Systems and methods for protecting the cerebral vasculature
Vascular filters and deflectors and methods for filtering bodily fluids. A blood filtering assembly can capture embolic material dislodged or generated during an endovascular procedure to inhibit or prevent the material from entering the cerebral vasculature. A blood deflecting assembly can deflect embolic material dislodged or generated during an endovascular procedure to inhibit or prevent the material from entering the cerebral vasculature.
1. A protection system for preventing embolic material from entering cerebral vasculature, the protection system comprising:
an outer sheath;
an articulatable distal sheath positioned radially inward of the outer sheath;
a distal filter, the distal filter configured to be deployed in a first vessel;
a proximal filter disposed proximate a distal end of the outer sheath and configured to be deployed within a third vessel; and
a debris deflector positioned between the proximal filter and the articulatable distal sheath in a pre-deployment configuration, the debris deflector configured to seal against an ostium of a second vessel,
wherein in a post-deployment configuration, the distal filter is positioned distal to the debris deflector.
2. The protection system of claim 1 , wherein the debris deflector comprises an opening, the articulatable distal sheath configured to be advanced through the opening of the debris deflector.
3. The protection system of claim 1 , wherein the distal filter is distinct and separate from the debris deflector.
4. The protection system of claim 1 , wherein the first vessel is a left subclavian artery.
5. The protection system of claim 1 , wherein the second vessel is a left common carotid artery.
6. The protection system of claim 1 , wherein the third vessel is a brachiocephalic artery.
7. The protection system of claim 1 , wherein the distal filter is open at a proximal end thereof and closed at a distal end thereof.
8. The protection system of claim 1 , wherein the proximal filter is open at a distal end thereof.
9. The protection system of claim 1 , wherein the debris deflector is configured to conform to a wall of an aorta in a vicinity of the ostium of the second vessel.
10. The protection system of claim 9 , wherein a central portion of the debris deflector includes a dome-shaped portion sized and configured to seal against a wall of a left common carotid artery proximate the ostium thereof.
11. The protection system of claim 1 , wherein the articulatable distal sheath is sized and adapted to releasably contain the distal filter prior to delivery of the distal filter at least partially within the first vessel.
12. The protection system of claim 1 , wherein the debris deflector can be rotated, translated, and/or apposed to an aortic arch by pulling against either the articulatable distal sheath or a deployed distal filter.
13. A protection system for preventing embolic material from entering cerebral vasculature, the protection system comprising:
an outer sheath;
an articulatable distal sheath positioned radially inward of the outer sheath;
a distal filter having a first compressed configuration sized to be received at least partially within a distal portion of the articulatable distal sheath and a second post deployment configuration sized and configured to be received within a left subclavian artery;
a debris deflector configured to conform to a wall of an aorta in a vicinity of an ostium of a left common carotid artery to seal against the ostium; and
a proximal filter disposed proximate a distal end of the outer sheath and configured to be received within a brachiocephalic artery in a deployed configuration.
14. The protection system of claim 13 , wherein the distal filter is open at a proximal end thereof and closed at a distal end thereof.
15. The protection system of claim 13 , wherein the proximal filter is open at a distal end thereof.
16. The protection system of claim 13 , wherein a central portion of the debris deflector includes a dome-shaped portion sized and configured to seal against a wall of left common carotid artery proximate the ostium thereof.
17. The protection system of claim 13 , wherein the articulatable distal sheath is sized and adapted to releasably contain the distal filter prior to delivery of the distal filter at least partially within the brachiocephalic artery.
18. A method of delivering and deploying a protection system for preventing embolic material from entering cerebral vasculature, the method comprising:
advancing an outer sheath that contains a distal filter, an articulatable distal sheath, a debris deflector, and a proximal filter, each in a compressed configuration, through a right subclavian artery of a patient to position a distal end of the outer sheath within a brachiocephalic artery;
extending the articulatable distal sheath containing the distal filter from the outer sheath;
articulating the articulatable distal sheath to position a distal end of the articulatable distal sheath adjacent to an ostium of a left subclavian artery of the patient;
extending the distal filter from the articulatable distal sheath to within the left subclavian artery of the patient and expanding the distal filter within the left subclavian artery to seal a proximal mouth of the distal filter against a wall of the left subclavian artery;
deploying the debris deflector with an aorta of the patient in apposition to the wall of the aorta at the ostium of a left common carotid artery; and
expanding the proximal filter with the brachiocephalic artery to seal a distal mouth of the proximal filter against the wall of the brachiocephalic artery,
wherein in their respective deployed configurations the mouth of the distal filter and the mouth of the proximal filter each face the debris deflector.
19. The method of claim 18 , wherein a proximal end of the proximal filter is affixed to the distal end of a core shaft disposed within the outer sheath.
20. The method of claim 18 , further comprising performing a transcatheter heart procedure.