Embolic containment
Devices, systems, and methods used to seal a treatment area to prevent embolic agents from migrating are described. The concept has particular benefit in allowing liquid embolic to be used with a variety of intravascular therapeutic applications, including for occluding aneurysms and arteriovenous malformations in the neurovasculature.
1. An aneurysm treatment device comprising: a pusher; an expandable structure delivered by the pusher, the expandable structure adopting a collapsed state when restrained in a catheter and an expanded state when freed from the catheter; an expandable structure controller spanning both the pusher and the expandable structure, where the expandable structure controller can be pushed or pulled independently of the pusher in order to manipulate a shape of the expandable structure so that the expandable structure can conform to a shape of a vascular treatment site; wherein the expandable structure includes an inner mesh layer and an outer mesh layer spaced apart from each other in the expanded state to form a gap sized to hold precipitated liquid embolic, wherein the inner mesh layer and the outer mesh layer are free of any connection mechanism or direct connection between each other, wherein both mesh layers are composed of metallic wires, and wherein the inner mesh layer is less porous than the outer mesh layer in order to prevent passage of the precipitated liquid embolic while allowing passage of an embolic solvent from the aneurysm past the inner mesh layer of the expandable structure.
2. The aneurysm treatment device of claim 1 , wherein the expandable structure includes a proximal tapered section, a cylindrical medial section, and a distal tapered section.
3. The aneurysm treatment device of claim 2 , wherein the distal tapered section includes the inner mesh layer and the outer mesh layer.
4. The aneurysm treatment device of claim 2 , wherein the cylindrical medial section includes the inner mesh layer and the outer mesh layer.
5. The aneurysm treatment device of claim 1 , wherein the aneurysm is a neurovascular sidewall aneurysm.
6. The aneurysm treatment device of claim 1 , further comprising a pocket formed by the gap between the inner mesh layer and the outer mesh layer to trap the liquid embolic.
7. The aneurysm treatment device of claim 1 , wherein the inner mesh layer has a plurality of pores and the pores are sized to allow passage of embolic solvent but not allow passage of liquid embolic.
8. The aneurysm treatment device of claim 7 , wherein the pores of the inner mesh layer are sized from 260 to 1000 microns.
9. The aneurysm treatment device of claim 7 , wherein the embolic solvent is dimethyl sulfoxide.
10. An aneurysm treatment device comprising: a pusher; an expandable structure delivered by the pusher, the expandable structure adopting a collapsed state when restrained in a catheter and an expanded state when freed from the catheter, a distal section of the expandable structure including a tubular element; the expandable structure comprising: an inner mesh layer having a first porosity; and an outer mesh layer having a second porosity that is higher than the first porosity; the inner mesh layer and the outer mesh layer being spaced apart from each other in the expanded state to form a pocket sized to hold precipitated liquid embolic; wherein the first porosity is sized to prevent passage of the precipitated liquid embolic therethrough while allowing passage of an embolic solvent therethrough; wherein the inner mesh layer is free from any connection mechanism or direct connection between the outer mesh layer; an expandable structure controller spanning both the pusher and the expandable structure, where the expandable structure controller can be pushed or pulled independently of the pusher; wherein the expandable structure controller is affixed to the tubular element of the expandable structure such that pushing or pulling the expandable structure controller manipulates a shape of the expandable structure so that the expandable structure can conform to a shape of a vascular treatment site.
11. The aneurysm treatment device of claim 10 , wherein the expandable structure controller extends distally beyond the tubular element.
12. The aneurysm treatment device of claim 11 , wherein a distal end of the expandable structure controller is bent.
13. The aneurysm treatment device of claim 11 , wherein a distal end of the expandable structure controller is coiled.
14. The aneurysm treatment device of claim 10 , wherein pores of the inner mesh layer are sized from 100 to 150 microns.
15. The aneurysm treatment device of claim 10 , wherein the expandable structure includes a proximal tapered section, a cylindrical medial section, and a distal tapered section where the distal tapered section includes the tubular element.
16. The aneurysm treatment device of claim 15 , wherein the tubular element is a radiopaque marker band.
17. An aneurysm treatment system comprising: a liquid embolic delivery catheter adapted to be placed into an aneurysm and adapted to deliver liquid embolic and an embolic solvent; and an expandable structure delivered by a pusher and adapted for placement in a blood vessel adjacent to the aneurysm, the expandable structure comprising: a proximal tapered section, a cylindrical medial section, and a distal tapered section; an inner mesh layer having a first porosity and an outer mesh layer having a second porosity that is higher than the first porosity; the inner mesh layer and the outer mesh layer being spaced apart from each other in the expanded state to form a pocket sized to hold precipitated liquid embolic; wherein the first porosity is sized to prevent passage of the precipitated liquid embolic therethrough while allowing passage of an embolic solvent therethrough; an expandable structure controller spanning both the pusher and the expandable structure; wherein the expandable structure controller is affixed to the expandable structure and can be pushed or pulled independently of the pusher in order to manipulate the shape of the expandable structure so that the expandable structure can conform to a shape of the blood vessel to prevent liquid embolic passage past the expandable structure, wherein the inner mesh layer is free from any connection mechanism or direct connection to the outer mesh layer.
18. The aneurysm treatment system of claim 17 , wherein the embolic solvent is dimethyl sulfoxide.
19. The aneurysm treatment system of claim 17 , wherein pores of the inner mesh layer have a size between 260 and 1000 microns.
20. The aneurysm treatment system of claim 17 , wherein the expandable structure includes a polymer coating.
21. The aneurysm treatment system of claim 20 , wherein the polymer coating is applied to the proximal tapered section.