Filamentary devices for treatment of vascular defects
Methods for treatment of a cerebral aneurysm within a cerebral vasculature of a patient are described. A microcatheter and a device for treatment of the aneurysm are provided. The device is a self-expanding resilient permeable shell having a plurality of elongate resilient filaments with a woven structure. The plurality of filaments includes small and large filaments. The filaments are bundled and secured to each other at a proximal end. A ratio of the total cross-sectional area of small filaments to the total cross-sectional area of large filaments may be between 0.56 and 1.89. The distal end of the microcatheter is advanced to a region of interest within a cerebral artery. The device is advanced through the lumen and out of the distal end of the microcatheter such that the permeable shell deploys and expands within the cerebral aneurysm. The microcatheter is then withdrawn from the cerebral artery.
1. A method of treating a cerebral aneurysm within a cerebral vasculature of a patient, comprising the steps of:
providing a microcatheter having a proximal end, a distal end, and a lumen therebetween;
providing a device for treatment of an aneurysm within a patient's vasculature, comprising:
a self-expanding resilient permeable shell having a proximal end, a distal end, a longitudinal axis and further comprising:
a plurality of elongate resilient filaments with a woven structure, wherein the plurality of filaments includes small filaments and large filaments, wherein the small filaments have a transverse dimension smaller than the transverse dimension of the large filaments, the woven structure having a radially constrained elongated state configured for delivery within a microcatheter with the thin woven filaments extending longitudinally from the proximal end to the distal end radially adjacent each other along a length of the filaments, wherein the filaments are bundled and secured to each other at a proximal end, wherein a ratio of the total cross-sectional area of small filaments to the total cross-sectional area of large filaments is between 0.56 and 1.89, and
advancing the distal end of the microcatheter to a region of interest within a cerebral artery;
advancing the device through the lumen and out of the distal end of the microcatheter such that the permeable shell deploys within the cerebral aneurysm, wherein the permeable shell expands to an expanded state within the cerebral aneurysm, the expanded relaxed state having a longitudinally shortened configuration relative to the radially constrained state; and
withdrawing the microcatheter from the cerebral artery, wherein the permeable shell is the only implant delivered into the cerebral aneurysm through the microcatheter before the microcatheter is withdrawn.
2. The method of claim 1 , wherein the permeable shell forms a generally spherical shape when in the expanded relaxed state.
3. The method of claim 1 , wherein the permeable shell forms a generally ovoid shape when in the expanded relaxed state.
4. The method of claim 1 , wherein the permeable shell forms a generally globular shape when in the expanded relaxed state.
5. The method of claim 1 , wherein the woven structure is adapted to reside within the aneurysm.
6. The method of claim 5 , wherein the device is adapted to span the neck of the aneurysm.
7. The method of claim 1 , wherein, after implantation, no part of the device extends over the aneurysm neck outside of the dome.
8. The method of claim 1 , wherein the smaller filaments have a transverse diameter of about 0.015 mm to about 0.05 mm.
9. The method of claim 1 , wherein the larger filaments have a transverse diameter of about 0.04 mm to about 0.1 mm.
10. The method of claim 1 , wherein the filaments are bundled and secured to each other at a distal end.
11. The method of claim 1 , wherein the ratio of the total cross-sectional area of small filaments to the total cross-sectional area of large filaments is between 1.21 and 1.89.
12. The method of claim 1 , wherein the ratio of the total cross-sectional area of small filaments to the total cross-sectional area of large filaments is between 1.06 and 1.89.