Filamentary devices for treatment of vascular defects

1. A method for treating an aneurysm having an interior cavity and a neck, comprising the steps of:

advancing an implant in a microcatheter to a region of interest in an artery, wherein the implant comprises a resilient self-expanding permeable shell including a radially constrained elongated state configured for delivery within a catheter lumen, an expanded state with a longitudinally shortened configuration relative to the radially constrained state, and a plurality of elongate filaments that are woven together to form a mesh and define a cavity of the permeable shell, wherein the expanded state has a proximal and a distal portion, and wherein the proximal portion includes at least one coil comprising a lumen, wherein at least a portion of at least two filaments of the plurality of elongate filaments is disposed within the lumen of the at least one coil;

deploying the implant within the aneurysm, wherein the permeable shell expands to the expanded state in the interior cavity of the aneurysm; and

withdrawing the microcatheter from the region of interest after deploying the implant.

2. The method of claim 1 , wherein the at least one coil has a helical shape.

3. The method of claim 1 , wherein the at least one coil includes a hydrogel.

4. The method of claim 1 , wherein the at least one coil comprises a number of coils selected from the group consisting of between about 2 and about 10, about 3 and about 12, about 4 and about 8, about 5 and about 10, about 5 and about 15, about 2 and about 30, and about 2 and about 25.

5. The method of claim 1 , wherein the proximal portion has a higher radial stiffness than the distal portion of the permeable shell.

6. The method of claim 1 , wherein the proximal portion has a radial stiffness that is 1.5 to 3 times higher than a radial stiffness of the distal portion of the permeable shell.

7. A method for treating an aneurysm having an interior cavity and a neck, comprising the steps of:

advancing an implant in a microcatheter to a region of interest in an artery, wherein the implant comprises a resilient self-expanding permeable shell including a radially constrained elongated state configured for delivery within a catheter lumen, an expanded state with a longitudinally shortened configuration relative to the radially constrained state, and a plurality of elongate filaments that are woven together to form a mesh and define a cavity of the permeable shell, wherein the expanded state has a proximal and a distal portion, and wherein the proximal portion includes one or more stiffening elements to augment a proximal stiffness of the device, wherein the one or more stiffening elements comprise a lumen, and wherein at least a portion of a filament at least two filaments of the plurality of elongate filaments is disposed within the lumen of the one or more stiffening elements;

deploying the implant within the aneurysm, wherein the permeable shell expands to the expanded state in the interior cavity of the aneurysm; and

withdrawing the microcatheter from the region of interest after deploying the implant.

8. The method of claim 7 , wherein the one or more stiffening elements have a helical shape.

9. The method of claim 7 , wherein the one or more stiffening elements include a hydrogel.

10. The method of claim 7 , wherein the one or more stiffening elements comprise a number of stiffening elements selected from the group consisting of between about 2 and about 10, about 3 and about 12, about 4 and about 8, about 5 and about 10, about 5 and about 15, about 2 and about 30, and about 2 and about 25.

11. The method of claim 7 , wherein the proximal portion has a higher radial stiffness than the distal portion of the permeable shell.

12. The method of claim 7 , wherein the proximal portion has a radial stiffness that is 1.5 to 3 times higher than a radial stiffness of the distal portion of the permeable shell.

13. A method for treating an aneurysm having an interior cavity and a neck, comprising the steps of:

advancing an implant in a microcatheter to a region of interest in an artery, wherein the implant comprises a resilient self-expanding mesh including a radially constrained elongated state configured for delivery within a catheter lumen and an expanded state with a longitudinally shortened configuration relative to the radially constrained state, wherein the mesh is formed from a plurality of interwoven elongate filaments that define a cavity therein, the mesh having a plurality of pores and a proximal and a distal portion, wherein the proximal portion of the mesh includes one or more reinforcing elements, such that a proximal porosity of the mesh is less than a distal porosity of the mesh, wherein the one or more reinforcing elements comprise a lumen, and wherein at least a portion of at least two filaments of the plurality of interwoven elongate filaments is disposed within the lumen of the one or more reinforcing elements, and;

deploying the implant within the aneurysm, wherein the mesh expands to the expanded state in the interior cavity of the aneurysm; and

withdrawing the microcatheter from the region of interest after deploying the implant.

14. The method of claim 13 , wherein the one or more reinforcing elements have a helical shape.

15. The method of claim 13 , wherein the one or more reinforcing elements include a hydrogel.

16. The method of claim 13 , wherein the one or more reinforcing elements comprise a number of reinforcing elements selected from the group consisting of between about 2 and about 10, about 3 and about 12, about 4 and about 8, about 5 and about 10, about 5 and about 15, about 2 and about 30, and about 2 and about 25.

17. The method of claim 13 , wherein the proximal portion has a higher radial stiffness than the distal portion of the permeable shell.