Vaso-occlusive devices and methods of use
Vaso-occlusive apparatuses, including implants, and methods of using them to treat aneurysms. For example, described herein are expandable vaso-occlusive implants that include one or more soft and expandable braided member coupled to a pushable member such as a coil that maybe inserted and retrieved from within an aneurism using a delivery catheter. In particular, the expandable implants described herein are configured to allow relatively soft and elongate implants to be pushed out of a cannula without binding up within the cannula.
1 . A vaso-occlusive device for occluding an aneurysm, comprising:
an elongate inner member having a proximal end and a distal end; and
a plurality of distally-open, adjacently arranged braided tubular members disposed over the inner member such that the inner member extends through a lumen of each braided tubular member, each braided tubular member having a proximal end and a distal end wherein the proximal end of each braided tubular member is fixed to the inner member at longitudinally spaced apart locations along the inner member and the distal end of each braided tubular member is not attached to the inner member, each braided tubular member having a proximal portion comprising a conical shaped portion which tapers outward from the proximal end towards the distal end of the braided tubular member to a distal end of the proximal portion and a distal portion connected to, and extending from, the distal end of the proximal portion and comprising a cylindrical shaped portion wherein the cylindrical shaped portion of the distal portion has a longer length than the conical shaped portion of the proximal portion;
wherein the inner member comprises a closed pitch coil having a proximal end adjacent to the proximal end of one of the braided tubular members;
wherein each of the braided tubular members has a radially collapsed configuration having a collapsed diameter when radially constrained within a delivery catheter, and a radially expanded configuration having an expanded diameter when released from the delivery catheter, wherein the expanded diameter is greater than the collapsed diameter; and
wherein the braided tubular members comprise braided strands forming pores between the braided strands, and in the radially expanded configuration, the pores have a pore size of less than 0.06 mm 2 such that the pores block blood from passing through the pores.
2 . The vaso-occlusive device of claim 1 , wherein the inner member is a pusher member configured to push the braided tubular members longitudinally out of the delivery catheter.
3 . The vaso-occlusive device of claim 2 , wherein the inner member comprises a closed pitch coil.
4 . The vaso-occlusive device of claim 1 , wherein each of the braided tubular members is formed from about 24 to 36 strands.
5 . The vaso-occlusive device of claim 4 , wherein braid angles formed between crossing strands of the braided tubular member in a direction of the longitudinal axis are about 35 degrees or less when the braided tubular member is held in a collapsed configuration within the delivery catheter.
6 . The vaso-occlusive device of claim 1 , wherein each of the braided tubular members is adjacently arranged longitudinally along the inner member such that the distal ends of each of the braided tubular members is non-overlapping with the proximal ends of an adjacent braided tubular member.
7 . The vaso-occlusive device of claim 1 , wherein the plurality of braided tubular members comprises at least 3 braided tubular members.
8 . The vaso-occlusive device of claim 1 , wherein each braided tubular member has a length of between 5 cm and 45 cm.
9 . The vaso-occlusive device of claim 1 , wherein the proximal end of each braided tubular member comprises a stress relief transition between the braided tubular member and the fixing to the inner member, the stress relief transition comprising one of: (a) an increase in a number of braided filaments bound to the proximal end; (b) an increase in diameter of one or more braid filaments in the proximal end relative to the other filaments; (c) additional filaments bonded, sutured, or tied to the proximal end.
10 . The vaso-occlusive device of claim 1 , wherein the proximal end of at least one of the braided tubular members is formed into a helical coil structure and the helical coil structure is attached to the inner member.
11 . A vaso-occlusion system for occluding an aneurysm, the system comprising:
a delivery catheter having a proximal end and a distal end having a distal end opening; and
a vaso-occlusive device adapted to be pushed out of, and retrieved back into, the distal end opening of the delivery catheter, the vaso-occlusive device comprising
an elongate inner member having a proximal end and a distal end, and
a plurality of distally-open, adjacently arranged braided tubular members disposed over the inner member such that the inner member extends through a lumen of each braided tubular member, each braided tubular member having a proximal end and a distal end wherein the proximal end of each braided tubular member is fixed to the inner member at longitudinally spaced apart locations along the inner member and the distal end of each braided tubular member is not attached to the inner member, each braided tubular member having a proximal portion comprising a conical shaped portion which tapers outward from the proximal end towards the distal end of the braided tubular member to a distal end of the proximal portion and a distal portion connected to, and extending from, the distal end of the proximal portion and comprising a cylindrical shaped portion wherein the cylindrical shaped portion of the distal portion has a longer length than conical shaped portion of the proximal portion,
wherein the inner member comprises a closed pitch coil having a proximal end adjacent to the proximal end of one of the braided tubular members;
wherein each of the braided tubular members has a radially collapsed configuration having a collapsed diameter when radially constrained within a delivery catheter and a radially expanded configuration having an expanded diameter when released from the delivery catheter, wherein the expanded diameter is greater than the collapsed diameter, and
wherein the braided tubular members comprise braided strands forming pores between the braided strands, and in the radially expanded configuration, the pores have a pore size of less than 0.06 mm 2 such that the pores block blood from passing through the pores.
12 . The vaso-occlusive system of claim 11 , wherein the inner member is a pusher member configured to push the braided tubular members longitudinally out of the delivery catheter.
13 . The vaso-occlusive system of claim 12 , wherein the inner member comprises a closed pitch coil.
14 . The vaso-occlusive system of claim 11 , wherein each of the braided tubular members is formed from about 24 to 36 strands.
15 . The vaso-occlusive system of claim 14 , wherein braid angles formed between crossing strands of the braided tubular member in a direction of the longitudinal axis are about 35 degrees or less when the braided tubular member is held in a collapsed configuration within the delivery catheter.
16 . The vaso-occlusive system of claim 11 , wherein each of the braided tubular members is adjacently arranged longitudinally along the inner member such that the distal ends of each of the braided tubular members is non-overlapping with the proximal ends of an adjacent braided tubular member.
17 . The vaso-occlusive system of claim 11 , wherein the plurality of braided tubular members comprises at least 3 braided tubular members.
18 . The vaso-occlusive system of claim 11 , wherein each braided tubular member has a length of between 5 cm and 45 cm.
19 . The vaso-occlusive system of claim 11 , wherein the proximal end of each braided tubular member comprises a stress relief transition between the braided tubular member and the fixing to the inner member, the stress relief transition comprising one of: (a) an increase in a number of braided filaments bound to the proximal end; (b) an increase in diameter of one or more braid filaments in the proximal end relative to the other filaments; (c) additional filaments bonded, sutured, or tied to the proximal end.
20 . The vaso-occlusive device of claim 11 , wherein the proximal end of at least one of the braided tubular members is formed into a helical coil structure and the helical coil structure is attached to the inner member.