Vascular stenting for aneurysms
View Patent ↗Described herein are flexible implantable occluding devices that can, for example, navigate the tortuous vessels of the neurovasculature. The occluding devices can also conform to the shape of the tortuous vessels of the vasculature. In some embodiments, the occluding devices can direct blood flow within a vessel away from an aneurysm or limit blood flow to the aneurysm. Some embodiments describe methods and apparatus for adjusting, along a length of the device, the porosity of the occluding device. In some embodiments, the occluding devices allows adequate blood flow to be provided to adjacent structures such that those structures, whether they are branch vessels or oxygen-demanding tissues, are not deprived of the necessary blood flow.
1. A method, of treating an aneurysm in a vessel of a patient, comprising:
expanding, in the vessel having the aneurysm, a first stent having a first stent proximal end and a first stent distal end, such that the first stent extends from a first location, proximal to the aneurysm, to a second location, distal to the aneurysm;
expanding, within the first stent, a second stent having a second stent proximal end and a second stent distal end, such that when the second stent is expanded and engages the first stent, the second stent is axially positioned substantially adjacent to the aneurysm, and the second stent distal end is positioned proximal to the first stent distal end, thereby impeding blood flow from the vessel into the aneurysm, wherein the second stent proximal end is substantially coterminous with the first stent proximal end;
applying an axially compressive force to a first portion of the first stent, the first portion overlying the aneurysm, whereby the first portion transitions from a first porosity to a second porosity, less than the first porosity, while (i) the first portion maintains a substantially constant cross-sectional dimension and (ii) wherein movement of a second portion of the first stent, distal to the first portion, is impeded by a frictional force applied by the first stent against a vessel wall distal to the aneurysm;
wherein applying an axially compressive force to the first portion of the first stent causes a third portion, of the second stent, in contact with the first portion, to transition from a third porosity to a fourth porosity, less than the third porosity.
2. The method of claim 1 , wherein blood flow through the first and second stents into the aneurysm is less than blood flow into the aneurysm would be through the first stent alone.
3. The method of claim 1 , wherein the first stent and the second stent have, when unrestrained, substantially the same porosity.
4. The method of claim 1 , wherein the axially compressive force is applied by an elongate member.
5. The method of claim 4 , wherein the elongate member is a lattice density adjusting implement.
6. A method, of treating a saccular aneurysm in a vessel of a patient, comprising:
expanding within the vessel a first stent such that the first stent extends from a first location distal to the saccular aneurysm of the vessel to a second location proximal to the saccular aneurysm; and
expanding a second stent, within the first stent, such that a first end of the second stent is between the first location and a distal side of an ostium of the saccular aneurysm and a second end of the second stent is between the second location and a proximal side of the ostium;
applying an axially compressive force to a first portion of the first stent, the first portion overlying the ostium, whereby the first portion transitions from a first porosity to a second porosity, less than the first porosity, while (i) the first portion maintains a substantially constant cross-sectional dimension and (ii) wherein movement of a second portion of the first stent, distal to the first portion, is impeded by a frictional force applied by the first stent against a vessel wall distal to the ostium;
wherein applying an axially compressive force to the first portion of the first stent causes a third portion, of the second stent, in contact with the first portion, to transition from a third porosity to a fourth porosity, less than the third porosity.
7. The method of claim 6 , wherein the first stent and the second stent have, when unrestrained, substantially the same porosity.
8. The method of claim 6 , wherein blood flow through the first and second stents into the saccular aneurysm is less than blood flow into the aneurysm would be through the first stent alone.
9. The method of claim 6 , wherein the axially compressive force is applied by an elongate member.
10. The method of claim 9 , wherein the elongate member is a lattice density adjusting implement.
11. A method, of treating a saccular aneurysm in a vessel of a patient, comprising:
expanding a first stent such that the first stent extends within the vessel from a first location, distal to a distal-most side of the saccular aneurysm, to a second location, proximal to a proximal-most side of the saccular aneurysm; and
expanding a second stent, within the first stent, such that the second stent extends from a third location, between the first location and the distal-most side of the saccular aneurysm, to a fourth location, between the second location and the proximal-most side of the saccular aneurysm;
applying an axially compressive force to a first portion of the first stent, the first portion overlying the saccular aneurysm, whereby the first portion transitions from a first porosity to a second porosity, less than the first porosity, while (i) the first portion maintains a substantially constant cross-sectional dimension and (ii) wherein movement of a second portion of the first stent, distal to the first portion, is impeded by a frictional force applied by the first stent against a vessel wall distal to the saccular aneurysm;
wherein applying an axially compressive force to the first portion of the first stent causes a third portion, of the second stent, in contact with the first portion, to transition from a third porosity to a fourth porosity, less than the third porosity.
12. The method of claim 11 , wherein the first stent and the second stent have, when unrestrained, substantially the same porosity.
13. The method of claim 11 , wherein blood flow through the first and second stents into the saccular aneurysm is less than blood flow into the aneurysm would be through the first stent alone.
14. The method of claim 11 , wherein the axially compressive force is applied by an elongate member.
15. The method of claim 14 , wherein the elongate member is a lattice density adjusting implement.