Treatment Systems Processes and Devices Addressing Cerebral Vasospasm/Vasoconstriction
Endovascular treatment of, for example, delayed cerebral vasospasm involves the placing of a microcatheter in the affected vessels followed by the teachings of the instant disclosure, which is clinically improved with comparison to stow infusion of a vasodilating compound. Systems, processes and self-expanding designed stents and stent-like members are featured whereas as stents and stent-like members are retrieved, nothing is left in the vessel.
1 . A treatment system for cerebral arterial vasospasm which comprises in combination:
a guide catheter effective for emplacement in the ICA/VCA;
Heparin and/or related compounds in treatment-based aliquots;
Imaging, further comprising, angiograms;
At least a microcatheter and microguidewire;
At least a retrievable stent, with radial forced tuned to the application; namely, less force than a dilatation balloon and,
Sheath-means for covering and advancing the at least a retrievable stent to a target zone, for a predetermined time interval.
2 . The system of claim 1 , wherein said at least a retrievable stent is self-expanding nitinol.
3 . The system of claim 2 , wherein said at least a retrievable stent is self-expanding and at least one of open and closed celled, whereby the radial force is less traumatic than vasospasm inducing alternatives, such as dilatation balloons which damage the extra-cellular matrix (ECM).
4 . The system of claim 3 , wherein said at least a retrievable stent is self-expanding and at least of open and closed celled, whereby the radial force is less traumatic than vasospasm inducing alternatives, and the stents/stent-like members being retrieved, nothing is left in the vessel.
5 . The system of claim 4 , whereby said at least a retrievable stent-means is self-expanding, and further comprising Ca+-channel blockers for use in the MC during stent deployment, as needed.
6 . The system of claim 5 , wherein at least a retrievable stent-means is removable, said devices having at least a drug covering or coating selected from the group of Everolimus; Paclitaxel; Sirolimus; Corolimus and any related compounds, salts, moieties which potentially reduce risk of thrombosis, lumen loss and related challenges.
7 . A Kit, comprising, in combination:
At least a guide catheter system;
At least a self-expanding sheath and retrievable stenting-means;
Further comprising an elongated structure ranging from approximately 20 cm to at least about 50 cm in length, the radial force designed to stretch but not damage the ECM;
A plurality of cells being smaller cells disposed about the stenting-means, whereby radial force is maintained within a range that does not cause the vessel to recoil or vasoconstrict, and;
Digital and hard copy instructions for use, imaging and electronic links to databases for patients, care-givers and related procedures.
8 . The Kit of claim 14 , further comprising:
Instructions to maintain the retrievable stenting means in situ for at least about 5, 7, 10 or more minutes.
9 . The Kit of claim 14 , further comprising:
Instructions to maintain the retrievable stenting means in situ for enough time to stretch but not damage the ECM.
10 . An improved vessel patency system, which comprises, in combination:
a stent-means/device for deployment in intracranial arteries experiencing vasospasm, in order to expand vessels to their optimal diameter and remain patent after the device is re-sheathed.
11 . The improved vessel patency system of claim 10 , further comprising:
the stent-means/device being self-expanding nitinol with small cells.
12 . The improved vessel patency system of claim 11 , further comprising:
said stent-means/device being self-expanding nitinol which adduces optimum control and radial force to mitigate/extenuate or prevent vasoconstriction/vasospasm, without damaging the ECM.
13 . The improved vessel patency system of claim 19 , further comprising:
a device ranging from approximately 2-6 mm in diameter and from at least about 20 cm to approximately 50 cm in length.
14 . The system of claim 13 , used for patients' refractory to standard medical treatment.
15 . The system of claim 13 , whereby an adjustable clot retriever is included with or substituted or the stent-means device.
16 . The system of claim 15 , whereby an adjustable clot retriever is optionally included.
17 . The system of claim 16 , whereby smooth vascular muscles are stretched, but no harm to the ECM occurs.
18 . The system of claim 15 , whereby smooth vascular muscles are stretched, but no harm to the ECM occurs.