Systems and methods for treating hydrocephalus
Systems and methods for implanting an endovascular shunt in a patient is disclosed. The system having an expandable anchor configured for being deployed in a dural venous sinus of a patient at a location distal to a curved portion of a wall of an inferior petrosal sinus (IPS) of the patient; an elongate guide member coupled to, and extending proximally from, the anchor; a shunt delivery catheter having a first lumen configured to receive the guide member, and a second lumen extending between respective proximal and distal openings in the shunt delivery catheter, the shunt delivery catheter further having a penetrating element coupled to a distal end of the catheter; and the system further having a guard at least partially disposed over, and movable relative to, the penetrating element.
1. A system for implanting an endovascular shunt in a patient, comprising:
an expandable anchor configured for being deployed in a dural venous sinus of a patient at a location distal to a curved portion of a wall of an inferior petrosal sinus (IPS) of the patient;
an elongate guide member coupled to, and extending proximally from, the anchor;
a shunt delivery catheter comprising a first lumen configured to receive the guide member, and a second lumen extending between respective proximal and distal openings in the shunt delivery catheter,
a penetrating element coupled to a distal end of the shunt delivery catheter; and
a guard at least partially disposed over, and movable relative to, the penetrating element, wherein the guard comprises
a tubular guard body having a first guard body lumen or recess configured to receive the penetrating element, and
a pull wire having a distal portion attached to the guard body, wherein the pull wire is configured to translate the guard body proximally or distally relative to the shunt delivery catheter so as to at least partially expose or cover, respectively, the penetrating element.
2. The endovascular shunt implantation system of claim 1 , wherein the shunt delivery catheter further comprises a third lumen extending from the proximal opening to the distal portion of the shunt delivery catheter, wherein the third lumen is configured to receive the pull wire.
3. The endovascular shunt implantation system of claim 1 , wherein a distal portion of the guard body is beveled or tapered.
4. The endovascular shunt implantation system of claim 1 , wherein the guard body comprises a second guard body lumen configured to accommodate passage therethrough of the guide member.
5. The endovascular shunt implantation system of claim 1 , further comprising a first radiopaque marker disposed in or on a wall of the guard body, wherein the guard body is movable relative to the penetrating element so that the first radiopaque marker may be positioned so as to at least partially overlie the penetrating element.
6. The endovascular shunt implantation system of claim 5 , wherein the pull wire is coupled to the first radiopaque marker.
7. The endovascular shunt implantation system of claim 5 , further comprising a second radiopaque marker disposed in or on the distal portion of the delivery catheter, wherein the guard body is movable relative to the delivery catheter so that the first radiopaque marker at least partially overlies the second radiopaque marker.
8. The endovascular shunt implantation system of claim 7 , wherein the second radiopaque marker is disposed at an angle with respect to a longitudinal axis of the delivery catheter and indicates an orientation of the penetrating element.
9. The endovascular shunt implantation system of claim 7 , wherein the second radiopaque marker comprises a marker band that reinforces a circumferential portion of the shunt delivery catheter encompassing both the first and second shunt delivery catheter lumens.
10. The endovascular shunt implantation system of any of claim 1 , further comprising
an endovascular shunt device disposed in the second lumen of the delivery catheter, and
an elongate pusher slidably disposed in the second lumen of the delivery catheter proximal of the endovascular shunt device, wherein the elongate pusher comprises or is otherwise coupled with a distal interlocking element configured to detachably engage corresponding proximal interlocking elements of the endovascular shunt device.