CA2447484A1 - Absorbable implantable vaso-occlusive member - Google Patents
Absorbable implantable vaso-occlusive member Download PDFInfo
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- CA2447484A1 CA2447484A1 CA002447484A CA2447484A CA2447484A1 CA 2447484 A1 CA2447484 A1 CA 2447484A1 CA 002447484 A CA002447484 A CA 002447484A CA 2447484 A CA2447484 A CA 2447484A CA 2447484 A1 CA2447484 A1 CA 2447484A1
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- Prior art keywords
- vaso
- occlusive
- stretch
- absorbable
- occlusive member
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Classifications
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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
-
- 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
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
- A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
-
- 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
- A61B17/12145—Coils or wires having a pre-set deployed three-dimensional shape
-
- 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
- A61B17/12154—Coils or wires having stretch limiting means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00004—(bio)absorbable, (bio)resorbable, resorptive
-
- 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
- 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
- A61B2017/12063—Details concerning the detachment of the occluding device from the introduction device electrolytically detachable
Abstract
Compositions comprising absorbable implantable vaso-occlusive members are described. Also described are methods of making and using these absorbable vaso-occlusive compositions.
Description
ABSORBABLE IMPLANTABLE VASO-OCCLUSIVE MEMBER
FIELD OF THE INVENTION
Compositions and methods for repair of aneurysms are described. In particular, completely or almost completely absorbable vaso-occlusive members are disclosed, as are methods of making and using these members.
BACKGROUND
An aneurysm is a dilation of a blood vessel (similar to a balloon) that poses a risk to health from the potential for rupture, clotting, or dissecting. Rupture of an aneurysm in the brain causes stroke, and rupture of an aneurysm in the abdomen causes shock.
Cerebral aneurysms are usually detected in patients as the result of a seizure or hemorrhage and can result in significant morbidity or mortality.
There are a variety of materials and devices which have been used for treatment of aneurysms, including platinum and stainless steel microcoils, polyvinyl alcohol sponges (Ivalone), and other mechanical devices. For example, vaso-occlusion devices are surgical implements or implants that are placed within the vasculature of the human body, typically via a catheter, either to block the flow of blood through a vessel making up that portion of the vasculature through the formation of an embolus or to form such an embolus within an aneurysm stemming from the vessel. One widely used vaso-occlusive device is a helical wire coil having windings which may be dimensioned to engage the walls of the vessels. (See, e.g., U.S. Patent No. 4,994,069 to Ritchart et al.) Other less stiff helically coiled devices have been described, as well as those involving woven braids.
U.S. Pat. No. 5,354,295 and its parent, U.S. Pat. No. 5,122,136, both to Guglielini et al., describe an electrolytically detachable embolic device. Vaso-occlusive coils having little or no inherent secondary shape have also been described. For instance, co-owxned U.S. Patent Numbers 5,690,666 and 5,826,587 by Berenstein et al., describes coils having little or no shape after introduction into the vasculax space.
Attempts to increase thrombogenicity of metal coils have also been attempted, for example by modifying the surface of the coil. WO 99/44538 discloses use of GDC
coils coated with biodegradable polymers or proteins. U.S. Pat. No. 5,669,931 to I~upiecki discloses coils that may be filed or coated with thrombotic or medicinal material. U.S. Pat.
No. 5,749,894 to Engleson discloses polymer coated vaso-occlusion devices.
U.S. Pat. No.
5,690,671 to McGurk discloses an embolic element which may include a coating, such as collagen, on the filament surface. U.S. Pat. No. 5,536,274 to Neuss shows spiral implants, some of which are coated with metal particles, silicone, PTFE, rubber latices, or polymers.
U.S. Patent No. 5,980,550 describes a vaso-occlusive device having a bioactive inner coating and a water-soluble outer coating. Co-owned WO/027445, titled "Bioactive Coating for Vaso-occlusive Devices," describes vaso-occlusive devices coated with a collagen-based material and, additionally, describes the use of a tie-layer between the device and the collagen-based coating.
Liquid embolics, such as cyanoacrylate glues and fibrin sealants, have also been used in animal and human subjects. See, e.g., Interventional Radiology, Dandlinger et al, ed., Thieme, N.Y., 1990:295-313; Suga et al. (1992) No S'hihkei Geka 20(8):865-873;
Moringlane et al. (1987) Surg Neurol 28(5):361-366; Moringlane et al. (1988) Acta Neu~ochif Suppl.
(Weih) 43:193-197. Of these liquid embolics, cyanoacrylate glues are the only liquid embolics currently available to neurosurgeons. However, chronic inflammation is typically seen with cyanoacrylate treatments (Herrera et al. (1999) Neuf of Med Chit (Tokyo) 39(2):134-139) and the degradation product, formaldehyde, is highly toxic to the neighboring tissues. See, Vinters et al (1995) Neu~o~aa'iodog~ 27:279-291. Another disadvantage of cyanoacrylate materials is that the polymer will adhere both to the blood vessel and to the tip of the catheter. Thus physicians must retract the catheter immediately after inj ection of the cyanoacrylate embolic material or risk adhesion of the cyanoacrylate and the catheter to the vessel.
WO 00/44306 discloses endovascular apparatuses comprising an at least partially absorbable polymeric or protein coil and a placement device.
None of these documents describe vaso-occlusive members having the characteristics described herein or methods of making such members.
SUMMARY OF THE INVENTION
Thus, this invention includes novel occlusive compositions as well as methods of using and making these compositions.
In one aspect, the invention includes an absorbable vaso-occlusive member comprising: (i) an absorbable material; and (ii) one or more stretch-resistant members fixedly attached to at least two locations of the absorbable material. Non-limiting examples of suitable absorbable materials include polyglygolic acid (PGA), poly-glycolic/poly-L-lactic acid co-polymers, polycaprolactone, polyhydroxybutyrate/hydroxyvalerate copolymers, poly-L-lactide, polydioxanone, polycarbonates, polyanhydrides, collagen, elastin, fibrinogen, fibronectin, vitronectin, laminin, gelatin and combinations thereof.
The vaso-occlusive members described herein can have any three-dimensional shape, including, for example, J-shaped, straight, cylindrical, spherical, tube-like, and helical coil.
In certain embodiments, for example where the vaso-occlusive member is configured as a helical coil having a plurality of helical winds, a first end, a second end and lumen between said first and second ends, the stretch-resistant member extends through said lumen of the coil and is attached to said first and second ends. Alternatively, the stretch-resistant member can be threaded through holes, perforations or winds of the three-dimensional member (e.g., threaded through winds of a coil or through perforations of a tube).
Furthermore, in any of the vaso-occlusive members described the stretch-resistant member can be attached to the interior or, alternatively, exterior of the members (e.g., helical coil or tube).
In certain embodiments, the stretch-resistant member is non- absorbable. In other embodiments, the stretch-resistant member is absorbable. For example, absorbable stretch-resistant members can be separately added elements or, alternatively, the stretch-resistant members) can be formed by modifying the absorbable material, for example by heating or soldering selected locations of the absorbable vaso-occlusive member, e.g., by soldering lines on the exterior or interior of a tube-shaped member or by heating or soldering one or more winds of a helically shaped member to connect at least two of said helical winds. In certain aspects, the stretch-resistant member comprises a mono-filament, for example polypropylene.
In other embodiments, the stretch-resistaait member is a multi-filament.
Any of the vaso-occlusive members described herein can further comprise a deployment tip, for example attached to at least one of the first end and second end of the member (e.g., coil or tube shape). The deployment tip can be, for example, an electrolytically detachable end adapted to detach from a pusher by imposition of a current on said pusher.
Further, any of the vaso-occlusive members described herein can further comprise a radio-s opaque material (for example powdered tantalum, powdered tungsten, bismuth oxide, and barium sulfate) and/or a bioactive material.
In yet another aspect, a method for producing a vaso-occlusive member is described comprising the steps of (i) preparing a generally linear primary element comprising an absorbable material; (ii) winding said primary element onto a mandrel; and (iii) heating said mandrel and said primary element to produce said three dimensional member (e.g, a 15 minute heating step at approximately 165°C). The vaso-occlusive member can have a variety of three-dimensional configurations including, for example, a helical coil configuration, a conical shape or a spiral shape. Further, any suitable mandrel can be used, for example, a stainless steel mandrel.
In yet another aspect, the invention includes a method for producing a vaso-occlusive member comprising the steps of preparing a tube-like structure comprising an absorbable material, for example by micro-machining.
In any of the methods described herein, the absorbable material can be, for example, polyglygolic acid (PGA), poly-glycolic/poly-L-lactic acid co-polymers, polycaprolactone, polyhydroxybutyrate/hydroxyvalerate copolymers, poly-L-lactide, polydioxanone, polycarbonates, polyanhydrides, collagen, elastin, fibrinogen, fibronectin, vitronectin, laminin, gelatin and combinations thereof.
Any of the methods described herein can further include the step of fixedly attaching one or more stretch-resistant members to two or more locations on the vaso-occlusive member, for example by knotting, heating or soldering the stretch-resistant member to the device or by heating, soldering, or plasticizing portions of the device to each other. In any of these methods, the stretch-resistant member can be either absorbable or non-absorbable.
Furthermore, the stretch-resistant member can be a mono-filament, for example, polypropylene or a multi-filament.
In any of the methods described herein, the vaso-occlusive member can further comprise one or more radio-opaque material, for example, powdered tantalum, powdered tungsten, bismuth oxide, and barium sulfate and/or one or more bioactive materials.
These and other embodiments of the subject invention will readily occur to those of slcill in the art in light of the disclosure herein.
BRIEF DESCRIPTION OF THE FIGURES
FIG. 1 depicts an exemplary absorbable vaso-occlusive member of the present invention having a helical configuration.
FIG. 2 depicts an exemplary stretch-resistant and absorbable vaso-occlusive member according to the present invention.
FIG. 3 depicts an electrolytic GDC-type detachment junction.
DESCRIPTION OF THE INVENTION
Occlusive (e.g., embolic) compositions are described. The embolic compositions include, for example, completely or substantially absorbable vaso-occlusive members.
Additional materials may also be used in these embolic compositions. The compositions described herein find use in vascular and neurovascular indications and are particularly useful in treating aneurysms, fox example small-diameter, curved or otherwise difficult to access vasculature, for example cerebral aneurysms. Methods of making and using these vaso-occlusive members also an aspects of this invention.
Advantages of the present invention include, but are not limited to, (i) promoting healing of aneurysms using complete (or virtually complete) absorption rather than partial absorption of the embolic material; (ii) reducing or eliminating painful mass effect associated with some aneurysms or use of some vaso-occlusive devices; (iii) encouraging greater tissue ingrowth in the aneurysm due to the absorbable nature of the member, which in turn results in (iv) more stable aneurysms.
All publications, patents and patent applications cited herein, whether above or below, are hereby incorporated by reference in their entirety.
It must be noted that, as used in this specification and the appended claims, the singular forms "a", "an", and "the" include plural referents unless the content clearly dictates otherwise. Thus, for example, reference to "a filament" includes a mixture of two or more such filaments and the like.
In one aspect, the invention includes absorbable material useftil in occluding aneurysms. The term "absorbable" refers to any agent which, over time, is no longer identifiable at the site of application in the form it was injected, for example having been removed via degradation, metabolism, dissolving or any passive or active removal procedure.
It will be mlderstood that in certain embodiments, not all of the material is absorbable. Thus, the term includes both complete and substantially complete absorption over a period of time ranging from hours to months. Preferably, 80-100% (or any value therebetween) of the material is absorbed; even more preferably 90 to 100% (or any value therebetween) of the material is absorbed and most preferably 100% of the material is absorbed over time. Thus, absorbable vaso-occlusive members are to be contrasted with hybrid devices made up of both absorbable material and non-absorbable material, such as nitinol, in which less than substantially all of the device is absorbed over time.
Thus, described herein are novel structures and novel methods of manufacturing absorbable vaso-occlusive members. Absorbable materials suitable for use in the compositions and methods of the present invention include, but are not limited to, polymers and proteins. Suitable polymers include, for example, polyglygolic acid (PGA), poly-glycolic/poly-L-lactic acid co-polymers, polycaprolactone, polyhydroxybutyrate/hydroxyvalerate copolymers, poly-L-lactide, polydioxanone, polycarbonates, and polyanhydrides. Non-limiting examples of bioabsorbable proteins include collagen, elastin, fibrinogen, fibronectin, vitronectin, laminin and gelatin. Many of these materials are commercially available. Fibrin-containing composition I
are commercially available, for example from Baxter. Collagen containing compositions axe commercially available, for example from Cohesion Technologies, Inc., Palo Alto, California. Fibrinogen-containing compositions are described, for example, in U.S. Patent Nos.
FIELD OF THE INVENTION
Compositions and methods for repair of aneurysms are described. In particular, completely or almost completely absorbable vaso-occlusive members are disclosed, as are methods of making and using these members.
BACKGROUND
An aneurysm is a dilation of a blood vessel (similar to a balloon) that poses a risk to health from the potential for rupture, clotting, or dissecting. Rupture of an aneurysm in the brain causes stroke, and rupture of an aneurysm in the abdomen causes shock.
Cerebral aneurysms are usually detected in patients as the result of a seizure or hemorrhage and can result in significant morbidity or mortality.
There are a variety of materials and devices which have been used for treatment of aneurysms, including platinum and stainless steel microcoils, polyvinyl alcohol sponges (Ivalone), and other mechanical devices. For example, vaso-occlusion devices are surgical implements or implants that are placed within the vasculature of the human body, typically via a catheter, either to block the flow of blood through a vessel making up that portion of the vasculature through the formation of an embolus or to form such an embolus within an aneurysm stemming from the vessel. One widely used vaso-occlusive device is a helical wire coil having windings which may be dimensioned to engage the walls of the vessels. (See, e.g., U.S. Patent No. 4,994,069 to Ritchart et al.) Other less stiff helically coiled devices have been described, as well as those involving woven braids.
U.S. Pat. No. 5,354,295 and its parent, U.S. Pat. No. 5,122,136, both to Guglielini et al., describe an electrolytically detachable embolic device. Vaso-occlusive coils having little or no inherent secondary shape have also been described. For instance, co-owxned U.S. Patent Numbers 5,690,666 and 5,826,587 by Berenstein et al., describes coils having little or no shape after introduction into the vasculax space.
Attempts to increase thrombogenicity of metal coils have also been attempted, for example by modifying the surface of the coil. WO 99/44538 discloses use of GDC
coils coated with biodegradable polymers or proteins. U.S. Pat. No. 5,669,931 to I~upiecki discloses coils that may be filed or coated with thrombotic or medicinal material. U.S. Pat.
No. 5,749,894 to Engleson discloses polymer coated vaso-occlusion devices.
U.S. Pat. No.
5,690,671 to McGurk discloses an embolic element which may include a coating, such as collagen, on the filament surface. U.S. Pat. No. 5,536,274 to Neuss shows spiral implants, some of which are coated with metal particles, silicone, PTFE, rubber latices, or polymers.
U.S. Patent No. 5,980,550 describes a vaso-occlusive device having a bioactive inner coating and a water-soluble outer coating. Co-owned WO/027445, titled "Bioactive Coating for Vaso-occlusive Devices," describes vaso-occlusive devices coated with a collagen-based material and, additionally, describes the use of a tie-layer between the device and the collagen-based coating.
Liquid embolics, such as cyanoacrylate glues and fibrin sealants, have also been used in animal and human subjects. See, e.g., Interventional Radiology, Dandlinger et al, ed., Thieme, N.Y., 1990:295-313; Suga et al. (1992) No S'hihkei Geka 20(8):865-873;
Moringlane et al. (1987) Surg Neurol 28(5):361-366; Moringlane et al. (1988) Acta Neu~ochif Suppl.
(Weih) 43:193-197. Of these liquid embolics, cyanoacrylate glues are the only liquid embolics currently available to neurosurgeons. However, chronic inflammation is typically seen with cyanoacrylate treatments (Herrera et al. (1999) Neuf of Med Chit (Tokyo) 39(2):134-139) and the degradation product, formaldehyde, is highly toxic to the neighboring tissues. See, Vinters et al (1995) Neu~o~aa'iodog~ 27:279-291. Another disadvantage of cyanoacrylate materials is that the polymer will adhere both to the blood vessel and to the tip of the catheter. Thus physicians must retract the catheter immediately after inj ection of the cyanoacrylate embolic material or risk adhesion of the cyanoacrylate and the catheter to the vessel.
WO 00/44306 discloses endovascular apparatuses comprising an at least partially absorbable polymeric or protein coil and a placement device.
None of these documents describe vaso-occlusive members having the characteristics described herein or methods of making such members.
SUMMARY OF THE INVENTION
Thus, this invention includes novel occlusive compositions as well as methods of using and making these compositions.
In one aspect, the invention includes an absorbable vaso-occlusive member comprising: (i) an absorbable material; and (ii) one or more stretch-resistant members fixedly attached to at least two locations of the absorbable material. Non-limiting examples of suitable absorbable materials include polyglygolic acid (PGA), poly-glycolic/poly-L-lactic acid co-polymers, polycaprolactone, polyhydroxybutyrate/hydroxyvalerate copolymers, poly-L-lactide, polydioxanone, polycarbonates, polyanhydrides, collagen, elastin, fibrinogen, fibronectin, vitronectin, laminin, gelatin and combinations thereof.
The vaso-occlusive members described herein can have any three-dimensional shape, including, for example, J-shaped, straight, cylindrical, spherical, tube-like, and helical coil.
In certain embodiments, for example where the vaso-occlusive member is configured as a helical coil having a plurality of helical winds, a first end, a second end and lumen between said first and second ends, the stretch-resistant member extends through said lumen of the coil and is attached to said first and second ends. Alternatively, the stretch-resistant member can be threaded through holes, perforations or winds of the three-dimensional member (e.g., threaded through winds of a coil or through perforations of a tube).
Furthermore, in any of the vaso-occlusive members described the stretch-resistant member can be attached to the interior or, alternatively, exterior of the members (e.g., helical coil or tube).
In certain embodiments, the stretch-resistant member is non- absorbable. In other embodiments, the stretch-resistant member is absorbable. For example, absorbable stretch-resistant members can be separately added elements or, alternatively, the stretch-resistant members) can be formed by modifying the absorbable material, for example by heating or soldering selected locations of the absorbable vaso-occlusive member, e.g., by soldering lines on the exterior or interior of a tube-shaped member or by heating or soldering one or more winds of a helically shaped member to connect at least two of said helical winds. In certain aspects, the stretch-resistant member comprises a mono-filament, for example polypropylene.
In other embodiments, the stretch-resistaait member is a multi-filament.
Any of the vaso-occlusive members described herein can further comprise a deployment tip, for example attached to at least one of the first end and second end of the member (e.g., coil or tube shape). The deployment tip can be, for example, an electrolytically detachable end adapted to detach from a pusher by imposition of a current on said pusher.
Further, any of the vaso-occlusive members described herein can further comprise a radio-s opaque material (for example powdered tantalum, powdered tungsten, bismuth oxide, and barium sulfate) and/or a bioactive material.
In yet another aspect, a method for producing a vaso-occlusive member is described comprising the steps of (i) preparing a generally linear primary element comprising an absorbable material; (ii) winding said primary element onto a mandrel; and (iii) heating said mandrel and said primary element to produce said three dimensional member (e.g, a 15 minute heating step at approximately 165°C). The vaso-occlusive member can have a variety of three-dimensional configurations including, for example, a helical coil configuration, a conical shape or a spiral shape. Further, any suitable mandrel can be used, for example, a stainless steel mandrel.
In yet another aspect, the invention includes a method for producing a vaso-occlusive member comprising the steps of preparing a tube-like structure comprising an absorbable material, for example by micro-machining.
In any of the methods described herein, the absorbable material can be, for example, polyglygolic acid (PGA), poly-glycolic/poly-L-lactic acid co-polymers, polycaprolactone, polyhydroxybutyrate/hydroxyvalerate copolymers, poly-L-lactide, polydioxanone, polycarbonates, polyanhydrides, collagen, elastin, fibrinogen, fibronectin, vitronectin, laminin, gelatin and combinations thereof.
Any of the methods described herein can further include the step of fixedly attaching one or more stretch-resistant members to two or more locations on the vaso-occlusive member, for example by knotting, heating or soldering the stretch-resistant member to the device or by heating, soldering, or plasticizing portions of the device to each other. In any of these methods, the stretch-resistant member can be either absorbable or non-absorbable.
Furthermore, the stretch-resistant member can be a mono-filament, for example, polypropylene or a multi-filament.
In any of the methods described herein, the vaso-occlusive member can further comprise one or more radio-opaque material, for example, powdered tantalum, powdered tungsten, bismuth oxide, and barium sulfate and/or one or more bioactive materials.
These and other embodiments of the subject invention will readily occur to those of slcill in the art in light of the disclosure herein.
BRIEF DESCRIPTION OF THE FIGURES
FIG. 1 depicts an exemplary absorbable vaso-occlusive member of the present invention having a helical configuration.
FIG. 2 depicts an exemplary stretch-resistant and absorbable vaso-occlusive member according to the present invention.
FIG. 3 depicts an electrolytic GDC-type detachment junction.
DESCRIPTION OF THE INVENTION
Occlusive (e.g., embolic) compositions are described. The embolic compositions include, for example, completely or substantially absorbable vaso-occlusive members.
Additional materials may also be used in these embolic compositions. The compositions described herein find use in vascular and neurovascular indications and are particularly useful in treating aneurysms, fox example small-diameter, curved or otherwise difficult to access vasculature, for example cerebral aneurysms. Methods of making and using these vaso-occlusive members also an aspects of this invention.
Advantages of the present invention include, but are not limited to, (i) promoting healing of aneurysms using complete (or virtually complete) absorption rather than partial absorption of the embolic material; (ii) reducing or eliminating painful mass effect associated with some aneurysms or use of some vaso-occlusive devices; (iii) encouraging greater tissue ingrowth in the aneurysm due to the absorbable nature of the member, which in turn results in (iv) more stable aneurysms.
All publications, patents and patent applications cited herein, whether above or below, are hereby incorporated by reference in their entirety.
It must be noted that, as used in this specification and the appended claims, the singular forms "a", "an", and "the" include plural referents unless the content clearly dictates otherwise. Thus, for example, reference to "a filament" includes a mixture of two or more such filaments and the like.
In one aspect, the invention includes absorbable material useftil in occluding aneurysms. The term "absorbable" refers to any agent which, over time, is no longer identifiable at the site of application in the form it was injected, for example having been removed via degradation, metabolism, dissolving or any passive or active removal procedure.
It will be mlderstood that in certain embodiments, not all of the material is absorbable. Thus, the term includes both complete and substantially complete absorption over a period of time ranging from hours to months. Preferably, 80-100% (or any value therebetween) of the material is absorbed; even more preferably 90 to 100% (or any value therebetween) of the material is absorbed and most preferably 100% of the material is absorbed over time. Thus, absorbable vaso-occlusive members are to be contrasted with hybrid devices made up of both absorbable material and non-absorbable material, such as nitinol, in which less than substantially all of the device is absorbed over time.
Thus, described herein are novel structures and novel methods of manufacturing absorbable vaso-occlusive members. Absorbable materials suitable for use in the compositions and methods of the present invention include, but are not limited to, polymers and proteins. Suitable polymers include, for example, polyglygolic acid (PGA), poly-glycolic/poly-L-lactic acid co-polymers, polycaprolactone, polyhydroxybutyrate/hydroxyvalerate copolymers, poly-L-lactide, polydioxanone, polycarbonates, and polyanhydrides. Non-limiting examples of bioabsorbable proteins include collagen, elastin, fibrinogen, fibronectin, vitronectin, laminin and gelatin. Many of these materials are commercially available. Fibrin-containing composition I
are commercially available, for example from Baxter. Collagen containing compositions axe commercially available, for example from Cohesion Technologies, Inc., Palo Alto, California. Fibrinogen-containing compositions are described, for example, in U.S. Patent Nos.
6,168,788 and 5,290,552. As will be readily apparent, absorbable materials can be used alone or in any combination with each other. The absorbable material may be in the form of a mono-filament or, alternatively, a multi-filament strands.
Furthermore, the absorbable materials can also be used in combination with additional components. For example, lubricious materials (e.g., hydrophilic) materials may be used to coat the member to help facilitate delivery. One or more bioactive materials may also be included. The term "bioactive" refers to any agent which exhibits effects ih vivo, for example a thrombotic agent, a therapeutic agent or the like. Non-limiting examples of bioactive materials include cytokines; extracellular matrix molecules (e.g.,collagen);
trace metals (e.g., copper); and other molecules that stabilize thrombus formation or inhibit clot lysis (e.g., proteins or functional fragments of proteins, including but not limited to Factor XIII, (3a-antiplasmin, plasminogen activator inhibitor-1 (PAI-1) or the like). Non-limiting examples of cytokines which may be used alone or in combination in the practice of the present invention include, basic fibroblast growth factor (~iFGF), platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-(3) and the like. Cytokines, extracellular matrix molecules and thrombus stabilizing molecules (e.g., Factor XIII, PAI-l, etc.) are commercially available from several vendors such as, for example, Genzyme (Framingham, MA), Genentech (South San Francisco, CA), Amgen (Thousand Oaks, CA), R&D Systems and hnrnunex (Seattle, WA).
Additionally, bioactive polypeptides can be synthesized recombinantly as the sequence of many of these molecules are also available, for example, from the GenBank database. Thus, it is intended that the invention include use of DNA or RNA encoding any of the bioactive molecules.
Furthermore, it is intended, although not always explicitly stated, that molecules having similar biological activity as wild-type or purified cytokines, extracellular matrix molecules and thrombus-stabilizing proteins (e.g., recombinantly produced or mutants thereof) and nucleic acid encoding these molecules are intended to be used within the spirit and scope of the invention. Further, the amount and concentration of liquid embolic and/or other bioactive materials useful in the practice of the invention can be readily determined by a skilled operator and it will be understood that any combination of materials, concentration or dosage can be used, so long as it is not harmful to the subject.
It also may be desirable to include one or more radio-opaque materials for use in visualizing the members in situ. Thus, the absorbable members may be coated or mixed with radio-opaque materials such as metals (e.g. tantalum, gold or platinum particles); barium 'sulfate; bismuth subcarbonate; or the like.
The absorbable vaso-occlusive members may take on a variety of shapes (e.g., configurations). FIG. 1 shows one embodiment of the present invention in which the absorbable material talces on a helical shape upon deployment. Braided absorbable vaso-occlusive members are also included within the scope of the present invention.
For example, a mufti-lead braid can be made by braiding absorbable materials) around a removable core wire. Additionally, the vaso-occlusive member may take the form of a tube-like structure, with or without one or more perforations or holes. It is further within the scope of this invention that the absorbable vaso-occlusive device comprise shapes or structures other than coils, braids and tubes, for examples, J-shaped, straight, cylindrical, spheres, ellipses, spirals, figure-8 shapes, etc. Any of the vaso-occlusive members described herein, for example tube-lilce structures, may be partially or fully micro-machined.
In certain embodiments, the vaso-occlusive members are "stretch-resistant."
(See, e.g., U.S. Patent Nos. 6,193,728; 6,013,084; 6,004,338; 5,853,418; and 5,833,705 for a description of non-absorbable stretch-resistant devices, all of which are hereby incorporated by reference in their entireties). Typically, stretch-resistant devices include a stretch-resistant member fixedly attached to two or more points on the device. The stretch-resistant member may be absorbable or, alternatively, may be a substantially non-absorbed material such as polypropylene. Both absorbable and non-absorbable materials (e.g., suture materials) are commonly available and can be used in the compositions and methods described herein.
The stretch-resistant member can be fixed to the absorbable device in one or more locations, for example near the ends, on the inside or outside surface or combinations thereof.
Furthermore, the stretch-resistant member can be attached by any means, including, but not limited, to heating (e.g. soldering), threading, knotting, plasticizing, etc.
Additionally, in certain embodiments, the stretch-resistant members) are formed by modifying the absorbable material so as to connect selected regions of the vaso-occlusive member to one another. For example, two or more individual winds of a helically shaped absorbable vaso-occlusive device may be heated, soldered or otherwise treated so that they are connected or otherwise fused, thereby forming one or more stretch-resistant members (and a stretch-resistant device).
Similarly, one or more modified regions may be formed by heating, soldering, plasticizing or the like, selected areas of a tube-shaped absorbable structure to make it stretch-resistant. It will be apparent that the modified regions may be of any shape, for example lines, curves, etc, and may be parallel or at angles to each other and/or parallel or at various angles to the longitudinal axis of the tube. Any of the modifications to the absorbable material that render the device stretch-resistant may be on the interior and/or exterior surfaces of the vaso-occlusive member.
Methods of Manufacture Methods of making the absorbable vaso-occlusive members described are also provided. The vaso-occlusive members described herein are typically formed by winding the absorbable material into a first helix, typically a coil; the frst helix is then wound into a secondary form. Typically, the secondary form is one which, when ejected from a delivery catheter, forms a three-dimensional shape to substantially fill the body cavity. Desirably, the vaso-occlusive member is of a size and shape suitable for fitting snugly within a vascular cavity (e.g., an aneurysm, or perhaps, a fistula).
Primary and secondary forms are generally provided by shaping the absorbable material, for example, winding the material on a mandrel or a removable core wire. Vaso-occlusive members according to the present invention can also be formed by winding a single or mufti-lead absorbable materials) around a removable core wire. Suitable winding mandrels, for winding both primary and secondary configurations, may be a variety of shapes (e.g., cylindrical, square, spherical, circular, rectangular, etc.) and may be solid or hollow.
Some exemplary shapes of mandrels are shown in co-owned U.S. Patent No.
5,957,948 to Mariant et al. As noted above, the winding mandrel is typically of sufficient heat resistance to allow a moderate annealing step. The mandrel may be made of stainless steel or other metallic material, alumina, zirconia or the like. Composite mandrels (e.g., composites of conductive and non-conductive materials) described in co-owned U.S. Serial No.
09/637,470 rnay also be employed.
Further, it is usually desirable to ensure that the primary coil does not unravel, for example by taping, clipping or otherwise attaching the primary coil (e.g., the ends) to the mandrel. The primary coil-mandrel complex is preferably annealed at a temperature between about 50° and 200°C, more preferably between about 75°
and 150°C and even more preferably around 100 ° C. The time of annealing can vary from seconds to hours. Amlealing may be omitted or performed at different temperatures, so long as the coil retains its shape after winding and can be readily removed from the mandrel.
In certain embodiments, the primary configuration is then wound into a secondary configuration on a mandrel. Again, suitable mandrels can be selected by the operator based on the desired size and shape of the resulting vaso-occlusive member. As with procedures for winding the primary configuration, clips or other securing means (e.g., tape) may be used to secure the vaso-occlusive member to the selected mandrel. The secondary coil-mandrel complex is preferably annealed, for example at a temperature between about 100° and 500°C, more preferably between about 100°C and 200°C and even more preferably between about 160 and 170 ° C. The time of annealing can vary from seconds to hours. The absorbable material may be wound or braided on the mandrel or other support structure manually. Alternatively, winding machines are commercially available and can be programmed to wind the absorbable material as desired. An exemplary helical secondary configuration is shown in FIG. 1.
As noted above, the devices described herein may also assume a variety of shapes upon deployment. An exemplary helical secondary configuration is shown in FIG.
1. Other shapes include, but are not limited to, spherical, ovoid, Figure-8, conical, spiral, random three-dimensional shapes and the like.
In certain embodiments, the absorbable device is made by injection-molding and/or micro-machining. (See, e.g., co-owned U.S. Patent Application Serial No.
09/866,892).
In embodiments that include a stretch-resistant member, the stretch-resistant member can be attached to the vaso-occlusive member in any number of ways including but not limited to, looping or threading of the stretch-resistant member through the turns and/or lumen (if the vaso-occlusive member is of a configuration to permit such looping or threading); heating, soldering; plasticizing or solvating the junction points to soften the material at the junction and, subsequently allowing re-solidification; or combinations of one or more of these procedures. For example, when the absorbable device is of a helical configuration or a tube with perforations, the stretch-resistant member may be threaded through the coil winds or through the perforations. It will also be apparent that the stretch-resistant member may be attached by any of these methods to the interior or exterior surface of the device. As noted above, the stretch-resistant member may be either absorbable or non-absorbable.
In certain embodiments, the stretch-resistant members) are formed from the absorbable material itself, for example, by heating or plasticizing selected regions of the device to fuse or otherwise connect the regions and make the device stretch-resistant. In view of the teachings herein, those skilled in the art will be readily able to determine which regions of the absorbable material should be modified and how the connections should be made.
Additional materials (e.g., bioactive materials and/or radio-opaque materials) can be made included using any conventional techniques, for example by dipping, coating or soaking the absorbable vaso-occlusive member in the additional material(s).
Other techniques as known in the art, such as shrink-wrapping, spraying may also be used. In additional, the additional materials) may be inj ected into the interior lumen and/or exterior surfaces of the absorbable member.
Methods of Use The embolic compositions described herein are often introduced into a selected site using the procedure outlined below. This procedure may be used in treating a variety of maladies. For instance in the treatment of an aneurysm, the aneurysm itself will be filled (partially or fully) with the compositions described herein.
Conventional catheter insertion and navigational techniques involving guidewires or flow-directed devices may be used to access the site with a catheter. The mechanism will be such as to be capable of being advanced entirely through the catheter to place absorbable vaso-occlusive member at the target site but yet with a sufficient portion of the distal end of the delivery mechanism protruding from the distal end of the catheter to enable detachment of the implantable vaso-occlusive member. For use in peripheral or neural surgeries, the delivery mechanism will normally be about 100-200 cm in length, more normally cm in length. The diameter of the delivery mechanism is usually in the range of 0.25 to about 0.90 nun. Briefly, the liquid embolics and/or occlusive members described herein are typically loaded into a carrier for introduction into the delivery catheter and introduced to the chosen site using the procedure outlined below. This procedure may be used in treating a variety of maladies. For instance, in treatment of an aneurysm, the aneurysm itself may be filled with the embolics (e.g., mechanical devices, absorbable vaso-occlusive members and/or liquid embolics and bioactive materials) which cause formation of an emboli and, at some later time, is at least partially replaced by neovascularized collagenous material formed around the implanted vaso-occlusive members.
A selected site is reached through the vascular system using a collection of specifically chosen catheters and/or guide wires. It is clear that should the site be in a remote site, e.g., in the brain, methods of reaching this site are somewhat limited.
One widely accepted procedure is found in U.S. Patent No. 4,994,069 to Ritchart, et al.
It utilizes a fine endovascular catheter such as is found in U.S. Patent No. 4,739,768, to Engelson. First of all, a large catheter is introduced through an entry site in the vasculature.
Typically, this would be through a femoral artery in the groin. Other entry sites sometimes chosen are found in the neck and are in general well known by physicians who practice this type of medicine. Once the introducer is in place, a guiding catheter is then used to provide a safe passageway from the entry site to a region near the site to be treated. For instance, in treating a site in the human brain, a guiding catheter would be chosen which would extend from the entry site at the femoral artery, up through the large arteries extending to the heart, around the heart through the aortic arch, and downstream through one of the arteries extending from the upper side of the aorta. A guidewire and neurovascular catheter such as that described in the Engelson patent are then placed through the guiding catheter. Once the distal end of the catheter is positioned at the site, often by locating its distal end through the use of radiopaque marker material and fluoroscopy, the catheter is cleared. For instance, if a guidewire has been ~ used to position the catheter, it is withdrawn from the catheter and then the assembly, for example including the absorbable vaso-occlusive member at the distal end, is advanced through the catheter.
Once the selected site has been reached, the absorbable vaso-occlusive member is extruded, for example by loading onto a pusher wire. Preferably, the vaso-occlusive member is loaded onto the pusher wire via a mechanically or electrolytically cleavable junction (e.g., a GDC-type junction that can be severed by application of heat, electrolysis, electrodynamic activation or other means). Additionally, the vaso-occlusive member can be designed to include multiple detachment points, as described in co-owned International Patent Application PCT/LJSO1/47662. They are held in place by gravity, shape, size, volume, magnetic field or combinations thereof. As noted above, the order in which the components of the vaso-occlusive composition are released from the catheter is not critical to the practice of the invention and can be determined by the operator.
EXAMPLES
Example 1: Primar~Confi We produced a series of primary coils having made from absorbable PGA
materials from 0.0055" PGA mono-filament (0.0055", Biogeneral Fiber Technology, Batch #
154) wound over a 0.007" OD stainless steel mandrel, with or without PTFE
tubing. The primary coils were wound using the procedures discussed above and annealed at a temperature of 100°C for 10 minutes. Well-shaped, easy to remove primary coils were formed.
Example 2: Secondary Confi urg-ation A series of absorbable vaso-occlusive members having secondary configurations were also produced. Primary coils were produced essentially as described in Example 1 and then the primary coil was wound into a secondary configuration, with or without PTFE tubing, around a 0.004" OD stainless steel mandrel. The secondary shapes were annealed at a temperature of 165 °C for between about 15 and 30 minutes. Absorbable vaso-occlusive members with secondary configurations, such as those shown in the Figures, were formed.
Example 3: Stretch-Resistant Configurations Absorbable vaso-occlusive members with secondary configurations produced as described in Example 2 were then modified to be stretch-resistant. In particular, the coil was modified so that suture material (non-absorbable, polypropylene mono-filament suture) was attached by threading and/or by soldering at two more locations of the secondary configuration. Subsequently, the suture-containing absorbable vaso-occlusive member was attached to a pusher wire for deployment.
Modifications of the procedure and vaso-occlusive members described above, and the methods of using them in keeping with this invention will be apparent to those having skill in this mechanical and surgical art. These variations are intended to be within the scope of the claims that follow.
Furthermore, the absorbable materials can also be used in combination with additional components. For example, lubricious materials (e.g., hydrophilic) materials may be used to coat the member to help facilitate delivery. One or more bioactive materials may also be included. The term "bioactive" refers to any agent which exhibits effects ih vivo, for example a thrombotic agent, a therapeutic agent or the like. Non-limiting examples of bioactive materials include cytokines; extracellular matrix molecules (e.g.,collagen);
trace metals (e.g., copper); and other molecules that stabilize thrombus formation or inhibit clot lysis (e.g., proteins or functional fragments of proteins, including but not limited to Factor XIII, (3a-antiplasmin, plasminogen activator inhibitor-1 (PAI-1) or the like). Non-limiting examples of cytokines which may be used alone or in combination in the practice of the present invention include, basic fibroblast growth factor (~iFGF), platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-(3) and the like. Cytokines, extracellular matrix molecules and thrombus stabilizing molecules (e.g., Factor XIII, PAI-l, etc.) are commercially available from several vendors such as, for example, Genzyme (Framingham, MA), Genentech (South San Francisco, CA), Amgen (Thousand Oaks, CA), R&D Systems and hnrnunex (Seattle, WA).
Additionally, bioactive polypeptides can be synthesized recombinantly as the sequence of many of these molecules are also available, for example, from the GenBank database. Thus, it is intended that the invention include use of DNA or RNA encoding any of the bioactive molecules.
Furthermore, it is intended, although not always explicitly stated, that molecules having similar biological activity as wild-type or purified cytokines, extracellular matrix molecules and thrombus-stabilizing proteins (e.g., recombinantly produced or mutants thereof) and nucleic acid encoding these molecules are intended to be used within the spirit and scope of the invention. Further, the amount and concentration of liquid embolic and/or other bioactive materials useful in the practice of the invention can be readily determined by a skilled operator and it will be understood that any combination of materials, concentration or dosage can be used, so long as it is not harmful to the subject.
It also may be desirable to include one or more radio-opaque materials for use in visualizing the members in situ. Thus, the absorbable members may be coated or mixed with radio-opaque materials such as metals (e.g. tantalum, gold or platinum particles); barium 'sulfate; bismuth subcarbonate; or the like.
The absorbable vaso-occlusive members may take on a variety of shapes (e.g., configurations). FIG. 1 shows one embodiment of the present invention in which the absorbable material talces on a helical shape upon deployment. Braided absorbable vaso-occlusive members are also included within the scope of the present invention.
For example, a mufti-lead braid can be made by braiding absorbable materials) around a removable core wire. Additionally, the vaso-occlusive member may take the form of a tube-like structure, with or without one or more perforations or holes. It is further within the scope of this invention that the absorbable vaso-occlusive device comprise shapes or structures other than coils, braids and tubes, for examples, J-shaped, straight, cylindrical, spheres, ellipses, spirals, figure-8 shapes, etc. Any of the vaso-occlusive members described herein, for example tube-lilce structures, may be partially or fully micro-machined.
In certain embodiments, the vaso-occlusive members are "stretch-resistant."
(See, e.g., U.S. Patent Nos. 6,193,728; 6,013,084; 6,004,338; 5,853,418; and 5,833,705 for a description of non-absorbable stretch-resistant devices, all of which are hereby incorporated by reference in their entireties). Typically, stretch-resistant devices include a stretch-resistant member fixedly attached to two or more points on the device. The stretch-resistant member may be absorbable or, alternatively, may be a substantially non-absorbed material such as polypropylene. Both absorbable and non-absorbable materials (e.g., suture materials) are commonly available and can be used in the compositions and methods described herein.
The stretch-resistant member can be fixed to the absorbable device in one or more locations, for example near the ends, on the inside or outside surface or combinations thereof.
Furthermore, the stretch-resistant member can be attached by any means, including, but not limited, to heating (e.g. soldering), threading, knotting, plasticizing, etc.
Additionally, in certain embodiments, the stretch-resistant members) are formed by modifying the absorbable material so as to connect selected regions of the vaso-occlusive member to one another. For example, two or more individual winds of a helically shaped absorbable vaso-occlusive device may be heated, soldered or otherwise treated so that they are connected or otherwise fused, thereby forming one or more stretch-resistant members (and a stretch-resistant device).
Similarly, one or more modified regions may be formed by heating, soldering, plasticizing or the like, selected areas of a tube-shaped absorbable structure to make it stretch-resistant. It will be apparent that the modified regions may be of any shape, for example lines, curves, etc, and may be parallel or at angles to each other and/or parallel or at various angles to the longitudinal axis of the tube. Any of the modifications to the absorbable material that render the device stretch-resistant may be on the interior and/or exterior surfaces of the vaso-occlusive member.
Methods of Manufacture Methods of making the absorbable vaso-occlusive members described are also provided. The vaso-occlusive members described herein are typically formed by winding the absorbable material into a first helix, typically a coil; the frst helix is then wound into a secondary form. Typically, the secondary form is one which, when ejected from a delivery catheter, forms a three-dimensional shape to substantially fill the body cavity. Desirably, the vaso-occlusive member is of a size and shape suitable for fitting snugly within a vascular cavity (e.g., an aneurysm, or perhaps, a fistula).
Primary and secondary forms are generally provided by shaping the absorbable material, for example, winding the material on a mandrel or a removable core wire. Vaso-occlusive members according to the present invention can also be formed by winding a single or mufti-lead absorbable materials) around a removable core wire. Suitable winding mandrels, for winding both primary and secondary configurations, may be a variety of shapes (e.g., cylindrical, square, spherical, circular, rectangular, etc.) and may be solid or hollow.
Some exemplary shapes of mandrels are shown in co-owned U.S. Patent No.
5,957,948 to Mariant et al. As noted above, the winding mandrel is typically of sufficient heat resistance to allow a moderate annealing step. The mandrel may be made of stainless steel or other metallic material, alumina, zirconia or the like. Composite mandrels (e.g., composites of conductive and non-conductive materials) described in co-owned U.S. Serial No.
09/637,470 rnay also be employed.
Further, it is usually desirable to ensure that the primary coil does not unravel, for example by taping, clipping or otherwise attaching the primary coil (e.g., the ends) to the mandrel. The primary coil-mandrel complex is preferably annealed at a temperature between about 50° and 200°C, more preferably between about 75°
and 150°C and even more preferably around 100 ° C. The time of annealing can vary from seconds to hours. Amlealing may be omitted or performed at different temperatures, so long as the coil retains its shape after winding and can be readily removed from the mandrel.
In certain embodiments, the primary configuration is then wound into a secondary configuration on a mandrel. Again, suitable mandrels can be selected by the operator based on the desired size and shape of the resulting vaso-occlusive member. As with procedures for winding the primary configuration, clips or other securing means (e.g., tape) may be used to secure the vaso-occlusive member to the selected mandrel. The secondary coil-mandrel complex is preferably annealed, for example at a temperature between about 100° and 500°C, more preferably between about 100°C and 200°C and even more preferably between about 160 and 170 ° C. The time of annealing can vary from seconds to hours. The absorbable material may be wound or braided on the mandrel or other support structure manually. Alternatively, winding machines are commercially available and can be programmed to wind the absorbable material as desired. An exemplary helical secondary configuration is shown in FIG. 1.
As noted above, the devices described herein may also assume a variety of shapes upon deployment. An exemplary helical secondary configuration is shown in FIG.
1. Other shapes include, but are not limited to, spherical, ovoid, Figure-8, conical, spiral, random three-dimensional shapes and the like.
In certain embodiments, the absorbable device is made by injection-molding and/or micro-machining. (See, e.g., co-owned U.S. Patent Application Serial No.
09/866,892).
In embodiments that include a stretch-resistant member, the stretch-resistant member can be attached to the vaso-occlusive member in any number of ways including but not limited to, looping or threading of the stretch-resistant member through the turns and/or lumen (if the vaso-occlusive member is of a configuration to permit such looping or threading); heating, soldering; plasticizing or solvating the junction points to soften the material at the junction and, subsequently allowing re-solidification; or combinations of one or more of these procedures. For example, when the absorbable device is of a helical configuration or a tube with perforations, the stretch-resistant member may be threaded through the coil winds or through the perforations. It will also be apparent that the stretch-resistant member may be attached by any of these methods to the interior or exterior surface of the device. As noted above, the stretch-resistant member may be either absorbable or non-absorbable.
In certain embodiments, the stretch-resistant members) are formed from the absorbable material itself, for example, by heating or plasticizing selected regions of the device to fuse or otherwise connect the regions and make the device stretch-resistant. In view of the teachings herein, those skilled in the art will be readily able to determine which regions of the absorbable material should be modified and how the connections should be made.
Additional materials (e.g., bioactive materials and/or radio-opaque materials) can be made included using any conventional techniques, for example by dipping, coating or soaking the absorbable vaso-occlusive member in the additional material(s).
Other techniques as known in the art, such as shrink-wrapping, spraying may also be used. In additional, the additional materials) may be inj ected into the interior lumen and/or exterior surfaces of the absorbable member.
Methods of Use The embolic compositions described herein are often introduced into a selected site using the procedure outlined below. This procedure may be used in treating a variety of maladies. For instance in the treatment of an aneurysm, the aneurysm itself will be filled (partially or fully) with the compositions described herein.
Conventional catheter insertion and navigational techniques involving guidewires or flow-directed devices may be used to access the site with a catheter. The mechanism will be such as to be capable of being advanced entirely through the catheter to place absorbable vaso-occlusive member at the target site but yet with a sufficient portion of the distal end of the delivery mechanism protruding from the distal end of the catheter to enable detachment of the implantable vaso-occlusive member. For use in peripheral or neural surgeries, the delivery mechanism will normally be about 100-200 cm in length, more normally cm in length. The diameter of the delivery mechanism is usually in the range of 0.25 to about 0.90 nun. Briefly, the liquid embolics and/or occlusive members described herein are typically loaded into a carrier for introduction into the delivery catheter and introduced to the chosen site using the procedure outlined below. This procedure may be used in treating a variety of maladies. For instance, in treatment of an aneurysm, the aneurysm itself may be filled with the embolics (e.g., mechanical devices, absorbable vaso-occlusive members and/or liquid embolics and bioactive materials) which cause formation of an emboli and, at some later time, is at least partially replaced by neovascularized collagenous material formed around the implanted vaso-occlusive members.
A selected site is reached through the vascular system using a collection of specifically chosen catheters and/or guide wires. It is clear that should the site be in a remote site, e.g., in the brain, methods of reaching this site are somewhat limited.
One widely accepted procedure is found in U.S. Patent No. 4,994,069 to Ritchart, et al.
It utilizes a fine endovascular catheter such as is found in U.S. Patent No. 4,739,768, to Engelson. First of all, a large catheter is introduced through an entry site in the vasculature.
Typically, this would be through a femoral artery in the groin. Other entry sites sometimes chosen are found in the neck and are in general well known by physicians who practice this type of medicine. Once the introducer is in place, a guiding catheter is then used to provide a safe passageway from the entry site to a region near the site to be treated. For instance, in treating a site in the human brain, a guiding catheter would be chosen which would extend from the entry site at the femoral artery, up through the large arteries extending to the heart, around the heart through the aortic arch, and downstream through one of the arteries extending from the upper side of the aorta. A guidewire and neurovascular catheter such as that described in the Engelson patent are then placed through the guiding catheter. Once the distal end of the catheter is positioned at the site, often by locating its distal end through the use of radiopaque marker material and fluoroscopy, the catheter is cleared. For instance, if a guidewire has been ~ used to position the catheter, it is withdrawn from the catheter and then the assembly, for example including the absorbable vaso-occlusive member at the distal end, is advanced through the catheter.
Once the selected site has been reached, the absorbable vaso-occlusive member is extruded, for example by loading onto a pusher wire. Preferably, the vaso-occlusive member is loaded onto the pusher wire via a mechanically or electrolytically cleavable junction (e.g., a GDC-type junction that can be severed by application of heat, electrolysis, electrodynamic activation or other means). Additionally, the vaso-occlusive member can be designed to include multiple detachment points, as described in co-owned International Patent Application PCT/LJSO1/47662. They are held in place by gravity, shape, size, volume, magnetic field or combinations thereof. As noted above, the order in which the components of the vaso-occlusive composition are released from the catheter is not critical to the practice of the invention and can be determined by the operator.
EXAMPLES
Example 1: Primar~Confi We produced a series of primary coils having made from absorbable PGA
materials from 0.0055" PGA mono-filament (0.0055", Biogeneral Fiber Technology, Batch #
154) wound over a 0.007" OD stainless steel mandrel, with or without PTFE
tubing. The primary coils were wound using the procedures discussed above and annealed at a temperature of 100°C for 10 minutes. Well-shaped, easy to remove primary coils were formed.
Example 2: Secondary Confi urg-ation A series of absorbable vaso-occlusive members having secondary configurations were also produced. Primary coils were produced essentially as described in Example 1 and then the primary coil was wound into a secondary configuration, with or without PTFE tubing, around a 0.004" OD stainless steel mandrel. The secondary shapes were annealed at a temperature of 165 °C for between about 15 and 30 minutes. Absorbable vaso-occlusive members with secondary configurations, such as those shown in the Figures, were formed.
Example 3: Stretch-Resistant Configurations Absorbable vaso-occlusive members with secondary configurations produced as described in Example 2 were then modified to be stretch-resistant. In particular, the coil was modified so that suture material (non-absorbable, polypropylene mono-filament suture) was attached by threading and/or by soldering at two more locations of the secondary configuration. Subsequently, the suture-containing absorbable vaso-occlusive member was attached to a pusher wire for deployment.
Modifications of the procedure and vaso-occlusive members described above, and the methods of using them in keeping with this invention will be apparent to those having skill in this mechanical and surgical art. These variations are intended to be within the scope of the claims that follow.
Claims (46)
1. An absorbable vaso-occlusive member comprising:
(i) an absorbable material; and (ii) one or more stretch-resistant members fixedly attached to at least two locations of the absorbable material.
(i) an absorbable material; and (ii) one or more stretch-resistant members fixedly attached to at least two locations of the absorbable material.
2. The vaso-occlusive member of claim l, wherein the vaso-occlusive member has a configuration selected from the group consisting of J-shaped, straight, cylindrical, spherical, tube-like, and helical coil.
3. The vaso-occlusive member of claim 2, wherein the absorbable,material is configured as a helical coil having a plurality of helical winds, a first end, a second end and lumen between said first and second ends.
4. The vaso-occlusive member of claim 3, wherein the stretch-resistant member extends through said lumen of the coil and is attached to said first and second ends.
5. The vaso-occlusive member of claim 3, wherein the stretch-resistant member is threaded through the winds of said coil.
6. The vaso-occlusive member of claim 3, wherein the stretch-resistant member is attached to the interior or exterior of the helical coil.
7. The vaso-occlusive member of claim 2, wherein the absorbable material is configured as a tube.
8. The vaso-occlusive member of claim 7, wherein the tube comprises a plurality of perforations therein.
9. The vaso-occlusive member of claim 8, wherein the stretch-resistant member is threaded through at least two of said perforations.
10. The vaso-occlusive member of claim 7, wherein the stretch-resistant member is attached to the interior or exterior of the tube.
11. The vaso-occlusive member of any of claims 1 to 10, wherein the stretch-resistant member is absorbable.
12. The vaso-occlusive member of any of claims 1 to 10, wherein the stretch-resistant member is non-absorbable.
13. The vaso-occlusive member of any of claims 1 to 11, wherein the stretch-resistant member is formed by modifying the absorbable material.
14. The vaso-occlusive device of claim 13, wherein the absorbable material is modified by heating or soldering at selected locations.
15. The vaso-occlusive device of claim 14, wherein the absorbable material is shaped as a helical coil comprising a plurality of helical winds and wherein the heating or soldering serves to connect at least two of said helical winds.
16. The vaso-occlusive device of claim 14, wherein the absorbable material is shaped as a tube and wherein the heating or soldering is at one or more positions on the exterior or interior of the tube.
17. The vaso-occlusive member of any of claims 1 through 11 and 13 through 16, wherein the absorbable material is selected from the group consisting of polyglygolic acid (PGA), poly-glycolic/poly-L-lactic acid co-polymers, polycaprolactone, polyhydroxybutyrate/hydroxyvalerate copolymers, poly-L-lactide, polydioxanone, polycarbonates, polyanhydrides, collagen, elastin, fibrinogen, fibronectin, vitronectin, laminin, gelatin and combinations thereof.
18. The vaso-occlusive member of any of claims 1 to 17, wherein the stretch-resistant member is a mono-filament.
19. The vaso-occlusive member of claim 18, wherein the mono-filament comprises polypropylene.
20. The vaso-occlusive member of any of claims 1 to 17, wherein the stretch-resistant member is a mufti-filament.
21. The vaso-occlusive member of any of claims 1 to 20, further comprising a deployment tip.
22. The vaso-occlusive member of claim 21, wherein the deployment tip comprises an electrolytically detachable end adapted to detach from a pusher by imposition of a current on said pusher.
23. The vaso-occlusive member of any of claims 1 to 22, further comprising a radio-opaque material.
24. The method of claim 23, where the radio-opaque material is selected from the group consisting of powdered tantalum, powdered tungsten, bismuth oxide, and barium sulfate.
25. The vaso-occlusive member of any of claims 1 to 24, further comprising a bioactive material.
26. A method for producing a vaso-occlusive member comprising the steps of (i) preparing a generally linear primary element comprising an absorbable material;
(ii) winding said primary element onto a mandrel; and (iii) heating said mandrel and said primary element to produce said three dimensional member.
(ii) winding said primary element onto a mandrel; and (iii) heating said mandrel and said primary element to produce said three dimensional member.
27. The method of claim 26, wherein the vaso-occlusive member has a three-dimensional configuration comprising a helical coil.
28. The method of claim 26, wherein the vaso-occlusive member has a three-dimensional configuration comprising a conical or spiral shape.
29. A method for producing a vaso-occlusive member comprising the steps of preparing a tube-like structure comprising an absorbable material.
30. The method of claim 29, wherein the preparing comprises micro-machining.
31. The method of any of claims 26 to 30, wherein the absorbable material is selected from the group consisting of polyglygolic acid (PGA), poly-glycolic/poly-L-lactic acid co-polymers, polycaprolactone, polyhydroxybutyrate/hydroxyvalerate copolymers, poly-L-lactide, polydioxanone, polycarbonates, polyanhydrides, collagen, elastin, fibrinogen, fibronectin, vitronectin, laminin, gelatin and combinations thereof.
32. The method of claim 26, wherein step (iii) comprises an approximately 1 S
minute heating step at approximately 165°C.
minute heating step at approximately 165°C.
33. The method of any of claims 26 to 32, further comprising the step of fixedly attaching one or more stretch-resistant members to two or more locations on the vaso-occlusive member.
34. The method of any of claims 26 to 32, further comprising the step of connecting two or more locations of the vaso-occlusive member to form one or more stretch-resistant members.
35. The method of claim 34, wherein the connections are formed by heating or soldering the two or more locations to one another.
36. The method any of claims 26 to 35, wherein the stretch-resistant member is absorbable.
37. The method any of claims 26 to 35, wherein the stretch-resistant member is non-absorbable.
38. The method of claim 36, wherein the stretch-resistant member is a mono-filament.
39. The method of claim 38, wherein the mono-filament comprises polypropylene.
40. The method of claim 33, wherein the stretch-resistant member is a multi-filament.
41. The method of claim 33, wherein the stretch-resistant member is knotted to the vaso-occlusive member.
42. The method of claim 33, wherein the stretch-resistant member is soldered to the vaso-occlusive member.
43. The method of any of claims 26 to 42, wherein the mandrel comprises stainless steel.
44. The method of any of claims 26 to 43, wherein the vaso-occlusive member further comprises at least one radio-opaque material.
45. The method of claim 44, wherein the radio-opaque material is selected from the group consisting of powdered tantalum, powdered tungsten, bismuth oxide, and barium sulfate.
46. The method of any of claims 26 to 45, wherein the vaso-occlusive member further comprises at least one bioactive material.
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| US09/866,887 US6585754B2 (en) | 2001-05-29 | 2001-05-29 | Absorbable implantable vaso-occlusive member |
| US09/866,887 | 2001-05-29 | ||
| PCT/US2002/017283 WO2002096272A2 (en) | 2001-05-29 | 2002-05-29 | Absorbable implantable vaso-occlusive member |
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|---|---|
| CA2447484A1 true CA2447484A1 (en) | 2002-12-05 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002447484A Abandoned CA2447484A1 (en) | 2001-05-29 | 2002-05-29 | Absorbable implantable vaso-occlusive member |
Country Status (6)
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| US (4) | US6585754B2 (en) |
| EP (1) | EP1395326A4 (en) |
| JP (2) | JP4398645B2 (en) |
| AU (1) | AU2002305772A1 (en) |
| CA (1) | CA2447484A1 (en) |
| WO (1) | WO2002096272A2 (en) |
Families Citing this family (87)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20070093889A1 (en) * | 1999-01-27 | 2007-04-26 | Wu Benjamin M | Non-Fragmenting Low Friction Bioactive Absorbable Coils for Brain Aneurysm Therapy |
| US7070607B2 (en) * | 1998-01-27 | 2006-07-04 | The Regents Of The University Of California | Bioabsorbable polymeric implants and a method of using the same to create occlusions |
| US6585754B2 (en) * | 2001-05-29 | 2003-07-01 | Scimed Life Systems, Inc. | Absorbable implantable vaso-occlusive member |
| US6921410B2 (en) * | 2001-05-29 | 2005-07-26 | Scimed Life Systems, Inc. | Injection molded vaso-occlusive elements |
| US6599299B2 (en) * | 2001-06-26 | 2003-07-29 | Leonard S. Schultz | Device and method for body lumen occlusion |
| US20060009840A1 (en) * | 2002-03-15 | 2006-01-12 | Hossainy Syed F | Carrier for releasing a therapeutic substance in response to the presence of an enzyme |
| US20050090856A1 (en) * | 2003-10-27 | 2005-04-28 | Scimed Life Systems, Inc. | Vasco-occlusive devices with bioactive elements |
| US20050107867A1 (en) * | 2003-11-17 | 2005-05-19 | Taheri Syde A. | Temporary absorbable venous occlusive stent and superficial vein treatment method |
| US20050137568A1 (en) * | 2003-12-17 | 2005-06-23 | Jones Donald K. | Activatable bioactive implantable medical device and method of use |
| US7294123B2 (en) * | 2003-12-17 | 2007-11-13 | Corris Neurovascular, Inc. | Activatable bioactive vascular occlusive device and method of use |
| US20050149109A1 (en) * | 2003-12-23 | 2005-07-07 | Wallace Michael P. | Expanding filler coil |
| JP2005198895A (en) * | 2004-01-16 | 2005-07-28 | Medicos Hirata:Kk | Bioabsorbable blood vessel blocking coil |
| US20050216049A1 (en) * | 2004-03-29 | 2005-09-29 | Jones Donald K | Vascular occlusive device with elastomeric bioresorbable coating |
| US7416757B2 (en) * | 2004-04-08 | 2008-08-26 | Cordis Neurovascular, Inc. | Method of making active embolic coil |
| US7247159B2 (en) * | 2004-04-08 | 2007-07-24 | Cordis Neurovascular, Inc. | Activatable bioactive vascular occlusive device |
| US20050267510A1 (en) * | 2004-05-26 | 2005-12-01 | Nasser Razack | Device for the endovascular treatment of intracranial aneurysms |
| US7749242B2 (en) * | 2004-06-21 | 2010-07-06 | Boston Scientific Scimed, Inc. | Expanding vaso-occlusive device |
| US20060025852A1 (en) | 2004-08-02 | 2006-02-02 | Armstrong Joseph R | Bioabsorbable self-expanding endolumenal devices |
| AU2012200186B2 (en) * | 2004-08-02 | 2014-02-20 | W. L. Gore & Associates, Inc. | Bioabsorbable self-expanding endolumenal devices |
| US20060047299A1 (en) * | 2004-08-24 | 2006-03-02 | Ferguson Patrick J | Vascular occlusive wire with extruded bioabsorbable sheath |
| US20060052822A1 (en) * | 2004-08-31 | 2006-03-09 | Mirizzi Michael S | Apparatus and material composition for permanent occlusion of a hollow anatomical structure |
| ATE448737T1 (en) | 2004-09-22 | 2009-12-15 | Dendron Gmbh | DEVICE FOR IMPLANTING MICROWL COILS |
| US7879064B2 (en) | 2004-09-22 | 2011-02-01 | Micro Therapeutics, Inc. | Medical implant |
| ES2440194T3 (en) * | 2004-11-09 | 2014-01-28 | Stryker Corporation | Vasocclusive devices comprising a proximal part of complex shape and a distal part with a smaller diameter |
| US20060155323A1 (en) | 2005-01-07 | 2006-07-13 | Porter Stephen C | Intra-aneurysm devices |
| US20060155324A1 (en) * | 2005-01-12 | 2006-07-13 | Porter Stephen C | Vaso-occlusive devices with attached polymer structures |
| JP2006198322A (en) * | 2005-01-24 | 2006-08-03 | Medicos Hirata:Kk | Intravascular embolus |
| US7972354B2 (en) | 2005-01-25 | 2011-07-05 | Tyco Healthcare Group Lp | Method and apparatus for impeding migration of an implanted occlusive structure |
| US20060178697A1 (en) | 2005-02-04 | 2006-08-10 | Carr-Brendel Victoria E | Vaso-occlusive devices including non-biodegradable biomaterials |
| US20060178696A1 (en) * | 2005-02-04 | 2006-08-10 | Porter Stephen C | Macroporous materials for use in aneurysms |
| US20060275341A1 (en) * | 2005-06-02 | 2006-12-07 | Miv Therapeutics Inc. | Thin foam coating comprising discrete, closed-cell capsules |
| US20070078479A1 (en) * | 2005-10-04 | 2007-04-05 | Boston Scientific Scimed, Inc. | Self-expanding vaso-occlusive devices with regulated expansion |
| US20070078480A1 (en) * | 2005-10-04 | 2007-04-05 | Boston Scientific Scimed, Inc. | Self-expanding biodegradable or water-soluble vaso-occlusive devices |
| US20080243068A1 (en) * | 2005-12-29 | 2008-10-02 | Kamal Ramzipoor | Methods and apparatus for treatment of venous insufficiency |
| JP2009525137A (en) * | 2006-02-02 | 2009-07-09 | ボストン サイエンティフィック リミテッド | Porous material used in aneurysms |
| US20070239193A1 (en) * | 2006-04-05 | 2007-10-11 | Boston Scientific Scimed, Inc. | Stretch-resistant vaso-occlusive devices with distal anchor link |
| CA2644847A1 (en) * | 2006-04-06 | 2007-10-11 | Reva Medical, Inc. | Embolic prosthesis for treatment of vascular aneurysm |
| US8777979B2 (en) | 2006-04-17 | 2014-07-15 | Covidien Lp | System and method for mechanically positioning intravascular implants |
| CA2649702C (en) | 2006-04-17 | 2014-12-09 | Microtherapeutics, Inc. | System and method for mechanically positioning intravascular implants |
| US9017361B2 (en) | 2006-04-20 | 2015-04-28 | Covidien Lp | Occlusive implant and methods for hollow anatomical structure |
| US20080046092A1 (en) * | 2006-08-17 | 2008-02-21 | Richard Champion Davis | Coil embolization device with stretch resistance fiber |
| US20080140002A1 (en) * | 2006-12-06 | 2008-06-12 | Kamal Ramzipoor | System for delivery of biologically active substances with actuating three dimensional surface |
| KR20100015520A (en) | 2007-03-13 | 2010-02-12 | 마이크로 테라퓨틱스 인코포레이티드 | An implant including a coil and a stretch-resistant member |
| KR20100015521A (en) | 2007-03-13 | 2010-02-12 | 마이크로 테라퓨틱스 인코포레이티드 | An implant, a mandrel, and a method of forming an implant |
| US8133242B1 (en) | 2007-04-27 | 2012-03-13 | Q-Tech Medical Incorporated | Image-guided extraluminal occlusion |
| US20080319527A1 (en) * | 2007-06-22 | 2008-12-25 | Lee Jeffrey A | Shaped multi-durometer filler |
| WO2009052432A2 (en) * | 2007-10-19 | 2009-04-23 | Coherex Medical, Inc. | Medical device for modification of left atrial appendange and related systems and methods |
| US20090143760A1 (en) * | 2007-11-30 | 2009-06-04 | Jacques Van Dam | Methods, Devices, Kits and Systems for Defunctionalizing the Gallbladder |
| US7987853B2 (en) | 2008-04-25 | 2011-08-02 | Conceptus, Inc. | Devices and methods for occluding a fallopian tube |
| WO2010016923A1 (en) * | 2008-08-06 | 2010-02-11 | Boston Scientific Scimed, Inc. | Vaso-occlusive devices with textured surfaces |
| EP2334242B1 (en) * | 2008-09-09 | 2014-11-26 | Boston Scientific Scimed, Inc. | Composite detachment mechanisms |
| US20100137898A1 (en) * | 2008-12-02 | 2010-06-03 | Boston Scientific Scimed, Inc. | Vaso-occlusive devices with attachment assemblies for stretch-resistant members |
| WO2010081033A1 (en) | 2009-01-08 | 2010-07-15 | Coherex Medical, Inc. | Medical device for modification of left atrial appendage and related systems and methods |
| US9901347B2 (en) * | 2009-05-29 | 2018-02-27 | Terus Medical, Inc. | Biliary shunts, delivery systems, and methods of using the same |
| US10064628B2 (en) | 2009-06-17 | 2018-09-04 | Coherex Medical, Inc. | Medical device for modification of left atrial appendage and related systems and methods |
| US9693781B2 (en) | 2009-06-17 | 2017-07-04 | Coherex Medical, Inc. | Medical device for modification of left atrial appendage and related systems and methods |
| US9649115B2 (en) | 2009-06-17 | 2017-05-16 | Coherex Medical, Inc. | Medical device for modification of left atrial appendage and related systems and methods |
| US9883864B2 (en) | 2009-06-17 | 2018-02-06 | Coherex Medical, Inc. | Medical device for modification of left atrial appendage and related systems and methods |
| US9351716B2 (en) | 2009-06-17 | 2016-05-31 | Coherex Medical, Inc. | Medical device and delivery system for modification of left atrial appendage and methods thereof |
| US10631969B2 (en) | 2009-06-17 | 2020-04-28 | Coherex Medical, Inc. | Medical device for modification of left atrial appendage and related systems and methods |
| US8211121B1 (en) | 2010-03-06 | 2012-07-03 | Q-Tech Medical Incorporated | Methods and apparatus for image-guided extraluminal occlusion using clamping jaws |
| JP5863278B2 (en) * | 2011-05-18 | 2016-02-16 | 株式会社カネカ | Method for producing in-vivo indwelling member |
| EP2755574A1 (en) * | 2011-09-13 | 2014-07-23 | Stryker Corporation | Vaso-occlusive device |
| US9579104B2 (en) | 2011-11-30 | 2017-02-28 | Covidien Lp | Positioning and detaching implants |
| US9011480B2 (en) | 2012-01-20 | 2015-04-21 | Covidien Lp | Aneurysm treatment coils |
| US9687245B2 (en) | 2012-03-23 | 2017-06-27 | Covidien Lp | Occlusive devices and methods of use |
| US9119948B2 (en) | 2013-02-20 | 2015-09-01 | Covidien Lp | Occlusive implants for hollow anatomical structures, delivery systems, and related methods |
| US10010328B2 (en) | 2013-07-31 | 2018-07-03 | NeuVT Limited | Endovascular occlusion device with hemodynamically enhanced sealing and anchoring |
| CN105899150B (en) | 2013-07-31 | 2018-07-27 | Neuvt 有限公司 | Method and apparatus for Endovascular Embolization |
| US10433847B2 (en) | 2013-12-17 | 2019-10-08 | The Board Of Regents Of The University Of Nebraska | Platform device and method of use to assist in anastomosis formation |
| CN104739478B (en) * | 2013-12-31 | 2017-05-10 | 微创神通医疗科技（上海）有限公司 | Spring coil and production method thereof |
| CN104739479B (en) * | 2013-12-31 | 2017-11-03 | 微创神通医疗科技（上海）有限公司 | A kind of turn and preparation method thereof |
| RU2016138131A (en) | 2014-02-27 | 2018-03-29 | Инкьюмедкс, Инк. | EMBOLIZING FRAME MICROSPIRALS |
| US9713475B2 (en) | 2014-04-18 | 2017-07-25 | Covidien Lp | Embolic medical devices |
| US9238090B1 (en) | 2014-12-24 | 2016-01-19 | Fettech, Llc | Tissue-based compositions |
| JP6763864B2 (en) | 2015-01-20 | 2020-09-30 | ニューロガミ メディカル インコーポレイテッド | Micrografts and usage for the treatment of intracranial aneurysms |
| US10736730B2 (en) | 2015-01-20 | 2020-08-11 | Neurogami Medical, Inc. | Vascular implant |
| US11484319B2 (en) | 2015-01-20 | 2022-11-01 | Neurogami Medical, Inc. | Delivery system for micrograft for treating intracranial aneurysms |
| US10857012B2 (en) | 2015-01-20 | 2020-12-08 | Neurogami Medical, Inc. | Vascular implant |
| US10925611B2 (en) | 2015-01-20 | 2021-02-23 | Neurogami Medical, Inc. | Packaging for surgical implant |
| US11090055B2 (en) | 2015-10-30 | 2021-08-17 | Incumedx Inc. | Devices and methods for delivering an implant to a vascular disorder |
| US10052108B2 (en) * | 2015-10-30 | 2018-08-21 | Incumedx, Inc. | Devices and methods for delivering an implant to a vascular disorder |
| US10420563B2 (en) | 2016-07-08 | 2019-09-24 | Neurogami Medical, Inc. | Delivery system insertable through body lumen |
| CN107773283A (en) * | 2016-08-31 | 2018-03-09 | 微创神通医疗科技（上海）有限公司 | Implant, implant preparation method and implant system |
| US11369355B2 (en) | 2019-06-17 | 2022-06-28 | Coherex Medical, Inc. | Medical device and system for occluding a tissue opening and method thereof |
| US11812969B2 (en) | 2020-12-03 | 2023-11-14 | Coherex Medical, Inc. | Medical device and system for occluding a tissue opening and method thereof |
| CN113768608B (en) * | 2021-09-24 | 2023-04-11 | 惠州市顺美医疗科技有限公司 | Automatic production process of spherical spring ring |
Family Cites Families (53)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US519172A (en) * | 1894-05-01 | Half to timothy j | ||
| US3266364A (en) * | 1962-10-22 | 1966-08-16 | Avdel Inc | Releasable fastener |
| US3479072A (en) * | 1966-06-20 | 1969-11-18 | John Kosar | Positive locking,nonmarring set screw |
| US3618135A (en) * | 1970-02-06 | 1971-11-02 | Avco Corp | Variable capacitor of the locking type |
| DE3335628A1 (en) * | 1983-09-30 | 1985-04-04 | Hilti Ag, Schaan | SPREADING DOWEL WITH RETRACTABLE SPREADING BODY |
| US4739768B2 (en) * | 1986-06-02 | 1995-10-24 | Target Therapeutics Inc | Catheter for guide-wire tracking |
| US5290552A (en) * | 1988-05-02 | 1994-03-01 | Matrix Pharmaceutical, Inc./Project Hear | Surgical adhesive material |
| US5634946A (en) * | 1988-08-24 | 1997-06-03 | Focal, Inc. | Polymeric endoluminal paving process |
| US4994069A (en) | 1988-11-02 | 1991-02-19 | Target Therapeutics | Vaso-occlusion coil and method |
| SE463779B (en) * | 1989-05-29 | 1991-01-21 | Scantool Hb | EXPANSION BOLT |
| US5354295A (en) | 1990-03-13 | 1994-10-11 | Target Therapeutics, Inc. | In an endovascular electrolytically detachable wire and tip for the formation of thrombus in arteries, veins, aneurysms, vascular malformations and arteriovenous fistulas |
| US5122136A (en) | 1990-03-13 | 1992-06-16 | The Regents Of The University Of California | Endovascular electrolytically detachable guidewire tip for the electroformation of thrombus in arteries, veins, aneurysms, vascular malformations and arteriovenous fistulas |
| DE4104702C2 (en) | 1991-02-15 | 1996-01-18 | Malte Neuss | Implants for organ pathways in spiral form |
| US5690666A (en) | 1992-11-18 | 1997-11-25 | Target Therapeutics, Inc. | Ultrasoft embolism coils and process for using them |
| US5527023A (en) * | 1994-07-08 | 1996-06-18 | Monogram Aerospace Fasteners | Alignment device with radially expandable tube |
| US5690671A (en) | 1994-12-13 | 1997-11-25 | Micro Interventional Systems, Inc. | Embolic elements and methods and apparatus for their delivery |
| DE69624525T2 (en) | 1995-03-30 | 2003-03-20 | Boston Scient Ltd | System for implanting liquid spirals with a secondary structure |
| US6143007A (en) * | 1995-04-28 | 2000-11-07 | Target Therapeutics, Inc. | Method for making an occlusive device |
| US5624461A (en) * | 1995-06-06 | 1997-04-29 | Target Therapeutics, Inc. | Three dimensional in-filling vaso-occlusive coils |
| NO962336L (en) * | 1995-06-06 | 1996-12-09 | Target Therapeutics Inc | Vaso-occlusive spiral |
| DK0754435T3 (en) * | 1995-06-30 | 2000-11-27 | Target Therapeutics Inc | Stretch-resistant co-occlusion spirals |
| US5582619A (en) * | 1995-06-30 | 1996-12-10 | Target Therapeutics, Inc. | Stretch resistant vaso-occlusive coils |
| US6013084A (en) * | 1995-06-30 | 2000-01-11 | Target Therapeutics, Inc. | Stretch resistant vaso-occlusive coils (II) |
| US5853418A (en) * | 1995-06-30 | 1998-12-29 | Target Therapeutics, Inc. | Stretch resistant vaso-occlusive coils (II) |
| US5749894A (en) | 1996-01-18 | 1998-05-12 | Target Therapeutics, Inc. | Aneurysm closure method |
| US5792154A (en) * | 1996-04-10 | 1998-08-11 | Target Therapeutics, Inc. | Soft-ended fibered micro vaso-occlusive devices |
| WO1997042881A1 (en) * | 1996-05-14 | 1997-11-20 | PFM PRODUKTE FüR DIE MEDIZIN AKTIENGESELLSCHAFT | Strengthened implant for bodily ducts |
| US5716376A (en) * | 1996-06-28 | 1998-02-10 | United States Surgical Corporation | Absorbable mixture and coatings for surgical articles fabricated therefrom |
| US6162537A (en) * | 1996-11-12 | 2000-12-19 | Solutia Inc. | Implantable fibers and medical articles |
| US6174330B1 (en) * | 1997-08-01 | 2001-01-16 | Schneider (Usa) Inc | Bioabsorbable marker having radiopaque constituents |
| US5984929A (en) * | 1997-08-29 | 1999-11-16 | Target Therapeutics, Inc. | Fast detaching electronically isolated implant |
| US6156061A (en) * | 1997-08-29 | 2000-12-05 | Target Therapeutics, Inc. | Fast-detaching electrically insulated implant |
| US6322576B1 (en) * | 1997-08-29 | 2001-11-27 | Target Therapeutics, Inc. | Stable coil designs |
| US6168788B1 (en) * | 1997-09-26 | 2001-01-02 | Leon Wortham | Fibrin glue without fibrinogen and biosealant compositions and methods |
| US6159165A (en) * | 1997-12-05 | 2000-12-12 | Micrus Corporation | Three dimensional spherical micro-coils manufactured from radiopaque nickel-titanium microstrand |
| US7070607B2 (en) * | 1998-01-27 | 2006-07-04 | The Regents Of The University Of California | Bioabsorbable polymeric implants and a method of using the same to create occlusions |
| WO1999044538A1 (en) | 1998-01-27 | 1999-09-10 | The Regents Of The University Of California | Biodegradable polymer/protein based coils for intralumenal implants |
| US20070093889A1 (en) * | 1999-01-27 | 2007-04-26 | Wu Benjamin M | Non-Fragmenting Low Friction Bioactive Absorbable Coils for Brain Aneurysm Therapy |
| US5935145A (en) * | 1998-02-13 | 1999-08-10 | Target Therapeutics, Inc. | Vaso-occlusive device with attached polymeric materials |
| US5941888A (en) * | 1998-02-18 | 1999-08-24 | Target Therapeutics, Inc. | Vaso-occlusive member assembly with multiple detaching points |
| US6063100A (en) * | 1998-03-10 | 2000-05-16 | Cordis Corporation | Embolic coil deployment system with improved embolic coil |
| CA2265062C (en) * | 1998-03-10 | 2008-09-16 | Cordis Corporation | Stretch resistant embolic coil with variable stiffness |
| US5980550A (en) | 1998-06-18 | 1999-11-09 | Target Therapeutics, Inc. | Water-soluble coating for bioactive vasoocclusive devices |
| US6187024B1 (en) | 1998-11-10 | 2001-02-13 | Target Therapeutics, Inc. | Bioactive coating for vaso-occlusive devices |
| US6569179B2 (en) * | 1998-11-10 | 2003-05-27 | Scimed Life Systems, Inc. | Bioactive three loop coil |
| AU6402699A (en) | 1999-01-27 | 2000-08-18 | Regents Of The University Of California, The | Biodegradable polymeriprotein based coils for intralumenal implants |
| US6179857B1 (en) * | 1999-02-22 | 2001-01-30 | Cordis Corporation | Stretch resistant embolic coil with variable stiffness |
| US6280457B1 (en) * | 1999-06-04 | 2001-08-28 | Scimed Life Systems, Inc. | Polymer covered vaso-occlusive devices and methods of producing such devices |
| US6494908B1 (en) * | 1999-12-22 | 2002-12-17 | Ethicon, Inc. | Removable stent for body lumens |
| US6551332B1 (en) * | 2000-03-31 | 2003-04-22 | Coalescent Surgical, Inc. | Multiple bias surgical fastener |
| US20030004533A1 (en) * | 2001-05-04 | 2003-01-02 | Concentric Medical | Bioactive polymer vaso-occlusive device |
| US6585754B2 (en) * | 2001-05-29 | 2003-07-01 | Scimed Life Systems, Inc. | Absorbable implantable vaso-occlusive member |
| WO2005069950A2 (en) * | 2004-01-22 | 2005-08-04 | Eva Corporation | Surgical fastener |
-
2001
- 2001-05-29 US US09/866,887 patent/US6585754B2/en not_active Expired - Lifetime
-
2002
- 2002-05-29 JP JP2002592792A patent/JP4398645B2/en not_active Expired - Fee Related
- 2002-05-29 AU AU2002305772A patent/AU2002305772A1/en not_active Abandoned
- 2002-05-29 WO PCT/US2002/017283 patent/WO2002096272A2/en active Application Filing
- 2002-05-29 EP EP02734619A patent/EP1395326A4/en not_active Withdrawn
- 2002-05-29 CA CA002447484A patent/CA2447484A1/en not_active Abandoned
-
2003
- 2003-04-25 US US10/423,304 patent/US7559933B2/en not_active Expired - Fee Related
-
2008
- 2008-01-23 US US12/009,880 patent/US20080125807A1/en not_active Abandoned
-
2009
- 2009-01-14 US US12/319,977 patent/US20090131972A1/en not_active Abandoned
- 2009-09-03 JP JP2009204155A patent/JP2010012282A/en not_active Withdrawn
Also Published As
| Publication number | Publication date |
|---|---|
| US20040024394A1 (en) | 2004-02-05 |
| JP2005503845A (en) | 2005-02-10 |
| US20090131972A1 (en) | 2009-05-21 |
| US6585754B2 (en) | 2003-07-01 |
| US7559933B2 (en) | 2009-07-14 |
| US20020193823A1 (en) | 2002-12-19 |
| AU2002305772A1 (en) | 2002-12-09 |
| EP1395326A4 (en) | 2008-02-20 |
| JP4398645B2 (en) | 2010-01-13 |
| JP2010012282A (en) | 2010-01-21 |
| US20080125807A1 (en) | 2008-05-29 |
| WO2002096272A3 (en) | 2003-05-01 |
| WO2002096272A2 (en) | 2002-12-05 |
| WO2002096272A9 (en) | 2003-01-30 |
| EP1395326A2 (en) | 2004-03-10 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| EEER | Examination request | ||
| FZDE | Dead |
Effective date: 20121203 |