of the primary struts 12. In other embodiments, the fourth ends 34 of the secondary struts 30 may lie at a point closer to the hub 11 than about halfway between hub 11 and the second ends 15 of the primary struts 12.
[0053] In some embodiments, the secondary struts 30 may include a substantially linear portion toward the fourth end 34. In such instances, the linear portion may be substantially parallel to the longitudinal axis X in the expanded state, either when deployed to a body vessel or an in an unconstrained configuration. Such a linear portion may allow for generation of greater radial force against a vessel to which the device is deployed, or may increase a wall-contacting portion of the device, or both. In some embodiments, this linear portion may have a length of about 1 mm to about 6 mm, or about 2 mm to about 5 mm, or about 3 mm. In another embodiment, the second arc 42 of at least one of the secondary struts 30 may continue such that the secondary struts 30 curve inward toward the longitudinal axis X, and, by extension, toward the center of the body vessel to which the filter 10 is deployed.
[0054] In certain embodiments, the primary struts 12 and the secondary struts 30 may be constructed of wires or wire segments which have the same thickness. A secondary strut 30 of such a construction allows for greater radial force generation. In this embodiment or in other embodiments, greater radial force is generated by the shorter strut length and the smaller radius of curvature of the strut. In one embodiment, the primary struts 12 and the secondary struts 30 may have a thickness of about 0.25 mm. In another embodiment, the primary struts 12 and the secondary struts 30 may have a thickness of about 0.36 mm. In other embodiments, the primary struts 12 and the secondary struts 30 may be constructed of wires or wire segments which have different thicknesses, including embodiments in which the secondary struts 30 are less thick than the primary struts 12. In one embodiment, the secondary struts have a thickness of about 0.24 mm, and the primary struts have a thickness of about 0.45 mm. In another embodiment, the secondary struts have a thickness of about 0.24 mm, and the primary struts may have a thickness of about 0.35 mm. The primary struts may be about twice as thick as the secondary struts, or about 1.5 times as thick as the secondary struts, or any ratio of between about 1 to 2 times as thick as the secondary struts, inclusive.
[0055] The amount of anticipated radial force to be generated by various struts may be adjusted by radial force balancing techniques. For example, filters of similar design may be constructed in subtly different ways in order to ensure that the radial force contributions of the primary struts and the secondary struts relative to one another are balanced as desired. In one example, a filter may realize an increase in radial force contribution from a secondary strut by incorporating secondary struts of the same length as a previous design, but using a thicker wire. Additionally, increasing the number of struts will increase the amount of radial force generated and allow for more contact between wire and the vessel wall after implantation of the device.
[0056] As mentioned, the primary struts 12, the secondary struts 30, and the collet 11 may be made of the same material. A shape memory metal may be particularly useful in the construction of the device 10. In particular, a cobalt-chrome alloy may be preferred. The device 10 may incorporate at least one radiopaque marker in order that implantation may be fluoroscopically tracked as the filter 10 is deployed, or alignment may be monitored after implantation. The radiopaque markers may be placed on the collet 11, or at the ends 15 of the primary struts 12, or along the secondary struts 30, or at an end of the retrieval hook 17, or any other portion of the device.
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[0058] It should be noted that for the purposes of this disclosure that, a filter manufactured to be circular at the fourth ends 34 of the secondary struts 30, and therefore would encompass a hemisphere defined by the second arcs 42 of the secondary struts 30, would fall within the scope of the present disclosure, as the circle would be considered in this case to be a subset of the category of an ovoid in which the measure of all distances from the center of the solid to an edge would be equal (rather than being in a greater/lesser relationship.)
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[0065] In the filters 201/202/203, two primary struts produce more radial force than four secondary struts. Each primary strut produces about 5 gram-force (gf) and each secondary strut about 1.5 gf, for a ratio of about 10:3 primary:secondary. In contrast, four secondary struts of filters 211/212/213 produce more radial force than two primary struts. In filters 211/212/213, each primary strut produces about 2 gf radial force, whereas each secondary strut produces about 4.5 gf, for a ratio of about 4:9. It may be desirable for a filter 10 of the present disclosure to be of such a construction that the amount of radial force produced by each secondary strut is substantially equal to that produced by each primary strut. In another embodiment, it may be preferable that the total radial force produced by all primary struts is substantially equal to that produced by all secondary struts. In another embodiment, the ratio of radial force produced by a primary strut 12 may be no more than twice that produced by a secondary strut. In another embodiment, each secondary strut 30 may produce at least twice the radial force of each primary strut 12.
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[0068] In the collapsed state, each primary strut 12 is configured to cross another primary strut 12 along the longitudinal axis X such that the arcuate segments 16, first curved portions 20 or second curved portions 23, occupy a first diameter D1. In this embodiment, the first diameter is greater than a second diameter D2 occupied by the anchoring hooks 26 for filter retrieval or delivery. It has been found that the first diameter of the arcuate segments 16 serves to clear a path of retrieval, reducing radial force from the sheath or blood vessel on the anchoring hooks 26 during removal of the filter 10 from a patient. The filter 10 may be delivered or retrieved by any suitable introducer system. In some embodiments, the introducer catheter may have an inside diameter of between about 4.5 French and 16 French, and more preferably between about 6.5 French and 14 French.
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[0071] As shown in
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[0076] The angle of each axial bend 425 may range between about 0.5 and about 5. As the primary struts 412 move between the closed state and the expanded state of the filter 410, the second curved distal portions 423 move radially, in a rotating fashion, from the longitudinal axis X toward the vessel wall. The rotating radial movement of the second curved distal portions 423 aid in reducing the risk of entanglement of the primary struts 412.
[0077] As shown in
[0078] Although the embodiments of this device have been disclosed as being constructed from wire having a round cross section, the struts could also take on other cross-sectional profiles, so long as the proper radial force and anchoring characteristics are maintained.
[0079] While the present invention has been described in terms of preferred embodiments, it will be understood, of course, that the invention is not limited thereto since modifications may be made to those skilled in the art, particularly in light of the foregoing teachings.