Endovascular shunts and methods of shunting
Endovascular assemblies may include a catheter, a shunt, and a wire. The shunt includes a frame and a liner secured about the frame. The wire extends through the catheter and is coupled to the shunt. The shunt is configured to move between a collapsed configuration and a radially expanded configuration in response to movement of the wire. Endovascular assemblies may be used to shunt a vessel.
1 . An endovascular assembly comprising:
a catheter defining a transport lumen extending from a proximal end of the catheter to a distal end of the catheter; and
a shunt comprising:
a proximal frame and a proximal wire coupled to and extending from the proximal frame;
a distal frame and a distal wire coupled to and extending from the proximal frame; and
a liner coupled to and extending between both the proximal frame and the distal frame, the proximal frame and the distal frame being formed separately and coupled together directly only via the liner,
wherein the proximal wire is configured to extend proximally from the proximal frame through the transport lumen of the catheter, and the distal wire is configured to extend proximally from the distal frame,
wherein the shunt is configured to move between (1) a collapsed configuration in which the shunt is constrained within the transport lumen of the catheter and has a first diameter, and (2) an expanded configuration in which the shunt is exposed from the transport lumen and has a second diameter greater than the first diameter, and
wherein the shunt is configured to move between (1) an elongated configuration in which the distal frame is spaced from the proximal frame by a first distance and (2) a shortened configuration in which the distal frame is spaced from the proximal frame by a second distance less than the first distance.
2 . The endovascular assembly of claim 1 , wherein the proximal frame and the distal frame are biased to expand radially, to cause the shunt to expand from the collapsed configuration to the expanded configuration when the shunt emerges from the distal end of the catheter.
3 . The endovascular assembly of claim 1 , wherein the proximal frame and the distal frame are configured to collapse when a proximal end of the shunt is withdrawn proximally into the distal end of the catheter.
4 . The endovascular assembly of claim 1 , wherein the distal frame is configured to move in a direction along the shunt between the elongated configuration and the shortened configuration in response to a relative movement between the distal wire and the catheter.
5 . The endovascular assembly of claim 4 , wherein a radial dimension of the shunt is unchanged in the elongated configuration and the shortened configuration.
6 . The endovascular assembly of claim 4 , wherein the distal wire is coupled to the proximal end of the distal frame.
7 . The endovascular assembly of claim 4 , further comprising a sheath extending through the transport lumen of the catheter, wherein the distal wire extends through the sheath.
8 . The endovascular assembly of claim 1 , wherein the proximal frame and the distal frame comprise nitinol.
9 . The endovascular assembly of claim 1 , wherein the liner comprises a fabric or a film.
10 . The endovascular assembly of claim 1 , wherein the liner comprises polytetrafluoroethylene (PTFE).
11 . The endovascular assembly of claim 1 , wherein the proximal frame comprises a proximal anchor and the distal frame comprises a distal anchor, and wherein the liner is secured to the proximal and distal anchors.
12 . The endovascular assembly of claim 11 , wherein the proximal anchor comprises a cylindrical anchor portion coupled to a conical anchor portion, wherein the cylindrical anchor portion is secured to an interior surface of the liner, wherein the conical anchor portion extends proximally from the liner, and wherein a proximal end of the conical anchor portion is secured to the proximal wire.
13 . The endovascular assembly of claim 11 , wherein the distal anchor comprises a conical portion extending proximally within the shunt, and wherein a proximal end of the conical portion is secured to the distal wire.
14 . The endovascular assembly of claim 11 , wherein a portion of the distal anchor is configured to be received within a portion of the proximal anchor when the shunt is transitioned to the shortened configuration.
15 . The endovascular assembly of claim 14 , wherein the portion of the distal anchor is a first sheath extending proximally away from the distal anchor,
wherein the portion of the proximal anchor is a second sheath extending proximally away from the proximal anchor,
the second sheath having a diameter greater than a diameter of the first sheath such that the first sheath is configured to be received within the second sheath.
16 . The endovascular assembly of claim 1 , further comprising an atraumatic tip,
wherein the atraumatic tip is secured to a distal end of the distal frame,
wherein the atraumatic tip is configured to be transitioned from a collapsed configuration to an expanded configuration when the atraumatic tip is deployed from the catheter.
17 . The endovascular assembly of claim 16 , wherein the atraumatic tip comprises an atraumatic whisk,
wherein the atraumatic whisk further comprises a rounded distal end portion configured to guide the catheter through a vessel of a patient,
wherein the rounded distal end portion is at least partially covered by a porous mesh.
18 . The endovascular assembly of claim 1 , wherein the shunt is configured to be deployed from the catheter without the aid of a guidewire.
19 . The endovascular assembly of claim 1 , wherein a proximal end of the distal frame is configured to be proximal to a proximal end of the liner in the shortened configuration.
20 . The endovascular assembly of claim 1 , wherein the liner is configured to span a gap across the first distance between the distal frame and the proximal frame when the shunt is in the elongated configuration.
21 . An endovascular shunt comprising:
a frame including:
a proximal anchor; and
a distal anchor movable relative to and nestable with the proximal anchor; and
a liner secured about the proximal and distal anchors,
wherein the shunt is configured to move (i) radially between a collapsed configuration and an expanded configuration and (ii) axially between an elongated configuration in which the proximal anchor is spaced a first distance from the distal anchor, and a shortened configuration in which the proximal anchor is spaced a second distance from the distal anchor, the second distance being less than the first distance.
22 . The endovascular shunt of claim 21 , wherein the frame is biased to expand radially, to cause the shunt to expand from the collapsed configuration to the expanded configuration.
23 . The endovascular shunt of claim 21 , wherein the frame includes a proximal frame portion including the proximal anchor, and a distal frame portion including the distal anchor, the distal frame portion being separate from the proximal frame portion.
24 . The endovascular shunt of claim 23 , wherein the liner includes a proximal end coupled to the proximal frame portion and a distal end coupled to the distal frame portion.
25 . The endovascular shunt of claim 21 , wherein the distal anchor is configured to be nested within the proximal anchor.
26 . The endovascular shunt of claim 21 , wherein the distal anchor is to be positioned at least partially within the proximal anchor in the shortened configuration.
27 . The endovascular shunt of claim 21 , wherein a radial dimension of the shunt is unchanged between the elongated configuration and the shortened configuration.
28 . An endovascular assembly comprising:
a catheter defining a transport lumen extending therethrough; and
a shunt comprising:
a distal frame and a distal elongate member coupled to and extending from the distal frame, and configured to extend proximally from the distal frame and through the transport lumen of the catheter and be manipulated to cause movement of the distal frame relative to the catheter and the proximal frame;
a proximal frame and a proximal elongate member coupled to and extending from the proximal frame, and configured to extend proximally from the proximal frame and through the transport lumen of the catheter and be manipulated to cause movement of the proximal frame relative to the catheter and the distal frame; and
a liner secured about the distal frame and the proximal frame,
wherein the proximal frame and the distal frame are coupled together directly only via the liner,
wherein the shunt is configured to move between an elongated configuration in which the distal frame is axially offset from the proximal frame by a first distance and a shortened configuration in which the distal frame is axially offset from the proximal frame by a second distance less than the first distance, and
wherein at least a portion of the liner is configured to extend axially across and circumferentially around an axial gap defined between the proximal frame and the distal frame when the shunt is in the elongated configuration.
29 . The endovascular assembly of claim 28 , wherein the shunt is configured to move, in response to a relative movement between the catheter and the shunt, between (1) a collapsed configuration within the transport lumen and (2) an expanded configuration defining an expanded shunt lumen outside the transport lumen.
30 . The endovascular assembly of claim 28 , wherein the proximal frame comprises a proximal anchor adjacent to a proximal end of the proximal frame and the distal frame comprises a distal anchor adjacent to a distal end of the distal frame, and wherein the proximal elongate member is secured to the proximal anchor and the distal elongate member is secured to the distal anchor.
31 . The endovascular assembly of claim 30 , wherein the proximal anchor comprises a cylindrical anchor portion coupled to a conical anchor portion, and wherein a proximal end of the conical anchor portion is secured to the proximal elongate member.
32 . The endovascular assembly of claim 30 , wherein the distal anchor comprises a conical portion extending proximally within the shunt, and wherein a proximal end of the conical portion is secured to the distal elongate member.
33 . The endovascular assembly of claim 28 , wherein a radial dimension of the shunt is substantially unchanged in the elongated configuration and the shortened configuration.
34 . The endovascular assembly of claim 28 , wherein the proximal elongate member is a wire or a sheath, and the distal elongate member is a wire or a sheath.