Systems and methods for treating aneurysms
Treatment of aneurysms can be improved by delivering an occlusive member (e.g., an expandable braid) to an aneurysm sac in conjunction with an embolic element (e.g., coils, embolic material). A treatment system for such treatment can include an electrolytically corrodible core wire having a proximal portion, a distal portion, and a detachment zone between the proximal portion and the distal portion. An occlusive member having a proximal hub is coupled to the core wire distal portion. A conduit extends along at least a portion of the core wire. The conduit has a lumen configured to pass an embolic element therethrough.
1. A treatment system comprising:
an electrolytically corrodible core wire having a proximal portion, a distal portion, and a detachment zone between the proximal portion and the distal portion;
an occlusive member having a proximal hub coupled to the core wire distal portion, the occlusive member having: (1) a constrained state for delivery to an aneurysm; (2) a first expanded state in which at least a portion of the occlusive member is configured to be disposed across a neck of the aneurysm; and (3) a second expanded state in which an embolic element disposed between a distal face of the occlusive member and a wall of the aneurysm causes a sidewall of a portion of the occlusive member to invert such that the portion of the occlusive member is convex towards the aneurysm wall in the first expanded state and concave towards the aneurysm wall in the second expanded state;
a conduit extending along at least a portion of the core wire, the conduit having a proximal portion, a distal portion configured to be disposed within the aneurysm alongside the occlusive member, the distal end extending distally beyond a distal end of the occlusive member, the conduit having a lumen configured to pass the embolic element therethrough, wherein a cross-sectional dimension of the conduit is smaller in the conduit distal portion than in the conduit proximal portion; and
one or more loops or bands extending circumferentially around both the conduit and the core wire to secure them together such that the conduit and the core wire can be advanced to the aneurysm together through a common delivery catheter.
2. The treatment system of claim 1 , wherein the conduit comprises a flexible tubular member.
3. The treatment system of claim 1 , further comprising a stylet configured to be removably disposed within the lumen of the conduit, the stylet comprising a proximal portion configured to be received within the conduit proximal portion, and a distal portion configured to be received within the conduit distal portion, wherein a cross-sectional dimension of the stylet is smaller in the stylet distal portion than in the stylet proximal portion.
4. The treatment system of claim 1 , wherein the conduit is coupled to the core wire such that the two cannot slide relative to one another.
5. The treatment system of claim 1 , wherein the core wire comprises a proximal insulating layer annularly contacting the proximal portion of the core wire and a distal insulating layer annularly contacting the distal portion of the core wire.
6. The treatment system of claim 1 , wherein the embolic element is a liquid embolic.
7. A treatment system comprising:
a core member having a proximal portion, a distal portion, and a detachment zone between the proximal portion and the distal portion;
an occlusive implant coupled to the core member distal portion, the occlusive implant having (1) a constrained state for delivery to an aneurysm; (2) a first expanded state in which at least a portion of the occlusive implant is configured to be disposed across a neck of the aneurysm; and (3) a second expanded state in which an embolic element disposed between a distal face of the occlusive implant and a wall of the aneurysm causes a sidewall of a portion of the occlusive implant to invert such that the portion of the occlusive implant is convex towards the aneurysm wall in the first expanded state and concave towards the aneurysm wall in the second expanded state;
a conduit extending along at least a portion of the core member, the conduit having a proximal portion, a distal portion, and a lumen configured to pass the embolic element therethrough to within the aneurysm at a location distal to a distal end of the occlusive implant; and
one or more couplers securing the conduit and the core member together such that the conduit and the core member can be advanced to the aneurysm together through a common delivery catheter,
wherein, the system is configured such that after detaching the distal portion of the core member via the detachment zone, the core member proximal portion and the conduit can be removed while the occlusive implant and the core member distal portion remain within the aneurysm.
8. The treatment system of claim 7 , wherein the conduit comprises a flexible tubular member.
9. The treatment system of claim 7 , wherein the detachment zone comprises a portion of the core member configured to be severed via electrolytic corrosion.
10. A treatment system comprising:
a core member having a proximal portion, a distal portion, and a detachment zone between the proximal portion and the distal portion;
an occlusive member having a proximal hub coupled to the core member distal portion, the occlusive member having: (1) a constrained state for delivery to an aneurysm; (2) a first expanded state in which at least a portion of the occlusive member is configured to be disposed across a neck of the aneurysm; and (3) a second expanded state in which an embolic element disposed between a distal face of the occlusive member and a wall of the aneurysm causes a sidewall of a portion of the occlusive member to invert such that the portion of the occlusive member is convex towards the aneurysm wall in the first expanded state and concave towards the aneurysm wall in the second expanded state; and
a conduit lumen extending along at least a portion of the core member and configured to pass the embolic element therethrough to within the aneurysm, the conduit lumen having a distal end configured to be disposed within the aneurysm alongside the occlusive member.
11. The treatment system of claim 10 , wherein the conduit lumen is defined by a conduit extending alongside at least a portion of the core member, the conduit having a distal end configured to extend distal to a distal end of the occlusive member.
12. The treatment system of claim 11 , further comprising one or more couplers that secure the conduit with respect to the core member.
13. The treatment system of claim 10 , wherein the detachment zone comprises a portion of the core member configured to be severed via electrolytic corrosion.
14. The treatment system of claim 10 , wherein the core member comprises an elongate tubular shaft, and wherein the conduit lumen extends through the elongate tubular shaft.
15. The treatment system of claim 10 , wherein the conduit lumen is configured to pass the embolic element through the core member.